To not take this medication?

[wingsnthat]

I was diagnosed with seb derm on my scalp recently. It’s essentially a chronic form of eczema, but more oily as opposed to dry. Eg I tend to get a breakout/rash on my scalp vs dandruff.

My dermatologist prescribed a highly potent steroid scalp lotion. It has side effects such as skin thinning and high risk of dependency. Therefore it can only be used occasionally, but as my condition is chronic I am finding it difficult to figure out when is a “worthy” time to use it or not. As soon as I stop using it, my rash reappears, so it’s only a temporary fix.

AIBU to just not use the steroid lotion? I just think it’s a slippery slope, as I don’t want to run the risk of steroid addiction? Any seb derm advice appreciated too!

Tbh I think you should just do what your Dr told you to do. Otherwise why visit one in the first place.

Well the steroid lotion is to help manage the symptoms, as there’s no cure to this condition. The issue is that my symptoms are permanent, but the steroid lotion cannot be used on a long term basis as it has side effects. Therefore it feels like a slippery slope to use it? The more I use it, the more I’ll run the risk of side effects.

Can ypu discuss this with the pharmacist or have another conversation with your GP? I kind of see where WellLarDeDar is coming from if you won't at least try the medication you have been prescribed.

T Gel coal tar shampoo ?

There might not be a cure but there is often prevention

www.fedup.com.au/factsheets/symptom-factsheets/eczema

This may be helpful as a start.

Did you not discuss this with your dermatologist? I have never heard of steroid dependency - are you sure this is a side effect? The only long term effect I've heard of is possible thinning of the skin over a long period of usage.

Could you get a more definitive answer from your dermatologist as to how sparingly you should use it? That way, perhaps you could ration it out.

Oh sorry for being unclear - I have been using the steroid lotion!

My symptoms resume as soon as I stop which is why I think I should stop using it. It’s a question of risking long term side effects for a very short term fix - if you’re familiar with seb derm and corticosteroids, you’d understand my hesitation

They’ve given me several boxes of it so I probably have about a year’s supply.

@KittytheHare yes corticosteroid addiction is a thing unfortunately - it’s more prevalent for chronic conditions like mine.

Essentially the body gets too used to it to the point where there’s a worse reaction when you don’t use it, and then you need something stronger to overcome the withdrawal flare up

I think you need to talk to your doctor about this, but ultimately it's your call

If it is getting the seb derm to a place where it can be managed, reassess what you use once you get to that point. For me, a trigger is foaming agents in shampoos (think SLS and the like) so finding one that keeps your scalp relatively calm is key. Then look at what else you can change- products etc. I use a shampoo bar and keep hair short so no product on it.

@Piemam thank you! I think I need to mainly figure out how to reduce yeast/fungus overgrowth? I seem to get used to nizoral shampoo, which is annoying as it has now stopped having an effect.

Your supposed to gradually step down doses to withdraw, eg every other day for a week, the three times a week then twice a week etc so your skin gets weaned off it and doesn’t just flare straight back up.
I would use it as it’s been advised to. It may just help your symptoms become more controlled and stay like that after weaning off.

Again, forgot to add, that overall my condition is mild? Therefore my flare ups aren’t that bad, and I have only been dealing with this for a few months out of my entire life. I’m not sure what has been the sudden recent trigger.

I don’t really need the steroid lotion as it’s manageable without it. Just wish my scalp was normal again !

Try looking up Dr. Dray on YouTube who is a dermatologist - I watched a video of hers earlier today all about controlling seb derm

Ah, the yeast might benefit from a short dose of antibiotic fucibet or something like that. Definitely ask the Doctor to explore possibilities.

Have you tried Body Shop ginger shampoo? It’s really wonderful for this

Surely the doctor gave it to you because they’re qualified to understand the medicine and how best to use it? I would use as instructed. Everything has potential side effects, that doesn’t mean you leave a condition untreated out of fear

Your doctor has actual qualifications, which will be hard earned.

Other randoms from from the internet including myself, not so much.

I would listen to your doctor first.

I know nothing about tbe condition, but I'd be inclined to try seeing a homeopath, especially if you are not happy with the only treatment available. If it doesn't work you have lost nothing except cost of appointment and treatment. Perhaps ask doctor about this.

You've been given a hard time OP

I don't know much about eczema itself. But I'd explore TheSandgroper's suggestions and try to see if there's something systemic that has suddenly caused this e.g.
.allergy to a new food or product, or food that you have started to consume too much
.other allergies
.hormonal changes
.get a full blood panel done to see if anything is out of whack (blood sugar, etc)

I hope you can resolve it soon

@Gothichouse40

I know nothing about tbe condition, but I'd be inclined to try seeing a homeopath, especially if you are not happy with the only treatment available. If it doesn't work you have lost nothing except cost of appointment and treatment. Perhaps ask doctor about this.

What would you ask an (actually qualified) doctor about seeing a quack? And presumably OP already has plenty of water.

Speak to the dermatologist who prescribed it about your concerns.

I struggle with something like this and use the scalp lotion. I try to use it as little as possible though. I've tried all sorts, medicated shampoo, apple cider vinegar etc. I can just about keep on top of it by using Balmonds scalp oil overnight, and sporadic steroid lotion when needed.

And also I have found I need to use shampoo without SLS. I currently use Sukin shampoo or Dr organic. My hairdresser says my hair is in fantastic condition because of the detergent free shampoo and scalp oil. I just tackle the flare up with the lotion

I can't comment on seb derm, but for eczema my dermatologist told me that underuse of steroids is a bigger problem - people don't really get it under control properly because GPs/pharmacists have to give so many warnings about using steroids sparingly. So the eczema persists and causes long term skin damage itself plus discomfort etc.

If your derm has advised you to use this lotion when needed to get the flare-ups under control, then you should be fine to use it in that way?it sounds as though you might be stopping using it too soon if youre getting a flare up as soon as you stop?

I agree it's helpful to identify what your triggers are and avoid those. Did the derm advise what to use on your hair in between/on an ongoing basis?