Isotretinoin for seborrheic eczema | Dermatologist explains

[@ashwajitsingh007]

Amazing as always sir… Hope you are doing well 😊

[@DiscoverDermatology]

Thanks Ashwajit, great to hear from you! We are all well and hope you are keeping well too. 👍

[@jimdagevos]

Dear dr. Yesudian, I am currently on a 10mg dosage of isotretinoine daily. It has been little over 2 months, and although my oil production has diminished, the symptoms of flaking/shedding have yet to improve. Do you have any patients with similar experiences, and if so, when did they see results. KR

[@DiscoverDermatology]

The dose of isotretinoin for a response in seborrhoeic eczema is variable. Sometimes, a higher dose of 20mg or even 30mg a day may be required. #Disclaimer# Please note that this video is for education purposes. It is not meant for personal advice as your own doctor/dermatologist will be the best person to answer specific queries.

[@jimdagevos]

Thank you sir. I will remain patient for the time being. If I see no improvement I will discuss it with my derm.@@DiscoverDermatology

[@aliboukind2596]

Also (and sorry for the second question) does the low dose usually prescribed for SD lead to chapped lips? Thank you so much in advance!

[@DiscoverDermatology]

Chapped lips can occur in those who are sensitive to the medication even on low doses.

[@mareedupriyanka3405]

Hi sir, im from India. Im suffering seborrheic dermatitis from past 4 years. I have used so many shampoos like Ketoconozole and lotions. Switched to ayurveda also. But there is no use at all. Excess of hair fall and chest,back acne, face also oil glands. Please suggest permanent solution for this problem.

[@DiscoverDermatology]

It is difficult to cure seb eczema as it tends to settle with time. We can control it with many treatments, some of which you have tried. One natural alternative to isotretinoin is to consider oral Vitamin A. Here is a video on it kzbin.info/www/bejne/m3umpaawrKerb68

[@miyabi8648]

Thank you so much for such an informative video. I took 30mg isotretinoin for roughly 10 months and my seborrheic dermatitis went away completely but now it’s coming back again sadly. Is it safe to keep taking it to control the symptom?

[@DiscoverDermatology]

Long term Isotretinoin is usually not advisable unless the dose is very low. Vitamin A supplements for a few months may be a natural alternative. Here is a video on it m.kzbin.info/www/bejne/m3umpaawrKerb68

[@aaaryan_goel]

Hi, I used 20mg isotretinoin everyday for 6 months and it cured my acne and oily skin but after a few months, my skin is very oily again and my scalp sebum is so much that I have to shampoo everyday but no acne anymore. I use Selsun 2.5 shampoo. Should i start with 5mg isotretinoin again and is it for the rest of the life?

[@DiscoverDermatology]

That is an option. Isotretinion may need to be used for a few months. If natural treatment is preferred, Vitamin A is another option. Here is a video on it m.kzbin.info/www/bejne/m3umpaawrKerb68

[@aliboukind2596]

Hello sir. Thanks for helping out everyone. I ve been having SD for a bit (had eczema since birth). I am reading that SD can come back after treatment. Are there any mitigation strategies to make sure it doesn’t happen? Can I be on the medication for the rest of my life if no symptoms present? Thanks in advance!

[@DiscoverDermatology]

Usually we use topical ketoconazole to control seborrhoeic eczema long term. It is not advisable to use oral agents long term.

[@onurkeskin4575]

hello sir, what sholud I do after the treatment because every patient says that the effects of oily skin and eczama always come back

[@DiscoverDermatology]

Thats could be right. The oily skin tends to be persistent and sometimes we may need long term low dose isotretinoin to control it.

[@EhabShahid]

Respected Sir, Can you please tell me if isotretinoin 20mg is effective for acne on scalp caused by topical corticosteroids?? Also what doses of isotretinoin can cause erectile dysfunction??

[@DiscoverDermatology]

Isotretinoin can be used at a dose of between 10 to 60mg a day for acne.If the current dose is able to control the condition, it can be continued. Erectile dysfunction is very rare and is not dose dependant. A natural alternative to isotretinoin is vitamin A. here is a video on it. kzbin.info/www/bejne/m3umpaawrKerb68 #Disclaimer# Please note that this video is for education purposes. It is not meant for personal advice as your own doctor/dermatologist will be the best person to answer specific queries.

[@danishbhatti9521]

Sir is Isotretinoin works by reducing sebum production in scalp which causes seborrheic dermatitis? Is it is also used for Seborrheic dermatitis?

[@DiscoverDermatology]

Yes, that is right. It reduces the oil in the skin and is therefore effective by preventing growth of the yeast that predisposes to seborrhoeic eczema

[@utsabbrohma]

Hi Dr, from Bangladesh here. I'm suffering from SD for 6 years, and i also just recovered from Benzodiazepin withdrawals for Anxiety disorder . My derm prescribed me 20mg Isotretinoin. I heard, it has side effects, so im concerned to take this as a recovered benzodiazepind withdrawal patient. Will it be okay to take isotretionin??

[@DiscoverDermatology]

The evidence in the literature suggests that isotretinoin is safe as long as it is monitored and everyone prescribed it has been screened for all the relevant medical issues. If there are any concerns about isotertinoin. high dose vitamin A is an option. Here is a video on it kzbin.info/www/bejne/m3umpaawrKerb68

[@Atifongo]

Sir I have been facing sehiboric dermatitis for over 6 years. Always perscribed ketoconazole 2% shampoo or cream. Every 2nd week I get dandruff around beard and mustaches and scalp, behind ears etc... Should I take this medication shown in this video?

[@DiscoverDermatology]

Isotretinoin is a good treatment option for resistant seborrheic eczema as mentioned in the video. #Disclaimer# Please note that this video is for education purposes. It is not meant for personal advice as your own doctor/dermatologist will be the best person to answer specific queries.

[@adwitiyasingh7701]

Hello doctor your video is very informative. Can you provide guidance. My wife has got warts on her feet recently and after a few months of self treatment they were removed surgically. Now the dermat suggests us to start isotretnoin treatment for 6 months to avoid any recurrence. Should we start the treatment. We also plan to conceive in the coming year, for which the doctor mentions we will have to wait for further 6 months post stopping the dosage. Is the understanding correct. Is there an alternative like vitamin A, vaccine etc.

[@DiscoverDermatology]

Isotretinoin is usually not advisable if a family is planned in the near future. It may be helpful for plane warts and I plan to doom video on it soon. Vitamin A can also cause problems in pregnancy so not advisable. Oral zinc may be an option. Here is a video on it. kzbin.info/www/bejne/oKe3c4ace8Zrprc

[@ahmadmuzamilfaqeerzai8973]

Hi Dr, after a month of isotretonion my scalp is really dry and itchy i stopped the medication but my scalp condition is still there advice?

[@DiscoverDermatology]

Vitamin A is sometimes used as a natural alternative for isotretinoin. It can be used for about 4 to 6 months, like isotretinoin . Here is a video on it kzbin.info/www/bejne/m3umpaawrKerb68

[@akashking3311]

Sir i have very oily skin and scalp which supplement will be best please reply am depressed about it

[@DiscoverDermatology]

A natural supplement that can act similar to Isotretinoin is vitamin A. here is a video that explains how it works in another oily condition of the skin, acne. kzbin.info/www/bejne/m3umpaawrKerb68

[@tawseefnabi4366]

Dear sir how many patients do you have recovered from this medicine isotretinoin

[@DiscoverDermatology]

Isotertinoin works as a possible treatment for seb eczema and there is evidence about twomthirds may benefit in some way. I use it fairly often when other treatments fail.

[@drcagrituran25]

What do you think about the antiseborrheic effect of biotin? Would you prefer biotin in your practice?

[@DiscoverDermatology]

There is some evidence that Biotin also has anti-seborrheic effect but Vitamin As effect is probably much more as it mimics the same action as Isotretinoin.

[@Nighion1]

Dear Dr, I've recently been prescribed and started Isotretinoin. I'm nearly a week into a course of 20mg per day and my previously present seborrhoeic dermatitis is now very painful and ever present. Can you recommend any way of lessening the pain or dealing with dry skin of seborrhoeic, I general I have dry skin since starting but the most painful areas are my rosacea areas and the seborrhoeic dermatitis within my beard region. It seems most of thr drying occurs over night.

[@DiscoverDermatology]

there may be co-exisiting rosacea that is making the skin very sensitive. There are a few moisturisers for sensitive skin that may be helpful. Here is a video on it kzbin.info/www/bejne/apKphHSBpdd5oJI

[@Nighion1]

@@DiscoverDermatology thank you for the video, quite educational.

[@christyabraham6014]

Can you take fluconzole with isotretinoin. Isotretinoin for the acne and sebhorreic dermitis and fluconzole for tinea versicolor and the fungus.

[@DiscoverDermatology]

Yes, bit can be used though the isotretinoin alone may work for both conditions.

[@danishbhatti9521]

My doctor explain me that if we reduces sebum production by isotretinoin then automatically buildup will reduces? Sir can you tell me does isotretinoin worka for seborrheic dermatitis? please

[@DiscoverDermatology]

Yes, your doctor is right. If you are worried about using Isotretinoin, another natural treatment that could help is oral Vitamin A. Here is a video on it. kzbin.info/www/bejne/m3umpaawrKerb68

[@saoodalrajehi3199]

Hi dr am from kuwait.. my dr prescribed for me 10 mg of the medication 5 times per week for this condition does this dosage work for seboherric dermatitis? Please am waiting your response.

[@DiscoverDermatology]

The dose used can vary quite a bit. Your doctor has suggested a reasonable dose, and if it is ineffective it can always be increased slowly.

[@danishbhatti9521]

I have been suffering 😞 from seborrheic dermatitis from last 6 years i have treated it with many doctor prescribe medicine... shampoos antifungal lotions .... but nothing works now my doctor prescribe me isotretinoin sir do isotretinoin works for seborrheic dermatitis? should i go for this treatment

[@DiscoverDermatology]

It's certainly worth trying if all other options have failed.

[@miyabi8648]

It got better once after taking the drug 20mg a day but it’s getting worse again recently even though I’ve been taking the drug. What should I do in this situation doc?

[@DiscoverDermatology]

It is unusual for seborrheic eczema to recur whilst on the treatment. It maybe worthwhile increasing the dose to 30mg or maybe 40mg a day provided there are no side effects.

[@Iemons]

Can it cause acne in patients who presented with no acne at the time of starting treatment but did present with mild to severe SD?

[@DiscoverDermatology]

Thats in unlikely as it is used to treat acne.

[@jacksonboy7432]

It possible but it don't leave scars if you don't touch that acne and that purging phase will last maximum 2-4 weekd

[@shaikthaslima4412]

How many months that treatment will continue sir?

[@DiscoverDermatology]

We usually use it for about 4 to 6 months

[@tanveeransari9526]

Am form india🇮🇳......How many days i should take tretmet and what mg of medicine

[@DiscoverDermatology]

Usually we use it for about 3 to 6 months at least. As mentioned inn the video, the usual dosage mentioned in previous studies is about 20 to 30mg a day.

[@sundergirijapathy6469]

Can Isotretinoin be used for Lichen planus Pigmentoasus?

[@DiscoverDermatology]

Yes, there are some reports suggesting that isotretinoin can be used once the inflammation of LPP has been switched off. Oral tranexamic acid is another option. Here is a video on it kzbin.info/www/bejne/mJW7gouAgamjg80

[@user-np5op9xt6n]

Thank you from Japan🙏 Is daily use more effective than every other day? If I use a low dose every other day, will the sebaceous gland reduction effect stop after I stop using it?

[@DiscoverDermatology]

Wow, great to see someone from Japan here! Glad you found the information helpful. My usual practice is to use it everyday till we get control of this condition and then use it on alternate days or even twice a week to maintain remission. It may recur if the medication is stopped. Another alternative is to use oral Vitamin A as a substitute for isotretinoin. Here is a video on this topic. Even though it mentions vitamin A for acne, it cam be considered an alternative for isotretinoin in seborrhoeic eczema too. kzbin.info/www/bejne/m3umpaawrKerb68

[@user-np5op9xt6n]

​@@DiscoverDermatology I'll start with vitamin A first. Sorry for asking so many questions while you are busy What are your thoughts on using oral itraconazole when Nizoral Ointment doesn't work? Not standard in Japan. Is delgocitinib ointment a good alternative to long-term steroid use?

[@DiscoverDermatology]

Oral itraconazole and fluconazole, topical ketoconazole are good options too. I did a video on Malassezia folliculitis, which is caused by a similar yeast, so the principles mentioned in that video could be helpful for seborrheic eczema too. Here is the video. kzbin.info/www/bejne/iJ-nk2aXn8mUjcU I do not have experience with delgotinib ointment as it is n to available in the UK yet. @@user-np5op9xt6n

[@user-np5op9xt6n]

@@DiscoverDermatology Thank you!

[@exo5860]

Can the sd stay away after ending the iso therapy? And would it be helpful to do the vitamin a therapy which u talked about in the comments?

[@DiscoverDermatology]

It is hard to predict sd. In some it may settle completely, whilst in others it may not. Vitamin A is certainly a useful option to consider but not everyone will have as good a response as isotretionoin.

[@exo5860]

@@DiscoverDermatology ok thank you sir

[@UzairKhan-vj3bc]

Hello sir 15 year se seborrheic se pareshan hu kiya hair remove sejata sir ye plz reply 😢

[@DiscoverDermatology]

This is certainly an option to consider.for resistant seborrhoea eczema. If it is difficult to get isotretinoin, vitamin A is a natural alternative. Here is a video on it. kzbin.info/www/bejne/m3umpaawrKerb68

[@tawseefnabi4366]

When will give isotretinoin capsule results if i have Seborrhic dermatitis and how long should i take only (one strip) or more and can isotretinoin worse dandruff at starting...

[@DiscoverDermatology]

Usually isotretinoin is taken for about 3 to 4 months to control seborrheic eczema. It usually does not worsen the situation. Vitamin A can also be used as an alternative. Here is a video on it kzbin.info/www/bejne/m3umpaawrKerb68

[@DrShimul86]

Is it reversible.. After stoppage of isotretinoin

[@DiscoverDermatology]

@@DrShimul86 Yes, it is an inflammatory dermatosis and can recur after cessation of isotretinoin. Using Vitamin A could be a natural alternative for isaotretinoin. Here is a video on it kzbin.info/www/bejne/m3umpaawrKerb68

[@harrywh774]

does the effect remains when the treatment ends?

[@DiscoverDermatology]

That's difficult to predict. Sometimes it stays away of sometime. On other occasions it may recur. Another long term natural option may be the use of oral Vitamin A. Here is a video on it. kzbin.info/www/bejne/m3umpaawrKerb68

[@tawseefnabi4366]

Sir i am taking sotret 10 mg but i feel joint pain what should i do should i leave or continue

[@DiscoverDermatology]

If there are any side effects, taking the medication less frequently or at a lower dose would be beneficial.

[@tawseefnabi4366]

Thanku sir

[@vidhyajain1228]

Hi dr can this medicine cause hair fall ?

[@DiscoverDermatology]

Only in higher doses. The dose used for Seb eczema is v small and is unlikely to cause it.

[@vidhyajain1228]

@@DiscoverDermatology thank you 🙏

[@satyamagrawal2776]

Sir apse consult kese kr skte hai....plz any contact

[@DiscoverDermatology]

I practice in the UK, so if you live in the UK, I can see you after I get a letter from your GP. My medical insurance covers only for treating those in this country.

[@vz779]

How much Vitamin A would equal 10 mg and how much 20mg Isotretinoin a day? Cuz i took 20mg for 7 months against my SD and quitted the Iso now and wanna change to Vitamin A

[@vz779]

Oh and will Vitamin A has the same Sideeffects like the heat attacks where ur face gets red and the skin feeling like sunburnt and dry eyes?

[@DiscoverDermatology]

There is n o direct correlation between vitamin A dose and isotretinoin dose. No study has been done on it. It may be useful to use a dose that does not cause side effects.

[@DiscoverDermatology]

@@vz779 In very high doses, it can cause side effects similar to isotretinoin.

[@vz779]

@@DiscoverDermatology thanks for the answers, which daily dose would u suggest to avoid seborrheic dermatitis to flare up again? Its mostly away right now

[@vz779]

And to avoid the sidewffects like dry eyes especially?

[@Dgn08]

Sir kya isotretinoin lene se seborrheic dar. Khatam ho jayega?

[@Ayurvedicguruji193]

Koi garanty nehi hay

[@DiscoverDermatology]

It wil control the condition. Dont think we can say it will be cured.

[@DiscoverDermatology]

@@Ayurvedicguruji193 Correct

[@Maxmaxmax63]

I just started accutane for this as my seb derm was completely unresponsive to everything (and I do mean, everything). 40mg a day though, not sure why my derm started me so high.

[@DiscoverDermatology]

Each doctor has their own favourite dose! I tend to use lower doses as they have less side effects and generally, they are quite effective even on the lower dose. Taking Vitamin A is sometimes an alternative if isotretinoin is not preferred. Here is a video on it. kzbin.info/www/bejne/m3umpaawrKerb68

[@Maxmaxmax63]

Thanks so much! I’ll update here after a few months if I see any improvement.

[@exo5860]

And how did it go? Im taking 10 mg isotretinoin the day too at tje moment

[@rickymunger9431]

Update? Thanks

[@Maxmaxmax63]

@@rickymunger9431 didn’t work for me, unfortunately. On zoryve now which helps a bit. Certainly not cured.

[@ahdalhafis2308]

Sir can i ask a doubt

[@DiscoverDermatology]

Yes that is no problem.

[@ahdalhafis2308]

@@DiscoverDermatology sir does seborrheic dermatitis in face cause trans epidermal water loss ?

[@DiscoverDermatology]

@@ahdalhafis2308 Yes, that is a very good point that you make. Any eczematous condition can cause increased transepidermal water loss.

[@ahdalhafis2308]

@@DiscoverDermatology sir is there any option to get your skin ‘s moisture back naturally

[@DiscoverDermatology]

@@ahdalhafis2308 Using moisturisers specific for sensitive skin may help,. Here is a video on the use of specific moisturisers for sensitive facial skin kzbin.info/www/bejne/apKphHSBpdd5oJI