What I’ve been doing:
1.) Adding a single pump of BIOM8 oil to my moisturiser once a day, to entire face
2.) Applying Skinoren (azelaic acid 15%) every night, to entire face
3.) Following up with Sebclair cream, applied only to affected areas (sides of my nose, crease on my chin), morning and night
4.) Applying 90% raw honey mask/10% distilled water mask to entire face for 3 hours every other night (as per this study: http://www.ncbi.nlm.nih.gov/pubmed/11485891). I’ve been doing this for almost a month at this point, and will continue it on a weekly basis for another 6 months as the study suggests.
I no longer have a bunch of clogged pores around my nose so I can say with absolutely certainty that the Nystatin cream was responsible for that, having stopped using it about 2 1/2 weeks ago. Also, the azelaic acid has been doing a pretty good job of keeping my acne in check (which is one of the reasons I’ve been using it), so I’m happy that I no longer have to use benzoyl peroxide at all at this point, after 5+ years of being so heavily reliant on it and suffering its drawbacks.
While progress on the acne front has been great, progress on the SD front has been painfully slow, especially considering I’ve been very strictly following a routine in which I’m attacking it from three angles (coming up on almost a month of these raw honey masks, and having used both BIOM8 oil and Sebclair consistently for over 2 weeks). Unlike acne, which I’m more than aware can take at least a couple of months to respond to a new treatment regimen, I’m under the impression that SD symptoms should respond in 2-4 weeks.
I’ll continue my current regimen regardless, probably for a fairly long time. My reasoning being that a.) slathering honey on my face every other night for the past 4 weeks has been a massive pain, but doing it for the next 6 months on just a weekly basis as per the study’s recommendations is a lot more manageable by comparison, b.) with the BIOM8 oil and Sebclair, even if they don’t end up doing much for my SD at least they also serve as moisturisers that don’t clog my pores, so they’re not doing any harm, and c.) I’m going to be using Skinoren indefinitely because it addresses my acne and post-inflammatory hyperpigmentation (I’m an azelaic acid convert at this point).
As I’ve been a bit frustrated with the slow response, if any, on the SD front I’ve been looking into how I can rule out the possibility of it being something else that manifests itself similarly to SD, and I came across this study about demodex dermatitis: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958185/
It mentions that demodex dermatitis symptoms can look an awful lot like SD but argues that it should be considered a separate condition. The subjects applied crotamiton cream to the affected areas twice daily for 2-4 weeks and the response rate was impressive – but what I find particularly interesting is that subjects responded very well to it even though some tested negative for a high demodex concentration on their face. They recommend crotamiton if you’ve been unimpressed with the results of other SD treatments (which at this rate might end up being the case for me).
Crotamiton is sold OTC in the UK as Eurax cream, so I’ve ordered a small tube. I’m not getting my hopes too high, but I want to give it a shot so I can at least rule it out if it doesn’t end up working. Moreover, it doesn’t contain the extremely pore-clogging isopropyl myristate (hooray!) so it shouldn’t do any harm. If I don’t notice improvement after 2-4 weeks then it’s reasonable to conclude that it’s not treating it.
Will post more updates further down the road.