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Hi,

I suspect the eyebrow problem may be sebhorrheic dermatitis (SD) with a possible mild underlying fungal problem. Fungal problems do cause the hair to break off almost level with the skin so the areas of hair loss on your eyebrows may have hairs present as almost a stubble in very small patches. The fact it is only on one eyebrow is promising since it indicates you are otherwise healthy and this seems to be a local problem confined to that eyebrow. Shampoo allergies are probably unlikely since the shampoo tends to wash down the face and from what you have said the condition is confined to one area so your shampoos are probably fine for you to use.

Considering this, our Psorexederm cream may help you. I say "may" since you have tried lots of products with limited success so I don't want to make wild promises but I think there is a good chance of success with the Psorexederm cream. To apply it the Psorexederm cream is dabbed on the eyebrows just at night and it melts into the skin, excess is wiped off with a tissue as it is zinc based and white in color so this is just to reduce it rubbing on your pillow. Note that hair from your eyebrows that is embedded in dead skin scale seems to come off in clusters. As the scale is replaced by healthy skin some scale may come away with hairs in it. Do not be concerned as this was going to occur anyway. Use gentle rubbing to wash your eyebrows with the intention of removing the scale. If you are too soft in massaging the area the hair and scale will matt together so be gentle but firm when washing and massaging the eyebrows. Use a circular motion then stroke along the brow from the nose out to the temple. Sounds complicated typing it but it is simple.

Any good face wash can be used to remove it in the morning. Cetaphil may be applied, massaged in and washed off for example. Any good wash wash would be fine. If itching is a problem during the day, then apply the hydrocortisone sparingly to control it but you should find you need it less and less.

The Psorexederm contains Wool Fat USP (the highest purity of lanolin) to penetrate the dry skin to reduce scaling, Coal tar is present to sooth itching and reduce any inflammation that may be present, Boric acid (a mineral antiseptic/antifungal) is present to eliminate fungal problems without the possibility of resistance to antibiotics occurring , zinc oxide to soothe itch is present and also vitamin A & D in small quantities to assist healing.

Assuming you are not allergic to this you are quite likely to benefit from this product applied every night and washed out in the morning. The overnight period is sufficiently long to allow the cream sufficient contact time to produce fairly rapid response. I would expect if the cream works well you should get good results within 2 weeks, if you didn't have a good improvement within 2 weeks then it is likely not to work for you.

I would say as an educated guess you have about a 70% chance of the psorexederm working well for you. In the unlikely case you find it doesn't help we are always happy to refund your money including postage.

Nail Fungus

As for your nail fungus, this is a common problem which worsens as you get older. If you are sitting around a public swimming pool and have a look around most people 50 years old and over have it to some degree. It is probably not related to your eyebrows but needs fairly aggressive treatment to control. Keep the nails trimmed as short as you can and clean any buildup of scale from underneath the nail. Wash the nail implements in some form of antiseptic to prevent spread to other nails. If the nails are affected mainly near the tips you have a good chance of controlling the infection. If the nail infection has travelled close to the base of the nail then antibiotics for fungal infection may be needed.
Please also review our 'David's Q&A - Treating infected Toe nails and Finger nails' page

Hope this helps,
Kind Regards,
David Hosking. 4 Feb 2009

QUESTION: Advice on Seborrheic Dermatitis (SD) - concern is face area especially eyebrows

Hi David, I would like some advice from you on my Seborrheic Dermatitis (SD). I had this problem on me for several years. It was all over my body when it first broke out, the scalp, face (forehead,eyebrows, nose,cheeks), body. I only went to a dermatologist after a year or so having this problem as I initially brushed it off as a case of having severely dry skin. I was prescribed the common steroids and corticosteroids like Dermasone and Hydrocortisone,anti-fungal agents like ketaconazole for my face, Coal Tar and again Nizoral(ketaconzole) for my scalp. Initially, my condition had seen a slight improvement.

My face cleared up a little and my scalp had seen slightly more improvement than my face. However, I was well aware of the significant and scary side effects that steroids could bring about. Moreover, the steroids and the anti-fungal agents prescribed to be used on my face (specifically for my eyebrows) wasn't really effective in clearing a t least 50% of the scales and even after I thought I had successfully cleared the scales on a specific patch, it just returns the next day or every other day. After which, I decided enough was enough, I requested to have a change to non-steroid based creams for my face(eyebrows) about the middle of last year and the doctor gave me Protopic(0.03%). Initially, results were comforting, as I could last up to 2 or 3 days without applying the cream after having applied it consecutively for a few days straight. Then, a few months into it, the scales on my eyebrows just keeps coming back every other day despite applying it consistently. My scalp condition has improved significantly till date now though, after using ketaconazole, I'm now maintaining ketaconazole at once a week.

My utmost concern now is my face area especially my eyebrows. The scales underneath my eyebrow area seem to be very stubborn in removing. I wake up almost every morning for the past 3 years with either flakes of dry skin around my eyebrow area and strands of eyebrow hair with tiny pices of dry skin flakes sticking at the roots of the hair all over my face and the pillow. I really dread waking up to this sight every morning, it's like a nightmare I could never wake up from. This condition has also caused my eyebrow area to be sparse as I frequently shed eyebrows when the scales loosen. I'm resigned to the fact that SD can't be cured but can only be controlled.

I happened to chance upon your website while googling for alternative remedies for SD. I read about the enquiries regarding SD and some of the testimonials but was rather skeptical about all the hype and praises for your products. I was thinking to myself, if it was that good, why do i still see loads of SD people walking in and out of the dermatologist's with no obvious results because honestly, if a product with such a long history( I assumed being for at least 8-10 years) being that good, why wasn't it snapped by my local dermatologists in hospitals or doctors in clinics. I'm from East Asia by the way. Let's assumed that they were ignorant, skeptical about your stuff as well or simply because attempts to bring your products out of Australia to S'pore hospitals and clinics were feeble. Please do correct me if I'm wrong about it simply beacuse I'm ignorant too :) Pardon me because after numerous and countless creams that were shuffed to me over these years wit hout significant improvement, I'm a little bit numb and cynical towards new stuff.

Finally, I reckoned that u would most probably recommend me the Psorexderm and Eczema Cream for my condition. So i hereby proceed to ask u a few questions about this product.

1) Is it a steroid based cream and if it isn't, would there be any potential side effects arising from long term usage?

2) I read that the Psorexderm cream has to be used together with the Hypoallergenic Balm. Is it necessary because u cautioned it so I had to ask. I don't realy like the idea of applying too many creams to my face and washing it out (especially now I'm contemplating using this on my eyebrow area). It's really a hassle and my eyebrow hair follicles would no doubt be clogged or choked with no room to breathe all day and night long, it would be even worse if the Psorexderm cream and the Hypoallergenic cream is oil-based or oily in nature, just like the Protopic prescribed by my doctor. (Coz' I read that the Hypoallergenic cream has to be applied 3 times a day, and the psorexderm cream day and night???) Wondering how am i going to manage that? I would really prefer to just use the Psorexderm cream once a day applying it at night and washing it out next day morning, just doing that would do fine for me. Please advise accordingly, thanks.

3) I understand from your website that this product (assuming it is successful in improving my condition) , can 'cure it' in 2 weeks time. However, how long do u reckon i can last without applying it before the condition starts to get back again?

Sincerely hoping that Mr. Hoskings can address all my concerns and queries about the product accordingly and give me any additional advice regarding the product and SD. Sorry if i sounded cynical or rude in any part of this :) Lastly, Thank you for taking the time to read and respond, which is rather long. Hope to hear from u soon, Mr Hoskings :)

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ANSWER: Advice on Seborrheic Dermatitis (SD) - concern is face area especially eyebrows

Hi, I think you are very reasonable regarding your questions and skepticism. I am the same.

Although all our testimonials are genuine, some of them certainly are very glowing.

Basically my policy is I give you a refund if the products haven't helped you. You are the sole judge of that. The products are unlikely to cure your problem in 2 weeks but if they are going to work you will have definitely seen improvement after 2 weeks. If you haven't, just let me know and I'll refund your money.

Of course if they work and you want to write a testimonial that would be nice :>)

As to why the dermatologists haven't recommended my products is due to several reasons.

1. Usually the normal things they have given you work, in your case they haven't.
2. I am a pharmacist with a small practice and have grown through word of mouth rather than being a manufacturer posting advertisements to the doctors.
3. They don't know about me yet.

As for the products:
The products are all oily as you will notice when you first apply them but allow the skin and eyebrows to be protected without skin dryness or excessive oiliness when used as advised. In your case the psorexederm will only be needed at night and the hypoallergenic balm in the morning (and again at night if dry skin is a problem)

For the scalp the Psorexederm scalp treatment applied every night usually will clear up the problem almost 100% after 2 weeks and may be continued longer if needed. It has an olive oil base with scale removing salicylic acid and inflammation reducing coal tar. Apply at night and wash off in the morning. The olive oil base keeps the scalp from drying out yet does not leave the scalp oily. To wash out your apply shampoo straight from the bottle onto the dry treated hair and massage in dissolving the oil then add water, work to a lather and the hair will wash totally clean.

For maintenance once the scalp problem is under control I recommend using a coal tar based shampoo such as Ego Sebitar or Neutrogena T gel at least 4 times a week and a normal shampoo on the other days of the week. I believe daily washing of the hair to be very helpful in keeping the condition controlled. If you get a flare-up you repeat the 2 week daily treatment with the lotion.

The psorexederm scalp lotion is strong and can't be used on the forehead or eye areas. (If a little gets on the forehead it won't hurt, just wipe it off.)

For the face you will need the Psorexederm cream to control the flaking and the Hypoallergenic face and body balm to prevent dryness and protect the skin (It contains chlorhexidine as a safe antiseptic) You will also need some Johnson and Johnson "no more tears" baby shampoo to wash the eyebrow area with.

The Psorexederm is applied to the eyebrows sparingly at night. It melts in contact with body heat so is easy to get to penetrate the skin and eyebrow hair follicles. In the morning apply a little "no more tears" shampoo to the area, massage in with your fingertip, apply water, work to a lather and wash off with light pressure to keep the area scale free. This sounds complicated when written but is easily done under the shower.

Using the psorexederm on it's own can result in skin dryness so I advise having the Hypoallergenic face and body balm to apply alternating with the Psorexederm. To start off I would have one day on the Psorexederm for the eyebrows and one day on the hypoallergenic balm and alternate. Increase the % times on the psorexederm but if dryness occurs increase the number of times you use the hypoallergenic face and body balm. Once all the scales are gone you should start to get normal eyebrow growth again.

Also apply hypoallergenic balm once or twice a day to any dry skin areas as it will protect and normalise these. It is also great for any dry skin problem and is safe so can even be used on the eyelids and lips. You are most welcome to let me know how you are progressing if you need advice to "fine tune" the treatment. The products are totally safe both in the short and long term and can be used when needed. They can be used more frequently than I have stated if you feel it worth trying but I feel what I have suggested should work and be reasonably easy for you to do. (The treatment should never be worse than the disease in my belief.)

As for how long skin improvements will last before you need to retreat, that's a hard one. Generally people are quite happy with the results and if the problem starts recurring they can treat it immediately before it gets bad. The hypoallergenic balm just at night and washed off in the morning is good to keep the eyebrows under control once things are normal although many people just treat until the problem has gone and retreat when needed.
Please let me know if you need any more info. Kind Regards, David Hosking. June 2011