Nystatin A Potential Seborrheic Dermatitis Treatment

The following is an email that was sent to me by one of the readers on this website. It outlines his journey and how he eventually stumbled upon a treatment that has been working for him. So here is Joakims – Nystatin Seborrheic Dermatitis Treatment:

I’ve struggled with SD for the last 5 years or so, and I had almost given up, but now I’ve found my solution. I realize people have SD to different degrees, so this might not be universal, but maybe you can help me reach the people at SkinDrone, and it might help some. Although, I think it will work for most people since it was so effective for me. I have no problems with SD any more. Not in my face, not in my scalp, not on my chest. All gone. I’ll begin with my story and then the solution (but to save you the suspense and disappointment if you already know about it and it didn’t work for you, it’s Nystatin).

Searching for a Treatment

I went to my doctor here in Denmark and he gave me Brentacort cream with hydrocortison (cortisol) and miconazol (some anti fungal). Now, I think we both agree that the steroid hormone cortisol cream is not the way to go. It makes the skin thinner and more sensitive in the long run. And I guess we are both in it for the long run, since there is apparently no permanent cure, only treatment and control. I also used nizoral shampoo and it made the scalp situation better, but again it didn’t really solve the problem. If I recall correctly, you had tried the same things with the same less-than-satisfying outcome. So, I just kind of came to terms with my condition since the visit to the doctors didn’t resolve the problem. I gave up on professional help.

Unexpected Remission

Last winter I went to the Philippines and the sun and salt-water made the seborrheic dermatitis go away – completely! I had no trouble at all even though both alcohol and poor sleep came along with me on that vacation. This gave me new hope, and I thought, there must be a way to get rid of it!

The Search Continues

So I started looking into the alternative treatments: I tried the salt-water treatment when I came back to Denmark, and I tried to sit in direct sunlight for at least 15 minutes a day – even during the cold and dark winter; I tried changing my diet – maybe it was the exotic food that had really cured me, while I was in the Philippines. I cut alcohol, coffee, milk (which actually did more than I care to admit), tried to eliminate bread and eggs and all sorts of stuff; I got fish-oil, extra vitamin-D and other dietary supplements; I went and bought a pure aloe vera extract and ordered Aveeno eczema moisturiser with colloidal oatmeal from Canada; I tried getting some time in the sauna regularly, since I had read somewhere that it might help; I tried to meditate; I tried drinking green tea every night and applying the teabag to my face. I literally tea-bagged myself to try to end this! I saw some progress, but compared to the amount of work involved and – which was far worse – the social stigma of not drinking neither coffee nor beer, it was just not worth it. Especially because I was not completely rid of the SD, it had only diminished. And I gave up on the alternative treatments.

My mother stayed hopeful and kept pushing me, so I went back to the doctor – desperate – and asked for something else. “I’ve tried everything, I don’t want cortisol, I’m open to alternative treatment, anything, what can you suggest?”. He said cortisol is the only way, but he was willing to send me to a dermatologist to finally determine if I really had SD or if it actually rosacea or something else.

The Last Appointment

So I pack my bag with all my alternative stuff that I want to present to the dermatologist. I prepare a speech to persuade him to consider alternative solutions. I’m so afraid that he will push the same damn cortisol cream on me, but I’m ready. I want to fight for another treatment. The dermatologist takes one look at me and says “oh, you’ve got SD, I’ve got just the thing for you”. I, half-joking/half-afraid, ask him if it’s a cortisol cream. “No no no, that’s the worst thing you can do. I’ve got something else for you, and I’m sure it will work wonders”. He gives me a prescription for another topical cream  and is ready to send me out the door. I’m so worked up at that point – my bag packed with pills and moisturisers that I’m ready to whip out and discuss, and my speech ready in the back of my mind. Because of all I’ve been through I find it hard to believe in this “miracle solution”. But he seems determined and tells me to come back if it doesn’t work. I haven’t talked to him since.

So what he prescribed to me is this Nystatin creme. It’s basically an anti-fungal without the steroid hormones. It’s a prescription drug in Denmark, but in Germany, he told me, it’s over-the-counter and you can use it almost as much as you want. But once every day should be enough. And it is. I was sceptical, but I gave it two weeks – still not drinking milk, and still watching out for beer and coffee – and it all went away. I never even applied it to my chest but the inflammation that I used to have there is completely gone. My scalp has also gotten better just from applying the cream to my face. I still use a shampoo with zinc pyrithione (like in Head&Shoulders, if I am not mistaken) and climbazole, but this is also over-the-counter and easy on the skin and hair.

How It Worked Out in The End

I can wear dark t-shirts again without getting dandruff all over them. I don’t have to worry about scratching my nose or running a hand through my hair. I don’t have to stay home in case I get a flare-up, because I don’t get those anymore. I tried to let go of the reins and have a beer or two, and maybe a cup of coffee, and still nothing. I don’t have to watch out anymore. Beer, coffee, exercise, and long, hot showers – and this is during winter with almost no sun. It’s just gone. For all I know I’m cured – you know, for good. I haven’t seen anything that resembles SD in 1½ months since I began the treatment – even though I’ve missed a few days here and there where I didn’t use the drug.

I think you can get Nystatin in the States as well: http://www.drugs.com/cdi/nystatin-cream.html but I’m not sure how the system works. Otherwise, have somebody send it from Germany where it’s just over-the-counter
If you are still struggling I hope this will help you. And I hope you haven’t heard of it before and just went “Oh, that. Yeah, that didn’t work for me”.

It truly changed my life and I hope it can do the same for you and all the readers of SkinDrone.

Thank You

Thank you Joakim for taking the time to write about your experience. It is detailed information like this that can help others who are likely taking the same path as you. When reading the email myself there were many parts that closely related to my own experience. Glad to hear that you have found a seborrheic dermatitis treatment that works for you. Once again, thank you for taking the time to write this and I hope it is useful for others.

100% of readers found this article helpful


  1. Goldenberg Gary "Optimizing treatment approaches in seborrheic dermatitis." The Journal of clinical and aesthetic dermatology 6.2 (2013): 44-9. PubMed
  2. A P Adams, E M Santschi, M A Mellencamp "Antibacterial properties of a silver chloride-coated nylon wound dressing." Veterinary surgery : VS 28.4 (1999): 219-25. PubMed
Last Updated:
in Seborrheic Dermatitis   257

About Michael Anders

After being affected by seborrheic dermatitis, I have made it my goal to gather and organize all the information that has helped me in my journey.

Share Your Thoughts

(will not be published)

Notable Community Replies

  1. anna says:

    Thanks for sharing.

    I live in Manila and am wondering if i could get Nystatin here. Is that the brand name? The ones i seen online are for vaginal infections. May i ask which one you used?

    Reply Permalink
  2. Hi Anna,

    Nystatin is the name of the actual anti-fungal agent. There are many brand names for it.
    Wikipedia has some details on it.

    I have also sent Joakim an email with your question.
    Hopefully he can help clarify which specific one he’s using.

    Reply Permalink
  3. joakim says:

    Hi Anna,
    sorry about the mix-up! I guess that goes to show that it’s always a good idea to double-check the helpful advice you find online, or to talk about it with a professional.
    Anyhow, the one I use is called Nystatin Lederle Creme and contains 25 g per tube. Actually, it doesn’t say anywhere on the packaging that it’s for SD, it just says it for fungal-infections so there might not be a distinction between creme from oral-, topical- or vaginal application. My guess is that any creme with nystatin as the active drug will do the trick, but I’m not a doctor, so you’d better consult one anyway :slight_smile:
    I found an image of the one I have at home: http://tinyurl.com/k8xg7q9. Maybe that will make it easier for you to compare. They might not have exactly the same one in the Philippines or even the US. It might be possible to buy it online from Germany since it’s an over-the-counter drug, but I haven’t looked into that yet. Let me know if you can’t find anything locally, then I will look into the possibility of buying it online and having it delivered. It doesn’t make any sense for me to spread the word about this if no one can get a hold of the drug unless they are in Denmark or Germany :slight_smile:
    I hope you can find a similar one, though! I really think it will do the trick.
    Best of luck,

    Reply Permalink
  4. anna says:

    Thanks for your reply Joakim.

    I’ll definitely call my dermatologist, who by the way keeps on insisting on a cotrisol cream. I’ve given up on that since it doesn’t really make it go away completely plus it a few days later it get really bad after using it.

    Wanted to share with you as well that at the moment, what I’m doing is the salt water treatment that I’ve been reading about online. It’s my 2nd day and it seems that the flaring has improved. It’s still visible and still inflamed but I think there is some improvement.

    Also, would you know anything about DermaZinc? BHA Exfoliants?

    Will let you know if I’m able to find Nystatin here.

    Grateful for your help,


    Reply Permalink
  5. Hi Anna,
    The DermaZinc is essentially the same as Head and Shoulders. Previously I have tried similar products from Noble Formula (tried the bar soap and the cream), it’s basically identical to the DermaZinc and sold on Amazon as well. My results were mixed. It worked really well at first. For 3-4 weeks my face was totally clear. Then it just seemed to stop doing it’s job. Also it made the skin quite a bit less healthy looking in general and quite sensitive to the sun. The reviews on Amazon for this stuff are fantastic though and based on those lot’s of people find success with it (there are also some who describe same experience as me).

    As for make up I have no idea since I’m a male. What I remember reading though, was that some women had great results with make up that contained UV protection. It is common to use zinc oxide as a UV protecting agent in skincare products. And zinc seems to actually benefit in reducing the SD.

    Good luck and hope your progress continues.

    Reply Permalink
  6. anna says:

    Thanks guys!

    Just so you know. I’ve been religiously washing the affected areas (jaw area) with sea salt and have been applying KETOCONAZOLE which my doctor says is the generic name for NYSTATIN. I don’t know if this is true though.

    So far, the salt wash has helped tremendously in reducing the swelling / flare up. I just started Ketaconozole yesterday so let’s see what happens.

    Grateful for your time.

    Reply Permalink
  7. Hi Joakim.

    Thanks for sharing your battle with SD. What symptoms did you have on your face? Was it red inflamed skin or more mild flaking only? What areas were affected?

    Reply Permalink
  8. Hi Maciej,
    I can’t find a photo that shows the facts, and the only websites I can find are in German, but I’ll translate:

    “1 g creme contains as the active ingredient: 100.000 IE Nystatin corresponding to 22,73 mg dry-matter.
    Other Ingredients: Macrogol stearat 1000 [a different name for polyethylene glycol], cetostearyl alcohol, isopropyl myristate, glycerol 85%, sorbic acid (E200), lactic acid (E270), sodium hydroxide, purified water.”

    But this is not meant as a moisturizer. The point of nystatin is not to avoid feeding the malassezia yeast, it is to use an anti-fungal to kill the yeast, so you don’t have to worry about moisturizing. I don’t know why the first anti-fungal I tried didn’t work (specifically miconazole combined with hydrocortisone in a creme). I read somewhere on wikipedia that their ways of killing the yeast are different. The azoles are lanosterol 14
    alpha-demethylase inhibitors, while nystatin works by ergosterol binding - it has to do with their cell membranes. Anyhow, the details are not important to us, the important thing to learn from this is that “anti-fungal” is a broad term and it would be a mistake to think no anti-fungal will work simply because one didn’t. So try another angle of attack :slight_smile:

    Personally I haven’t heard of sulfacetamide 10% and sulfur 5% or tried it on myself, but wikipedia says it is a suggested treatment. Maybe Michael has some experience with it?

    Reply Permalink
  9. I have tried many natural remedies and prescription drugs. Currently, I’m on 1% ciclopirox. I don’t have flaking, just red inflamed skin on my chin and nasal folds. 2 dermatologists have said it is seb derm. However, nothing has healed the face redness as of yet.

    Joakim - How long did you use the Nystatin before you saw improvement with the redness? And how long until you experienced complete remission of the skin redness?

    I really appreciate your help!

    Reply Permalink
  10. Thanks a lot for answer. I have friend whos working in pharmacy and he could make me cream because in PL we dont have nystatin cream - nystatin is only in form granules and infusion. Unfortunately components from your cream arent avalible in pharmacys (only in larger production) but I hope that friend use good components - I told him to avoid from using oils.

    I don’t understand second part of your post: “But this is not meant as a moisturizer. The point of nystatin is not to avoid feeding the malassezia yeast, it is to use an anti-fungal to kill the yeast, so you don’t have to worry about moisturizing.” Cound you write more clearly? My english is quite bad sorry.

    Reply Permalink
  11. If I recall correctly I started using nystatin around December 8th and by Christmas Eve it was gone. I think I started seeing improvements after the first week or so. It was a pretty fast process of recovery, actually. I used it daily at the time. Now, I tend to forget 2 days a week or so, but in the beginning I was on point!
    My dermatologist sounded very confident when he prescribed me the stuff. He was like “Try this and I bet you’ll see improvements by the end of week the. Otherwise come see me again.” Now I wonder what he would have done, had I come back. Maybe he was just reassuring me, and he knew I wouldn’t come back.
    I’d recommend you trying it if you have the possibility. I also tried other anti-fungals that didn’t do it for me. I think ciclopirox and nystatin work differently, so there’s hope! :slight_smile:

    Reply Permalink
  12. Hi Maciej,
    I found a website that looks like it sends nystatin to most European countries - including Poland. Otherwise, it’s an over-the-counter drug in Germany, so if you go to Germany you can buy it without a prescription from your doctor. Anyway, here is the website if your friend cannot help you make it: http://www.apons.eu/nystatin-lederle-creme

    The point I was trying to make is this: With nystatin you are killing the SD. The reason we should avoid oils is that we don’t want to feed the SD, but when we have already killed it then it doesn’t matter with the oils.
    I have completely stopped using moisturizers since I got nystatin. I don’t get dry, red skin anymore so there is no need to moisturize (with or without the oils). I hope that makes more sense - otherwise just ask again if there is something you want me to explain better :slight_smile:

    Best of luck!

    Reply Permalink
  13. ron says:

    Hi Joakim, thanks for sharing this. I also have SD and planning to buy Nystatin Lederle creme soon!

    Reply Permalink
  14. Hi, Joakim, MICHAEL , all

    Thanks for sharing your story with us, i have SD(seborrheic dermatitis ) 10 years now and i have tried almost everything to control it. What i found to be effective was keep washing my face once daily(at night usually) with a no-soap cleanser which doesn’t dry my skin applying aloe vera moisturizer when my skin looks dry and when a rush appears using once daily ketoconazole cream(fungoral is the brand’s name) for 7 days. The first 1-2 days my skin reacts and doesn’t like it but then at day 2 or 3 it calms down and you couldnt tell i had a rush there.I also save every second day because if i dont my skin becomes flaky , and i apply fresh aloe vera from the plant to me face whenever i can.For my scalp i am using a shampoo that doesnt dry my skin out and ACV remedy some days per week.

    I am interested on what you suggested (Nystatin cream) because i believe we should check all of our options and i am currently trying to find alternatives that work better than the solutions i’ve already found.

    My questions are :

    1. how many times per day and how many days in a row did you apply the Nystatin cream)?
    2. what is your maintenance routine after you controlled SD?
    3. what other things are you doing in order to help your SD not coming back?

    Thank you MICHAEL for this beautiful site and i am looking forward to your answear joakim

    Reply Permalink
  15. Thank you, Michael, for this site.
    It is really helpful to compare experiences.
    I have not tried the products or sun screens with zinc oxide but will investigate which brands might be good. Since my skin is quite oily, I was happy to discover an oil free sunscreen by Jason - which has Titanium Dioxide - but I couldn’t find zinc oxide on it - could it be the same type of ingredient? Not tested yet though.
    I have ordered Nystatin from Germany to be sent to me in the UK via www.parcemed.de - so will report back on how it works in the next weeks.

    In case this helps others, here is what I have tried so far. This is not very scientific - just subjective.

    1. Lamilsil - a UK brand against athlete’s foot - fungacide terbinafine hydrochloride 1 % - this worked in getting extremely inflamed skin calmed down. Used it for a week but then the effect seemed to lessen or stand still.
    2. Clarity Superdrug Skin Rescue - (UK drugstore brand) for spots -with Salicyclic Acid. This is my favorite spot fighting cream as it does not dry the skin. Helps with oiliness, does not inflame SD.
    3. Oxy on the Spot (UK brand, GlaxoKline - with Benzoyl Peroxide. A bit harsher than Clarity so I use it only on spots.
    4. 100% Tea tree oil - not bad but too harsh for longer use. Good with 100% 1:1 tea tree oil / apple cider vinegar combined on a cotton ball and brushed onto (non-inflamed) skin. But overkill for sensitive skin.
    5. For eye brows only: 1:1 apple cider vinegar on cotton balls rubbed lightly over eyebrow areas. SD completely gone after doing this twice daily for 2 days. Too harsh for rest of face. No return of SD on eyebrows 3 weeks later - only used this method for one week but the effect has lasted.
      Face washes:
    6. I used to use Clinique Facial Soap mild, - fragrance free, unisex though marketed to women. I bought some for my brother who has the same condition and he liked it. It only takes 5 splashes of water to completely wash off - used at night for many years.
    7. With the sudden SD - needed something like it but more moisturizing - so found this African Soap
      which moisturizes and cleans oily skin - and only 5 splashes of water needed - my best SD discovery so far.
      I do think there is a link with the gut (my SD started after food poisoning) and I do have cravings for salt (make lots of popcorn).

    I am grateful to this and other forums because for a long time I did not understand this delicate dance between oily skin and dry, flaking skin - and the product dance that goes with this. My SD is better now - much calmer - barely visible - and I look forward to testing the Nystatin. Am grateful to the contributors here.

    Reply Permalink
  16. Unfortuntenly it doesnt work on me but I have been using suplements for 1week (biotin 10mg/ MSM 8g / capryl acid 2tabs and probiotics (acidophilus)) and my seb derm slowly disappears. If i’ll have more time I’ll write more information about this (my english is poor so I need time to write sth:P).

    Reply Permalink
  17. Read a lot here, nice to find you all. I think the answer is out there but the dermatologists won’t tell us. I bet we find it though. I tried the listerene protocol last year and killed my scalp sd for months…but fall came and so did sd…and I can’ t get a handle on it again. ( I put listerene on scalp, put shower cap on and left it several hours). As a female I have lots of hair these protocols screw up trying to get at my scalp. Do NOT trust presc. Strength Nizoral…it fried my hair texture (actual side effect). Any Nystatin for scalp treatment…oral?

    Reply Permalink
  18. kelly says:

    I feel like I have had SD for many years but ever since I had my first child it has only gotten worse. I was diagnosed by my doctor and I’ve tried the Nizoral shampoo, t-SAL, T-Gel. I’ve also tried no-poo, baking soda and ACV with limited results. I just hate having this gunk on my scalp. It’s the only location I have SD. I also have thick long hair which makes it difficult getting to the scalp to treat it. I am intrigued by this nystatin and I have also heard by controlling the yeast growth internally helps as well. Thanks for having this site! I know I’m not the only one, but it’s not something that is talked about often.

    Reply Permalink
  19. Finally! I’ve been dealing with SD for over ten years. I hate it. It’s all over my scalp and behind one ear. Occasionally, I’ve had to use an antibiotic for some reason or other over the years and loved that my SD went away for those precious ten days of using the drug. But the SD always came back.

    When I was doing chemo a couple years ago my SD was totally gone for all those months! Hated the chemo - but loved the freedom of a scaly scalp! I’ve just been given Nystatin for yeast under the breast. It didn’t work, but I’m going to use it on my head to see what happens. The antibiotic I’m on is helping under the breast. Go figure.

    I have rosacea. Does this all intermix in some way? Yeast? Oily skin? Rosacea?

    Reply Permalink
  20. My son has SD (head, face, chest and back). The creams prescribed by the dermatologist (Ketoconazole creams and shampoo, other steroids creams and oral antibiotics) worked okay based on how well and how often they were used. His flare-ups would be severe to the point of getting an abscess or two in his face requiring the oral medicine.

    My grandson’s pediatrician prescribed Nystatin cream and ointment for a diaper rash. I was extremely impressed with how fast and how well it worked. I researched other uses for the Nystatin and was pleased to learn it can be used for SD. Good results were noticeable overnight. Although the ointment is easier to apply to face and scalp, the cream does well on chest and back.

    Thank you, Michael, for confirming.

    Reply Permalink
  21. It is actually not that surprising, and not the first time I hear a story like that. Nystatin is by no means an unknown, obscure drug. It is on WHO’s list of most essential medicines, so I guess it’s pretty widely used to treat a number of yeast infections. But maybe the idea of using it to treat SD is relatively new, or at least unconventional. The go-to methods seems to be the hydro-cortisone cream and ketoconazole shampoo - which didn’t really work for me :slight_smile:

    But I am happy to hear that you are seeing progress.
    All the best to you and your family :slight_smile:

    Reply Permalink
  22. I have been itching for months and couldn’t find anything to help. I read your article and added the nystantin to my daily routine, and guess what I am finally not itching. I see my dermatologist next week, so excited to tell her what I found

    Reply Permalink
  23. hakan says:

    Thanks for an amazing site and your helpfull way of living.

    I have ordered biom8 and I’m also looking forward to the probiotic spray when it’s ready for sale.

    I just bought Restoraderm as it’s available in Sweden. I will use it until the biom8 arrives.

    There is a group on yahoo that clears sed derm with a strict food protocol. It mainly consists of vegetables and fruits and processed foods are not allowed like sugar, fries, bread, high fat food, meat and so on.

    I made an incorrect post the other day saying that the Nystatin from amazon i Germany contains aluminium hydroxide. However the cream Nystain USP does contain aluminium hydroxide.

    I have not seen the list of ingredients of the Nystatin cream from Germany. Does any one have this product called Nystatin Läderle? Does it contain aluminium?

    The reason I’m concerned for this is the many scientific based papers that states that aluminium can cause seriouse diseases like cancer. Search for aluminium on mercola.com.

    Thanks for your time

    Hakan in Sweden

    Reply Permalink
  24. jay says:

    Hey Joakim,

    Looks like the Nystatin cream has done wonders for you (and other people). Great find by your dermatologist and interesting that he recommended it over the ‘common’ antifungals, immunosuppressants and steroid creams.

    Keen to try this, but I’ve got my flakes / scaling under control and I’m simply looking to get rid of the very apparent redness from the sides of my nose and the red blotches on the bridge of my nose, did this help control your redness? I feel like Rudolph some days!

    What is the best place to buy this from for people in Europe outside of Germany / Denmark (particularly UK residents)? Bit worried about using my card on a website I barely understand, even with Google Translate, the lack of final confirmation on cost is a bit worrying for P&P etc.

    Also interested in your take on SD and gut flora, I’ve been reading a lot about this. Especially the link between the gut and the rest of the body such as immune responses, diseases and how it appears inflammation seems to be the route of pretty much every modern day illness. Will also follow up with a comment about your SD clearing when you went abroad to the Philippines, this is something I’ve come across quite a lot in my research…

    For anyone else looking, the ingredients list seems to be the following for the Nystatin Lederle Cream:
    Nystatin 2.2%
    Cetyl stearyl alcohol (vegetable)
    Water, purified
    Sodium hydroxide
    Isopropyl myristate
    Polyoxyethylene (20) monostearate
    Sorbic acid
    Glycerol 85%
    Lactic acid

    The only worrying ingredient is “Isopropyl Myristate” which is an irritant and quite bad for anyone who is prone to acne. Might be worth watching out for as this could cause issues. Lactic acid is also an AHA.

    Reply Permalink
  25. shane says:

    Hey, I purchased from Apons in Germany. I was a bit apprensive ordering from websites I know nothing about and especially that most of the correspondense is in German. But it arrived last week so it seems to be fine. Surely there other products available even on perscription that match the ingredients in Nystatin. Im on my 3rd day using the cream and its doing a lot of good already!!

    Reply Permalink
  26. met says:

    Shane please let us know if u have any success with it as well, here in italy i couldnt find a nystatin cream with no corticosteroids included so i would have to order it from amazon.de but i want to be sure before applying new stuff on my face. I ve been suffering this condition since i was 19 y old. It worsened along the years. First was only on the nose sides. Then on the hairline and in the end all over the scalp and the forehead. I keep it at bay using aluseb (not sure if this product is sold outside italy too) wich cleared it completely on the hairline but couldnt do much for the forehead. Recently the situation on my scalp got worse and i cant seem to find a shampoo that doesnt irritate it. Showering it s a nightmare. Well anyway just let me know about your results with nystatin and possibly this new product sold in uk. Last thing: sunbaths and the salty water of adriatic sea always clear it completely for me during summer. But it always comes back…

    Reply Permalink
  27. Hi Shane,

    Took a look. Strange how they don’t appear to have much information about the product listed (ingredients and etc).

    Not sure if you have seen it yet, but I’ve made my own all natural solution a couple months back. Which, came out of my research while trying to write a book on the subject.
    It’s called Biom8 and user feedback has been quite good so far. You can check it out here:

    Personally try to keep it’s advertisement on this website to a minimal, but it’s honestly been the best thing I’ve tried.
    My own write up on my experience is here.

    Hope that helps and look forward to any updates.

    Reply Permalink
  28. joakim says:

    Exciting news! :slight_smile: I’m looking forward to hearing how it goes!

    I usually apply the creme after a shower, which I usually do in the morning. But as I mentioned, I don’t really have any fanatic schedule or routine. Some days, I wont use it at all, and sometimes I will feel a SD-sort of sensation on my skin or notice small signs of irritation or redness and just apply some before bedtime to be proactive - maybe even without a face-wash. One thing I try to do, though, is to complete at least 4 days of treatment if I feel the need, in order to combat resistance. It’s just something that I do, not something I was told to do, but I reason that small doses once in a while might select for the more resistant fungi. Sort of like with other antibiotics, where you have to complete a full treatment, even after the symptoms disappear. But you don’t have to worry about that at first, as you should use it daily for at least 2 weeks, I’d say. By then, if it’s effective for you, I hope that you are almost back to your normal self :slight_smile:

    Initially, I might even have used it twice daily. I actually cannot recall. But I do remember my dermatologist saying that you don’t really have to be worried about using “too much” - not like with hydrocortisone. So you can do that, if you feel like it - morning and evening. That doesn’t mean, however, that I applied a face mask of nystatin to my face every night. Just work it into the skin wherever there’s inflammation. I use less than a pea now, but maybe a pea-sized ball is alright in the beginning. You’ll figure it out. But work it in gently, don’t leave a layer on the skin. And then you’ll diminish your consumption down the road. I’m only on my second tube after using it on-and-off for a year now.

    I have not had a full-blown flare-up since forever, so I can’t actually tell if it would comeback if I completely discontinued the use of nystatin. The reason I still use it from time to time is just to be proactive and because I already have it. I’ve been very casual with the use during summer without problems. Last spring, however, I had a flare-up, but maybe it wont happen again? Maybe my hormone levels have changed – and with that the composition of my nose-lipids --, maybe I’m not as stressed anymore, maybe by using nystatin I have helped my body reestablish a natural balance that it can now maintain after this initial, helpful push. I will find out, I guess, when I finish this tube. I might go cold-turkey for a while then, and only buy a new one if it returns.

    The trip to the Philippines is an example of the horrible self-diagnosis one can perform when dealing with SD. The effect was non-negotiable: The SD disappeared. But I changed SO MANY things. I was living in Beijing at the time, studying, and went on vacation to the Philippines. So my diet changed from Chinese food to Filipino food, my environment changed (sea water, more direct sun-light, less pollution, being outside much more, etc.), I went from stressful work to relaxing holiday and so many other factors. There’s no real conclusion to be drawn from the trip except that something – one or more of those changes – had actually made the SD go into remission. That’s the one thing I gained from that: That it was possible to treat. And that gave me hope and motivation to keep looking for a solution.

    End of speculations for now – work’s a-calling :slight_smile:

    But good luck with the treatment! I wish you all the best.
    Imagine: in a week or two, it might be all gone :wink: Just in time for Christmas!

    Reply Permalink
  29. jay says:

    Hey Joakim, Michael and anyone else interested - just posting my update on Nystatin (sadly it’s not positive as I was hoping).

    Tried it from last Monday (9th) until this Tuesday (17th) and didn’t see an improvement of any kind. Redness was still quite full on and if anything, it actually increased the amount of dry skin / flakiness I had around the nasal folds. It also had the strange effect of making the sebum on my nose almost ‘bead’ into little water droplets - like my skin couldn’t absorb it properly. Not sure on the reasoning behind that, but since ceasing application that hasn’t happened.

    Could’ve given it a bit more time, but the fact that I saw no improvement didn’t really give me much hope.

    There are a couple of older studies I’ve been reading up on that suggest Malassezia counts between healthy subjects and those with SD are very similar, and it’s in fact a sebum composition problem (which could also stem from internal issues or possibly genetics).

    I might go down the route of trying to increase LA in the skin whilst reducing oleic acid which seems to be an irritant and a primary cause in skin barrier disruption. Just need to save up and then I’ll try a mix of borage oil and possibly Michael’s topical Biom8.

    Reply Permalink
  30. ian says:

    Hey everyone,
    I received my order of Nystatin cream from Germany today, so I’ll keep you guys posted on how it works after a week or two. Will be using it once or twice a day. I figured the more experiences we share here, the more collectively informed we can be about possible treatments. Sorry to hear that Jay’s experience with it so far has been disappointing.

    I also ordered the BIOM8 oil, which I intend to incorporate into my routine when I receive it. Between that and Nystatin I’m hoping there will be a noticeable improvement soon. I figured this would be a good combination in the sense that I’ll use the BIOM8 oil on a regular basis all over my face, whereas I’ll concentrate the Nystatin cream on just the problem areas (since I don’t want to apply a fairly thick cream all over my face).

    Here’s some background on my situation:
    I’m 31, male. I’ve been a long-time sufferer of persistent mild-moderate acne since the beginning of my 20’s (my only concern in my teenage years was a blackhead-ridden nose so I thought I had dodged the acne bullet, but boy was I wrong). While I was studying at uni in the US I went on two 6-month courses of Accutane (at the standard dosage), spaced out by a few years, both of which only managed to temporarily clear it up. Then I discovered the regimen promoted at acne.org (where you apply an overly generous amount of benzoyl peroxide all over your face twice a day). The acne.org regimen didn’t clear me up entirely, but kept me clear enough that I stuck with it religiously for a good 5 years or so. However, it left my skin feeling constantly dry and raw and I wasn’t satisfied with how its effects continued to fluctuate so much, so I went off of it, suffered with some pretty nasty breakouts until I eventually settled into an alternative routine that’s a lot gentler and doesn’t involve heaping an inordinate amount of benzoyl peroxide on my face (now I just use Epiduo gel, which is a mixture of benzoyl peroxide and a retinoid and can be applied as just a pea-sized amount nightly). My acne still pops up much more regularly than I’d like but at least my face isn’t the active volcano that it was at the beginning of the year shortly after quitting the BP regimen.

    These past few years I was noticing some flakiness on the sides of my nose. I initially attributed this to the dryness caused by my constant benzoyl peroxide use, but even after making it a point to avoid that area when I applied the BP, the flakiness persisted. Jojoba oil was useful to control the flakes, so it never bothered me much. However, a little over a year ago these areas have gradually become much redder, oilier, and even itch pretty badly at times, and over the past few months it’s reached a new high and I’ve become very self-conscious about it. There’s also a very small pustule on the side of my nose, which I initially thought was just a run-of-the-mill pimple, yet it’s stuck around for 10 months now. If I extract it, it simply comes back. If I leave it alone, it crusts over and flakes off, stays red, and then comes back. It’s like it’s stuck in a time loop. That’s when I realised that what’s happening around my nose isn’t acne but some kind of persistent infection that simply wasn’t resolving on its own. So I spent my 20’s suffering from acne and I’ll get to spend my 30’s suffering from acne AND seb derm? Oh joy.

    The reason I mention my constant benzoyl peroxide use following the acne.org regimen is that I noticed that shortly after quitting it at the beginning of this year, my face has started producing an extreme amount of oil. I’ve always been a bit shiny-faced (the only positive being that it means I’m often told I look considerably younger than I am) but now it’s ridiculous. 15-20 minutes after washing and the oil returns in full force until I look like I’m sweating from a heavy workout. I don’t know if my many years of BP overuse have caused this, or if they simply hid the problem because I was routinely drying up my face with so much BP (I did moisturise after each application but my skin sucked up all the moisturiser, I’m guessing because the BP dried it out so much that it needed it). Either way, there seems to be a pretty direct correlation with my face’s excessive oiliness and my seborrheic dermatitis because I noticed where I suffer from it is even oilier than the rest of my face.

    I’ve tried many topical treatments (primarily antifungals as I’m trying to avoid corticosteroid creams), but if I don’t find a solution soon I’ll be at my wit’s end and feel compelled to ask for a prescription for a third round of Accutane (albeit this time on a much lower dose spread out over a longer time, which appears to be a lot more common here in Europe) to control this trifecta of oiliness, seb derm, and acne.

    So the things I’m trying now are:
    1.) Azelaic Acid 10% applied all over the face once a day – seems like a particularly wise choice in my case because azelaic acid appears to be one of the few topicals that can treat seb derm AND acne at the same time with supposedly good results. It’s still too early to tell if it’ll have an effect, though.
    2.) Nystatin cream applied only to the problem area once/twice a day.
    3.) And when I receive the BIOM8 oil it’ll be applied all over the face right after my morning shower.

    As I said I’ll let you know the results. I’m giving it till the end of the year to see if there’s at least some improvement. Then I’ll ask if I can get an oral antifungal. If I ultimately end up going down the low-dose Accutane route, I’ll let you know the results from that as well. I’m pretty fed up, all in all. If this seb derm issue had been my first face problem since adolescence I’d probably have a lot more patience with it, but since it’s coming off the top of a decade-long struggle against acne I feel pretty emotionally drained. -__-

    Reply Permalink
  31. shane says:

    Hi Guys,

    I ordered 3 packs of Nystatin Cream from Apons and received the order here in Ireland today. But they sent me Paste not Cream!!! I know for sure I ordered the Cream not Paste, because I ordered the cream in Oct and when I ordered this time I accessed the product from my previous order which arrived correctly.

    I emailed them and outlined the problem, but I know they’ll say I selected paste bla bla bla and therefore they won’t take it back. So my question is. Whats the consistency of the paste?? will it dissolve in my skin like an ointment?? I don’t want to open it incase by a small chance they take it back but if they don’t. Can I use the paste normally?? Otherwise its 3 bottles, complete waste :frowning: Thanks guys!

    Reply Permalink
  32. ian says:

    I actually managed to pinpoint the ingredient responsible: isopropyl myristate. It’s in a lot of antifungal creams and unsurprisingly I just discovered that it’s in the Nystatin cream I bought from Germany as well. Unfortunately it’s known to be an extremely comedogenic ingredient, one of the biggest offenders since it’s so commonplace.

    So sadly I’m going to have to stop using the Nystatin cream. :confused:

    If anyone is interested in buying it off of me on the cheap, let me know, since it’s either that or it’s going in the rubbish. I used it for just 5 days so it’s almost a full tube’s worth. (I’m in the UK, by the way, so bear that in mind).

    Reply Permalink
  33. jay says:

    Hi Ian - sorry I didn’t check in before and see your post regarding acne & SD.

    As you’ve already pointed out, Isopropyl Myristate is a horrible ingredient for anyone who is acne prone. We had a quick look over the ingredients further down the comment thread and I pointed this out as being a massive irritant for those with sensitive skin - it’s definitely a shame as other people have had great success with the Nystatin!

    The Azelaic acid should hopefully be beneficial to both the SD and acne. It seems to work for a variety of reasons: “Studies confirm antimicrobial properties, sebosuppressive activity, anti-keratinizing activity, anti-inflammatory and immunomodulatory effects and antimycotic activity — including specific activity against Malassezia”. But as with everything some people find it a god-send cream and others find it just worsens their condition; hit and miss as always.

    Let me know how you get on with the BioM8 oil as it’s something I’m keen to try, but at the moment I’m having to try out cheap remedies due to Christmas & helping out my parents with a couple of things. Also interested to see your experience with AzA (15% tends to be one of the most effective, but I’m unsure if various formulations will have differing ingredients that cause irritation), as I have a tube of Finacea lying around which is good until 2016 and I might be persuaded into trying that again.

    I’d also like to touch on the anti-fungal and Accutane route as something that might help you. Whilst I don’t have any experience with the anti-fungals, they’re extremely cheap to try (Fluconazole can be bought on Amazon for around £1 per tablet and I believe you can use it once a week for maximum efficacy with minimal to no side effects) and this should at least give you an idea if any of your skin issues are fungal in nature. In regards to low-dose Accutane, I have a lot of experience with this, I was on 10mg every other day for 6 months, then dropped to 2 x 10mg a week and I was virtually clear of all acne symptoms, did nothing for SD though and sebum remained on my nose… Could be because my dosage was extremely low, but I had very few side effects aside from slightly dry lips (easily manageable) and occasional loose stools, but that could be because I was constantly altering my diet.

    But I’m keen to try out as many other things as possible before I resort to conventional heavy-duty treatments!

    Let me know how things go - wish you all the best with the skin :slight_smile:


    Reply Permalink
  34. I am new to this site, saw it first about two weeks ago.I am currently awaiting the Biom8 oil, while basically trying out coconut oil on my sd, which is on my scalp, in back from about middle of my head down to where my hair ends. It been such a pain, fir so long. I have long curly hair, so its not visable, but is sooo uncomfortable.
    i have been to dermatologists all my life, who just give the same old advice, shampoos that,while they may have ingredients to quell the sd, they wind up leaving my scalp feeling burning, tight, itchy and irritated. I am now on my own personal quest fir natural solutions…seems that maintenance is all I can expect. Maybe a cure? So far, I am feeling a pretty decent relief by using pure coconut oil.
    There is a doctor in New York City, (i live 25 mikes away) Dr. Ash, who is an integrative type doctor, who says, on his website that he prescribes Nystatin for SD. I am interested, but have not yet checked this out with a doctor yet, as i believe it must be prescribed, not over the counter. I wonder, for thosee of you using it, how do you know what strength to use, or how many times to apply, in order to kill the fungus, but not cause skin chaos? I am quite excited to try it, because if its even a temporary type “cure” wow, I ll be forever grateful

    Reply Permalink
  35. tj01 says:

    Hello Michael,

    I trust you are doing well.

    Thank you for your suggestion. I live in Istanbul Turkey and here we only have nystatin for oral use. But if you think that it helps to reduce acne, I will try to get help from Germany with custom formula.
    I tried not to apply nystatin directly on face but this time the risk of sd appeared which I never want to face again.
    I hope I can find a way to have it in Istanbul.

    Thank you,

    Reply Permalink
  36. ian says:

    Just to continue with my updates here.

    My routine has been mostly similar to what I’ve been doing for the past month, with a couple minor changes.

    As of the past week I now just occasionally use Michael’s BIOM8 Oil as a cleanser and mix it with shampoo in the shower. I didn’t notice results from using it as a daily moisturiser after several weeks, but it works just fine as a gentle cleanser so I continue to use it this way (better than throwing it away, after all). Then I use a simple light moisturiser with minimal ingredients (Sebamed Clear Face Gel) and that’s it.

    I wash my face, and then apply Skinoren gel (15% Azelaic Acid) as always (can’t tell if it’s helping my SD at all but it helps my acne, so I’ll continue to use it). I used to apply Sebclair (aka Promiseb) cream at this stage, but I replaced it with a very interesting cream I found called Ducray Kelual DS Cream. Like Sebclair it has piroctone olamine which is an antifungal, but the interesting thing is that it also happens to have crotamiton, which I mentioned in a previous post was the ingredient used in a study to treat demodex mites. The fact that they included crotamiton lends further credence to my theory that a demodex involvement shouldn’t be entirely ruled out as a cause of symptoms that manifest very similarly to SD.

    Here’s the full ingredients list for the Ducray Kelual DS cream:

    Aqua, Caprylic/Capric Triglyceride, Cyclomethicone, Dicaprylyl Ether,Cetearyl Alcohol, Acetamide MEA, Glycolic Acid, Guandine Carbonate, Glyceryl Stearate, Plymethyl Methacrylate, Ceteareth-33, Crotamiton, Piroctone Olamine, Serenoa Serrulata fruit Extract (Serenoa Serrulata Extract), Tetrasodium EDTA.

    I don’t do raw honey masks anymore because they had no effect on my SD and were a pain to do. I’ve been wanting to keep my routine as simple and stress-free as possible and I’ve kept it that way, and have no intentions of doing otherwise anymore.

    As for results, if there have been any it’s been quite minimal. I think the sides of my nose might be slightly less pink, but it’s hard to say.

    But to echo what I said in my last post, I continue to suspect that I might have demodex involvement because my dermatitis appears to manifest itself a bit differently from the standard SD symptoms. Namely, from the photos and accounts of SD sufferers I’ve noticed that there’s this tendency towards concentrated patches of redness that look like flakey rashes. I would describe what I have as more of a diffuse pinkness across my central face (minus the forehead, which is completely clear) that gradually fades out towards my cheeks, and my nasolabial folds and chin crease are a bit redder than that surrounding pinkness. Basically, I always look like I have a mild sunburn.

    Therefore I want to rule out the possibility of demodex involvement. In the study I posted previously, they recommend using a 10% crotamiton cream/lotion for 2-4 weeks. The Ducray Kelual DS cream contains crotamiton (which could be why I’m seeing extremely marginal improvement, if any) but judging from its location on the ingredient list I’d say it’s only a fraction of the 10% concentration recommended by the study. There is a cream available OTC in the UK called Eurax that does contain 10% – I ordered it a while back but then I left the country for the holiday and didn’t receive it in time, but now that I’ve returned I’m going to start using it.

    So for the next 2 weeks I’m going to apply Eurax to my entire face morning and night. If I see improvement I’ll continue the course for an additional 2 weeks. If I don’t see any improvement whatsoever, then I at least have eliminated it as a possibility and can just focus on it being a case of SD.

    Michael, I’ll be sure to report back about my results after this trial. Interesting that you’re also encountering more research about demodex!

    Also interesting about that person who didn’t see results from the BIOM8 Oil, like myself, but noticed improvement from the Probiotic Spray. I’ll bear that in mind. I want to give this crotamiton trial a proper shot first, but if it doesn’t work out then I’d be interested in trying out the spray, because if it is indeed SD then I clearly need a different angle of attack. Beyond the Kelual DS cream I’m currently using and another cream I found that contains climbazole and piroctone olamine, I’ll be a bit exhausted for options on the SD treatment front if I end up having to return to it. I don’t suppose there’d be any discount available for those curious in trying out the spray after giving the oil a go with no results? No worries if not.

    Cheers and Happy New Year!

    • Ian
    Reply Permalink
  37. simon says:

    Hi Ian,
    As it happens, I’m also experimenting with Skinoren gel and Kelual DS Creme right now after an (short) unsuccessful trial with BIOM8 Oil. For the time being I decided to leave the Kelual out to see what the skinoren gel does on its own. So far I would also say that it helps with pimples but not so much with the SD scaling and redness, but it is still too early to definitely tell.

    I tried out the Kelual Creme in addition for some days which didn’t seem to make much of a difference. But this was not an adequate treatment period. I recognized though that the Kelual has a tendency to try out the skin, a little bit like the Skinoren gel. This was also a reason why I decided against using both compounds together.

    With regard to this Demodex theory that you referred to: I think for myself I can pretty much rule that out. I applied a whole tube of Soolantra Creme (Ivermectin) over several weeks onto the affected areas of my face but had no positive results from it. But let’s see what turns out of your Eurax experiment.

    Reply Permalink
  38. ian says:

    Hey Simon,

    Wow, then we’re in quite a similar boat! I’m definitely a fan of azelaic acid in terms of treating acne, though I was hopeful that it’d have more of an effect on my SD seeing as some research points to it being helpful in that regard. Scaling hasn’t been much of a problem for me (for all I know the azelaic acid could be the reason why?), but my primary concern has always been the redness and it hasn’t had any noticeable effect on that. That said, the way I see it, it helps my acne and at least doesn’t appear to be aggravating my SD (which I worry might be the case if I were to use other, more irritating acne treatments like Retin-A), so I’m going to keep using it regardless.

    It’s understandable that a combination of azelaic acid and the Kelual DS creme can be a bit too drying, as the latter contains a decent amount of glycolic acid. I noticed that myself when I’ve been using the two together. I tried a “treatment phase” of the Kelual DS creme, using it both morning and night for 2 weeks (as is suggested on the manufacturer’s website), but now Intend to just use it twice a week and only at night. On those nights I’m thinking that instead of using the Skinoren and Kelual together I’ll just use the Kelual, to minimise the dryness/irritation.

    Sorry to hear that the ivermectin cream didn’t have any positive results for you. I’m not getting my hopes high that crotamiton will be my saviour, as promising as the results of that study are, but I want to at least go through a proper treatment course of it as otherwise it’ll always be nagging me in the back of my mind. Moreover, giving it 2 weeks isn’t much of a commitment – I was willing to do the same trial period for antifungal creams like the Nystatin but, unlike those creams, the crotamiton cream doesn’t appear to have any problematic ingredients that will almost assuredly clog my pores and wreak havoc on my face!

    Reply Permalink
  39. marc says:

    Hello, my name is Marc and I’m a long time SD sufferer, and just like everyone here on this site, I’ve tried everything. Jumped from derma to derma hoping that one might have the answer to all of my questions, but most of all a medication that can stop SD. If it’s not to much of a troubled to ask, can someone please point me to the right direction where I may purchase BIOM8 and Nystatin creme. Willing to try anything that might have every possibility of curing my SD. Please Help!!

    Reply Permalink
  40. Hi - this is in response to Marc - below a link from an Amazon.de pharmacy that delivers to the UK and probably also to other countries? Hope this helps.
    I am still very grateful to Joakim for pointing out this cream and for Michael for the blog and research which is so interesting and makes so much sense. My use is less frequent now but the effect of the Nystatin is always almost immediate after a flare-up and after about 12 months of on and off usage. Great stuff, thanks again for the tip and this great forum.

    Reply Permalink
  41. mark says:

    Hi all, it says that Nystatin Lederle Cream is unavailable on Amazon, has anyone sourced it anywhere else ? Thanks

    Reply Permalink
  42. Hey Joakim,

    I was just wondering did you end up trying out Brentan and did it work for you? I’m currently trying out a miconazole cream and have a tube of nystatin on its way to me. Hoping it will work for me as I have tried everything. The miconazole cream so far has reduced itching and redness on my nose but not fully healed yet but it’s early days and seems to be quite promising. If anyone is based in U.K I am using Dakarin (athletes foot cream) and ordered the Nystatin from pharmasana.co.uk

    Reply Permalink
  43. shane says:

    The Nystain cream really worked for me. I’m still using it a year and a half later. Once or twice a week and it basically keep it’s at bay. Handy that you found some where in the UK that stocks it! The nearest outlet I found was Germany. I might try that place in the UK it’ll be quicker as I’m in Dublin. Shane.

    Reply Permalink
  44. received my nystatin cream yesterday and tried it for the first time and the cream is yellow and very thick? It is a brand called nystaderm, was just wondering if all nystatin creams are this colour and consistency or have i bought the wrong type.

    Reply Permalink
  45. Hi all,

    Just wanted to report on my results with Nystatin. I have got nystatin acis cream (yellowish color) from the amazon.de and have been using it for 4 weeks now. The results are great, not 100% clear but around 90% I think. The side-effect is that the skin seems to get greasier. It also proved quite effective for the SD in my ears (as opposed to ketoconazole). Thanks Joakim for suggesting this! And Michael, thanks for creating this great sharing place!

    I also wanted to ask Joakim and others using Nystatin for a longer period whether they notice any wear off of the effectiveness of the cream with time?

    Reply Permalink
  46. Hi, I read almost all previous comments and you (Joakim) were using Nystatin lederle crème, which was discontinued. Have you changed to Nystatin Acis crème? is it as good as the lederle version? I am thinking of giving it a try. I have SD in my eyebrows and nose. My nose gets so red after using dead sea salt which was working but stopped, same happened with ketoconazole cream. So next would be biom8, which I already ordered and if that fails I will try Nystatin.

    Reply Permalink
  47. I also tend to get red/flaky patches on my face in the usual SD places. It seems the linked Nystatin product on Amazon.de is no longer available. I have been successfully using for quite a few years Dermacombin Creme which also contains 100,000IU of Nystatin. It also contains several other antibacterial and antifungal ingredients and also some cortisone. The thing is it is so effective that after 2-3 applications my skin returns to normal and flare ups are quite rare (say once a month) so I am not too concerned about the cortisone long term. I use the creme very rarely, usually due to its 6 months expiry date I need to throw most of it. Also I have suffered from sweat rash in my arm pits a few years ago, this cream cured it completely and it has not returned ever since.

    Reply Permalink