Thank you to our wonderful patient who sent the below video.
Using keratinolytics makes sense to me for patients with MGD, particularly in patients who have rosacea. One of the key components of Lipiflow is the removal of the keratin layer covering the meiboman glands that is often present prior to Lipiflow. Similarly, IPL may help decrease keratin formation over the meibomian gland orifice.
Selenium disulfide, also known as selenium sulfide, is a medication used to treat many skin conditions. I have recommended this in the past but it can burn and cause allergy in some patients. The below video makes a case of how Selenium disulfide can break sulfide bonds and stop keratin formation. It may help in some patients who can tolerate it.
This company will come out with drops or ointment likely. But there are over the counter options which I have recommended in the past which can help some patients. Is it better than Tea Tree Oil, Avenova, Acuicyn? I don’t know: they will all say they kill Demodex and it will take years and money to perform a head to head study.
Here are some over the counter products that I have recommended in the past.
1% Selenium Sulfide
Below is a nice review article on different keratinolytics: ketoconazole works as well but is very strong & not necessarily needed.
Ketoconazole vs. Selenium Sulfide
- Ketoconazole and selenium sulfide are antifungal agents used to treat itching, flaking, scaling, and dry skin on the scalp due to dandruff. Ketoconazole and selenium sulfide are also used for treating seborrhea (a red, itchy rash) and tinea versicolor, a fungal infection of the skin.
- Brand names for ketoconazole include Nizoral, Nizoral A-D, Ketodan, Extina, Xolegel, and Kuric. Brand names for selenium sulfide include Head & Shoulders, Selsun Blue, SelRx, and Selsun Rx.
- Side effects of ketoconazole and selenium sulfide that are similar include hair loss (rare), and scalp tingling.
- Side effects of ketoconazole that are different from selenium sulfide include rash, itching, nausea, vomiting, abdominal pain, headache, dizziness, fatigue, impotence, blood count abnormalities, serious allergic reactions (anaphylaxis), and depression.
- Side effects of selenium sulfide that are different from ketoconazole include oily hair, dry hair, dry scalp, hair loss, hair discoloration, scalp irritation, skin irritation, sweating, burning sensation, garlic breath, or tremor.
What are ketoconazole and selenium sulfide?
What are the side effects of ketoconazole and selenium sulfide?
- abdominal pain,
- impotence, and
- blood count abnormalities.
- Oily hair
- Dry hair
- Dry scalp
- Hair loss
- Hair discoloration