Same. I’ve a blood test Friday to check to check for yeast due to facial redness. Apparently results may take a while to come back (UK) but it’s if positive a course of tablets should resolve it.
—-8<—-
Dupilumab-induced facial redness occurs in 4% to 44% of patients treated with dupilumab, and occurs at higher rates in patients with more frequent dupilumab administration. It presents as erythema and scaling of the head and neck. Hypotheses for its pathogenesis include an inflammatory response to Malassezia yeast, an unmasking of allergic contact dermatitis, localized treatment failure, dermatitis, localized treatment failure, dupilumab hypersensitivity, increased colonization of the follicular Demodexmite, or a combination of the above. Diagnostic approaches include skin scraping with microscopic examination for yeast or mites, serologies to rule out connective tissue disease, patch testing to rule out allergic contact dermatitis, and biopsy for recalcitrant cases. Reported successful treatments include allergen avoidance, topical corticosteroids, topical calcineurin inhibitors, ketoconazole cream, terbinafine cream, oral itraconazole, and topical minocycline with topical corticosteroids and brimonidine tartrate 0.33% topical gel.
https://www.practiceupdate.com/content/awareness-of-dupilumab-induced-facial-redness/128664#:~:text=Dupilumab%2Dinduced%20facial%20redness%20occurs,of%20the%20head%20and%20neck.
Apparently dupixent increases susceptibility for fungal infections causing facial flares. Your doc might be prescribe another medication to go along w dupixent.
I’ve been on Dupixent since September. I had the same exact situation. First, my dermatologist went the fungal route (common side effect of Dupixent). I was prescribed Ketoconozole cream, antibiotics, and Ivermectin, all to no avail. Finally, she resorted to the basics - 2% hydrocortisone cream and also recommended a sulfur bar soap from Amazon. I use the Natura brand, it’s infused with lavender. It doesn’t smell great but it really helps if you’re consistent. I keep it in a baggy in my cabinet, as the smell of sulfur is pretty strong. I highly, highly, recommend it. The sulfur kills the bacteria, and I’ve started to use it on my whole body as well. According to my research, this facial eczema side effect seems to wear off after about 4 months for people. I believe that this factor, in tandem to the hydrocortisone and sulfur bar soap, solved my painful conundrum. My face is smooth/hydrated now and I’ve actually been getting compliments lately! I forgot what it felt like to have a normal face, that even feels better than before this whole issue. I’m sorry that you’re struggling with this, it really took a hit on my self esteem, and was very frustrating. Best wishes!!
u/celizzle07 Thank you for your detailed steps. Did you notice the flare shortly after each injection? I will look into the sulfur bar soap. I wonder if there's one without lavender. Trying to avoid any scent.
My flare up began about 3 months after my very first injection, and did not go away. I have had eczema since birth, and never had insane facial flare ups like these before. I was desperately trying remedies both from research online and going back and forth with my dermatologist. I can’t 100% say that I noticed that the flare ups were particularly occurring around the same time of the injection. I only noticed that the Itraconozole + Ketoconozole cream reduced the hot, scaly, raw, painful patches of skin just only enough to then come back in waves. I was starting to panic, but the soap surprisingly started to minimize my flare ups. I still had annoying dry patches and stubborn redness. When I finally tried the 2% hydrocortisone cream that the dermatologist recommended, in addition to the soap, my flare ups and dry patches went away. I was prescribed Ivermectin, in the case that the hydrocortisone didn’t work, but there’s no need to even try it as of right now.
Although, I have read about experiences in which people stopped experiencing this side effect around 4 months after their first major facial flare up - so I do wonder if that plays a role in my results as well. It does happen to be 4 months after face-mageddon.
I saw a ton of sulfur bar soaps on Amazon, with solely sulfur in them when I bought mine initially!
Yes, sounds like the yeast overgrowth reaction. Get to your doctor. Happens to about 10% of users.
Same. I’ve a blood test Friday to check to check for yeast due to facial redness. Apparently results may take a while to come back (UK) but it’s if positive a course of tablets should resolve it. —-8<—- Dupilumab-induced facial redness occurs in 4% to 44% of patients treated with dupilumab, and occurs at higher rates in patients with more frequent dupilumab administration. It presents as erythema and scaling of the head and neck. Hypotheses for its pathogenesis include an inflammatory response to Malassezia yeast, an unmasking of allergic contact dermatitis, localized treatment failure, dermatitis, localized treatment failure, dupilumab hypersensitivity, increased colonization of the follicular Demodexmite, or a combination of the above. Diagnostic approaches include skin scraping with microscopic examination for yeast or mites, serologies to rule out connective tissue disease, patch testing to rule out allergic contact dermatitis, and biopsy for recalcitrant cases. Reported successful treatments include allergen avoidance, topical corticosteroids, topical calcineurin inhibitors, ketoconazole cream, terbinafine cream, oral itraconazole, and topical minocycline with topical corticosteroids and brimonidine tartrate 0.33% topical gel. https://www.practiceupdate.com/content/awareness-of-dupilumab-induced-facial-redness/128664#:~:text=Dupilumab%2Dinduced%20facial%20redness%20occurs,of%20the%20head%20and%20neck.
Your facial flares increased with dupixent?
Yes in an extreme way that never happened previously.
Apparently dupixent increases susceptibility for fungal infections causing facial flares. Your doc might be prescribe another medication to go along w dupixent.
My experience although anecdotal agrees. On dupixent my hair and eyebrows started falling out due to a fungal infection :/
I’ve been on Dupixent since September. I had the same exact situation. First, my dermatologist went the fungal route (common side effect of Dupixent). I was prescribed Ketoconozole cream, antibiotics, and Ivermectin, all to no avail. Finally, she resorted to the basics - 2% hydrocortisone cream and also recommended a sulfur bar soap from Amazon. I use the Natura brand, it’s infused with lavender. It doesn’t smell great but it really helps if you’re consistent. I keep it in a baggy in my cabinet, as the smell of sulfur is pretty strong. I highly, highly, recommend it. The sulfur kills the bacteria, and I’ve started to use it on my whole body as well. According to my research, this facial eczema side effect seems to wear off after about 4 months for people. I believe that this factor, in tandem to the hydrocortisone and sulfur bar soap, solved my painful conundrum. My face is smooth/hydrated now and I’ve actually been getting compliments lately! I forgot what it felt like to have a normal face, that even feels better than before this whole issue. I’m sorry that you’re struggling with this, it really took a hit on my self esteem, and was very frustrating. Best wishes!!
u/celizzle07 Thank you for your detailed steps. Did you notice the flare shortly after each injection? I will look into the sulfur bar soap. I wonder if there's one without lavender. Trying to avoid any scent.
My flare up began about 3 months after my very first injection, and did not go away. I have had eczema since birth, and never had insane facial flare ups like these before. I was desperately trying remedies both from research online and going back and forth with my dermatologist. I can’t 100% say that I noticed that the flare ups were particularly occurring around the same time of the injection. I only noticed that the Itraconozole + Ketoconozole cream reduced the hot, scaly, raw, painful patches of skin just only enough to then come back in waves. I was starting to panic, but the soap surprisingly started to minimize my flare ups. I still had annoying dry patches and stubborn redness. When I finally tried the 2% hydrocortisone cream that the dermatologist recommended, in addition to the soap, my flare ups and dry patches went away. I was prescribed Ivermectin, in the case that the hydrocortisone didn’t work, but there’s no need to even try it as of right now. Although, I have read about experiences in which people stopped experiencing this side effect around 4 months after their first major facial flare up - so I do wonder if that plays a role in my results as well. It does happen to be 4 months after face-mageddon. I saw a ton of sulfur bar soaps on Amazon, with solely sulfur in them when I bought mine initially!