Re: Klaron instead of Noritate?

[Guest guest]

Hi All--perhaps someone can help me. Went to my derm

today and he gave me Klaron for the bumps/papules.

When I asked how to apply it--before or after

Noritate--he said to discontinue to Noritate. I was

confused! I said, but I thought I would be using this

cream " forever. " Quoting his words back in Dec. when

I was diagnosed with cea. He said he didn't think

it was helping me and to discontinue it. For some

background - I started with Metrocream in Dec., and

changed to Noritate in Jan. because that's when I

started to break out more. Then in February, I

started tetracycline. Is anyone out there using

Klaron (with or without using Noritate)? My big fear

is in 2 months I'll go back and he'll put me back on

Noritate and I'll have to start all over

again.....Today My derm. also gave me an RX for

Doxycycline instead of the tetracyline.

My derm. was not familiar with the other oral

antibiotics Dr. Nase mentions, or using antihistimines

to treat flushing for rosacea. In fact we was very

surprised by the thickness of Dr. Nase's book! He's a

nice guy, but getting close to retirement--perhaps

it's time to find a new derm. Confused as ever here

in NY. Anyone with experience with Karon or

Doxycycline or stopping Noritate -- please educate me!

Many thanks! Michele

__________________________________________________

[Guest guest]

Hi All--perhaps someone can help me. Went to my derm

today and he gave me Klaron for the bumps/papules.

When I asked how to apply it--before or after

Noritate--he said to discontinue to Noritate. I was

confused! I said, but I thought I would be using this

cream " forever. " Quoting his words back in Dec. when

I was diagnosed with cea. He said he didn't think

it was helping me and to discontinue it. For some

background - I started with Metrocream in Dec., and

changed to Noritate in Jan. because that's when I

started to break out more. Then in February, I

started tetracycline. Is anyone out there using

Klaron (with or without using Noritate)? My big fear

is in 2 months I'll go back and he'll put me back on

Noritate and I'll have to start all over

again.....Today My derm. also gave me an RX for

Doxycycline instead of the tetracyline.

My derm. was not familiar with the other oral

antibiotics Dr. Nase mentions, or using antihistimines

to treat flushing for rosacea. In fact we was very

surprised by the thickness of Dr. Nase's book! He's a

nice guy, but getting close to retirement--perhaps

it's time to find a new derm. Confused as ever here

in NY. Anyone with experience with Karon or

Doxycycline or stopping Noritate -- please educate me!

Many thanks! Michele

__________________________________________________

[Guest guest]

Hi All--perhaps someone can help me. Went to my derm

today and he gave me Klaron for the bumps/papules.

When I asked how to apply it--before or after

Noritate--he said to discontinue to Noritate. I was

confused! I said, but I thought I would be using this

cream " forever. " Quoting his words back in Dec. when

I was diagnosed with cea. He said he didn't think

it was helping me and to discontinue it. For some

background - I started with Metrocream in Dec., and

changed to Noritate in Jan. because that's when I

started to break out more. Then in February, I

started tetracycline. Is anyone out there using

Klaron (with or without using Noritate)? My big fear

is in 2 months I'll go back and he'll put me back on

Noritate and I'll have to start all over

again.....Today My derm. also gave me an RX for

Doxycycline instead of the tetracyline.

My derm. was not familiar with the other oral

antibiotics Dr. Nase mentions, or using antihistimines

to treat flushing for rosacea. In fact we was very

surprised by the thickness of Dr. Nase's book! He's a

nice guy, but getting close to retirement--perhaps

it's time to find a new derm. Confused as ever here

in NY. Anyone with experience with Karon or

Doxycycline or stopping Noritate -- please educate me!

Many thanks! Michele

__________________________________________________

[Guest guest]

Michele, Klaron is another topical antibiotic like Noritate. The

mechanism of action for all these topicals are as anti-inflammatory

agents so only one is used at a time, but some people do better with

one antibiotic than with another. Klaron uses a different antibiotic,

a sulfonamide instead of metronidazole. It may be that the added

sulfur will help you. The trade-off is that sulfonamides can have

more side effects than the metronidazoles, so they aren't usually

tried first. Whatever, I hope it works for you.

Personally, I never respond to the tetracyclines, I only respond to

doxycycline. Some of my tricks: I'm careful to keep the blood level

constant by taking one of the 100 mg caps/pills every 12 hours. I

also avoid any dairy products or vitamin/mineral pills or antacids

one hour before or two hours after. That's very important, because

doxycycline is easily inactivated by those three things. Stay with

the doxycycline for at least 6 weeks before saying it doesn't help at

all; if it helps even a little, continue it for the full 12 weeks.

And be careful not to further irritate your skin with skin care

products. Use just a gentle cleanser, and the mildest water-based

moisturizer with simethicone, or basic oil product -- these act as a

protective barrier twice a day as your epidermal layer heals. The

topical antibiotic goes on before the moisturizer/oil. And your

sunblock for when you go out.

Your doctor sounds to be slowly advancing a textbook treatment of

rosacea, and he started off very gentle.

Try not to be frustrated if the Klaron doesn't work for you or if you

develop a reaction to it -- if the Doxycycline works (there's an

excellent chance it will, and you'll know in 6-12 weeks) you may just

hold off on all topical antibiotics while the doxy has a chance to

work. Then, with improved skin, Noritate may be a more effective

maintenance cream. That's how I use oral and topical antibiotics. So

don't give up on Noritate yet, though Klaron may be the answer for

you.

You aren't my patient, I'm not your doctor, but I hope that clarifies

what I suspect are your dermatologist's plan.

Good luck. Keep us posted.

Marjorie

Marjorie Lazoff, MD

> Hi All - perhaps someone can help me? Went to my

> derm. on Monday and he gave me Klaron for the

> bumps/papules. When I asked how to apply it--before

> or after Noritate--he said to discontinue the

> Noritate! I was confused! I said, " But I thought I

> would using this cream 'forever.' " Quoting his word

> back in December when I was diagnosed in Dec. and he

> gave me Metrocream. He said he didn't think the

> Noritate was helping me and to discontinue it!

>

> (This gets long here.) For some background - I started

> with Metrocream in Dec. (applied to cheeks and nose).

> Four weeks later, I called and said I'm breaking out,

> and he switched me to Noritate. At my next appt. in

> Feb. he told me to apply the Noritate all over my

> face--not just cheeks and nose. (I was breaking out on

> my forehead, between my eyebrows, temple and

> chin--these areas are not red, nor are they

> flakey--just small bumps/papules--some flesh colored

> and some light red in color. Some felt like a pin

> prick to the touch, others did not.) He also gave me

> tetracycline 250 mg. 2x's a day, which he then

> increased 3 weeks later to 500 mg 2x's a day, as I

> looked liked " possible perioral derm., or just rosacea

> kicking in per the diagnosis. "

>

> Is anyone out there using Klaron (with or without

> Noritate)? My big fear is in 2 months I'll go back

> and he will put me on Noritate again and I'll have to

> start all over from square one. On Monday he also

> switched me to doxycycline instead of tetracycline.

> My chin cleared last week finally!, so what he saw is

> my bumps on one temple, forehead, sides of nose

> (between nose and cheeks), few on my nose, and between

> eyebrows. Again these areas are not red (well nose is

> a bit pink), nor dry or nor flakey. T-zone is a bit

> oily though. The bumps are light red or flesh

> colored. My cheeks are red (blotchy), but not bumpy,

> skin is smooth, and I have spider veins on cheeks and

> bridge of nose.

>

> Prior to all this I have not taken any antibiotics,

> with the exception of having step throat late in

> August, which I took Zithromax. I am allergic to

> Penicillin.

>

> My derm was not familiar with the other oral

> antibiotics Dr. Nase mentions or using antihistimines

> to treat flushing for rosacea. In fact he was very

> surprised by the thickness of Dr. Nase's book! He's a

> nice guy and getting close to retirement--perhaps it's

> time if find a new derm? Confused as ever here in

> NY. Anyone with experience with Klaron or Doxycycline

> (after using tetra.) or stopping Noritate --please

> educate me!

>

> BTW--Also trying to identify triggers--can't say I've

> found positive proof of any foods--other than spicey

> and alcohol. Which I didn't eat/use much in the past,

> and don't do at all now. Have greatly increased my

> water intake. Using Dr. Sy's flushing remedity,

> taking Vit. C and Niacinimide. I use vita oil and

> Zinko. Watching and limited carbs and sugars (I used

> to be a cookie monster!) Eating lots of veggies, and

> making Matija's soup! My big hurdles are heat and

> stress..... I used to drink 1 diet coke everyday, but

> even gave that up! Never been a coffee or tea drinker

> either; I'm 41. Sorry this is so long. Any thoughts?

> Michele

>

> __________________________________________________

>

[Guest guest]

Michele, Klaron is another topical antibiotic like Noritate. The

mechanism of action for all these topicals are as anti-inflammatory

agents so only one is used at a time, but some people do better with

one antibiotic than with another. Klaron uses a different antibiotic,

a sulfonamide instead of metronidazole. It may be that the added

sulfur will help you. The trade-off is that sulfonamides can have

more side effects than the metronidazoles, so they aren't usually

tried first. Whatever, I hope it works for you.

Personally, I never respond to the tetracyclines, I only respond to

doxycycline. Some of my tricks: I'm careful to keep the blood level

constant by taking one of the 100 mg caps/pills every 12 hours. I

also avoid any dairy products or vitamin/mineral pills or antacids

one hour before or two hours after. That's very important, because

doxycycline is easily inactivated by those three things. Stay with

the doxycycline for at least 6 weeks before saying it doesn't help at

all; if it helps even a little, continue it for the full 12 weeks.

And be careful not to further irritate your skin with skin care

products. Use just a gentle cleanser, and the mildest water-based

moisturizer with simethicone, or basic oil product -- these act as a

protective barrier twice a day as your epidermal layer heals. The

topical antibiotic goes on before the moisturizer/oil. And your

sunblock for when you go out.

Your doctor sounds to be slowly advancing a textbook treatment of

rosacea, and he started off very gentle.

Try not to be frustrated if the Klaron doesn't work for you or if you

develop a reaction to it -- if the Doxycycline works (there's an

excellent chance it will, and you'll know in 6-12 weeks) you may just

hold off on all topical antibiotics while the doxy has a chance to

work. Then, with improved skin, Noritate may be a more effective

maintenance cream. That's how I use oral and topical antibiotics. So

don't give up on Noritate yet, though Klaron may be the answer for

you.

You aren't my patient, I'm not your doctor, but I hope that clarifies

what I suspect are your dermatologist's plan.

Good luck. Keep us posted.

Marjorie

Marjorie Lazoff, MD

> Hi All - perhaps someone can help me? Went to my

> derm. on Monday and he gave me Klaron for the

> bumps/papules. When I asked how to apply it--before

> or after Noritate--he said to discontinue the

> Noritate! I was confused! I said, " But I thought I

> would using this cream 'forever.' " Quoting his word

> back in December when I was diagnosed in Dec. and he

> gave me Metrocream. He said he didn't think the

> Noritate was helping me and to discontinue it!

>

> (This gets long here.) For some background - I started

> with Metrocream in Dec. (applied to cheeks and nose).

> Four weeks later, I called and said I'm breaking out,

> and he switched me to Noritate. At my next appt. in

> Feb. he told me to apply the Noritate all over my

> face--not just cheeks and nose. (I was breaking out on

> my forehead, between my eyebrows, temple and

> chin--these areas are not red, nor are they

> flakey--just small bumps/papules--some flesh colored

> and some light red in color. Some felt like a pin

> prick to the touch, others did not.) He also gave me

> tetracycline 250 mg. 2x's a day, which he then

> increased 3 weeks later to 500 mg 2x's a day, as I

> looked liked " possible perioral derm., or just rosacea

> kicking in per the diagnosis. "

>

> Is anyone out there using Klaron (with or without

> Noritate)? My big fear is in 2 months I'll go back

> and he will put me on Noritate again and I'll have to

> start all over from square one. On Monday he also

> switched me to doxycycline instead of tetracycline.

> My chin cleared last week finally!, so what he saw is

> my bumps on one temple, forehead, sides of nose

> (between nose and cheeks), few on my nose, and between

> eyebrows. Again these areas are not red (well nose is

> a bit pink), nor dry or nor flakey. T-zone is a bit

> oily though. The bumps are light red or flesh

> colored. My cheeks are red (blotchy), but not bumpy,

> skin is smooth, and I have spider veins on cheeks and

> bridge of nose.

>

> Prior to all this I have not taken any antibiotics,

> with the exception of having step throat late in

> August, which I took Zithromax. I am allergic to

> Penicillin.

>

> My derm was not familiar with the other oral

> antibiotics Dr. Nase mentions or using antihistimines

> to treat flushing for rosacea. In fact he was very

> surprised by the thickness of Dr. Nase's book! He's a

> nice guy and getting close to retirement--perhaps it's

> time if find a new derm? Confused as ever here in

> NY. Anyone with experience with Klaron or Doxycycline

> (after using tetra.) or stopping Noritate --please

> educate me!

>

> BTW--Also trying to identify triggers--can't say I've

> found positive proof of any foods--other than spicey

> and alcohol. Which I didn't eat/use much in the past,

> and don't do at all now. Have greatly increased my

> water intake. Using Dr. Sy's flushing remedity,

> taking Vit. C and Niacinimide. I use vita oil and

> Zinko. Watching and limited carbs and sugars (I used

> to be a cookie monster!) Eating lots of veggies, and

> making Matija's soup! My big hurdles are heat and

> stress..... I used to drink 1 diet coke everyday, but

> even gave that up! Never been a coffee or tea drinker

> either; I'm 41. Sorry this is so long. Any thoughts?

> Michele

>

> __________________________________________________

>

[Guest guest]

>

> Michele, Klaron is another topical antibiotic like Noritate. The

> mechanism of action for all these topicals are as anti-inflammatory

> agents so only one is used at a time, but some people do better

with

> one antibiotic than with another. Klaron uses a different

antibiotic,

> a sulfonamide instead of metronidazole. It may be that the added

> sulfur will help you. The trade-off is that sulfonamides can have

> more side effects than the metronidazoles, so they aren't usually

> tried first. Whatever, I hope it works for you.

Metronidazole is pretty much used for its anti-inflammatory effects.

One slight better point in favor of Na Sulfacetamide (Klaron) is that

it covers for gram negatives. Klaron is free of sulfer, unlike the

sulfacet/novacet/plexions. Sulfer is decidedly bad for the skin long

term as it is a subversive comedogenic -- while masking inflammatory

eruptions by being anti-inflammatory.

>

> Personally, I never respond to the tetracyclines, I only respond to

> doxycycline. Some of my tricks: I'm careful to keep the blood level

> constant by taking one of the 100 mg caps/pills every 12 hours. I

> also avoid any dairy products or vitamin/mineral pills or antacids

> one hour before or two hours after. That's very important, because

> doxycycline is easily inactivated by those three things. Stay with

> the doxycycline for at least 6 weeks before saying it doesn't help

at

> all; if it helps even a little, continue it for the full 12 weeks.

>

Better, get branded Minocin or Dynacin, 100 mg q 12 h. Food or w/o

food, just stay away from the minerals.

If the tetracylines do not work, the culture for staph aureus, or

gram negatives and treat appropriately.

> And be careful not to further irritate your skin with skin care

> products. Use just a gentle cleanser, and the mildest water-based

> moisturizer with simethicone, or basic oil product -- these act as

a

> protective barrier twice a day as your epidermal layer heals. The

> topical antibiotic goes on before the moisturizer/oil. And your

> sunblock for when you go out.

>

I agree that the bid washing is better. Why exactly??

> Your doctor sounds to be slowly advancing a textbook treatment of

> rosacea, and he started off very gentle.

>

> Try not to be frustrated if the Klaron doesn't work for you or if

you

> develop a reaction to it -- if the Doxycycline works (there's an

> excellent chance it will, and you'll know in 6-12 weeks) you may

just

> hold off on all topical antibiotics while the doxy has a chance to

> work. Then, with improved skin, Noritate may be a more effective

> maintenance cream. That's how I use oral and topical antibiotics.

So

> don't give up on Noritate yet, though Klaron may be the answer for

> you.

>

> You aren't my patient, I'm not your doctor, but I hope that

clarifies

> what I suspect are your dermatologist's plan.

>

> Good luck. Keep us posted.

Keep rotating topical antibiotics and you're asking for resistance.

Better to get on 100 mg bid minocyline and if that doesn't work after

two months, then get on zithromax 500 mg day one and 250 mg

thereafter. If that doesn't work, get on low dose accutane.

>

> Marjorie

>

> Marjorie Lazoff, MD

>

>

> > Hi All - perhaps someone can help me? Went to my

> > derm. on Monday and he gave me Klaron for the

> > bumps/papules. When I asked how to apply it--before

> > or after Noritate--he said to discontinue the

> > Noritate! I was confused! I said, " But I thought I

> > would using this cream 'forever.' " Quoting his word

> > back in December when I was diagnosed in Dec. and he

> > gave me Metrocream. He said he didn't think the

> > Noritate was helping me and to discontinue it!

For topicals to exert their benificial effect, it can take up to

three months. Topical retinoids can take towards the end of this

spectrum, especially if a ramp up dosage schedule is followed. The

fastest acting topical for pustules is eith benzaclin or sulfacet

types (though they contain sulfur).

> >

> > (This gets long here.) For some background - I started

> > with Metrocream in Dec. (applied to cheeks and nose).

> > Four weeks later, I called and said I'm breaking out,

> > and he switched me to Noritate. At my next appt. in

> > Feb. he told me to apply the Noritate all over my

> > face--not just cheeks and nose. (I was breaking out on

> > my forehead, between my eyebrows, temple and

> > chin--these areas are not red, nor are they

> > flakey--just small bumps/papules--some flesh colored

> > and some light red in color. Some felt like a pin

> > prick to the touch, others did not.) He also gave me

> > tetracycline 250 mg. 2x's a day, which he then

> > increased 3 weeks later to 500 mg 2x's a day, as I

> > looked liked " possible perioral derm., or just rosacea

> > kicking in per the diagnosis. "

> >

Somthing in noritate and/or metro triplets is irritating you.

Probably not metronidazole, though. Probably a secondary

ingredient. You could patch test with metronidazole in a known non

irritating base if you really want to know, or just get on a real

oral antibiotic (not tetracyline)

> > Is anyone out there using Klaron (with or without

> > Noritate)? My big fear is in 2 months I'll go back

> > and he will put me on Noritate again and I'll have to

> > start all over from square one. On Monday he also

> > switched me to doxycycline instead of tetracycline.

> > My chin cleared last week finally!, so what he saw is

> > my bumps on one temple, forehead, sides of nose

> > (between nose and cheeks), few on my nose, and between

> > eyebrows. Again these areas are not red (well nose is

> > a bit pink), nor dry or nor flakey. T-zone is a bit

> > oily though. The bumps are light red or flesh

> > colored. My cheeks are red (blotchy), but not bumpy,

> > skin is smooth, and I have spider veins on cheeks and

> > bridge of nose.

> >

doxy is a step in the right direction. it's time to step up to

minocyline.

> > Prior to all this I have not taken any antibiotics,

> > with the exception of having step throat late in

> > August, which I took Zithromax. I am allergic to

> > Penicillin.

> >

Zithromax has the advantage over mincyline -- high skin levels,

activity against staph aureus, etc, possibly better anti-

inflammatory. However, you probably want to reserve zithromax for

uri's. Your topical antibiotics will select for resistance and

plasmids can be transferred to sinus flora. Plasmids with resistance

to metros and sulfonamides can also carrry resistance for uri

antibiotics, and it is documented that skin bacteria can transfer

cross species, as well. Additionally, I recall a study (look on

pubmed) showing metonidazole percutaneously absorbed and transferred

via sinus secrections to the gi tract, causing resistance of gi

flora -- which would then lead to other resistance.

> > My derm was not familiar with the other oral

> > antibiotics Dr. Nase mentions or using antihistimines

> > to treat flushing for rosacea. In fact he was very

> > surprised by the thickness of Dr. Nase's book! He's a

> > nice guy and getting close to retirement--perhaps it's

> > time if find a new derm? Confused as ever here in

> > NY. Anyone with experience with Klaron or Doxycycline

> > (after using tetra.) or stopping Noritate --please

> > educate me!

> >

Nase favored biaxin over zithro in his book, but he never tried

zithro. I favor zithro. I believe zithro has higher skin levels.

and favor zithro as well. Copy the newer antibiotic

section and refernces and give it to him.

> > BTW--Also trying to identify triggers--can't say I've

> > found positive proof of any foods--other than spicey

> > and alcohol. Which I didn't eat/use much in the past,

> > and don't do at all now. Have greatly increased my

> > water intake. Using Dr. Sy's flushing remedity,

> > taking Vit. C and Niacinimide. I use vita oil and

> > Zinko. Watching and limited carbs and sugars (I used

> > to be a cookie monster!) Eating lots of veggies, and

> > making Matija's soup! My big hurdles are heat and

> > stress..... I used to drink 1 diet coke everyday, but

> > even gave that up! Never been a coffee or tea drinker

> > either; I'm 41. Sorry this is so long. Any thoughts?

> > Michele

> >

> > __________________________________________________

> >

[Guest guest]

>

> Michele, Klaron is another topical antibiotic like Noritate. The

> mechanism of action for all these topicals are as anti-inflammatory

> agents so only one is used at a time, but some people do better

with

> one antibiotic than with another. Klaron uses a different

antibiotic,

> a sulfonamide instead of metronidazole. It may be that the added

> sulfur will help you. The trade-off is that sulfonamides can have

> more side effects than the metronidazoles, so they aren't usually

> tried first. Whatever, I hope it works for you.

Metronidazole is pretty much used for its anti-inflammatory effects.

One slight better point in favor of Na Sulfacetamide (Klaron) is that

it covers for gram negatives. Klaron is free of sulfer, unlike the

sulfacet/novacet/plexions. Sulfer is decidedly bad for the skin long

term as it is a subversive comedogenic -- while masking inflammatory

eruptions by being anti-inflammatory.

>

> Personally, I never respond to the tetracyclines, I only respond to

> doxycycline. Some of my tricks: I'm careful to keep the blood level

> constant by taking one of the 100 mg caps/pills every 12 hours. I

> also avoid any dairy products or vitamin/mineral pills or antacids

> one hour before or two hours after. That's very important, because

> doxycycline is easily inactivated by those three things. Stay with

> the doxycycline for at least 6 weeks before saying it doesn't help

at

> all; if it helps even a little, continue it for the full 12 weeks.

>

Better, get branded Minocin or Dynacin, 100 mg q 12 h. Food or w/o

food, just stay away from the minerals.

If the tetracylines do not work, the culture for staph aureus, or

gram negatives and treat appropriately.

> And be careful not to further irritate your skin with skin care

> products. Use just a gentle cleanser, and the mildest water-based

> moisturizer with simethicone, or basic oil product -- these act as

a

> protective barrier twice a day as your epidermal layer heals. The

> topical antibiotic goes on before the moisturizer/oil. And your

> sunblock for when you go out.

>

I agree that the bid washing is better. Why exactly??

> Your doctor sounds to be slowly advancing a textbook treatment of

> rosacea, and he started off very gentle.

>

> Try not to be frustrated if the Klaron doesn't work for you or if

you

> develop a reaction to it -- if the Doxycycline works (there's an

> excellent chance it will, and you'll know in 6-12 weeks) you may

just

> hold off on all topical antibiotics while the doxy has a chance to

> work. Then, with improved skin, Noritate may be a more effective

> maintenance cream. That's how I use oral and topical antibiotics.

So

> don't give up on Noritate yet, though Klaron may be the answer for

> you.

>

> You aren't my patient, I'm not your doctor, but I hope that

clarifies

> what I suspect are your dermatologist's plan.

>

> Good luck. Keep us posted.

Keep rotating topical antibiotics and you're asking for resistance.

Better to get on 100 mg bid minocyline and if that doesn't work after

two months, then get on zithromax 500 mg day one and 250 mg

thereafter. If that doesn't work, get on low dose accutane.

>

> Marjorie

>

> Marjorie Lazoff, MD

>

>

> > Hi All - perhaps someone can help me? Went to my

> > derm. on Monday and he gave me Klaron for the

> > bumps/papules. When I asked how to apply it--before

> > or after Noritate--he said to discontinue the

> > Noritate! I was confused! I said, " But I thought I

> > would using this cream 'forever.' " Quoting his word

> > back in December when I was diagnosed in Dec. and he

> > gave me Metrocream. He said he didn't think the

> > Noritate was helping me and to discontinue it!

For topicals to exert their benificial effect, it can take up to

three months. Topical retinoids can take towards the end of this

spectrum, especially if a ramp up dosage schedule is followed. The

fastest acting topical for pustules is eith benzaclin or sulfacet

types (though they contain sulfur).

> >

> > (This gets long here.) For some background - I started

> > with Metrocream in Dec. (applied to cheeks and nose).

> > Four weeks later, I called and said I'm breaking out,

> > and he switched me to Noritate. At my next appt. in

> > Feb. he told me to apply the Noritate all over my

> > face--not just cheeks and nose. (I was breaking out on

> > my forehead, between my eyebrows, temple and

> > chin--these areas are not red, nor are they

> > flakey--just small bumps/papules--some flesh colored

> > and some light red in color. Some felt like a pin

> > prick to the touch, others did not.) He also gave me

> > tetracycline 250 mg. 2x's a day, which he then

> > increased 3 weeks later to 500 mg 2x's a day, as I

> > looked liked " possible perioral derm., or just rosacea

> > kicking in per the diagnosis. "

> >

Somthing in noritate and/or metro triplets is irritating you.

Probably not metronidazole, though. Probably a secondary

ingredient. You could patch test with metronidazole in a known non

irritating base if you really want to know, or just get on a real

oral antibiotic (not tetracyline)

> > Is anyone out there using Klaron (with or without

> > Noritate)? My big fear is in 2 months I'll go back

> > and he will put me on Noritate again and I'll have to

> > start all over from square one. On Monday he also

> > switched me to doxycycline instead of tetracycline.

> > My chin cleared last week finally!, so what he saw is

> > my bumps on one temple, forehead, sides of nose

> > (between nose and cheeks), few on my nose, and between

> > eyebrows. Again these areas are not red (well nose is

> > a bit pink), nor dry or nor flakey. T-zone is a bit

> > oily though. The bumps are light red or flesh

> > colored. My cheeks are red (blotchy), but not bumpy,

> > skin is smooth, and I have spider veins on cheeks and

> > bridge of nose.

> >

doxy is a step in the right direction. it's time to step up to

minocyline.

> > Prior to all this I have not taken any antibiotics,

> > with the exception of having step throat late in

> > August, which I took Zithromax. I am allergic to

> > Penicillin.

> >

Zithromax has the advantage over mincyline -- high skin levels,

activity against staph aureus, etc, possibly better anti-

inflammatory. However, you probably want to reserve zithromax for

uri's. Your topical antibiotics will select for resistance and

plasmids can be transferred to sinus flora. Plasmids with resistance

to metros and sulfonamides can also carrry resistance for uri

antibiotics, and it is documented that skin bacteria can transfer

cross species, as well. Additionally, I recall a study (look on

pubmed) showing metonidazole percutaneously absorbed and transferred

via sinus secrections to the gi tract, causing resistance of gi

flora -- which would then lead to other resistance.

> > My derm was not familiar with the other oral

> > antibiotics Dr. Nase mentions or using antihistimines

> > to treat flushing for rosacea. In fact he was very

> > surprised by the thickness of Dr. Nase's book! He's a

> > nice guy and getting close to retirement--perhaps it's

> > time if find a new derm? Confused as ever here in

> > NY. Anyone with experience with Klaron or Doxycycline

> > (after using tetra.) or stopping Noritate --please

> > educate me!

> >

Nase favored biaxin over zithro in his book, but he never tried

zithro. I favor zithro. I believe zithro has higher skin levels.

and favor zithro as well. Copy the newer antibiotic

section and refernces and give it to him.

> > BTW--Also trying to identify triggers--can't say I've

> > found positive proof of any foods--other than spicey

> > and alcohol. Which I didn't eat/use much in the past,

> > and don't do at all now. Have greatly increased my

> > water intake. Using Dr. Sy's flushing remedity,

> > taking Vit. C and Niacinimide. I use vita oil and

> > Zinko. Watching and limited carbs and sugars (I used

> > to be a cookie monster!) Eating lots of veggies, and

> > making Matija's soup! My big hurdles are heat and

> > stress..... I used to drink 1 diet coke everyday, but

> > even gave that up! Never been a coffee or tea drinker

> > either; I'm 41. Sorry this is so long. Any thoughts?

> > Michele

> >

> > __________________________________________________

> >

[Guest guest]

>

> Michele, Klaron is another topical antibiotic like Noritate. The

> mechanism of action for all these topicals are as anti-inflammatory

> agents so only one is used at a time, but some people do better

with

> one antibiotic than with another. Klaron uses a different

antibiotic,

> a sulfonamide instead of metronidazole. It may be that the added

> sulfur will help you. The trade-off is that sulfonamides can have

> more side effects than the metronidazoles, so they aren't usually

> tried first. Whatever, I hope it works for you.

Metronidazole is pretty much used for its anti-inflammatory effects.

One slight better point in favor of Na Sulfacetamide (Klaron) is that

it covers for gram negatives. Klaron is free of sulfer, unlike the

sulfacet/novacet/plexions. Sulfer is decidedly bad for the skin long

term as it is a subversive comedogenic -- while masking inflammatory

eruptions by being anti-inflammatory.

>

> Personally, I never respond to the tetracyclines, I only respond to

> doxycycline. Some of my tricks: I'm careful to keep the blood level

> constant by taking one of the 100 mg caps/pills every 12 hours. I

> also avoid any dairy products or vitamin/mineral pills or antacids

> one hour before or two hours after. That's very important, because

> doxycycline is easily inactivated by those three things. Stay with

> the doxycycline for at least 6 weeks before saying it doesn't help

at

> all; if it helps even a little, continue it for the full 12 weeks.

>

Better, get branded Minocin or Dynacin, 100 mg q 12 h. Food or w/o

food, just stay away from the minerals.

If the tetracylines do not work, the culture for staph aureus, or

gram negatives and treat appropriately.

> And be careful not to further irritate your skin with skin care

> products. Use just a gentle cleanser, and the mildest water-based

> moisturizer with simethicone, or basic oil product -- these act as

a

> protective barrier twice a day as your epidermal layer heals. The

> topical antibiotic goes on before the moisturizer/oil. And your

> sunblock for when you go out.

>

I agree that the bid washing is better. Why exactly??

> Your doctor sounds to be slowly advancing a textbook treatment of

> rosacea, and he started off very gentle.

>

> Try not to be frustrated if the Klaron doesn't work for you or if

you

> develop a reaction to it -- if the Doxycycline works (there's an

> excellent chance it will, and you'll know in 6-12 weeks) you may

just

> hold off on all topical antibiotics while the doxy has a chance to

> work. Then, with improved skin, Noritate may be a more effective

> maintenance cream. That's how I use oral and topical antibiotics.

So

> don't give up on Noritate yet, though Klaron may be the answer for

> you.

>

> You aren't my patient, I'm not your doctor, but I hope that

clarifies

> what I suspect are your dermatologist's plan.

>

> Good luck. Keep us posted.

Keep rotating topical antibiotics and you're asking for resistance.

Better to get on 100 mg bid minocyline and if that doesn't work after

two months, then get on zithromax 500 mg day one and 250 mg

thereafter. If that doesn't work, get on low dose accutane.

>

> Marjorie

>

> Marjorie Lazoff, MD

>

>

> > Hi All - perhaps someone can help me? Went to my

> > derm. on Monday and he gave me Klaron for the

> > bumps/papules. When I asked how to apply it--before

> > or after Noritate--he said to discontinue the

> > Noritate! I was confused! I said, " But I thought I

> > would using this cream 'forever.' " Quoting his word

> > back in December when I was diagnosed in Dec. and he

> > gave me Metrocream. He said he didn't think the

> > Noritate was helping me and to discontinue it!

For topicals to exert their benificial effect, it can take up to

three months. Topical retinoids can take towards the end of this

spectrum, especially if a ramp up dosage schedule is followed. The

fastest acting topical for pustules is eith benzaclin or sulfacet

types (though they contain sulfur).

> >

> > (This gets long here.) For some background - I started

> > with Metrocream in Dec. (applied to cheeks and nose).

> > Four weeks later, I called and said I'm breaking out,

> > and he switched me to Noritate. At my next appt. in

> > Feb. he told me to apply the Noritate all over my

> > face--not just cheeks and nose. (I was breaking out on

> > my forehead, between my eyebrows, temple and

> > chin--these areas are not red, nor are they

> > flakey--just small bumps/papules--some flesh colored

> > and some light red in color. Some felt like a pin

> > prick to the touch, others did not.) He also gave me

> > tetracycline 250 mg. 2x's a day, which he then

> > increased 3 weeks later to 500 mg 2x's a day, as I

> > looked liked " possible perioral derm., or just rosacea

> > kicking in per the diagnosis. "

> >

Somthing in noritate and/or metro triplets is irritating you.

Probably not metronidazole, though. Probably a secondary

ingredient. You could patch test with metronidazole in a known non

irritating base if you really want to know, or just get on a real

oral antibiotic (not tetracyline)

> > Is anyone out there using Klaron (with or without

> > Noritate)? My big fear is in 2 months I'll go back

> > and he will put me on Noritate again and I'll have to

> > start all over from square one. On Monday he also

> > switched me to doxycycline instead of tetracycline.

> > My chin cleared last week finally!, so what he saw is

> > my bumps on one temple, forehead, sides of nose

> > (between nose and cheeks), few on my nose, and between

> > eyebrows. Again these areas are not red (well nose is

> > a bit pink), nor dry or nor flakey. T-zone is a bit

> > oily though. The bumps are light red or flesh

> > colored. My cheeks are red (blotchy), but not bumpy,

> > skin is smooth, and I have spider veins on cheeks and

> > bridge of nose.

> >

doxy is a step in the right direction. it's time to step up to

minocyline.

> > Prior to all this I have not taken any antibiotics,

> > with the exception of having step throat late in

> > August, which I took Zithromax. I am allergic to

> > Penicillin.

> >

Zithromax has the advantage over mincyline -- high skin levels,

activity against staph aureus, etc, possibly better anti-

inflammatory. However, you probably want to reserve zithromax for

uri's. Your topical antibiotics will select for resistance and

plasmids can be transferred to sinus flora. Plasmids with resistance

to metros and sulfonamides can also carrry resistance for uri

antibiotics, and it is documented that skin bacteria can transfer

cross species, as well. Additionally, I recall a study (look on

pubmed) showing metonidazole percutaneously absorbed and transferred

via sinus secrections to the gi tract, causing resistance of gi

flora -- which would then lead to other resistance.

> > My derm was not familiar with the other oral

> > antibiotics Dr. Nase mentions or using antihistimines

> > to treat flushing for rosacea. In fact he was very

> > surprised by the thickness of Dr. Nase's book! He's a

> > nice guy and getting close to retirement--perhaps it's

> > time if find a new derm? Confused as ever here in

> > NY. Anyone with experience with Klaron or Doxycycline

> > (after using tetra.) or stopping Noritate --please

> > educate me!

> >

Nase favored biaxin over zithro in his book, but he never tried

zithro. I favor zithro. I believe zithro has higher skin levels.

and favor zithro as well. Copy the newer antibiotic

section and refernces and give it to him.

> > BTW--Also trying to identify triggers--can't say I've

> > found positive proof of any foods--other than spicey

> > and alcohol. Which I didn't eat/use much in the past,

> > and don't do at all now. Have greatly increased my

> > water intake. Using Dr. Sy's flushing remedity,

> > taking Vit. C and Niacinimide. I use vita oil and

> > Zinko. Watching and limited carbs and sugars (I used

> > to be a cookie monster!) Eating lots of veggies, and

> > making Matija's soup! My big hurdles are heat and

> > stress..... I used to drink 1 diet coke everyday, but

> > even gave that up! Never been a coffee or tea drinker

> > either; I'm 41. Sorry this is so long. Any thoughts?

> > Michele

> >

> > __________________________________________________

> >

[Guest guest]

Dr. Lazoff & Double 0 7:

Thank you ever so much for your responses. I shall

keep the group posted in a few weeks. I truly

appreciate your enducating me about the meds. Thank

you--I've been using moisturizer (vita oil) then the

Klaron, then sunblock. I will now use the Klaron

first! I value your input! Thanks again! Michele

--- emarjency emarjency@...> wrote:

>

>

> Michele, Klaron is another topical antibiotic like

> Noritate. The

> mechanism of action for all these topicals are as

> anti-inflammatory

> agents so only one is used at a time, but some

> people do better with

> one antibiotic than with another. Klaron uses a

> different antibiotic,

> a sulfonamide instead of metronidazole. It may be

> that the added

> sulfur will help you. The trade-off is that

> sulfonamides can have

> more side effects than the metronidazoles, so they

> aren't usually

> tried first. Whatever, I hope it works for you.

>

> Personally, I never respond to the tetracyclines, I

> only respond to

> doxycycline. Some of my tricks: I'm careful to keep

> the blood level

> constant by taking one of the 100 mg caps/pills

> every 12 hours. I

> also avoid any dairy products or vitamin/mineral

> pills or antacids

> one hour before or two hours after. That's very

> important, because

> doxycycline is easily inactivated by those three

> things. Stay with

> the doxycycline for at least 6 weeks before saying

> it doesn't help at

> all; if it helps even a little, continue it for the

> full 12 weeks.

>

> And be careful not to further irritate your skin

> with skin care

> products. Use just a gentle cleanser, and the

> mildest water-based

> moisturizer with simethicone, or basic oil product

> -- these act as a

> protective barrier twice a day as your epidermal

> layer heals. The

> topical antibiotic goes on before the

> moisturizer/oil. And your

> sunblock for when you go out.

>

> Your doctor sounds to be slowly advancing a textbook

> treatment of

> rosacea, and he started off very gentle.

>

> Try not to be frustrated if the Klaron doesn't work

> for you or if you

> develop a reaction to it -- if the Doxycycline works

> (there's an

> excellent chance it will, and you'll know in 6-12

> weeks) you may just

> hold off on all topical antibiotics while the doxy

> has a chance to

> work. Then, with improved skin, Noritate may be a

> more effective

> maintenance cream. That's how I use oral and topical

> antibiotics. So

> don't give up on Noritate yet, though Klaron may be

> the answer for

> you.

>

> You aren't my patient, I'm not your doctor, but I

> hope that clarifies

> what I suspect are your dermatologist's plan.

>

> Good luck. Keep us posted.

>

> Marjorie

>

> Marjorie Lazoff, MD

>

>

> > Hi All - perhaps someone can help me? Went to my

> > derm. on Monday and he gave me Klaron for the

> > bumps/papules. When I asked how to apply

> it--before

> > or after Noritate--he said to discontinue the

> > Noritate! I was confused! I said, " But I thought

> I

> > would using this cream 'forever.' " Quoting his

> word

> > back in December when I was diagnosed in Dec. and

> he

> > gave me Metrocream. He said he didn't think the

> > Noritate was helping me and to discontinue it!

> >

> > (This gets long here.) For some background - I

> started

> > with Metrocream in Dec. (applied to cheeks and

> nose).

> > Four weeks later, I called and said I'm breaking

> out,

> > and he switched me to Noritate. At my next appt.

> in

> > Feb. he told me to apply the Noritate all over my

> > face--not just cheeks and nose. (I was breaking

> out on

> > my forehead, between my eyebrows, temple and

> > chin--these areas are not red, nor are they

> > flakey--just small bumps/papules--some flesh

> colored

> > and some light red in color. Some felt like a pin

> > prick to the touch, others did not.) He also gave

> me

> > tetracycline 250 mg. 2x's a day, which he then

> > increased 3 weeks later to 500 mg 2x's a day, as I

> > looked liked " possible perioral derm., or just

> rosacea

> > kicking in per the diagnosis. "

> >

> > Is anyone out there using Klaron (with or without

> > Noritate)? My big fear is in 2 months I'll go

> back

> > and he will put me on Noritate again and I'll have

> to

> > start all over from square one. On Monday he also

> > switched me to doxycycline instead of

> tetracycline.

> > My chin cleared last week finally!, so what he saw

> is

> > my bumps on one temple, forehead, sides of nose

> > (between nose and cheeks), few on my nose, and

> between

> > eyebrows. Again these areas are not red (well

> nose is

> > a bit pink), nor dry or nor flakey. T-zone is a

> bit

> > oily though. The bumps are light red or flesh

> > colored. My cheeks are red (blotchy), but not

> bumpy,

> > skin is smooth, and I have spider veins on cheeks

> and

> > bridge of nose.

> >

> > Prior to all this I have not taken any

> antibiotics,

> > with the exception of having step throat late in

> > August, which I took Zithromax. I am allergic to

> > Penicillin.

> >

> > My derm was not familiar with the other oral

> > antibiotics Dr. Nase mentions or using

> antihistimines

> > to treat flushing for rosacea. In fact he was

> very

> > surprised by the thickness of Dr. Nase's book!

> He's a

> > nice guy and getting close to retirement--perhaps

> it's

> > time if find a new derm? Confused as ever here

> in

> > NY. Anyone with experience with Klaron or

> Doxycycline

> > (after using tetra.) or stopping Noritate --please

> > educate me!

> >

> > BTW--Also trying to identify triggers--can't say

> I've

> > found positive proof of any foods--other than

> spicey

> > and alcohol. Which I didn't eat/use much in the

> past,

> > and don't do at all now. Have greatly increased

> my

> > water intake. Using Dr. Sy's flushing remedity,

> > taking Vit. C and Niacinimide. I use vita oil and

> > Zinko. Watching and limited carbs and sugars (I

> used

> > to be a cookie monster!) Eating lots of veggies,

> and

> > making Matija's soup! My big hurdles are heat and

> > stress..... I used to drink 1 diet coke everyday,

> but

> > even gave that up! Never been a coffee or tea

> drinker

> > either; I'm 41. Sorry this is so long. Any

> thoughts?

> > Michele

> >

> > __________________________________________________

> >

[Guest guest]

Dr. Lazoff & Double 0 7:

Thank you ever so much for your responses. I shall

keep the group posted in a few weeks. I truly

appreciate your enducating me about the meds. Thank

you--I've been using moisturizer (vita oil) then the

Klaron, then sunblock. I will now use the Klaron

first! I value your input! Thanks again! Michele

--- emarjency emarjency@...> wrote:

>

>

> Michele, Klaron is another topical antibiotic like

> Noritate. The

> mechanism of action for all these topicals are as

> anti-inflammatory

> agents so only one is used at a time, but some

> people do better with

> one antibiotic than with another. Klaron uses a

> different antibiotic,

> a sulfonamide instead of metronidazole. It may be

> that the added

> sulfur will help you. The trade-off is that

> sulfonamides can have

> more side effects than the metronidazoles, so they

> aren't usually

> tried first. Whatever, I hope it works for you.

>

> Personally, I never respond to the tetracyclines, I

> only respond to

> doxycycline. Some of my tricks: I'm careful to keep

> the blood level

> constant by taking one of the 100 mg caps/pills

> every 12 hours. I

> also avoid any dairy products or vitamin/mineral

> pills or antacids

> one hour before or two hours after. That's very

> important, because

> doxycycline is easily inactivated by those three

> things. Stay with

> the doxycycline for at least 6 weeks before saying

> it doesn't help at

> all; if it helps even a little, continue it for the

> full 12 weeks.

>

> And be careful not to further irritate your skin

> with skin care

> products. Use just a gentle cleanser, and the

> mildest water-based

> moisturizer with simethicone, or basic oil product

> -- these act as a

> protective barrier twice a day as your epidermal

> layer heals. The

> topical antibiotic goes on before the

> moisturizer/oil. And your

> sunblock for when you go out.

>

> Your doctor sounds to be slowly advancing a textbook

> treatment of

> rosacea, and he started off very gentle.

>

> Try not to be frustrated if the Klaron doesn't work

> for you or if you

> develop a reaction to it -- if the Doxycycline works

> (there's an

> excellent chance it will, and you'll know in 6-12

> weeks) you may just

> hold off on all topical antibiotics while the doxy

> has a chance to

> work. Then, with improved skin, Noritate may be a

> more effective

> maintenance cream. That's how I use oral and topical

> antibiotics. So

> don't give up on Noritate yet, though Klaron may be

> the answer for

> you.

>

> You aren't my patient, I'm not your doctor, but I

> hope that clarifies

> what I suspect are your dermatologist's plan.

>

> Good luck. Keep us posted.

>

> Marjorie

>

> Marjorie Lazoff, MD

>

>

> > Hi All - perhaps someone can help me? Went to my

> > derm. on Monday and he gave me Klaron for the

> > bumps/papules. When I asked how to apply

> it--before

> > or after Noritate--he said to discontinue the

> > Noritate! I was confused! I said, " But I thought

> I

> > would using this cream 'forever.' " Quoting his

> word

> > back in December when I was diagnosed in Dec. and

> he

> > gave me Metrocream. He said he didn't think the

> > Noritate was helping me and to discontinue it!

> >

> > (This gets long here.) For some background - I

> started

> > with Metrocream in Dec. (applied to cheeks and

> nose).

> > Four weeks later, I called and said I'm breaking

> out,

> > and he switched me to Noritate. At my next appt.

> in

> > Feb. he told me to apply the Noritate all over my

> > face--not just cheeks and nose. (I was breaking

> out on

> > my forehead, between my eyebrows, temple and

> > chin--these areas are not red, nor are they

> > flakey--just small bumps/papules--some flesh

> colored

> > and some light red in color. Some felt like a pin

> > prick to the touch, others did not.) He also gave

> me

> > tetracycline 250 mg. 2x's a day, which he then

> > increased 3 weeks later to 500 mg 2x's a day, as I

> > looked liked " possible perioral derm., or just

> rosacea

> > kicking in per the diagnosis. "

> >

> > Is anyone out there using Klaron (with or without

> > Noritate)? My big fear is in 2 months I'll go

> back

> > and he will put me on Noritate again and I'll have

> to

> > start all over from square one. On Monday he also

> > switched me to doxycycline instead of

> tetracycline.

> > My chin cleared last week finally!, so what he saw

> is

> > my bumps on one temple, forehead, sides of nose

> > (between nose and cheeks), few on my nose, and

> between

> > eyebrows. Again these areas are not red (well

> nose is

> > a bit pink), nor dry or nor flakey. T-zone is a

> bit

> > oily though. The bumps are light red or flesh

> > colored. My cheeks are red (blotchy), but not

> bumpy,

> > skin is smooth, and I have spider veins on cheeks

> and

> > bridge of nose.

> >

> > Prior to all this I have not taken any

> antibiotics,

> > with the exception of having step throat late in

> > August, which I took Zithromax. I am allergic to

> > Penicillin.

> >

> > My derm was not familiar with the other oral

> > antibiotics Dr. Nase mentions or using

> antihistimines

> > to treat flushing for rosacea. In fact he was

> very

> > surprised by the thickness of Dr. Nase's book!

> He's a

> > nice guy and getting close to retirement--perhaps

> it's

> > time if find a new derm? Confused as ever here

> in

> > NY. Anyone with experience with Klaron or

> Doxycycline

> > (after using tetra.) or stopping Noritate --please

> > educate me!

> >

> > BTW--Also trying to identify triggers--can't say

> I've

> > found positive proof of any foods--other than

> spicey

> > and alcohol. Which I didn't eat/use much in the

> past,

> > and don't do at all now. Have greatly increased

> my

> > water intake. Using Dr. Sy's flushing remedity,

> > taking Vit. C and Niacinimide. I use vita oil and

> > Zinko. Watching and limited carbs and sugars (I

> used

> > to be a cookie monster!) Eating lots of veggies,

> and

> > making Matija's soup! My big hurdles are heat and

> > stress..... I used to drink 1 diet coke everyday,

> but

> > even gave that up! Never been a coffee or tea

> drinker

> > either; I'm 41. Sorry this is so long. Any

> thoughts?

> > Michele

> >

> > __________________________________________________

> >

[Guest guest]

Dr. Lazoff & Double 0 7:

Thank you ever so much for your responses. I shall

keep the group posted in a few weeks. I truly

appreciate your enducating me about the meds. Thank

you--I've been using moisturizer (vita oil) then the

Klaron, then sunblock. I will now use the Klaron

first! I value your input! Thanks again! Michele

--- emarjency emarjency@...> wrote:

>

>

> Michele, Klaron is another topical antibiotic like

> Noritate. The

> mechanism of action for all these topicals are as

> anti-inflammatory

> agents so only one is used at a time, but some

> people do better with

> one antibiotic than with another. Klaron uses a

> different antibiotic,

> a sulfonamide instead of metronidazole. It may be

> that the added

> sulfur will help you. The trade-off is that

> sulfonamides can have

> more side effects than the metronidazoles, so they

> aren't usually

> tried first. Whatever, I hope it works for you.

>

> Personally, I never respond to the tetracyclines, I

> only respond to

> doxycycline. Some of my tricks: I'm careful to keep

> the blood level

> constant by taking one of the 100 mg caps/pills

> every 12 hours. I

> also avoid any dairy products or vitamin/mineral

> pills or antacids

> one hour before or two hours after. That's very

> important, because

> doxycycline is easily inactivated by those three

> things. Stay with

> the doxycycline for at least 6 weeks before saying

> it doesn't help at

> all; if it helps even a little, continue it for the

> full 12 weeks.

>

> And be careful not to further irritate your skin

> with skin care

> products. Use just a gentle cleanser, and the

> mildest water-based

> moisturizer with simethicone, or basic oil product

> -- these act as a

> protective barrier twice a day as your epidermal

> layer heals. The

> topical antibiotic goes on before the

> moisturizer/oil. And your

> sunblock for when you go out.

>

> Your doctor sounds to be slowly advancing a textbook

> treatment of

> rosacea, and he started off very gentle.

>

> Try not to be frustrated if the Klaron doesn't work

> for you or if you

> develop a reaction to it -- if the Doxycycline works

> (there's an

> excellent chance it will, and you'll know in 6-12

> weeks) you may just

> hold off on all topical antibiotics while the doxy

> has a chance to

> work. Then, with improved skin, Noritate may be a

> more effective

> maintenance cream. That's how I use oral and topical

> antibiotics. So

> don't give up on Noritate yet, though Klaron may be

> the answer for

> you.

>

> You aren't my patient, I'm not your doctor, but I

> hope that clarifies

> what I suspect are your dermatologist's plan.

>

> Good luck. Keep us posted.

>

> Marjorie

>

> Marjorie Lazoff, MD

>

>

> > Hi All - perhaps someone can help me? Went to my

> > derm. on Monday and he gave me Klaron for the

> > bumps/papules. When I asked how to apply

> it--before

> > or after Noritate--he said to discontinue the

> > Noritate! I was confused! I said, " But I thought

> I

> > would using this cream 'forever.' " Quoting his

> word

> > back in December when I was diagnosed in Dec. and

> he

> > gave me Metrocream. He said he didn't think the

> > Noritate was helping me and to discontinue it!

> >

> > (This gets long here.) For some background - I

> started

> > with Metrocream in Dec. (applied to cheeks and

> nose).

> > Four weeks later, I called and said I'm breaking

> out,

> > and he switched me to Noritate. At my next appt.

> in

> > Feb. he told me to apply the Noritate all over my

> > face--not just cheeks and nose. (I was breaking

> out on

> > my forehead, between my eyebrows, temple and

> > chin--these areas are not red, nor are they

> > flakey--just small bumps/papules--some flesh

> colored

> > and some light red in color. Some felt like a pin

> > prick to the touch, others did not.) He also gave

> me

> > tetracycline 250 mg. 2x's a day, which he then

> > increased 3 weeks later to 500 mg 2x's a day, as I

> > looked liked " possible perioral derm., or just

> rosacea

> > kicking in per the diagnosis. "

> >

> > Is anyone out there using Klaron (with or without

> > Noritate)? My big fear is in 2 months I'll go

> back

> > and he will put me on Noritate again and I'll have

> to

> > start all over from square one. On Monday he also

> > switched me to doxycycline instead of

> tetracycline.

> > My chin cleared last week finally!, so what he saw

> is

> > my bumps on one temple, forehead, sides of nose

> > (between nose and cheeks), few on my nose, and

> between

> > eyebrows. Again these areas are not red (well

> nose is

> > a bit pink), nor dry or nor flakey. T-zone is a

> bit

> > oily though. The bumps are light red or flesh

> > colored. My cheeks are red (blotchy), but not

> bumpy,

> > skin is smooth, and I have spider veins on cheeks

> and

> > bridge of nose.

> >

> > Prior to all this I have not taken any

> antibiotics,

> > with the exception of having step throat late in

> > August, which I took Zithromax. I am allergic to

> > Penicillin.

> >

> > My derm was not familiar with the other oral

> > antibiotics Dr. Nase mentions or using

> antihistimines

> > to treat flushing for rosacea. In fact he was

> very

> > surprised by the thickness of Dr. Nase's book!

> He's a

> > nice guy and getting close to retirement--perhaps

> it's

> > time if find a new derm? Confused as ever here

> in

> > NY. Anyone with experience with Klaron or

> Doxycycline

> > (after using tetra.) or stopping Noritate --please

> > educate me!

> >

> > BTW--Also trying to identify triggers--can't say

> I've

> > found positive proof of any foods--other than

> spicey

> > and alcohol. Which I didn't eat/use much in the

> past,

> > and don't do at all now. Have greatly increased

> my

> > water intake. Using Dr. Sy's flushing remedity,

> > taking Vit. C and Niacinimide. I use vita oil and

> > Zinko. Watching and limited carbs and sugars (I

> used

> > to be a cookie monster!) Eating lots of veggies,

> and

> > making Matija's soup! My big hurdles are heat and

> > stress..... I used to drink 1 diet coke everyday,

> but

> > even gave that up! Never been a coffee or tea

> drinker

> > either; I'm 41. Sorry this is so long. Any

> thoughts?

> > Michele

> >

> > __________________________________________________

> >

[Guest guest]

> Thank you ever so much for your responses. I shall

> keep the group posted in a few weeks. I truly

> appreciate your enducating me about the meds. Thank

> you--I've been using moisturizer (vita oil) then the

> Klaron, then sunblock. I will now use the Klaron

> first! I value your input! Thanks again! Michele

You're welcome. Just to complicate life let me say that I've

heard some advocate putting the oil on directly after cleasing, and

then the antibiotic cream. I don't subscribe to that, as I fear the

oil may interfere with the absorption of the cream, and the cream may

interfere with the oil performing its full protective function.

But if your dermatologist or Dr Sy told you differently, please

follow his/her/their advice -- not mine.

Marjorie

Marjorie Lazoff, MD

[Guest guest]

> Thank you ever so much for your responses. I shall

> keep the group posted in a few weeks. I truly

> appreciate your enducating me about the meds. Thank

> you--I've been using moisturizer (vita oil) then the

> Klaron, then sunblock. I will now use the Klaron

> first! I value your input! Thanks again! Michele

You're welcome. Just to complicate life let me say that I've

heard some advocate putting the oil on directly after cleasing, and

then the antibiotic cream. I don't subscribe to that, as I fear the

oil may interfere with the absorption of the cream, and the cream may

interfere with the oil performing its full protective function.

But if your dermatologist or Dr Sy told you differently, please

follow his/her/their advice -- not mine.

Marjorie

Marjorie Lazoff, MD

[Guest guest]

> Thank you ever so much for your responses. I shall

> keep the group posted in a few weeks. I truly

> appreciate your enducating me about the meds. Thank

> you--I've been using moisturizer (vita oil) then the

> Klaron, then sunblock. I will now use the Klaron

> first! I value your input! Thanks again! Michele

You're welcome. Just to complicate life let me say that I've

heard some advocate putting the oil on directly after cleasing, and

then the antibiotic cream. I don't subscribe to that, as I fear the

oil may interfere with the absorption of the cream, and the cream may

interfere with the oil performing its full protective function.

But if your dermatologist or Dr Sy told you differently, please

follow his/her/their advice -- not mine.

Marjorie

Marjorie Lazoff, MD

[Guest guest]

> You're welcome. Just to complicate life let me say that I've

> heard some advocate putting the oil on directly after cleasing, and

> then the antibiotic cream. I don't subscribe to that, as I fear the

> oil may interfere with the absorption of the cream, and the cream may

> interfere with the oil performing its full protective function.

This was the dilemma I had with using MetroCream and Vita K ... it didn't

seem to matter which way I did it... only one cream on your face at a time

seems to work. Thus, I gave up Vita K, it was not doing anything that I

could see anyways.

a

[Guest guest]

> You're welcome. Just to complicate life let me say that I've

> heard some advocate putting the oil on directly after cleasing, and

> then the antibiotic cream. I don't subscribe to that, as I fear the

> oil may interfere with the absorption of the cream, and the cream may

> interfere with the oil performing its full protective function.

This was the dilemma I had with using MetroCream and Vita K ... it didn't

seem to matter which way I did it... only one cream on your face at a time

seems to work. Thus, I gave up Vita K, it was not doing anything that I

could see anyways.

a

[Guest guest]

A dermatologist not familiar with minocyline??? Sounds like he's

giving you the run around. Are you in an HMO, by any chance??

These topical antibiotics aren't really useful for much more than

maintenance, after clearing, if that. You should have been on either

doxy or minocyline from the outset, full dose, 200 mg per day.

Then the creams would have had a shot at maintaining the remission.

But if you have any more than a mild mild mild case or rosacea, good

luck seeing any great improvement with noritate or klaron or both

applied in the proper order while saying a prayer to the god of

angiogenesis to spare you from suffering.

I don't really subscribe to the antihistamine theory, I'd put my

money on either minocyline, zithromax, or accutane.

>

> Hi All--perhaps someone can help me. Went to my derm

> today and he gave me Klaron for the bumps/papules.

> When I asked how to apply it--before or after

> Noritate--he said to discontinue to Noritate. I was

> confused! I said, but I thought I would be using this

> cream " forever. " Quoting his words back in Dec. when

> I was diagnosed with cea. He said he didn't think

> it was helping me and to discontinue it. For some

> background - I started with Metrocream in Dec., and

> changed to Noritate in Jan. because that's when I

> started to break out more. Then in February, I

> started tetracycline. Is anyone out there using

> Klaron (with or without using Noritate)? My big fear

> is in 2 months I'll go back and he'll put me back on

> Noritate and I'll have to start all over

> again.....Today My derm. also gave me an RX for

> Doxycycline instead of the tetracyline.

>

> My derm. was not familiar with the other oral

> antibiotics Dr. Nase mentions, or using antihistimines

> to treat flushing for rosacea. In fact we was very

> surprised by the thickness of Dr. Nase's book! He's a

> nice guy, but getting close to retirement--perhaps

> it's time to find a new derm. Confused as ever here

> in NY. Anyone with experience with Karon or

> Doxycycline or stopping Noritate -- please educate me!

> Many thanks! Michele

>

> __________________________________________________

>