Re: First post, feedback to my derms prescriptions

[Guest guest]

Art, your skin and history sound almost exactly like mine. Regarding

the lasers, I've had thirteen photoderm treatments. Eight during the

last eight months of 2001, and five more about two years ago. Also

had V-Beam treatments, Versa-Pulse treatments and Dio-lite laser

treatments.

The Photoderm seems to be the most effective at general

pinkness/redness. They use it to treat your entire flush zone,

overlapping a little bit as they go. They use the V-Beam to target

specific areas with visible tiny veins, but treat much of your face

too. Those two treatments can be used together.

If possible you should see a doctor who administers both treatments

for a consultation about which one might be more appropriate for your

skin. He should be able to give you a better answer than any of us in

this group when he examines your skin.

Try to find a doctor who has treated many cea patients.

Minocyline can be helpful, I still use it. I work with a lady who has

developed cea after having flawless skin most of her life. She's

in her late 30's now. I knew her before she had cea and it's

true, she had perfect, beautiful skin. She resisted going on

antibiotics but couldn't control the cea, it just continued to

worsen despite using the common metrogel and metrocream. She

recently started the Minocycline and is finally seeming some relief.

[Guest guest]

I was to elaborate on the my prior post in this thread because this

post is very instructive to members of this list. It shows several

things.

First, y'all need to check to see if y'all have comedones when

embarking upon a course of treatment. Generally, if you have

comedones, it is because of a keratinization disorder, i.e. acne.

this could be innately something wrong with your skin, your

environment, or more likely than not SOME TOPICAL YOU ARE APPLYING.

Ok, w/o comedones, treatment for pustules can occur without threat of

serious flare if you start retinoids. You must stay away from the

nose and nasolabial folds! With comedones, serious flare is surely

imminent. Take two weeks of full dose minocyline and no other

topicals except cetaphil BAR washing bid, and then slowly add the

topical retinoid, of which the only one rosaceans should consider is

differin gel -- maybe two nights a week for 2 weeks, three nights a

week for 2 wks, etc, tapering up to every night. Do not use any

other topicals at this time, reason being is that more likely than

not they are comedogenic. for really bad ones, you can spot treat

with benzaclin and/or azelic. spot treat only!

A better way is to use my algorithm, because the oral isotretinoin

will at the same time be anti-inflammatory and reduce sebum

production, which will minimize the flare even more than a taper up

of differin gel + minocyline.

For those w/o comedones, they will be the quickest responders to low

dose accutane, because their flare will be minimized, and they may

not even require the initial antibiotics.

also, when we have a decent full dose oral antibiotic (and so far the

only decent ones are mino and zithro), more likely than not, applying

a topical antibiotic will be antagonistic bacteriologically wise.

The only way to know for sure would be sensitivity testing using the

combination of antibiotics, but know this, you most likely will have

antagonism.

after three months all the comedones will be gone forever, as long as

you don't get any crazy ideas to start junk topicals.

Now, what I want to see are some good clinical trials comparing

minocin vs zithromax vs naprosyn vs antibiotic + nsaid combination,

to see which one will best ameliorate the initial retinoid flare.

> Art, your skin and history sound almost exactly like mine.

Regarding

> the lasers, I've had thirteen photoderm treatments. Eight during

the

> last eight months of 2001, and five more about two years ago. Also

> had V-Beam treatments, Versa-Pulse treatments and Dio-lite laser

> treatments.

>

> The Photoderm seems to be the most effective at general

> pinkness/redness. They use it to treat your entire flush zone,

> overlapping a little bit as they go. They use the V-Beam to target

> specific areas with visible tiny veins, but treat much of your face

> too. Those two treatments can be used together.

>

> If possible you should see a doctor who administers both treatments

> for a consultation about which one might be more appropriate for

your

> skin. He should be able to give you a better answer than any of us

in

> this group when he examines your skin.

>

> Try to find a doctor who has treated many cea patients.

>

> Minocyline can be helpful, I still use it. I work with a lady who

has

> developed cea after having flawless skin most of her life.

She's

> in her late 30's now. I knew her before she had cea and it's

> true, she had perfect, beautiful skin. She resisted going on

> antibiotics but couldn't control the cea, it just continued to

> worsen despite using the common metrogel and metrocream. She

> recently started the Minocycline and is finally seeming some relief.

[Guest guest]

I was to elaborate on the my prior post in this thread because this

post is very instructive to members of this list. It shows several

things.

First, y'all need to check to see if y'all have comedones when

embarking upon a course of treatment. Generally, if you have

comedones, it is because of a keratinization disorder, i.e. acne.

this could be innately something wrong with your skin, your

environment, or more likely than not SOME TOPICAL YOU ARE APPLYING.

Ok, w/o comedones, treatment for pustules can occur without threat of

serious flare if you start retinoids. You must stay away from the

nose and nasolabial folds! With comedones, serious flare is surely

imminent. Take two weeks of full dose minocyline and no other

topicals except cetaphil BAR washing bid, and then slowly add the

topical retinoid, of which the only one rosaceans should consider is

differin gel -- maybe two nights a week for 2 weeks, three nights a

week for 2 wks, etc, tapering up to every night. Do not use any

other topicals at this time, reason being is that more likely than

not they are comedogenic. for really bad ones, you can spot treat

with benzaclin and/or azelic. spot treat only!

A better way is to use my algorithm, because the oral isotretinoin

will at the same time be anti-inflammatory and reduce sebum

production, which will minimize the flare even more than a taper up

of differin gel + minocyline.

For those w/o comedones, they will be the quickest responders to low

dose accutane, because their flare will be minimized, and they may

not even require the initial antibiotics.

also, when we have a decent full dose oral antibiotic (and so far the

only decent ones are mino and zithro), more likely than not, applying

a topical antibiotic will be antagonistic bacteriologically wise.

The only way to know for sure would be sensitivity testing using the

combination of antibiotics, but know this, you most likely will have

antagonism.

after three months all the comedones will be gone forever, as long as

you don't get any crazy ideas to start junk topicals.

Now, what I want to see are some good clinical trials comparing

minocin vs zithromax vs naprosyn vs antibiotic + nsaid combination,

to see which one will best ameliorate the initial retinoid flare.

> Art, your skin and history sound almost exactly like mine.

Regarding

> the lasers, I've had thirteen photoderm treatments. Eight during

the

> last eight months of 2001, and five more about two years ago. Also

> had V-Beam treatments, Versa-Pulse treatments and Dio-lite laser

> treatments.

>

> The Photoderm seems to be the most effective at general

> pinkness/redness. They use it to treat your entire flush zone,

> overlapping a little bit as they go. They use the V-Beam to target

> specific areas with visible tiny veins, but treat much of your face

> too. Those two treatments can be used together.

>

> If possible you should see a doctor who administers both treatments

> for a consultation about which one might be more appropriate for

your

> skin. He should be able to give you a better answer than any of us

in

> this group when he examines your skin.

>

> Try to find a doctor who has treated many cea patients.

>

> Minocyline can be helpful, I still use it. I work with a lady who

has

> developed cea after having flawless skin most of her life.

She's

> in her late 30's now. I knew her before she had cea and it's

> true, she had perfect, beautiful skin. She resisted going on

> antibiotics but couldn't control the cea, it just continued to

> worsen despite using the common metrogel and metrocream. She

> recently started the Minocycline and is finally seeming some relief.

[Guest guest]

I was to elaborate on the my prior post in this thread because this

post is very instructive to members of this list. It shows several

things.

First, y'all need to check to see if y'all have comedones when

embarking upon a course of treatment. Generally, if you have

comedones, it is because of a keratinization disorder, i.e. acne.

this could be innately something wrong with your skin, your

environment, or more likely than not SOME TOPICAL YOU ARE APPLYING.

Ok, w/o comedones, treatment for pustules can occur without threat of

serious flare if you start retinoids. You must stay away from the

nose and nasolabial folds! With comedones, serious flare is surely

imminent. Take two weeks of full dose minocyline and no other

topicals except cetaphil BAR washing bid, and then slowly add the

topical retinoid, of which the only one rosaceans should consider is

differin gel -- maybe two nights a week for 2 weeks, three nights a

week for 2 wks, etc, tapering up to every night. Do not use any

other topicals at this time, reason being is that more likely than

not they are comedogenic. for really bad ones, you can spot treat

with benzaclin and/or azelic. spot treat only!

A better way is to use my algorithm, because the oral isotretinoin

will at the same time be anti-inflammatory and reduce sebum

production, which will minimize the flare even more than a taper up

of differin gel + minocyline.

For those w/o comedones, they will be the quickest responders to low

dose accutane, because their flare will be minimized, and they may

not even require the initial antibiotics.

also, when we have a decent full dose oral antibiotic (and so far the

only decent ones are mino and zithro), more likely than not, applying

a topical antibiotic will be antagonistic bacteriologically wise.

The only way to know for sure would be sensitivity testing using the

combination of antibiotics, but know this, you most likely will have

antagonism.

after three months all the comedones will be gone forever, as long as

you don't get any crazy ideas to start junk topicals.

Now, what I want to see are some good clinical trials comparing

minocin vs zithromax vs naprosyn vs antibiotic + nsaid combination,

to see which one will best ameliorate the initial retinoid flare.

> Art, your skin and history sound almost exactly like mine.

Regarding

> the lasers, I've had thirteen photoderm treatments. Eight during

the

> last eight months of 2001, and five more about two years ago. Also

> had V-Beam treatments, Versa-Pulse treatments and Dio-lite laser

> treatments.

>

> The Photoderm seems to be the most effective at general

> pinkness/redness. They use it to treat your entire flush zone,

> overlapping a little bit as they go. They use the V-Beam to target

> specific areas with visible tiny veins, but treat much of your face

> too. Those two treatments can be used together.

>

> If possible you should see a doctor who administers both treatments

> for a consultation about which one might be more appropriate for

your

> skin. He should be able to give you a better answer than any of us

in

> this group when he examines your skin.

>

> Try to find a doctor who has treated many cea patients.

>

> Minocyline can be helpful, I still use it. I work with a lady who

has

> developed cea after having flawless skin most of her life.

She's

> in her late 30's now. I knew her before she had cea and it's

> true, she had perfect, beautiful skin. She resisted going on

> antibiotics but couldn't control the cea, it just continued to

> worsen despite using the common metrogel and metrocream. She

> recently started the Minocycline and is finally seeming some relief.