Guest guest Posted March 26, 2002 Report Share Posted March 26, 2002 > I saw a new derm today for a second opinion. I waited for an hour, but my appointment lasted exactly six minutes. He was friendly (unlike my other Derm) but obviously way too busy to give some kid very much attention. He didnt think I had cea. He thought I had folicular acne (Yah,right, that explains the red, flushed cheeks real well). cea or acne vulgaris + rosacea?? Somtimes it's a tough call. Sometimes the treatment that is more acne oriented works for rosaceans with a lot of greast. You can have one or both at the same time. If you have any acne on your back or jawline or neck or comedones, then you have both. If you use any peels, just keep the acid away from the rosacea flush zone. They can work on some very small scars, if that is a problem. But seriously, take this dermatologist up on his offer for Zithromax. Just make sure you get enough, don't let him skimp and put you on a three times a week presciprtion. Take a Z-Pack and follow it with one 250 mg capsular tablet forever, or until you clear. He wanted to put me on these M.D. Forte products that contain alot of Glycolic acid, and put me on Azalex, and Zithromax, and for me to go off of all my cea medicines. The lady who gave me the samples even said they WOULD cause tons of redness and peeling, and stinging, and soreness, and drying, and patches etc.. Yuck.. like I need that. > Azalex has been studied for rosacea. It is anti-inflammatory, slightly expresses and clears comedones, and anti-bacterial to staph and p. acnes, though not at much as benzoyl peroxide. Dr. Nase is against it per his book, but why not try it in non flush zones. > Anyway, does anyone know anything about Azalex? He said it'd help for cea too.... but the name sounds vaguely familiar, and I think it may actually be a cea no-no... Just wondering if I should give it a try or not. Also debating about whether instead of weening slowly off my Minocycline next month (original plan) if I shouldn't switch to pulse-dosed Zithromax, and then ween off that. If you've been on minocyline for several months, at 100 mg bid, and not improved, the stop it all at once and get on Zithromax. Don't do pulsed dose Zithromax. If you're going to use it, use it right. Pulsed dose is a good recipe for resistance. You might even want to use topical benzoyl peroxide or azalex while on the Zithromax to prevent emerging resistance. The correct dose is outlined above. If you don't want antibiotics, get on Accutane and a non comedogenic oil free moisturizer with bid face washing. Another rant about antibiotic resistance. We as a society should get serious about stopping non medical antibiotic use. No antibiotics for pets, livestock, and other non humans. Also, avoid combinations of antibiotics, avoid topical antibiotics, and instead opt for full dose single regimen orals. Also the more we use low dose Accutane, the less we need to worry about emerging antibiotic resistance. Also, the more we use Accutane, the more girls we will have on oral conraceptives. Another plus, if you ask me. (either way I wanna be off antibiotics by the end of the summer, but I'm really afraid of another real bad flare like last time) Definitely not going near the Glycolic acid. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2002 Report Share Posted March 26, 2002 > I saw a new derm today for a second opinion. I waited for an hour, but my appointment lasted exactly six minutes. He was friendly (unlike my other Derm) but obviously way too busy to give some kid very much attention. He didnt think I had cea. He thought I had folicular acne (Yah,right, that explains the red, flushed cheeks real well). cea or acne vulgaris + rosacea?? Somtimes it's a tough call. Sometimes the treatment that is more acne oriented works for rosaceans with a lot of greast. You can have one or both at the same time. If you have any acne on your back or jawline or neck or comedones, then you have both. If you use any peels, just keep the acid away from the rosacea flush zone. They can work on some very small scars, if that is a problem. But seriously, take this dermatologist up on his offer for Zithromax. Just make sure you get enough, don't let him skimp and put you on a three times a week presciprtion. Take a Z-Pack and follow it with one 250 mg capsular tablet forever, or until you clear. He wanted to put me on these M.D. Forte products that contain alot of Glycolic acid, and put me on Azalex, and Zithromax, and for me to go off of all my cea medicines. The lady who gave me the samples even said they WOULD cause tons of redness and peeling, and stinging, and soreness, and drying, and patches etc.. Yuck.. like I need that. > Azalex has been studied for rosacea. It is anti-inflammatory, slightly expresses and clears comedones, and anti-bacterial to staph and p. acnes, though not at much as benzoyl peroxide. Dr. Nase is against it per his book, but why not try it in non flush zones. > Anyway, does anyone know anything about Azalex? He said it'd help for cea too.... but the name sounds vaguely familiar, and I think it may actually be a cea no-no... Just wondering if I should give it a try or not. Also debating about whether instead of weening slowly off my Minocycline next month (original plan) if I shouldn't switch to pulse-dosed Zithromax, and then ween off that. If you've been on minocyline for several months, at 100 mg bid, and not improved, the stop it all at once and get on Zithromax. Don't do pulsed dose Zithromax. If you're going to use it, use it right. Pulsed dose is a good recipe for resistance. You might even want to use topical benzoyl peroxide or azalex while on the Zithromax to prevent emerging resistance. The correct dose is outlined above. If you don't want antibiotics, get on Accutane and a non comedogenic oil free moisturizer with bid face washing. Another rant about antibiotic resistance. We as a society should get serious about stopping non medical antibiotic use. No antibiotics for pets, livestock, and other non humans. Also, avoid combinations of antibiotics, avoid topical antibiotics, and instead opt for full dose single regimen orals. Also the more we use low dose Accutane, the less we need to worry about emerging antibiotic resistance. Also, the more we use Accutane, the more girls we will have on oral conraceptives. Another plus, if you ask me. (either way I wanna be off antibiotics by the end of the summer, but I'm really afraid of another real bad flare like last time) Definitely not going near the Glycolic acid. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2002 Report Share Posted March 26, 2002 > I saw a new derm today for a second opinion. I waited for an hour, but my appointment lasted exactly six minutes. He was friendly (unlike my other Derm) but obviously way too busy to give some kid very much attention. He didnt think I had cea. He thought I had folicular acne (Yah,right, that explains the red, flushed cheeks real well). cea or acne vulgaris + rosacea?? Somtimes it's a tough call. Sometimes the treatment that is more acne oriented works for rosaceans with a lot of greast. You can have one or both at the same time. If you have any acne on your back or jawline or neck or comedones, then you have both. If you use any peels, just keep the acid away from the rosacea flush zone. They can work on some very small scars, if that is a problem. But seriously, take this dermatologist up on his offer for Zithromax. Just make sure you get enough, don't let him skimp and put you on a three times a week presciprtion. Take a Z-Pack and follow it with one 250 mg capsular tablet forever, or until you clear. He wanted to put me on these M.D. Forte products that contain alot of Glycolic acid, and put me on Azalex, and Zithromax, and for me to go off of all my cea medicines. The lady who gave me the samples even said they WOULD cause tons of redness and peeling, and stinging, and soreness, and drying, and patches etc.. Yuck.. like I need that. > Azalex has been studied for rosacea. It is anti-inflammatory, slightly expresses and clears comedones, and anti-bacterial to staph and p. acnes, though not at much as benzoyl peroxide. Dr. Nase is against it per his book, but why not try it in non flush zones. > Anyway, does anyone know anything about Azalex? He said it'd help for cea too.... but the name sounds vaguely familiar, and I think it may actually be a cea no-no... Just wondering if I should give it a try or not. Also debating about whether instead of weening slowly off my Minocycline next month (original plan) if I shouldn't switch to pulse-dosed Zithromax, and then ween off that. If you've been on minocyline for several months, at 100 mg bid, and not improved, the stop it all at once and get on Zithromax. Don't do pulsed dose Zithromax. If you're going to use it, use it right. Pulsed dose is a good recipe for resistance. You might even want to use topical benzoyl peroxide or azalex while on the Zithromax to prevent emerging resistance. The correct dose is outlined above. If you don't want antibiotics, get on Accutane and a non comedogenic oil free moisturizer with bid face washing. Another rant about antibiotic resistance. We as a society should get serious about stopping non medical antibiotic use. No antibiotics for pets, livestock, and other non humans. Also, avoid combinations of antibiotics, avoid topical antibiotics, and instead opt for full dose single regimen orals. Also the more we use low dose Accutane, the less we need to worry about emerging antibiotic resistance. Also, the more we use Accutane, the more girls we will have on oral conraceptives. Another plus, if you ask me. (either way I wanna be off antibiotics by the end of the summer, but I'm really afraid of another real bad flare like last time) Definitely not going near the Glycolic acid. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2002 Report Share Posted March 27, 2002 Just so you know- I took Zithromax (5 days) for an upper respiratory infection about a year and a half ago and it cleared my rosacea up in 3 days. I looked great for about 5 or 6 days (it was wonderful!) but my redness returned as soon as I ended my course of Zithromax. I have wondered why Drs don't prescribe it for rosacea. I couldn't take it cause it also caused all kinds of other side effects, but I would think some people could. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2002 Report Share Posted March 27, 2002 Zithromax is used and can be used for rosacea. The only real reason not to use it would be from and an ID standpoint. We want to keep zithromax working wonderfully for uri, sinusitus, lri, etc. However, if we as a society get our act together and ban antibiotic use for non humans, stop using topical antiobiotics, and always use benzoyl peroxide or azeleic acid concurrently with oral antibiotics, then this whole resistance issue would be much less bothersome. > Just so you know- I took Zithromax (5 days) for an upper respiratory > infection about a year and a half ago and it cleared my rosacea up in 3 days. > I looked great for about 5 or 6 days (it was wonderful!) but my redness > returned as soon as I ended my course of Zithromax. I have wondered why Drs > don't prescribe it for rosacea. I couldn't take it cause it also caused all > kinds of other side effects, but I would think some people could. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2002 Report Share Posted March 27, 2002 Zithromax is used and can be used for rosacea. The only real reason not to use it would be from and an ID standpoint. We want to keep zithromax working wonderfully for uri, sinusitus, lri, etc. However, if we as a society get our act together and ban antibiotic use for non humans, stop using topical antiobiotics, and always use benzoyl peroxide or azeleic acid concurrently with oral antibiotics, then this whole resistance issue would be much less bothersome. > Just so you know- I took Zithromax (5 days) for an upper respiratory > infection about a year and a half ago and it cleared my rosacea up in 3 days. > I looked great for about 5 or 6 days (it was wonderful!) but my redness > returned as soon as I ended my course of Zithromax. I have wondered why Drs > don't prescribe it for rosacea. I couldn't take it cause it also caused all > kinds of other side effects, but I would think some people could. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2002 Report Share Posted March 27, 2002 Adam, I'm an academic physician by training, so I would recommend Strong Memorial Hospital. Their general medical in particular has an excellent national reputation, and their subspecialties are highly regarded as well. Their clinics may have a sliding scale, if your health plan doesn't cover it. Regarding the phone conversation, no good doctor would do that. Have you told your doctor you'd like to spend some time sitting down with a health professional and talking over your skin condition in more detail than is practical during your appointments with him/her? Perhaps there's someone in his office who can accomodate you. Ask too for any patient education information related to your skin problem for you to look over, as a good starting point for discussions. I can't know for certain, but there's nothing I've read in your posts leads me to believe your problem is related to candida. Marjorie Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2002 Report Share Posted March 27, 2002 There are two common ways to get an appointment at a university hospital. One is to ask your present physician for a referral. He may or may not know someone on staff to refer to you directly, and hopefully (though not likely) your insurance will cover such a referral. Another way is to call the clinical department itself and ask for an appointment. If you request to be a patient in their clinic, you will probably be assigned to a physician in post-graduate or fellowship training. At most hospitals that can be hit-or-miss, but at a top hospital like Strong Memorial the residents and fellows are likely to be excellent and well-supervised, and if you aren't happy it's easy to change. It depends on your insurance or reported income as to whether or how much they will pay; unfortunately, it's no longer the free ride it was a decade or two ago. If you tell the clinical department you'd like to become a private patient you will most likely be assigned to a new staff physician and see him/her in their hospital-based practice. What your insurance doesn't cover will be an out-of-pocket expense, although they may have a sliding scale fee schedule there as well. Good luck. Let us know how it goes. Marjorie Marjorie Lazoff, MD > Adam, I'm an academic physician by training, so I would recommend > Strong Memorial Hospital. Their general medical in particular has an > excellent national reputation, and their subspecialties are highly > regarded as well. Their clinics may have a sliding scale, if your > health plan doesn't cover it. > > Regarding the phone conversation, no good doctor would do that. Have > you told your doctor you'd like to spend some time sitting down with > a health professional and talking over your skin condition in more > detail than is practical during your appointments with him/her? > Perhaps there's someone in his office who can accomodate you. Ask too > for any patient education information related to your skin problem > for you to look over, as a good starting point for discussions. > > I can't know for certain, but there's nothing I've read in your posts > leads me to believe your problem is related to candida. > > Marjorie > > Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2002 Report Share Posted March 27, 2002 There are two common ways to get an appointment at a university hospital. One is to ask your present physician for a referral. He may or may not know someone on staff to refer to you directly, and hopefully (though not likely) your insurance will cover such a referral. Another way is to call the clinical department itself and ask for an appointment. If you request to be a patient in their clinic, you will probably be assigned to a physician in post-graduate or fellowship training. At most hospitals that can be hit-or-miss, but at a top hospital like Strong Memorial the residents and fellows are likely to be excellent and well-supervised, and if you aren't happy it's easy to change. It depends on your insurance or reported income as to whether or how much they will pay; unfortunately, it's no longer the free ride it was a decade or two ago. If you tell the clinical department you'd like to become a private patient you will most likely be assigned to a new staff physician and see him/her in their hospital-based practice. What your insurance doesn't cover will be an out-of-pocket expense, although they may have a sliding scale fee schedule there as well. Good luck. Let us know how it goes. Marjorie Marjorie Lazoff, MD > Adam, I'm an academic physician by training, so I would recommend > Strong Memorial Hospital. Their general medical in particular has an > excellent national reputation, and their subspecialties are highly > regarded as well. Their clinics may have a sliding scale, if your > health plan doesn't cover it. > > Regarding the phone conversation, no good doctor would do that. Have > you told your doctor you'd like to spend some time sitting down with > a health professional and talking over your skin condition in more > detail than is practical during your appointments with him/her? > Perhaps there's someone in his office who can accomodate you. Ask too > for any patient education information related to your skin problem > for you to look over, as a good starting point for discussions. > > I can't know for certain, but there's nothing I've read in your posts > leads me to believe your problem is related to candida. > > Marjorie > > Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 27, 2002 Report Share Posted March 27, 2002 There are two common ways to get an appointment at a university hospital. One is to ask your present physician for a referral. He may or may not know someone on staff to refer to you directly, and hopefully (though not likely) your insurance will cover such a referral. Another way is to call the clinical department itself and ask for an appointment. If you request to be a patient in their clinic, you will probably be assigned to a physician in post-graduate or fellowship training. At most hospitals that can be hit-or-miss, but at a top hospital like Strong Memorial the residents and fellows are likely to be excellent and well-supervised, and if you aren't happy it's easy to change. It depends on your insurance or reported income as to whether or how much they will pay; unfortunately, it's no longer the free ride it was a decade or two ago. If you tell the clinical department you'd like to become a private patient you will most likely be assigned to a new staff physician and see him/her in their hospital-based practice. What your insurance doesn't cover will be an out-of-pocket expense, although they may have a sliding scale fee schedule there as well. Good luck. Let us know how it goes. Marjorie Marjorie Lazoff, MD > Adam, I'm an academic physician by training, so I would recommend > Strong Memorial Hospital. Their general medical in particular has an > excellent national reputation, and their subspecialties are highly > regarded as well. Their clinics may have a sliding scale, if your > health plan doesn't cover it. > > Regarding the phone conversation, no good doctor would do that. Have > you told your doctor you'd like to spend some time sitting down with > a health professional and talking over your skin condition in more > detail than is practical during your appointments with him/her? > Perhaps there's someone in his office who can accomodate you. Ask too > for any patient education information related to your skin problem > for you to look over, as a good starting point for discussions. > > I can't know for certain, but there's nothing I've read in your posts > leads me to believe your problem is related to candida. > > Marjorie > > Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
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