Ask Dr. Rockoff...

[Brady Barrows]

Dr. A. Rockoff, a board certified dermatologist, affiliated with Tufts University School of Medicine, is answering questions about rosacea at this url >

http://www.medhelp.org/forums/Dermatology/wwwboard.html

A list of some of the questions are at this url >

http://www.medhelp.org/HealthTopics/Rosacea.html

[clsykes00]

This derm causes me concern based on 2 of only 3 posts I have read of his, which follow:

---------------------

Your questions are quite perceptive. I spend a fair amount of time in my office telling people who ahve some redness or a few blood vessels, or ho fluch sometimes that they don't have roscaea. Some doctors may differ, but I consider rosacea to be pimples and pustules which may be associated with redness and flushing (but not always--blacks get rosacea too.) In any case, roscaea is most definitely not always progressive; I have plenty of patients who have an outbreak from time to time, and that's it.

A lot of the rosacea hype comes from organiations and groups supported by companies who make rosacea medicine. Although I admit my view is not shared by all, I think the condition deserves a little treatment and not much attention or concern. With that approach, I think my patients do fine.

best.

Dr. R


-----------------

Accutane may help rosacea for a while, but isn't likely to keep the condition gone for good (and rosacea tends to be chronic ir at least recurring.)

The oral contraceptive pill is likewise not that useful either for acne or rosacea. I don't rely on it, unless a patient chooses to go on the pill for conraception or hormone regulation.

On the bright side, topical and/or oral antibiotics will almost always work for rosacea. If your doctor eventually comes down firmly on the side of an acne diagnosis, then Accutane might make more sense if ll else fails.

Don't give up.

Dr. R

[clsykes00]

Another one:

There are several different light-based systems that can help blood vessels. Many are lasers. The IPL produces light that isn't laser light. Both kinds work well. The pulsed dye laser your doctor wants to use is fine for what you have.

I'm not sure why your doctor wants you to not have facials or microdermabrasion. You might ask him. These esthetic procedures help smooth the face a bit, but don't change the size of the pores. Nothing really does that.

Best.

Dr. Rockoff

[ian]

I've come across his posts every once in awhile during Google searches -- sometimes he's so rude it's hillarious. I can't tell if he's joking, or actually giving sound advice.

I like to think of him as the Simon Cowell of Dermatology.

[scrumptious]

Your questions are quite perceptive. I spend a fair amount of time in my office telling people who ahve some redness or a few blood vessels, or ho fluch sometimes that they don't have roscaea. Some doctors may differ, but I consider rosacea to be pimples and pustules which may be associated with redness and flushing (but not always--blacks get rosacea too.) In any case, roscaea is most definitely not always progressive; I have plenty of patients who have an outbreak from time to time, and that's it.

A lot of the rosacea hype comes from organiations and groups supported by companies who make rosacea medicine. Although I admit my view is not shared by all, I think the condition deserves a little treatment and not much attention or concern. With that approach, I think my patients do fine.

I think its a common misconception that there is a 'true' rosacea type that has to contain pustules, papules, permanent redness and flushing. Quite obviously that's not the case in the same way that asthmatics can be as broad a spectrum as those who only need to puff on their inhaler twice a week and those who rely on a nebuliser daily.

With that said i think there's something quite healthy about his attitude. i think its mentally counterproductive to a rosacea patient to tell them it WILL progress and there is no cure.

[hope]

I disagree. I think you should call a card a card. If a patient has resistant rosacea and all the available avenues have been persued, it's OK for a physician to be honest and say, "your screwed for the time being, but here's to hoping that the future will provide you with a cure".

This is far preferable to bull**** in my opinion.

[scrumptious]

I disagree. I think you should call a card a card. If a patient has resistant rosacea and all the available avenues have been persued, it's OK for a physician to be honest and say, "your screwed for the time being, but here's to hoping that the future will provide you with a cure".

This is far preferable to bull**** in my opinion.

I agree. However i was suggesting that if on the initial diagnosis the physician tells you there is no cure and it's antibiotics and metrogel for life, such as my dermatologist did. it makes you feel entirely hopeless.

If however you have pursue avenue after avenue and am spending out hand over fist for no results, then yes i think its germane to say 'right now there is no treatment for what you have', which is a little different to 'there is no cure'.

[hope]

agreed

[Gumbo]

Brady, are you aware that doctor doesn't believe demodex causes skin problems, which goes against your views?

[Brady Barrows]

Dr. Rockoff

Brady, are you aware that doctor doesn't believe demodex causes skin problems, which goes against your views?

Wow Gumbo, you dug this post up from the distant past out of the ash heaps. I don't even recall Dr. Rockoff nor have I followed this. I usually just post anything rosacea related and posted this in the public interest. Thanks for letting me know about Dr. Rockoff's view on demodex. Maybe with enough evidence Dr. Rockoff will change his views.

[Gumbo]

It wasn't meant to be an attack on you. I just wanted to point it out...

[Brady Barrows]

no problem.....

It wasn't meant to be an attack on you. I just wanted to point it out...

I didn't think you were attacking me. Thanks for dragging this thread back up from the dust and clearing this up for me.