How to piss off a dermatologist in just 7 words...

[findingaway]

Its a beautiful day. Something felt just a tiny bit magical. Today, after 2 months of self diagnosis and my docs rather half hearted diagnosis, i was heading to a dermatologist. Finally some answers. Well, just got back from the dermatologist...

My face isn't that bad today, luckily I had taken some pictures of my flares to show him. The conversation went something like this...

Dermatologist: 'I see...does it get scaly?'
Me: 'No. Oh and i also have MGD and blephitits which is how all this started. I was outside on the swing seat in summer and came in and I had a red patch on my cheek. I thought it was sunburn, but it never went away and only got worse' I said.*
Dermatologist: 'Does it itch?'*
Me: 'No, but it does burn a lot and*I also blush a lot more then I used to and that's when it flares'*
Dermatologist: 'Hmm' he says... 'I think it's Seborrheic Dermatitits, but it could be rosacea, but I doubt it and you seriously wouldn't want that'
Me: 'Right, what about the flushing and flaring? I didn't think that was a symptom of Seborrheic Dermatitis, nor the burning' I said
Dermatologist: He shrugs 'do you flush to alcohol?'
Me: 'No, luckily I don't. But I do flush to embarrassment, excercise, cold weather, hot baths, spicy foods, stress and my skin has become very sensitive to face wash. I never used to flush to these things like this'
Dermatologist: 'I'm going to prescribe you a steroid cream, apply it...'
Me: 'I don't want to use steroid cream'
Demontologist: 'And why is that?'
Me: 'Because it may work in the short term, but if it is rosacea, then it could make it worse' I said
Demontologist: 'You shouldn't believe eveything you read. But if it does get worse, we'll cross that bridge when we come to it'
Me: 'I really don't want to risk it' i said, worried now 'maybe another treatment is available?'
Demontologist: 'This is hydrocortisone. It's the most mild of all steroids. I'm not giving you a strong one. It won't thin your skin. Apply it when your skin flares'
Me: 'With all due respect' thinking not much was due at this point 'it might also be*Keratosis pilaris rubra atrophicans faciei' I said pronouncing it completely wrong 'I hadn't even thought of it unit I saw someone on a forum had been mis-diagnosed with rosacea and was that. Apparently a white patch in the middle is typical of how it manifests on the face. That's what I have in the middle of mine. Plus, also flushing and blushing. That and rosacea seem quite similar'
Demontologist: 'It's not that. That is a horrible condition and you don't want that. Try the hydrocortisone cream and in two days it'll be gone'
Me: 'With respect, I won't use it even if you prescribe it to me'
Demontologist: 'Well what's the point of coming to see a dermatologist then?'
Me: 'So I can get am accurate diagnosis'
Demontologist: 'No one can give you an accurate diagnosis'*
Me: 'Well, there has been some research and apparently you can test for*Glycomics Analyses of Tear Fluid in the tear film'
Dermatologist: 'Well' (laughing) 'I'm not an *Optometrist, so I cannot help'
Me: 'I just thought as the skin and eye conditions are so closely related, you might be able to test rather then giving me something that might make it better or worse as you cannot give an accurate diagnosis'
Demontologist: Try the steroid cream or if you prefer I don't have to prescribe you anything'

Raised eyebrows followed and a sustained period of uncomfortable silence while he wrote out the paperwork...

So I am no further forward...I still don't really know what it is I'm dealing with... Rosacea, SD, KP. All? Some? One? Something else entirely?*

Is it a good idea to try the steroid cream? Maybe he is right?

Maybe I should posts some pics on here and get some opinions.

[DukeCity]

I think most of us have been in your shoes, very very frustrating - that's why it's so important to find a great Doc/Derm who treats rosacea consistently/daily. - Please do post some pics, we have a lot of very intelligent rosacea veterens on here, but still find a Derm that knows what they're doing.

[Brady Barrows]

Your report is now #100 of a collection I have been accumulating for some time now and can be read by clicking here. Your diagnosis was more amusing than any of the others. I would hope you could afford to get a second opinion and let us know the results. You should join the RRDi and write an article for our journal or at least ask the MAC some questions.

[findingaway]

very very frustrating

You've hit the nail on the head!

I will post some pics I think. But might just cover up my face a bit as feel a bit self conscious of being recognised.

[Peter]

Sorry to hear about your experience but unfortunately this can happen and it's not amusing when it happens to you. I had something similar happen to me with a female NHS dermatologist and it was obvious she was clueless about rosacea so I quickly moved on. Ditch this dermatologist and try and find one who has a proven track record of treating rosacea or who can at least tell you exactly which condition you have.

If you live in the UK then I would recommend you try and see Dr Tony Chu at Hammersmith hospital in London but you will need a referral from your GP. Remember as with anything there are good and bad dermatologists out there but there are plenty of good ones around although you have to be prepared to do your homework to find them.

Good luck

Peter

[findingaway]

Sorry to hear about your experience but unfortunately this can happen and it's not amusing when it happens to you. I had something similar happen to me with a female NHS dermatologist and it was obvious she was clueless about rosacea so I quickly moved on. Ditch this dermatologist and try and find one who has a proven track record of treating rosacea or who can at least tell you exactly which condition you have.

If you live in the UK then I would recommend you try and see Dr Tony Chu at Hammersmith hospital in London but you will need a referral from your GP. Remember as with anything there are good and bad dermatologists out there but there are plenty of good ones around although you have to be prepared to do your homework to find them.

Good luck

Peter

Thanks Peter,

I doubt my GP will make another referral unless it gets worse! But thanks all the same. I think I will explore some other options.

Since I adjusted my 'dose' of RLT to 10mW/cm2 for 10 mins giving 6J/cm2, my skin has been calmer. Here hopes it's cumulative!

[Peter]

I was once in a similar situation to you because the NHS dermatologist I saw also told me that I had seborrheic dermatitis, even though it would have been obvious to a proficient dermatologist that I had rosacea. Anyway after seeing her twice I went back to my GP and insisted that he referred me to Dr Chu as a private patient. I wasn't rude but just assertive because at the end of the day it was my face, my skin and I wanted the best advice and the best treatment options for it. My advice to you would be for you to do the same and if your GP isn't going to help you obtain a second opinion then change GP's - it's your right to do so.

As I told you by PM I think you have been overdoing it with your lamp. Some of these lamps are more powerful than others and not everybody can tolerate the ones that also emit IR. As with all treatments for rosacea there are never any guarantees that everybody will respond the same way with RLT so you may well have to experiment initially to work out what your best regime is e.g. every other day might be more suitable if your skin is more sensitive in the early stages. If you search for "Judworth's" story on here you will find that she had some problems to start off with RLT but eventually found that by reducing the time and frequency she started to see results.

Well I found the effects of RLT were cumulative but it does take a lot of patience and it could take a couple of years before you reap the maximum benefit if indeed you are suited to it.

Peter

[findingaway]

Hi Peter,

Yes I have slowed down now. Instead of nearly 65 J/cm2, I have reduced it to 6 J/cm2 (10 mins at a distance of 4-6cm with a 70mW/cm2 unit means it relative to a 10mW/cm2 unit) and I am starting to see results. All be it subtle.

I am willing to see a cumulative effect over 2 years if I know it is improving

How long did it take before you saw results? What were you milestones?

Thanks

[phlika29]

Sorry to hear about your experience. You wrote it in a very amusing way.

Whilst we cant offer you an official diagnosis, it may be helpful to post up a photo. As you say you can edit it to remove any features that you feel might make you recognisable.

[findingaway]

Sorry to hear about your experience. You wrote it in a very amusing way.

Whilst we cant offer you an official diagnosis, it may be helpful to post up a photo. As you say you can edit it to remove any features that you feel might make you recognisable.

You can either laugh or cry. I tend to laugh most of the time

Ok. Will post some pics up when I get a sec to edit my features out.