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Thread: my 16 year old son may have rosacea??? questions about skin care

  1. #21
    Senior Member Brady Barrows's Avatar
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    Quote Originally Posted by browneyes View Post
    Thank you again! You just answered a question I asked on the thread. My son was treated with the Ivermectin - it was something like take 4 pills and a week later take another 4 - it did not make a difference so I now know demodectic rosacea is ruled out.
    Sounds like your doc is on top of this. Soolantra is simply topical ivermectin, so likely won't help. Suggest you read up on what other treatments have worked for phenotype 5.
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  2. #22
    Senior Member Brady Barrows's Avatar
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    Quote Originally Posted by browneyes View Post
    I have learned so much in just the few hours I have been back and forth on this site. Phenotype 5 and subtype 3 are the same? As I think back about the two doctors I have seen (actually one was a PA) I realize it was the PA that did the ANA blood test and some others to test for other diseases. He also took a sample of a pustule to rule out other things. He was also not a fan of Accutane and never suggested my son take it.

    The second doctor has been in practice for over 30 years and is a pediatric dermatologist. He is not aware of any of the tests the PA in the other practice did and he himself did not suggest we do any of those things. He treated with Ivermectin, now doxycycline, and is anxious to give him Accutane because he says he thinks he has a mix of acne and rosacea on his nose.

    I thank all of you who have responded and I have lots of learning and educating to do! I would like to know all about other treatments for phenotype 5 besides Accutane? Of course I'm just assuming he has phenotype 5 by what I have read and what my son's nose looks like.

    Are there folks who just do not treat with meds at all?
    Of course, there are some here who only treat with natural treatments. There really isn't any magic bullet. If there were, there would be no RF or RRDi.

    Everyone is so different and there are so many to choose from. The phenotype classification was just recently announced in November 2016, so the medical community has been slow to accept this superior classification over subtypes which has been around since 2002 (and has been controversial since it began). Medical literature continues to refer to the subtype classification but in time, phenotypes will be the standard. Yes, Phenotype 5 and Subtype 3 are the same. Your doctor is trying to rule out other skin conditions that mimic rosacea, which is excellent to do. If you can ask your PA to be listed on our RRDi MAC I would appreciate it, since he seems to know rosacea very well.
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  3. #23
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    Quote Originally Posted by Brady Barrows View Post
    Of course, there are some here who only treat with natural treatments. There really isn't any magic bullet. If there were, there would be no RF or RRDi.

    Everyone is so different and there are so many to choose from. The phenotype classification was just recently announced in November 2016, so the medical community has been slow to accept this superior classification over subtypes which has been around since 2002 (and has been controversial since it began). Medical literature continues to refer to the subtype classification but in time, phenotypes will be the standard. Yes, Phenotype 5 and Subtype 3 are the same. Your doctor is trying to rule out other skin conditions that mimic rosacea, which is excellent to do. If you can ask your PA to be listed on our RRDi MAC I would appreciate it, since he seems to know rosacea very well.

    Hi Brady,

    Thanks for lots of information and clarification. The PA that I saw was in a practice that I have not been to in a while. He was great and he did the ANA tests and other tests to rule out juvenile diseases. He also took a sample and had it tested. He did not give my son the oral Ivermectin but did give us the Soolantra. The PA is not a fan of Accutane and also said he didn't think my son would be a good candidate for it because he gets headaches. He suggested the Ceravu (sp) cream and other advice. After no real clear results I decided to see a pediatric dermatologist in a different practice.

    The pediatric dermatologist is the doc who gave us the oral Ivermectin and now Doxy twice a day and has made it clear that if it doesn't work he would like my son to take the Accutane. He said he is not sure and maybe it is a mix of acne and rosacea.

    I would be happy to call the PA and ask him if he would be listed on this website. I can also ask the pediatric dermatologist as well. I just received a recommendation from a friend to go to UMass Medical. He said they have a great derm team I am going to make an appt there as well.

    Thank you again!

  4. #24
    Senior Member Brady Barrows's Avatar
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    browneyes,

    A recently published paper concluded, "Expert groups and evidence-based guidelines agree that topical retinoids should be considered the foundation of acne therapy." So this article explains the increased use of retinoids by physicians over antibiotics since there is concern over antibiotic resistance. This article states, "The use of retinoids plus BPO targets multiple pathways and can often eliminate the need for antibiotics, reducing the likelihood of antibiotic resistance."

    Isotretinoin is just one of the several retinoids used to treat acne. The retinoids mentioned in the article are, "adapalene 0.1% and 0.3%; tazarotene 0.1%; tretinoin 0.01%, 0.025%, 0.038%, 0.04%, 0.05%, 0.08%, and 0.1% in the USA; isotretinoin 0.05% and 0.1% in other regions of the world" and reviews "the evidence supporting why retinoids should be considered the foundation of acne therapy (with a focus on topical retinoids)." And since you mention your son is age 16, it is noted in the article, "Both dermatologists and other physicians were less likely to prescribe a retinoid for patients aged 19 or older compared to those aged 10–19." The topical retinoids mentioned are a "fixed combination adapalene 0.3%-benzoyl peroxide (BPO) 2.5% (0.3 A/BPO; Epiduo Forte®, Galderma Laboratories) and topical retinoids (adapalene, tazarotene, or tretinoin) and Retinoids are also available in fixed-combination formulations with BPO [adapalene-BPO 0.1%/2.5% and 0.3%/2.5% (Epiduo® and Epiduo Forte®, Galderma Laboratories)] and clindamycin [tretinoin 0.025%/clindamycin phosphate 1.2% (Veltin, Aqua Pharmaceuticals; Ziana®, Valeant Pharmaceuticals)]."

    The article does address the concern of "retinoid irritation" and offers "Strategies to minimize tolerability issues" in Table 1 but does not mention anything about long term risks of 'accutane induced rosacea' which many in RF and other anecdotal reports have confirmed happens to some.
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    Quote Originally Posted by Brady Barrows View Post
    browneyes,

    A recently published paper concluded, "Expert groups and evidence-based guidelines agree that topical retinoids should be considered the foundation of acne therapy." So this article explains the increased use of retinoids by physicians over antibiotics since there is concern over antibiotic resistance. This article states, "The use of retinoids plus BPO targets multiple pathways and can often eliminate the need for antibiotics, reducing the likelihood of antibiotic resistance."

    Isotretinoin is just one of the several retinoids used to treat acne. The retinoids mentioned in the article are, "adapalene 0.1% and 0.3%; tazarotene 0.1%; tretinoin 0.01%, 0.025%, 0.038%, 0.04%, 0.05%, 0.08%, and 0.1% in the USA; isotretinoin 0.05% and 0.1% in other regions of the world" and reviews "the evidence supporting why retinoids should be considered the foundation of acne therapy (with a focus on topical retinoids)." And since you mention your son is age 16, it is noted in the article, "Both dermatologists and other physicians were less likely to prescribe a retinoid for patients aged 19 or older compared to those aged 10–19." The topical retinoids mentioned are a "fixed combination adapalene 0.3%-benzoyl peroxide (BPO) 2.5% (0.3 A/BPO; Epiduo Forte®, Galderma Laboratories) and topical retinoids (adapalene, tazarotene, or tretinoin) and Retinoids are also available in fixed-combination formulations with BPO [adapalene-BPO 0.1%/2.5% and 0.3%/2.5% (Epiduo® and Epiduo Forte®, Galderma Laboratories)] and clindamycin [tretinoin 0.025%/clindamycin phosphate 1.2% (Veltin, Aqua Pharmaceuticals; Ziana®, Valeant Pharmaceuticals)]."

    The article does address the concern of "retinoid irritation" and offers "Strategies to minimize tolerability issues" in Table 1 but does not mention anything about long term risks of 'accutane induced rosacea' which many in RF and other anecdotal reports have confirmed happens to some.

    Hi Brady,

    Thank you for passing along the paper - I am going to print it and take it to my next derm appt. After reading the article, I looked through some of the creams and gels my son has been prescribed. I know he has been prescribed Adapalene and Tretinoin but it had to be more than a couple of years ago because I don't have it and must have thrown it away because it expired. I also think it was prescribed to him when we were not being so diligent about the treatment. I do have Aczone still which I realize after reading is not a retinoid and he did use that pretty regularly and it didn't help.

    With all this said and with your help, I think it may be a good idea to try the adapalene or tretinoin again. I do think I'm going to have to make an apt with someone other than the pediatric dermatologist because he seems to be pretty adamant about the Accutane.

    The dermatologist that prescribed the retinoids did exactly what the paper you sent me stated and that was to prescribe the meds for my son who was probably about 14 at the time.

    Is Accutane available in the U.S. as a cream or gel?

    Thank you so much! His nose looks sooooo bad tonight!

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    Quote Originally Posted by browneyes View Post
    Hi Brady,

    Thank you for passing along the paper - I am going to print it and take it to my next derm appt. After reading the article, I looked through some of the creams and gels my son has been prescribed. I know he has been prescribed Adapalene and Tretinoin but it had to be more than a couple of years ago because I don't have it and must have thrown it away because it expired. I also think it was prescribed to him when we were not being so diligent about the treatment. I do have Aczone still which I realize after reading is not a retinoid and he did use that pretty regularly and it didn't help.

    With all this said and with your help, I think it may be a good idea to try the adapalene or tretinoin again. I do think I'm going to have to make an apt with someone other than the pediatric dermatologist because he seems to be pretty adamant about the Accutane.

    The dermatologist that prescribed the retinoids did exactly what the paper you sent me stated and that was to prescribe the meds for my son who was probably about 14 at the time.

    Is Accutane available in the U.S. as a cream or gel?

    Thank you so much! His nose looks sooooo bad tonight!
    I'm noticing that he has a new outbreak on the left side of his face and his face actually looks swollen.

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    Hi Brady,

    Is the Rosacea Diet appropriate for my 16 year old son...actually he will be 17 next month.

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    Hello everyone,

    I am so glad I found this Forum...while I am learning so much, I am also finding myself with many questions.

    My 17 year old son has a food allergy to tree nuts and carries and epi pen. He has a mastocytoma on his arm (I was told this is ok as long as he does not present with many of them). This mastocytoma has been on his forearm for years and he never presented with another one. It seems to get irritated or swell a bit when he exercises.

    In February he was stomach issues with severe pain. He has been taking omeprazole since and the pediatrician talked to me about H Pylori and acid, etc... We stopped the medicine for a short bit but the pain came back and so he is scheduled to have an endoscopy in 8 days but will I likely have to reschedule because he is sick. They want to check to see if he has allergic esophagitis? He has been off the doxy for a few days and was prescribed a different antibiotic and is now having a horrible acne breakout on the side of his face and it looks swollen.

    I realize my thoughts are all over the place but I wonder if some of this is related somehow. After reading many of the posts I think it would be a good idea to take him to allergist to test for other food groups and gluten and celiac???

    I actually don't know which issue to deal with first! The stomach, the allergies, the rosacea????

  9. #29
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    Heya it's hard for me to give you any advice coz it's your son and it's emotional for you both and I'm not a derm. But if his got outbreaks and there swollen then you should get him accutane ASAP.
    If the outbreaks look bad then there chances they can scar. Which in return later in life is even worse!
    I look at this way if someone has lot of outbreaks and there swollen and look painful and sore and looks irrated then I wouldn't screw around with diet and herbs and 10000 million other rosacea cures out there. Coz it can take him 10 years find out what is causing it. Just bite the bullet and go with the derm who suggested accutane.

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    Quote Originally Posted by RaymondS View Post
    Heya it's hard for me to give you any advice coz it's your son and it's emotional for you both and I'm not a derm. But if his got outbreaks and there swollen then you should get him accutane ASAP.
    If the outbreaks look bad then there chances they can scar. Which in return later in life is even worse!
    I look at this way if someone has lot of outbreaks and there swollen and look painful and sore and looks irrated then I wouldn't screw around with diet and herbs and 10000 million other rosacea cures out there. Coz it can take him 10 years find out what is causing it. Just bite the bullet and go with the derm who suggested accutane.
    Hi Raymond,
    Thanks for the reply. Yes it is very emotional...really hard for me to wrap my head around and as a cancer survivor who had plenty of chemo I wouldn't think I would be this fearful but as you say he's my son.

    I called the derm today and we went in to see him. He gave me the iPledge book and we read it and he gave me the base line blood work to have. He suggested starting him on 30 mg once a day but will want to increase it he said if he tolerates it ok. Not sure how I feel about that . He said if you don't increase your acne may clear on a lower dose but may come back instead of never coming back after taking a higher dose.

    He also said again - he thinks it's more rosacea than acne but it's hard for him to think this because my son is so young to have rosacea like this.

    It was nice of him to see me today on short notice - we are going to see the other PA that we liked so much tomorrow and the pediatrician on Friday. His father wants him to take it.

    Hope you are doing well!

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