Ask The Dermatological Medical Assistant

I was given Differin for my acne and afer using it as prescribed for two weeks I had terribly dry skin; how does that help fine lines? Or is that with extended use? I stopped use because I was more afraid of damaging my 36 year-old skin with dryness than zits.
Also, will IPL help with the brown spots I wound up with on my face after years of being on The Pill?

See a doctor. Using steroids could make some conditions worse, not better.

There’s nothing that can make thin skin thicker, that I know of. Spend your money on concealer and you’ll be much happier with the results. You could also try sleeping with your head elevated.

Moisturizer is necessary. Dry skin is much more susceptible to infection, not to mention itchy, especially if you live in a dry climate like I do.

The vast majority of sun damage that causes skin cancers occurs before age 20. You should still wear sunscreen and avoid burns, but there’s not much you can do to undo those burns in the past. Do monthly self-exams of your skin, because you are at risk. Do make sure you use sunscreen that blocks both A and B rays, and that you reapply it often, like every 1.5-2 hours.

Medications like this remove the very top layer of skin cells, including the dead ones. Try using it every 3rd night for a week, then every other night for a week, and see if you can’t work your way up to every night. Use a heavy cream that’s noncomedogenic for dryness. Peeling and dryness is normal, but your skin should get used to the medication after a while, and it should stop.

I don’t think that we’re using IPL on melasma- those brown spots from hormones. We’re using creams that contain hydroquinone. They can help, but it is a very slow process and can take several months. Make sure you’re using sunscreen so it doesn’t get worse. They’re getting ready to take hydroquinone off the market due to concerns about it causing cancer in lab mice, so if you want to try that, better hurry. You can buy a lower concentration of it over the counter still.

There are several kinds of tinea. Your condition does sound like tinea versicolor. My doctors still use SelsunBlue a lot for this. It can occur on the arms as well as the trunk. If you try the SelsunBlue for a couple of months and it doesn’t help, there are prescription creams and pills that could help.

It works. Just make sure the string is sterile before use.
Again, thank you for your responses and for opening this thread.

The Differin took care of a small skin tag I had on my browline, but it came back about 6 weeks ago.

Thank you so much for this thread and your great responses in it! Do you think people aren’t asking the right questions at the time they’re prescribed something or does our confusion come from maybe not retaining everything the docs tell us?

You’re welcome, and thanks too!

I think that dermatology is so complicated, and we’re not really given tons of information from birth on like we are with heart disease, cancer, diabetes, etc. So when something comes up and you go to a dermatologist, all the information they’re giving you at once and at rapid-fire speed can cause your head to spin. My doctors give out a lot of handouts, so that you’re free to read up on your condition at home instead of trying to memorize what they’re saying.

It took me much longer to learn my current job than any other jobs I’ve been at, and I still learn something new about dermatology at least a couple of times a week. It has to be one of the most complex fields in medicine, I think.

Okay, lots of questions here about acne so far. I’m one of those guys who in my late 30s still gets acne. Yes, I bathe daily and have very good hygiene. I can deal with the occasional pimple on my face, I’ll spot treat it and it will go away. I’d prefer not to get them at all but “whatcha-gonna-do”, right?

Here’s my problem of late. For the last several months I have had a continual outbreak of acne that covers my right shoulder, chest, and neck. It is always localized to that area. Generally speaking, it is to many pimples and over to big an area to use spot-treatment type stuff. I’ve tried switching my laundry detergent to a “Free” type detergent with no dye, scents, etc. to see if that helped. The acne went away after that and stayed gone for about 2 days and then pop - it is back. So the detergent change could have just been coincidental to the clearing up. I drink a lot of water daily, very rarely drink pop or eat candy type stuff. Not sure why this keeps recurring in the same area.

Oh, and second question - Any tips for dealing with blackheads behind the ears? You know, down in the crease between the ear and the skull? I get them back there and my thick man-fingers just can’t get them and squeeze them out.

Any suggestions?

MeanJoe - Who really does not look like a ogre, even though this post certainly makes me sound like one!

I’ve been putting off my yearly visit to the Derm’s. The PA I see for skin cancer checks is friendly enough but I don’t know how to change the course of my appointments. 1) She likes to keep up the chit chat but it has nothng to do with my skin. We talk about my choice in bra’s, her participation in biathlons and her choice in bra’s. 2) I would like to steer her back to the to topic of my freckled, speckled, skin tagged, blotchy skin. But I feel she is dismissive (wtf?) 3) Once a year when i see her, she sees somthing suspicious on my back, a small speckled spot, which of course leads to a biopsy each of which has been negative three years running. Last time, I asked her if she saw anyspots that she thinks will turn suspicious the next year. And where is my mole map? Im not a happy client.

Am I wrong to expect to more learn about the changes happening in my skin and how to minimize those, during my appointments?

I have been seriously looking into having this done. I have broken blood vessels along the edges of my nose, a few spots on my cheeks, and even a lone spot on my forehead. Drives me nuts. My grandmother has it pretty badly on her cheeks, so I want to reduce what I can now before it gets as bad as hers.
From what I’ve learned obout IPL, this seems to be the best treatment - it’s quick, relatively painless, and not as expensive as laser treatment.
I’m having a hard time finding a reputable dermatologist who does it. Can you give me an idea of what I should look for? Is years of experience a good indicator? Lots of testimony and photos to back it up? Any good sites for finding qualified IPL derms?
Anything else I am missing? :slight_smile:

I’m out in the sun every chance I get. I also could be more liberal in my use of sunscreen - but I’m an adult and fairly hard-headed.

That being said, I have a few spots on my face and forehead that could probably stand to be looked at by a dermatologist. Image my suprise when I call to schedule an appointment and was told the next opening was in 6 months. Wow, popular guy. I’ll keep checking - 3 months, 5 months, and 6 months again.

Why would the wait be so long? Lots of kids needing acne treatments? Big sale on botox injections?

Let’s hope I dont’ have melanoma.

I get pimples and blackheads along my jaw and on my back. Sometimes when I have taken antiboitics my skin clears up. It also tends to clear up when I’m under lots of stress.

I think I might be over cleaning my skin but I’m not sure what else to do. I use regular bath soap when bathing then Nutritioniste by Garnier and then I use Clean and Clear sensitive skin astringent. My skin feels oilier afterwards.

Someone suggested not using so many soaps and start using lotions. But I really hate the oily feeling lotions leave and I don’t understand how putting something oily on your body would help it clear up.

Any ideas would be great. I would really like to be able to wear shirts and dresses with open backs again.

I have a few different questions:

  1. What is the best way to get rid of acne scars? Are there any good OTC treatments? I only have a couple, so I’d rather not spend a ton of money.

  2. I have one large broken blood vessel on my arm. Since it’s totally cosmetic I doubt insurance would cover removing it, but I’m sick of people asking me what happened to my arm. Any idea what the cost would be to remove it?

  3. What’s the deal with facials? I’ve never had one, but I’ve heard many conflicting things - they’re great for you’re skin, they’re awful and they cause pimples, etc.

  4. I have one pimple that keeps popping up in the exact same place - and I mean exact, not just the same area. It’s like there is just this one pore above my lip that just doesn’t work correctly. Do you know what causes this or if there is any way to prevent it? It’s pretty painful when I get it.

I have issues with my face becoming ridiculously dry and peeling after showering in the morning, I think it might have something to do with the “hard” water we have here. Is there any better solution than just coating my entire face in moisturizing lotion after showering? I feel like I might just be trading dry skin for blackheads…

EDIT: Another question I had was regarding “stretch marks”. I have a few on my legs that have been there since puberty basically, and the actual marks feel like there is a gap in the skin underneath the top layer. They have never shown any indication of healing up and going away. Are there any treatments to eliminate them or are they basically permanent?

Why the heck can’t I wear my engagement and wedding ring anymore? I wore them for about 18 months with no problems. Starting in late June, I notice my left ring finger, right under my ring, hurts. The skin is flaky and itchy. Fine, I put my rings on my right ring finger. Same thing happens there.

All summer I’ve been trying to deal with it in different ways. First tried making sure that every time I get my hands wet I make sure my ring finger is dry. Then try anti-fungal creme when Mr. Athena says it looks like athlete’s foot. Next try moisturizing. Nothing really works - it starts getting better but if I put my ring back on, it flares up again.

My rings look clean. They’re 19K gold and I have never had an allergy or reaction to gold before (I wear gold earrings with no problem). I suppose I should get them professionally cleaned in case there’s something on them. Lately I just don’t wear my rings, and it really sucks to not wear my wedding rings. Makes me sad. :frowning:

Do you guys see a lot of people with trichotillomania? If so what types? If the person is already medication for OCD and to curb impulse control symptoms is there anything you can do for the skin and hair follicules that have been messed up?

because umm…my friend…yeah thats it…my friend wants to know

I’ve had vitiligo for about 15 years now, not a high priority on my list of things to be concerned about, but since you’ve started the thread…

Are there treatments that work?

How permanent are they?

How long to they take?

And thanks!

I’ve been seeing a dermatologist for a couple of years now for my acne. He has prescribed antibiotics and Retin-A. The pills seem to be helping, but when I asked how long I’d have to take them, he told me, “Until your skin decides to stop having acne!” I’m 37, so I don’t see any reason why my skin would make that decision at this point.

Anyway, my question is about the Retin-A. Every time I use it as directed, within a few days my skin is absolutely fried. The peeling happens all over, in very tiny pieces, so I look like my face is covered in white fuzzy stubble. I’m embarrassed to be seen in public! I suppose I could get some abrasive and scrub hell out of it, but that just doesn’t seem like the thing to do when your skin is already burning.

I haven’t mentioned this to my doctor, for fear he’d knock on my head and say, “Hello, McFly…it’s Retin-A…makes your skin peel!” But I’m almost ready to be laughed at now, so I figure I’ll warm up by asking you first. :slight_smile: Is that what’s supposed to happen, and if so, how am I supposed to go to work when I look like an albino Oscar the Grouch?