So, I have this dyshidrotic exczema; I know it can’t be cured, I know its genetic, and I know its triggered by stress. In a prior life when I had easy to deal with health insurance and lived in a town where there was one major health provider (Huge university hospital + satellite health centers) I had a diagnosis from a GP, a visit to the dermatologist, and was given some strong steroid ointment to use as needed (but never more than 3 weeks at a time).
That was fine for the last oh say five years. Now I’m in law school and under a lot of stress between trying to find a 2L summer position, working on a journal, trying to write my student note with a partner I don’t get along with very well, planning a wedding, keeping my grades up for my scholarship… yeah, that’s about it.
Long story short, I have eczema all over my hands and its spreading rapidly and far more than ever before in my life. Its all up and down both sides of the fingers of both hands, and there’s a red, oozing patch the size of a half dollar on my right palm which is VERY awkward in interview scenarios (I have to bandage it up which is hard because bandaids don’t stick to your palm).
I went to the Health Center and they basically just patted me on the head and said “yeah that’s eczema, uncurable, genetic, stress triggered… don’t scratch… come back if it gets infected” and sent me on my way.
I am nearing the end of my 3 week steroid cream cycle (used too long it can permanently affect your thyroid, I’m told) with no end in sight. I want more medical advice – there must be something I can do to improve the situation – but no idea how to go about it.
-I don’t have a GP, I go to Planned Parenthood for the girl parts and the Health Center for coughs or whatever (I’m rarely sick, actually).
-My insurance is a 80% reimbursement plan, so I will be out of pocket for the visit.
-How do I find a dermatologist or a GP or anyone who can help me? I don’t have time to go through the phone books and interview people on their expertise.
While I suspect there are a lot of Family Physicians who could help you, I know all too well that there are too many out there that won’t be real effective with this type of problem.
So I would advise finding a dermatologist who is board certified by the American Board of Dermatology. http://www.abderm.org/ can help some. Apparently it doesn’t give a geographic list of who’s certified, sadly.
But you should still be able to call a dermatologist’s office and ask if they are certified by this board.
Then you should be able to find someone who will do more than throw high potenty steroid creams at it (though that is often the right thing to do). Maybe some leukotriene inhibitors, or some tacrolimus, or some real potent stuff like oral prednisone or methotrexate, or imuran, needs to be employed.
Other specialists to consider would be an allergist/immunologist, one who’s board certified in that specialty. Bad eczema is often driven by food or environmental allergies. Cow’s milk, wheat, eggs, soy, peanut and tree nuts, & fish are common food culprits, and dust or mold, cat dander, temperature changes, & low humidity also contribute.
But personally I’d probably start with a derm doc.
In human medicine can someone not boarded call themselves a “dermatologist”? In veterinary medicine, it is considered unethical (and in my state, illegal) to call oneself a specialist without board certification.
It might be worth it to call your health center back and tell them that the treatment they gave is not effective this time around. You may be able to get another apopointment. If not, ask them to recommend dermatologists in the community.
Actually, my HC didn’t treat me in any way. Hey first do no harm, right? But it would have been nice to find out from them, instead of the internet, that you can take a Claritin for the itching (among other new developments, my eczema is itchy for the first time ever in my life). I should have demanded a fungal culture damnit.
Thanks for the link QtM. I don’t have any obvious allergies other than nickel & penicillin, and my brother’s been through the ringer with elimination & challenge diets with absolutely no results, so I am not eager to go down that road myself. I shall hie myself to a board certified Dermatologist.
Sure, you don’t have to pass the derm boards to call yourself a dermatologist. Just don’t claim to be board-certified.
A generalist may have an interest and expertise in many areas of medicine, and state that their practice includes such things as diabetes or substance abuse, without having to be an endocrinologist or an addictionist.
As long as one is duly licensed to practice medicine and surgery, one can call themselves a brain surgeon. Just don’t expect to get credentialed at the local hospital to practice brain surgery without the requisite experience.
