Question I am tired of going to see dermatogists. My condition is not getting better. They don't even spend time to check my skin. I have acne for many years. I have tried acuntane before. Now, the doctor gave me retin-a micro and Klaron. None of them worked. And I also have seborrheic dermatitis. I have both of those symptoms at the same time. I don't know what to do. If I put on acne medications, the skin will peel off. If I put on Desonide lotion, made by Fougera, then my skin will get oily. If you know any good doctors accepting GHI DC-37 insurance, please let me know.
I really don't know what to do. Plus, I also have psoraisis. I am using Clobex shampoo right now, but it only works if I use it all the time. Please spend some time and help me out. If you can, I will thank you later...either treat you to a expensive dinner or give you finanical advice (I have a finance degree and stock broker license). Thank you.
Answer For acne there are only three types of intervention. 1) Oral antibiotics like Minocin or Doryx or Keflex or Bactrim or Ampicillin. 2)Blue light with Levulonic Acid. The doctor puts levulonic acid on your face for 45 minutes and then you sit under a blue light for 10 minutes. You would need 4-6 treatments. Blue light with levulonic acid is effective but you may need one treatment every 3-6 months to keep your face clear. 3)Accutane is the most effective medication for acne, 80% of people who take accutane never have acne again. The 20% that have recurring acne can either take another 5 months of accutane or go on low dose accutane. Low dose accutane is 40mg three times per week for males and 20mg three times a week for females. For patients with resistant acne, the low dose accutane works wonders--keeps the face dry and free from acne.
Seborrheic dermatits is genetic and can be controlled but not curred. Shampoos are Clobex Shampoo, Loprox shampoo, Capex Shampoo, Nizoral Shampoo, and Dermasmooth FS which is left on over night and washed off in the morning. For Seb Derm it is trial and error to see which shampoo works the best. For people with resistant Seb Derm there is oral antifungal medication like Sporonox or Diflucan or Nizoral. For patients with resistant Seb Derm I use the oral medications.
If you have Psoriasis the newest treatment is the Biologics. They are expensive but work very well. The one I use the most is called Enbrel. However, one has to give themselves shots in the thigh or abdomen twice a week. Enbrel is very effective.
I am not familiar with all of the insurance companies and cannot help you with that aspect. I tell patients that if they have difficult skin problems that they should visit a Medical School where there is a Derm Program as the Doctors at Medical Schools are usually better at treating difficult skin diseases.
In summary if you were my patient for your acne I would place you on low dose accutane. For your psoiasis I would give you Enbrel and for your seborrheic dermatitis I would place you on oral antifungal medications as seb derm is caused by a yeast like organism.
At the present time there is no cure for psoriasis or seb derm just control.
