Hi Dr. Rockoff,
Can you recommend anything for the minor swelling of the lips?
Thanks again,
Josh
None of these factors (type of pill, time of taking) matters.
Dr. Rockoff
Hi Dr. Rockoff
Well I took your advice and got another opinion. I gave this derm a list of meds I was on and he took a look at my back. I asked him about one last try with accutane since nothing else seemed to help. Without hesitation he said ok to it. He didn't object or question it and I didn't push the issue either. If he would have said no, I would have complied. Seems to me that he must have felt it was "severe" enough to warrant accutane.
Anyway I wanted to know your suggestions on treating the dry lip side effect. In the past I've used Aquaphor which works great but my lips tend to get a red tint around them. Is there anything I can use to help reduce this. I'd rather not look like I'm wearing lipstick if I can avoid it, haha This dry/chapped lip side effect is the only one that ever annoyed me so I could at least control it somewhat, this last course might not be so bad.
Thanks in advance,
Josh
Hello again Dr. Rockoff
A few questions about the vitamin E if you don't mind. What kind should I take? I've seen the regular d-alpha Tocopherol and the mixed version. Does it make a difference? Also from what I understand vitamin E is fat soluble so I should take it with food, correct? Would it hurt to take both the Accutane and vitamin E at the same time, say after a meal for example? Finally,since Accutane is a derivative of vitamin A, is there any harm with taking two fat soluble vitamins (A and E) simultaneously?
Sorry for the abundance of questions. I have researched the dry lip condition as much as I could before asking you my previous question. In fact I have read elsewhere about the vitamin E so I had already picked up a bottle, but I didn't want to start using it until I consulted a professional. You know how information on the internet can be...not_always_reliable
Thanks in advance,
Josh
2 capsules of Vitamin E 400IU may help, along with the Aquaphor.
Dr. Rockoff
Thanks for your response. It's of course hard to gauge tone from an e-mail.
I don't think that at 22 you're likely to grow out of acne soon, or at least you can't count on it. I also am unaware that your doctor would be in any legal jeopardy if he prescribed it to you. Basically, it's a judgment call.
Bottom line, I'd get another opinion.
Dr. Rockoff
Thanks for the tip. I think you may have miss understood me in a sense. I never demanded anything. I went in and he gave me a two minute evaluation and then decided to go with the doxycycline. He told me that I'll probably grow out of it soon so it shouldn't be a problem. I agree that sometimes you will get a better response from antibiotics after a few courses of accutane. But I suppose I felt that a year on minocycline with virtually no result might account for something.
I'm a professional myself, and I have to deal with my clients demanding things on a daily basis. Here's my point. I'm not a doctor, and I respect all the individuals that work in your profession. However on the same note, I respect when my clients inquire about certain things as long as they educated themselves before hand. In my case I educated myself as much as I could and from my research, a third course of accutane *may* be beneficial. Is that a definate? Of course not and I understand that it may fail The second course cleared my face fairly well.
Besides, he really is a good doctor. It's not that I don't trust his judgement. It's more about how people are sue crazy in this country, and they can cause restrictions on certain drugs as well as doctors' treatment methods. I could almost detect the reluctance in his voice. Hey I can't blame him or any other doctor for that. I wouldn't want to risk losing everything either. Anyway thanks for the advice. I'll probably get another opinion, and if it doesn't work out then I'll accept it.
Thanks again,
Josh
I don't know about the perjru part, but I am inclined to agree with your dermatologist that if Accutane has failed to give you a long-term remission over two courses, a thrid course will probably result in another relapse. Also, treatments like doxycycline that don't work before Accutane often work afterwards.
I guess you can always get another opinion, but here's a tip: professionals like physicians have a bit of a problem with patients/clients who come in "demanding" a certain treatment, who are intolerant of alternate suggestions, however patientlt explained, and who consider a visit in which they didn't get what they demanded a "waste of time."
Medical treatment is a partnerhsip that requires mutual patience and trust. It sounds as though your current dermatologist took the time to explain his position. Still, if you've lost confidence in his judgment, you ought to look elsewhere.
Take care.
Dr. Rockoff