I hate to say it, but I didn't have much luck with the dermatopathologist I saw today. Like the dermatologists I've seen previously, the one I saw today just kept saying "It appears that you just have acne scarring." I schooled him on AMVC and provided print outs to show him....he noted he had heard of it in the past, but has not had experience with any patient with circumstances such as mine (scarring that comes on its own without trauma or acne). It seemed to be something new to him, more or less. At most he could tell me that it was very "plausible" that what I had was AMVC, but from a medical professional's standpoint, it was impossible to make a certain diagnosis because the condition is supposedly so rare (there are no cases to compare it to, no references). He said even if he were to take a biopsy of my facial skin, under a microscope it would just show the presence of scar tissue, which would render the biopsy pointless since acne scars have exactly that - scar tissue - underneath.
What plan of action I was given was since "AMVC" is supposedly caused by an inflammatory process within the skin, the doctor prescribed me some sort of anti-inflammatory oral antibiotic in addition to a sulfate/something face wash and a topical gel with the same sulfate ingredient plus benzoyl peroxide. He noted these would calm inflammation, which hopefully would then "prevent" these scars from showing up. It was hard to convince him I didn't want to go the whole oral and topical antibiotic route because I had experienced this with the derms I've seen in the past, who just resort to prescribing me acne-related stuff. I noted I had tried this route before to no results, but he kept insisting saying, "Well, this is different. It's not the same stuff." At one point I could tell the doc was a little frustrated with me since I kept trying to steer away from being prescribed anything. Now the face stuff he prescribed was also because I had noted that aside from my scarring, my cheeks seem almost puffy when I look in a mirror in natural lighting (esp if I look downwards...some areas look puffy and haggardly looking, to put it extremely) - I noted that I never had this appearance in the past. He said I had some mild seborrheic dermatitis (The strange thing is, I have no redness at all though, which is weird).
I will go ahead and use the face wash to see if it helps with the odd puffiness I've observed. The oral antibiotic I will not take since I've succumbed to toxic difficiles (antibiotic poisoning in the intestines) in the past. As for the topical, I am extremely against benzoyl peroxide (I'm sure many people here know that it's very bad for the skin). I should have noted this when he was prescribing the topical, but I was just too in the moment trying to get this guy to help me. I'm gonna try calling tomorrow to ask if he has an alternative to the topical.
All in all, it was a disappointing visit, and I felt like I was back in 2013, trying to defend myself to derms who do not understand my symptoms. I cannot keep taking time off from my work, so I don't know if I will or will not see another dermatopathologist, because I did have a list of docs aside from this one that I had put together.
Edited by boafriend, 02 March 2015 - 09:07 PM.