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lioness101

Condescending Dermatologist Negates Feelings

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A little background. I am in my mid forties and have dealt with acne since my teens. My acne has been pretty much under control, but I still get cysts and large blemishes every now and then. Spirolactone has been a miracle for me to keep my skin under control. I decided to try to decrease the dose and had a breakout. My skin tends to break out and not stop for weeks on end. I know my skin and this cycle well. I rely on cortisone injections for bad breakouts because the large blemishes takes weeks to heal. I go to an office where i can get fit in whenever I need to be seen as long as I see the PA. Last week I was going on a trip and and my forehead broke out with a large blemish. I made it worse by putting BP on it. I went in for an injection the morning I was due to leave. The PA treated me like I was a moron. Mind you I have been dealing with a breakout for six weeks already and felt like crap. She looks at me and says that she does not get what the issue is and that her eyes don't even go towards the blemish. I am an intelligent person and knew I had a huge red mark in the middle of my forehead. Luckily the injection worked and I had a good trip. I was wondering if anyone else had a dermatologist negate your feelings or how upset you skin was making you feel? I just find being my age and still breaking out so embarrassing. It seems no one else I know who is my age deals with this........

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Hey there,

I'm sorry this happened to you. I am 39 years old and only this last June discovered Spironolactone, which has been a miracle for me. I am currently 99% clear but since the age of 12 had moderate to severe acne on my face, hairline, neck, chest, back and arms.

I really feel like people cannot understand what we go through unless they are/have gone through the same thing. Otherwise they can't understand the psycological effects acne has on its sufferers.

The only advice I can really give you is to not let this kind of negative thing have this much of an effect on you. It's a waste of your energy to give it another minute of your time. If you really feel strongly about it, write a letter to the doctor in question explaining your concerns. Then let it go. Or vent on here and then let it go :). Your time and energy are more valuable than that.

Take care!

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Complain to the doctor directly. Most doctors aren't going to lose business because of a pissy PA. (I'm assuming you're in the U.S. where you still have a choice of what doctor to go to...)

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I can relate to what you are saying as I also have had acne since my teens and am now middle-aged. I also love spiro! Although it doesn't totally clear things up for me...have to do more as well. I'm so sorry you had such a bad experience! I'm assuming this PA was younger. I too had a similar experience, although it was with my former dermatologist. She was younger than me and a total extrovert...always bubbly and outgoing. This was fine except that while I was seeing her I never thought she took me seriously. Here I was 50 years old with cysts, redness, swelling and acne all over my chin, nose, and forehead. My skin was a mess and scarring from decades of acne and my sense of self was devastated. I was sooooo tired of dealing with acne. I had to give this derm ideas of what to try. I.e. --- she had never heard of spironolactone. And there were times when I was in tears from pain and embarrasment but she just poo-poo'd me. She once even pointed out a miniscule teeny tiny pimple on her face as proof that I was making too much of a fuss. There was no comparison between her tiny, almost invisible pimple, and my face full of misery. Her solution to my chronic acne was full strength Bactrim (antibiotic) for several years. Yeah, it worked but wreaked havoc with my gut. Then she insisted that I stop everything. I tried to tell her that I had tried that many many times before but always broke out horribly. She insisted...so about 2 years ago I tried it. HUGE MISTAKE. Need I say more? My skin went crazy...deep cysts, redness, horrid scaling, etc. And this is at age 59. Such hell. In the same practice was a derm I had gone to in my 30's, who put me on accutane (which worked beautifully while I was on it) but then I moved away. He is considered tops in adult acne. He took one look at my face and put me on the regime below...which within a month or so practically cleared up my skin. The only thing I've done in addition is diet-wise...avoiding all sugars, alcohol, fats (except for minimal olive oil), and dairy. I have always eaten healthy but now I'm religious about it...whole foods only. Occasionally I eat some pasta or a rice flour waffle.

My current derm, Dr Naverson, is amazing. He patiently answers all my questions...such as why me at my age? (answer --- some adults, a relative minority, have a genetic predisposition of extreme sensitivity to androgens and to not shedding skin cells properly...a combo that means acne at any age) He also is empathetic because he had severe acne when younger and has the scars to prove it. Now he is helping me get over residual image problems because eventhough I'm almost clear, I freak out if I even get a teeny pimple or inflamed whitehead. Acne PTSD.

My only wish is that I had kept on being his patient in my 30's. I am convinced he could have saved me a lot of grief...and emotional trauma. As it was I struggled along with derms who put me on antibiotics...with natural "cures" that never worked...with barely concealed depression.

I guess my advice to you is to not put up with this PA. Talk with your main derm. Ask for someone else. I put up with that terrible former derm for 5 years despite not getting very good treatment. This was a reflection of my damaged self-esteem and inability to stick up for myself.

Good luck --- message me if you want.

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Lol yea, definitely. I paid $250 for genesis laser because they recommended it and I broke out in pustules alllllll over my chin and jaw. I seriously cried and they said it's not a big deal and wrote me a prescription for 100$+ worth of medications to clear it. Thanks for nothing..I am contemplating switching to a different clinic..

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While it's courtious to be respectful of another's feelings, unfortunately you don't need to pass a sympathy test to enter the medical field. More times than not, not just doctors or nurses, people won't understand "what the big deal is." It's very very common for someone to simply not understand the plight of another person because they have yet to be affected by it.

It's really annoying and I think it's happened to all of us, in some form or another. Don't let situations like this get you down. Hang in there.

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So sorry, just saw all the amazing responses! I have not been on this site for a long time! So nice to know there are wonderful supportive people around! I decided to not allow the PA to bother me anymore and mainly go to another office where I am friends with all the female derms (because they all attend my gym). I am treated like a friend and they are very sympathetic if I am having a breakout.

Wishing everyone a happy healthy new year.

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Is it just a trend that Physician's Assistants are condescending and rude? I went to the derm last week for the first time, and the PA just about made me cry, telling me that I'd have to go on antibiotics and that they would make it worse before it gets better. But the dermatologist came in and she was sweet as anyone could be and very supportive.

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