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Sun Aug 17, 2008 6:57 am  |
My long awaited derm appointment is in 2 weeks time and I have no idea what to expect. I've read in acne.org or some other acne boards that unlike in the US, the appointment in the UK is very short and the dr will ask what you want between Differin, Retin-a and something else (not Taz cos in the UK, Taz is for psorasis [sp?] and not for acne). And that the appointment is over in less than 10 minutes, though the waiting time is over an hour.
I'm still unsure of whether to wear makeup or not, but I'm thinking of just light layer of bb cream and nothing else...but would the dr examine my skin at close???
Do I need to tell him what I'm using and take all my skincare products to the appointment?
Doctors here highly discourage people from buying anything over the Internet, so I dont think I'll be telling him/her that I'm already using Retin-A bought from ADC...but can he tell from looking at my face that I'm a RA user?
Thanks for your help  |
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Sun Aug 17, 2008 9:47 am |
Hi yeahyeah. Five years ago, I had to wait for four months for an appt with a derm regarding melasma. I already knew what it was, and I knew what I wanted (hyrdoquinone). I was wearing makeup when I arrived, and was asked by the nurse to remove all makeup from affected areas. When the derm came in, he looked at my skin, confirmed what I already knew (that it was melasma), and told me that some patients had success with laser but he wasn't sure I could get it on the NHS. I brought in some hydroquinone that a relative had given me (and had been working - I wanted a prescription for more) and he said he thought I should learn about camouflage makeup and made me an appt with a nurse who could teach me techniques. He was useless and the appt was a total waste of my time. I went back to dealing with it on my own and eventually succeeded in controlling the melasma (the hydroquinone worked, and I never allow it to come back because I never go out without sunscreen and keep my face out of the sun).
I am sure I had a particularly bad experience, and if I had to go back to a UK derm I would be a lot more prepared now then I was then. So here's my advice to you: be prepared to remove some or all of your makeup (bring it with you if you want to reapply once your appt is over); yes, either bring along your retin-a or tell him you're using it and sound as informed as you can so that he knows he is dealing with someone who won't be fobbed off easily; rather than expect him to come up with a plan of action for your issues the way a US derm might, you'd be best to have some idea of what you want. (I couldn't tell by your post - are you going primarily for a prescription for retin-a/tretinoin? If so, I don't think you'll have a problem.)
Good luck. I'll be really interested to hear how you get on because although I'd like to go back for a couple of niggly problems I've put it off because of my previous experience. |
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Easy Eye Solutions, Frownies, Tanaka Massage, Retin-A. |
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Sun Aug 17, 2008 4:29 pm |
Thanks graceless_lady! All I've read on the Internet forums are bad experiences with UK derms 
So no makeup...that's gonna be so hard. Would the derm actually touch your skin or just quickly glance at it under those lights?
I think I will have to think of a story as to why I have Retin-A cos I dont want to tell them that I bought it online. TBH, I have no idea what I want to get from this appointment. I bought 3 tubes of Retin-A 0.05% from ADC so I've got enough to last me a while.
I'll keep this thread updated once I've seen my derm.
Any other advice are welcome |
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Sun Aug 17, 2008 5:24 pm |
This advice isn't specifically for dealing with dermatologists but with doctors more generally:
1. Write down all of your concerns and questions in advance and bring the list with you. It's frustrating to have an issue that you meant to raise but forgot once in the appointment.
2. Get as much diagnostic information as you can: what does the doctor believe is causing your issues, what other conditions might cause similar symptoms, are there additional diagnostic tests that might confirm the diagnosis?
3. Determine the doctor's recommended treatment plan. What can you expect from following the plan? What time frame would you expect to see improvements, and at what point if you don't see improvements should the plan be modified or abandoned? Are there side effects to watch out for? What should you do if they occur? How does the doctor's treatment plan mesh with an overall skincare and cleansing routine?
Daytime or nightime use? Suncare recommendations? Is there a "second best" plan if the first plan doesn't work? If so, what makes it a second option instead of the first option--cost? effectiveness? side effect?
4. Ask about compatibility with other skincare products that you use or are considering using--retinoids, vitamin c, copper peptides, skincare tools, etc. I'd be completely honest about having used retin A. If the doctor raises any eyebrows, you can say that you buy a lot of skincare and cosmetic products online. The onus is not on you the consumer to figure out when a prescription is needed, it's on the seller.
5. Ask about the science behind any recommendations that you don't fully understand or that seem unusual to you. I always ask for citations to publications because, as I tell the doctor, "I like to be an informed patient."
Best of luck with your appointment! |
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Mon Aug 18, 2008 5:18 pm |
| Thanks so much for the helpful tips flitcraft. I'll try to make a list of the questions thats on my mind, but I have to keep that short as I'm pretty sure that the time inside the derms office will be very short cos whenever I have any appointments with my GP or in the hospital, the waiting time will be about an hour but the tiem with the doctor will be less than 15minutes |
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Thu Aug 21, 2008 11:17 am |
I rang the hospital this morning to re-arrange my appointment, as I couldnt make the one in 2 weeks time. It must be my lucky day or something cos they had a free slot tomorrow due to someone cancelling their appointment!
So my appointment is tomorrow and I'm excited but scared at the same time. I asked the appointments clerk who the doctor was and even though its a bit stalker-ish, I googled the doctors name to check out her qualifications  . She sounds pretty good, with over 20 years of experience so she should know her thing 
I'll update this thread tomorrow! |
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Fri Aug 22, 2008 4:18 am |
That was THE worse experience ever. Waited for maybe 45 minutes then when I went into her office, it was messy and she wasnt what I imagined her to be- old, frumpy, messy hair, red cheeks, some broken caps and her nails were slightly dirty.
I was prepared to answer any questions and even wrote down most of the brands/products I've used in the past but she was mean and nasty, asking me how long I've used x product for, but that was maybe a year ago, plus she could easily have checked the database for the types of meds my GP put me on. I had a slight feeling that shes not that great with the computer and new technology. She kept on asking me, I know you went through two tubes but FOR HOW LONG and I told me that I just use 1cm of the gel once a day and she said I KNOW BUT FOR HOW LONG. I was on the verge of crying and shouting back at her that I forgot about these things.
She told me that she never heard of half the things I've used- bb creams, Cellcosmet, DDF and when she asked me if Cellcosmet's packaging states non-comedogenic, I seriously do not remember so she lectured me on always using products for spot-prone skin, non-comedogenic and oil-free and that every single product I use must say that otherwise it will clog my pores and counteract the Retin-A, which I do know but I also know that I can tolerate some ingredients like mineral oil cos my GP actually prescribed a cream with mineral oil as the first ingredient.
She did check my face under a magnifying glass, which she took about 5 minutes to find . She then did the most unscientific thing I could ever think of...she gave me a sheet of paper with 6 pictures of a boy with acne and asked me how I compare to them when I was at the worst. Surely there's other ways to assess my acne! And finding that sheet of paper took her another few mintues and she only managed to find it when the nurse came in. She's so clumsy!
She doesnt seem to know much about anything either. When I told her how my acne first came about and the areas that were affected, she said "yeah most people seem to get acne from the top of the face to bottom" then I asked her why and she looked slightly puzzled and said she didnt know.
She didnt even want to write Finacea to me saying that its for rosacea and not really for acne but I insisted and asked her several times but she just looked at me in a condescending way that kinda made me want to cry and the fact that the nurse switched the fan on didnt help me hold back the tears. But in the end, I managed to get her to write a note to my GP to prescribe the finacea to me---which I dont really understand why she didnt write the script herself- might be hospital policy but I have no idea.
Good job I dont have to see her again, as I have an on-going prescription for Retin-A (I use generic 0.05% retin-A from ADC but I think the UK has Janssen-Cilag and the highest strength is 0.025%, but that's alcohol based so I guess its stronger. just have to wait til next week to collect my meds)
Well that's the end of my rant!
ETA- she also suggested that I could use Retin-A twice a day....what do you ladies think? |
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Fri Aug 22, 2008 5:39 am |
yeahyeah.
I am sorry to hear about your bad experience with this impolite, ugly dermatologist with an untreated case of rosacea. Unfortunately, it's not unusual that doctors behave in a manner that make their patients want to cry.
I believe this derm is a typical representative of the derms who work in public hospitals. They are mostly dealing with medical conditions like skin cancer, suspicious moles, psoriasis, severe cases of eczema etc. and only know about a couple of different medications to treat acne.
If you want an appointment with a nice, polite derm with flawless skin, you need to go to a private clinic. The derms at such places have up-to-date knowledge about skin care brands and treatments and are more likely to give you the prescriptions you ask for.
The only drawback with these derms, is that the appointments cost a h*** of a lot of money for us people in Europe.
PS. I think Retin-A twice a day is a bad advice. It may very well give your skin a waxy and dull appearance. |
_________________
Female, 40, Norway. Normal/dry skin, starting to see signs of aging. Staples: Glycolic acid cleanser, SkinCeuticals Phloretin CF, Revaleskin, NIA24. |
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Fri Aug 22, 2008 6:23 am |
Thanks septembergirl. Come to think of it, most of the doctors I see in the hospital dont really know what they're on about and are quite useless compared to the doctors I see in Hong Kong.
Yeah, maybe she thought that my case isnt as severe as her other patients as she did comment on why I needed to be refered and that my GP could quite easily get me the meds, and none of the patients in the waiting area had acne.
I can honestly say that I've read far more informative posts on this board and other beauty boards than seeing the derm. Maybe she was trying to dumb things down for me but some of the things she says is common sense and anyone can tell me it, for example, "The red marks left from your spots, they will go away in time. Just give it time".
Wish I could afford to see a private derm. A quick search on the Internet shows that it could cost Ł100+ for one appointment  !
Thanks septembergirl, I think I will just use the Retin-A once a day rather than listen to her.
One more thing she asked me which I couldnt really answer was "why do you need a moisturiser?".
I said that cos my skin is slightly dehydrated and dry from the retin-a but she wasnt happy with that answer and tried to get me to use retin-a cream which I read could clog pores. |
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Fri Aug 22, 2008 9:23 am |
| Oh, yeahyeah, I'm so sorry that your appointment with the dermatologist was so disappointing! Just stick around here, then, we're probably a better source of skincare information that even a 100 pound an hour private derm...And we're a lot cheaper! |
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Fri Aug 22, 2008 9:30 am |
Ugh. yeahyeah, I'm sorry to hear that things have not improved too much since my visit several years back. I think Septembergirl hit the nail on the head - NHS dermatologists are more geared for medical conditions.
The good news is that the gap in the market appears to have been noticed and there are clinic springing up that - while not purely medical - are several gears up from a standard beauty salon, and often have part-time doctors coming in to do injections, laser treatments or whatever. I think a very good esthetician is a much better option for us in the UK than an NHS derm. Coupled with the knowledge we can learn here on EDS, and prescriptions our own GP may be able to give us, I know I have no plans to attempt to see an NHS derm anytime soon.
So sorry to hear it went badly for you though. |
_________________
Easy Eye Solutions, Frownies, Tanaka Massage, Retin-A. |
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Fri Aug 22, 2008 9:32 am |
| flitcraft wrote: |
| Oh, yeahyeah, I'm so sorry that your appointment with the dermatologist was so disappointing! Just stick around here, then, we're probably a better source of skincare information that even a 100 pound an hour private derm...And we're a lot cheaper! |
 Yep, you lot are cheaper, better and more convenient! Hopefully when I get my Finacea and incorporate that into my regime with the Retin-A, it would control my acne  |
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Fri Aug 22, 2008 9:52 am |
Oh 'yeahyeah', what a shame it was such a dissappointing session for you.. She sounds like a real scrub to me!
I agree with everything 'flit' + 'SG' said to you.
That twit should never have told you to use Retin-A twice a day. First of all, more isn't better, and secondly light degrades it. Not to mention that your skin is much more sensitive to sunlight while you're using it even at night.
For what it's worth, I would suggest you give Viterol A a try for a month along with the Retin-A. (Alternate nights!!!). It's main function is renewing the skin. Even though it's main benefit is anti-aging, it's been known to help with acne also, especially the remaining red marks. Here is a UK site, where you can purchase and read more about it;
http://www.essentialdayspa.com/forum/redirect.php?u=http://divineskin.com/viterol/howit.asp
http://www.bizrate.co.uk/skincareproducts/oid495559827.html
As for the dry/dehydrated skin; drink plenty of water, spritz often with distilled water and try a light coating of Emu or Avocado oil. (Contrary to popular belief, not all oil clogs the pores!)
Again, I'm so sorry you had such a miserable experience..
ETA: I screwed up the links.. Viterol A for "face" is what you want to check out! |
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Fri Aug 22, 2008 4:43 pm |
Thanks for all your replies .
If my acne doesnt improve, I will definately try to find a good esthetician but at the same time get some precription meds to use from my GP. But to find a good esthetician will be extremely difficult...and expensive. But if she can suggest ways to control my acne then its money well spent .
I'm definately not going to use the Retin-A in the mornings. I do remember reading MUA that someone said that light degrades Retin-A but dont understand how that so called derm didnt know that.
Thanks for the links Kassy. I'm saving up right now for my hol so no more new products for me 
Once I get my Finacea I will be using that in the morning and Retin-A at night, keep it simple! |
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Fri Aug 22, 2008 7:53 pm |
Yeahyeah sorry to hear about your bad experience with the derm and ongoing battle with acne.
Have you ever tried Dermawand. I dont use it for anti-aging purpose although that's what I first bought it for, I ended up discovering it works great to keep skin clean. My breakout is not server but I had great success with it. 2 minutes everyday helps to keep me blemish free for the last 6 month. Maybe that's something you can consider as well. |
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Sat Aug 23, 2008 2:39 am |
Hi, Kassy_A. ViterolA from DS Laboratories sounds like an interesting product with all the three vitamins A, C and E on the ingredients list. It also got a couple of good reviews here on EDS. Do you have any personal experience with it? |
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Female, 40, Norway. Normal/dry skin, starting to see signs of aging. Staples: Glycolic acid cleanser, SkinCeuticals Phloretin CF, Revaleskin, NIA24. |
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Sat Aug 23, 2008 7:11 am |
| pinkberry wrote: |
Yeahyeah sorry to hear about your bad experience with the derm and ongoing battle with acne.
Have you ever tried Dermawand. I dont use it for anti-aging purpose although that's what I first bought it for, I ended up discovering it works great to keep skin clean. My breakout is not server but I had great success with it. 2 minutes everyday helps to keep me blemish free for the last 6 month. Maybe that's something you can consider as well. |
HI pinkberry
No, I've not tried Dermawand. A couple of months ago, I was intending to purchase one of the blue light devices- baby quasar, tanda, lightstim but after reading the reviews and googling for blue light therapy. I didnt really find as much info and user reviews for the effect it has on acne and for such an expensive product, I didnt want take the "risk".
But I'll keep the dermawand in mind, and when I get a job after finishing uni, I'll see if I can afford it |
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Sat Aug 23, 2008 9:48 am |
| Septembergirl wrote: |
[
Hi, Kassy_A. ViterolA from DS Laboratories sounds like an interesting product with all the three vitamins A, C and E on the ingredients list. It also got a couple of good reviews here on EDS. Do you have any personal experience with it? |
I bought the one for the face a couple of weeks ago, because I fell in love with the ingredients. I was actually surprised that it was so affordable. I had never heard of it before, and found it while I was browsing at drugstore.com
I started using Retin-A .05% about a month ago, and although my skin is handling it well, I decided to alternate that every other night with the Viterol A.
It's hard for me to really say anything about it one way or another, because I'm lucky to not have any problems I need to correct, other than a little more tightening is always nice. I don't have any pigmentation problems, no acne and except for a couple of crows feet, no wrinkles.
What I can tell you is that it's a very nice serum, little or no fragrange + sinks right in. I haven't experienced any irritation. I can also tell you that in the a.m. following my application, I do see a bit of flaking that is easily removed with my microfiber cloth. So that tells me it's doing it's job.
I'm actually thinking about making my next C serum with a little bit of this. I just have to check what the PH is first.. If that's low enough I'll probably give it a try...(Just make sure not to use sulpher topically with it..for you DIY'ers. So no MSM in my next batch!)
ETA: Info on Viterol A
VITEROL A FACE
Viterol.A® (viatrozene gel) 16% - for Wrinkles and Expression Lines
The latest weapon in the fight against aging
• Visibly lifts, firms, and brightens the skin
• Reduces the appearance of wrinkles
• Removes age spots
• Clinically proven
• Preferred by users over StriVecting-SD®
• Exceptional value
Get ready for flawless skin
Viterol.A is the first anti-aging aid that contains viatrozene, a new compound that visibly reduces wrinkles and expression lines and significantly improves the over-all skin health. The greatest benefit of Viterol.A is that it is a continuous and safe treatment, the effect of which does not wear off.
Bill Lawler, M.D., a cosmetic surgeon with a 26-year history in aesthetics, witnessed the evolution of nearly all skin care products. “Viterol.A does something completely different then other creams. While Botox is still the treatment of choice for deep furrows and certain types of wrinkles, Viterol.A is the most effective topical treatment for fine lines that I have encountered in my practice. There is also a clearly visible improvement in skin smoothness and firmness,” he said.
We promise, but how do you really know?
You have already seen hundreds of claims from a plethora of skin care manufacturers who pedal seemingly miraculous cures in all types of creams, lotions, and serums and yet more likely then not you were disappointed with the results. So why should you trust our claims about Viterol.A? First, Viterol.A is clinically proven as a successful treatment for the signs of aging. Second, DS Laboratories (the manufacturer of Viterol.A) is so confident that you will see an improvement in the condition of your skin, that you can return the unused portion of Viterol.A and get double of your money back! How many other manufacturers offer this kind of guarantee?
Directions:
Use at night. Wash and dry the face and neck well and apply a fine layer of the cream, avoiding the area around the eyes and the eyelids. To achieve more noticeable effects, continue the treatment every day for a month. In the morning use daytime moisturizing lotion, preferably containing sun filter. Complement the treatment with Viterol.A for Eyes and Corners of the Mouth.
Note: * Viterol.A is recommended for men and women over the age of 30. ** Some irritation may occur at the beginning of treatment. *** Viterol.A increases sensitivity to the sun and it is highly
recommended to use sunscreen everyday during treatment.
Active ingredient: Viatrozene 16%
Other ingredients:
Deionised Water, Almond Oil, Nanosomes of Vitamin A, Vitamin E, Vitamin C, D-Panthenol, Gingko Biloba, Chestnut and Witch Hazel, Propylene Glycol, Polysorbate 80, Triethanolamine, Carbomer, Fragrance and Methyl Paraben. |
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Sat Aug 23, 2008 10:06 am |
| Thanks a lot for the detailed information, Kassy. EDS carries this product, too! |
_________________
Female, 40, Norway. Normal/dry skin, starting to see signs of aging. Staples: Glycolic acid cleanser, SkinCeuticals Phloretin CF, Revaleskin, NIA24. |
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Sat Aug 23, 2008 10:13 am |
| Septembergirl wrote: |
| Thanks a lot for the detailed information, Kassy. EDS carries this product, too! |
Cool..  I didn't know that.
Thanks! |
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Sat Aug 23, 2008 10:27 am |
| Anyone have any idea what the active ingredient, viatrozene, is? Also, any links to the clinical studies that the advertisement says proves its effectiveness? I couldn't find anything at all on PubMed... |
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Sat Aug 23, 2008 12:17 pm |
| flitcraft wrote: |
| Anyone have any idea what the active ingredient, viatrozene, is? Also, any links to the clinical studies that the advertisement says proves its effectiveness? I couldn't find anything at all on PubMed... |
This should help!
http://divineskin.com/viterol/clinical.asp |
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Sat Aug 23, 2008 12:25 pm |
What really caught my eye about this product was that it helps promote lymphatic drainage..You all know how I hate my 'dreaded bags', so if anything will help to reduce some of that fluid/fat, I'm all over it...
Here's one quote:
Viterol.A is a topical treatment with various compounds encapsulated in phospholipidic micro spheres that instantaneously penetrate into the deepest layers of the skin and release their contents over a 12 hour period. Viterol.A encourages the action of the lymphatic system, increases the hydration and elasticity of the skin, fights free radicals, and reduces skin roughness. The skin becomes visibly healthier, smoother, and firmer with redefined facial outlines. It is not just a wrinkle reducer; Viterol.A is total rejuvenation treatment that can give you a more youthful appearance in just 2 weeks of use. |
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Sun Aug 24, 2008 4:31 pm |
| No worries Kassy, I'm enjoying reading about the Viterol A |
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