Thread: My dermatologist said...

Originally Posted by Warrior372

FYI. All doctors do 'grand rounds' their last year in medical school before choosing a specialty. While in these rounds, which take about a year, they experience every general specialty in medicine. This stretches from the ER, to OB/GYN, to intensive care and everything in between. I am not necessarily saying what this dermatologist said is 100% correct, but I am sure that they have seen their fair share and have enough experience to reference when diagnosing a basic skin condition. A Dermatologist is a doctor who specializes in the diagnosis and treatment of skin diseases, this is a 3 year specialty beyond medical school. I am not saying they know more then anyone in here about shaving, but I am sure they know what is wrong with his skin and how to best treat it.

Just so others know. Grand Rounds is an educational excersise done every month, in every specialty, at every teaching hospital there is. We don't "do grand rounds" in our last year of medical school, but attend grand rounds as a part of a rotation in a specialty. Trust me, after ten years of training, and six years of practice in general and vascular surgery, the amount of information that a typical medical school graduate has about wound care is miniscule at best. As previously stated, her idea to use an antibiotic cream was a good one, but her other rec's about the type of shaving cream and razor to use are wrong.

Originally Posted by fccexpert

I
This still does not answer the question as to why the mix of antifungal and antibacterial compounds. Perhaps the doctor is uncertain as to the cause of the supposed infection, perhaps she thinks there are two infections; you can only know by asking which is what I suggested.

There are good reasons not to use antibiotics unecessarily so it is always appropriate to ask why a particular treatment is being prescribed. Any doctor that is not comfortable with this type of question should be avoided and in my opinion should not be prescribing medicine at all.[/QUOTE]

You clearly didn't read my post... antifungals are often used as a prophylactic with topical antibiotics. Eliminating all surface bacteria leaves no competition for yeasts or other fungi in the wound, and secondary infection can develop...

Originally Posted by fccexpert

There are good reasons not to use antibiotics unecessarily so it is always appropriate to ask why a particular treatment is being prescribed. Any doctor that is not comfortable with this type of question should be avoided and in my opinion should not be prescribing medicine at all.

In your uniformed opinion, yes. You've made this judgement with, evidently, no understanding of microbiota or immunology aside from what you've picked up from the evening news or some quack like Mercola.

Originally Posted by BKratchmer

You clearly didn't read my post... antifungals are often used as a prophylactic with topical antibiotics. Eliminating all surface bacteria leaves no competition for yeasts or other fungi in the wound, and secondary infection can develop...

This is certainly not common practice in the Netherlands. We never prescribe topical antifungals in conjunction with topical antibiotics. Occasionally we combine oral antibiotics with antifungals for patients that are known to be at risk of vaginal or oral candidiasis. On rare occasions when you have good reason to combine them in one cream you do not mix 2 creams, thereby diluting the active ingredients of both creams. What I would do on such rare accasions is: take e.g. Fucidin cream and add 2% of ketoconazole.

Originally Posted by Kees

This is certainly not common practice in the Netherlands. We never prescribe topical antifungals in conjunction with topical antibiotics. Occasionally we combine oral antibiotics with antifungals for patients that are known to be at risk of vaginal or oral candidiasis.

I ought correct myself. There are other ways than anti-fungal compounds this is accomplished- acid pH, etc. And I by no means wanted to imply it was frequent or the rule... rather that it is a valid method of treatment and not "Uncertainty" or malpractice as some are quick to insinuate.

Originally Posted by winterkid

Has anyone heard of this prescription before?

not me

Originally Posted by winterkid

What about any unscented soaps that may be out there?

I dunno

Are you sure?

Originally Posted by hoglahoo

not me

I dunno

The original poster hasn't been back to this thread since starting it, and to me it looks like at this point it has deteriorated into a "I'm so right" type of posts.

I don't care who is right and who is wrong, and who is the biggest expert, but nobody except the doctor of the original poster carries any responsibility in this matter, so while she may be wrong she is accountable, while none of the posters here are.

Anyways, in my opinion this thread has ran its course of being helpful and I am going to close it.

If you want to discuss microbiology and medicine feel free to start your own thread, preferably on a forum about these things.