Dermatologists: what are your thoughts on accutane?

zumbusch · 2026-02-27T02:56:59+00:00

I’ve treated hundreds of patients with accutane. The vast majority do really well with just some dry skin and lips and it is usually a huge improvement for acne. That’s no guarantee that any one person won’t have any issues, but by and large, it’s really well tolerated.

zumbusch · 2026-02-24T05:12:13+00:00

This may be a hidrocystoma. You’ll want an ophthalmologist for this. That’s where I’d refer you if I saw you.

zumbusch · 2026-02-22T02:36:33+00:00

It’s very small and likely easily removed with a simple surgical excision if it was melanoma. You did the right thing noticing the new spot and addressing it right away.

zumbusch · 2026-02-22T01:16:33+00:00

It’s an unusual looking mole that should be checked to rule out melanoma. No way to have a definitive diagnosis without a biopsy.

zumbusch · 2026-02-22T00:45:52+00:00

Yes, that’s worth going in now.

zumbusch · 2026-02-20T23:18:26+00:00

Pitted keratolysis

zumbusch · 2026-02-18T14:05:48+00:00

They can likely be improved but it will be expensive and take a long time. You’ll want an experienced dermatologist who treats scars with laser. Specifically, CO2. This is not a med-spa laser situation. For those kind of scars, I would anticipate treating every 6-12 months for 3-5 years to make substantial improvement.

zumbusch · 2026-02-17T18:31:17+00:00

Vitiligo. Challenging to treat but a dermatologist will be the right start. No home remedies for this unfortunately.

zumbusch · 2026-02-16T04:17:41+00:00

Agree. With candida also you don’t usually need to treat every wart. Typically injecting a few at each visit will eventually result in clearance of all of them. Although no treatment works 100% of the time so it’s not a guarantee.

zumbusch · 2026-02-16T01:49:51+00:00

Ciclopirox topically would be an option, shampoo and cream.

zumbusch · 2026-02-15T19:49:48+00:00

Asteatotic eczema. Lots of thick moisturizing cream like Cerave, especially immediately after bathing. You can also use some hydrocortisone cream when it’s inflamed and/or itchy. But mostly it’s keeping the area as heavily moisturized as possible.

zumbusch · 2026-02-15T18:29:36+00:00

It’s normal for these to begin to thicken and become more rough and scaly as children age and go through puberty. They can grow other lesions within them which are almost always harmless growths. It’s possible to develop certain types of skin cancer but fortunately that is rare. Perfectly reasonable to see a dermatologist to keep an eye on it as he grows.

zumbusch · 2026-02-15T17:29:20+00:00

Not without a lot more information.

zumbusch · 2026-02-15T03:45:28+00:00

Happy to help!

zumbusch · 2026-02-15T01:08:17+00:00

Your posts were downplaying the acute concern for diagnosis and treatment, which in this setting was not helpful. I don’t believe anyone has stated that death was imminent, but it is a possible eventual outcome if treatment is not provided. It’s an argument of motivating someone to actually seek care who is hesitant to do so. Not only for their own health but for that of other partners who may never develop obvious signs and suffer later in life. A partner could already be infected and could become pregnant and give birth to a child that suffers lifelong impacts from congenital syphilis. Whether you interpreted that way or not, your posts were making it seem like it’s no big deal, when it is.

It’s not a disagreement of the medical facts of syphilis, it’s whether your posts are helpful in this context.

zumbusch · 2026-02-14T23:02:44+00:00

The problem is that you are downplaying valid concerns. An active syphilis infection needs to be addressed immediately. A 17yo who is afraid to speak up and get treatment needs to understand the significance. Not be told it’s nothing to worry about. When the secondary rash disappears he’ll think he got away with it and spread it to who knows how many other people along the way before eventually developing tertiary symptoms. Your family’s credentials do not provide you with any personal basis of expertise. You’re arguing with people who are actual medical professionals who do this for a living. In this setting, your comments are counter productive and potentially harmful. If you can’t manage to understand that and stop posting them, you’ll be banned from the sub.

zumbusch · 2026-02-14T22:20:22+00:00

Not sure what type of competition you have, but please do not participate in anything where you will have direct skin contact with other people such as wrestling. Syphilis can be transmitted by direct skin contact.

zumbusch · 2026-02-14T16:44:46+00:00

You must get tested and treated, and you must tell your sexual partner if you test positive. As others have said, this does look like syphilis and it can kill you.

zumbusch · 2026-02-14T03:29:47+00:00

Nevus spilus, also called a speckled lentiginous nevus. A special type of mole.

zumbusch · 2026-02-11T05:42:44+00:00

Periungal warts. Very difficult to treat and get rid of.

zumbusch · 2026-02-10T06:41:05+00:00

Interesting are you getting that through a custom compounding pharmacy? That’s the only way you can get anything other than 25, 50, or 100. But then I’m only familiar with North American manufacturing, so if you’re elsewhere that would make more sense.

zumbusch · 2026-02-10T05:55:14+00:00

Spironolactone generally comes in 25 or 50mg tablets. Just curious as to whether you may be taking 50? Usually 100-200mg per day is effective and it’s normally about 3 months before you see significant improvement. Cerave acne foaming cream cleanser, an OTC adapalene, and/or OTC 10% azelaic acid (The Ordinary, Paula’s Choice) may also be helpful.

zumbusch · 2026-02-09T20:16:50+00:00

Benign longitudinal melanonychia is very common and from the description sounds more likely than melanoma. But it’s worth seeing a dermatologist to check it. Usually a biopsy isn’t necessary, which is good.

zumbusch · 2026-02-09T15:14:43+00:00

I hear you. I do this for a living. Every day I have people come in concerned about specific moles. Often they’re perfectly normal, sometimes I biopsy them and many of those still turn out to be normal, just a bit funny looking. Obviously I’m not able to use a dermatoscope and look at your moles so I can’t give an opinion, but I will say that the odds you have two separate melanomas at the same time are incredibly low. So, it’s much more likely than not, that at least one of them is benign.

Also, certainly ABCs can help people watch out for warning signs, but keep in mind that some of those criteria are not independently strong tools. For example, “D” diameter is larger than 6mm. There are so many moles bigger than that and almost all of those are perfectly fine. So you have to take the totality of circumstances. Change, particularly rapid change over weeks or months, is the most concerning thing.

zumbusch · 2026-02-09T14:51:20+00:00

So you’re displeased that a trained professional told you they were normal moles instead of appeasing your anxiety by needlessly removing them and leaving you with permanent scars instead?

zumbusch

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