Dermatologist appointment: What should I say?


Dec 13, 2013
I'm going to have an appointment with a dermatologist. He may recommend Retin-A for my acne, but Retin-A is a synthetic and toxic form of vitamin A. He said vitamin E can work for acne scars, fortunately he has that knowledge. I don't know what to expect. I have acne, dandruff, rosacea, and stretch marks to treat.

I have skin itchiness in stressful situations, and someone suggested that a doctor might prescribe an anti-histamine for it. What kind of anti-histamines are typically prescribed in the US, and which should I aim to have prescribed?

I also have rosacea, and he may prescribe an antibiotic for it since it's sometimes used for that. Is there any good study I can show him that antibiotics help rosacea, or that endotoxin makes it worse? Also, are there any mechanical therapies for rosacea which are actually healthy for the cells in the nose? I've heard about microdermabrasion, but that doesn't sound healthy.

I don't know if I should mention low testosterone (which was proven), high cortisol (which was proven), or high estrogen/low progesterone (not proven, but obvious symptoms). I don't know what it would lead to, or if it would be a waste of words.


Nov 9, 2012
I've seen a derma for similar problem, before I read about RP. I don't think dermatologists add much value if you already have read about RP (check out his recent article on rosacea). They might recommend you microdermabrasion and tetracyclines. Both sound scary, and the tetracyclines only have a temporary effect on the skin it will flare up again once you end the treatment. Getting cyproheptadine would be worth it however, although not specifically for rosacea.

I think high powered LEDs are an interesting idea for skin repair, a way to concentrate red light for a few minutes on damaged areas.


Thread starter
Dec 13, 2013
I did read RP's article about rosacea, but it didn't go away by supplementing more thyroid, or taking niacinamide, thiamine, vitamin A, K, D, or eating liver. Also rubbed progest-E on my nose a few times, but didn't do anything.

Are lasers something dermatologists use for rosacea? I have heard about laser treatment for eyes to improve eyesight (assuming it's red light) and salons where red light is used.

How readily would a dermatologist prescribe cyproheptadine?


Feb 20, 2013
In a KMUD interview RP talked about a lady instantly curing bad eczema
applying novocaine. He also mentioned in oneradio interview that skin and
gut are closely related. Someone asked him about using far infra red sauna and
niacin use for Rosacea. He commented one should use niacinamide, not other form of B3.
Here is a summary of that interview ... ry-1-2014/


Nov 23, 2013
Before Peat I used to dissolve aspirin in distilled water to make my own homemade topical toner. I wonder if applying topical aspirin in that manner would help you any? I'm sure it isn't a miracle cure but it should help with surface inflammation while you continue to use all the other measures for healing your gut and everything else. I wish you the best. I don't know what you would say to a dermatologist though.


Jul 24, 2013
Unless it's a very special practice, a dermatologist is a specialist who will prefer to address only issues related to the specialty. Also, most office visits are very brief.

My suggestion is to make a list of the issues and then to prioritize the list. Since appointment time is usually brief, check off the list in the room, so the doc can see you are determined to get through the issues. See what the recommendations are-you can always search for alternative solutions later.

If some procedure is recommended, like mechanical therapies, that would be at a different visit so there is time to think things over.

My guess, and only a guess, is that generally a dermatologist, unless directed otherwise, will assign priorities based on severity (as estimated by the dermatologist) and appearance (esp. the facial appearance), since that troubles people.

The majority of U.S. anti-histamines are over-the-counter, and the main dividing point is between the "first generation" ones like Benadryl that often cause daytime drowsiness, and later ones, which do not. A physician may suggest one of these first, for convenience and lower cost (if meds are paid for out of pocket).

Inconveniently, Cyproheptadine remains by prescription only in the U.S. If you wish to try it and get a prescription, since it's less commonly used, it's best to offer specific rationale, like that it worked well for a family member.

You can ask, at the end, if the dermatologist thinks that low testosterone or high cortisol would affect these issues. My guess is that there would be little specifics and that the dermatologist would refer you back to your primary doctor.

Incidentally, though I was experimenting for different purposes, several different serotonin-lowering maneuvers (tianeptine, cyproheptadine, gelatin, niacinamide, others) all relieved a dandruff/itchiness issue that started years back following illness.

Antibiotic treatments for rosacea have been used. (Doxycycline is in the same antibiotic category as minocycline, discussed in other posts on the forum.)

J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S57-65. doi: 10.1016/j.jaad.2013.04.041.
Emerging therapies in rosacea. Layton A1, Thiboutot D
"Rosacea is a common skin disorder with multiple symptoms. The emergence of research that furthers understanding of pathophysiological mechanisms has created new targets for disease treatment. Specifically, there is a need for new treatments that address the various erythematic symptoms associated with rosacea. Systemic and topical therapies have both yielded positive results in treating rosacea with various medications. Subantimicrobial-dose doxycycline is one such promising treatment...."


Jul 24, 2013
Elizajones said:
The ability of antibiotics to kill bacteria does not seem to be important when treating rosacea.1 Instead, the antibiotics may reduce overall inflammation of your skin....

Dr. Peat has discussed at different times the roles of antibiotics in reducing inflammation and lowering endotoxin burden. ... buse.shtml
"Anthraquinones, because of the presence of several oxygen molecules, had low electron densities and were stable. The tetracyclines, with related structure, have some similar properties, and are antiinflammatory, as well as antibiotic." ... ging.shtml
"A few decades ago, when rosacea was believed to be the result of a local infection, antibiotics were used to treat it, and some of them, including tetracycline, helped. It was discovered that some antibiotics have anti-inflammatory actions, apart from their germicidal effects, and now it is very common to prescribe the chronic use of tetracycline to suppress symptoms."
"In women and rats, antibiotics were found to cause blood levels of estrogen and cortisol to decrease, while progesterone increased. This effect apparently resulted from the liver's increased ability to inactivate estrogen and to maintain blood sugar when the endotoxin stress was decreased.
"Now that hog farmers' use of antibiotics to stimulate growth has been discouraged, they have sought vegetables that have a natural antibiotic effect, reducing the formation and absorption of the intestinal toxins. The human diet can be similarly adjusted, to minimize the production and absorption of the bacterial toxins." ... ties.shtml
"Therapies that have been successful in treating “schizophrenia” include penicillin, sleep therapy, hyperbaric oxygen, carbon dioxide therapy, thyroid, acetazolamide, lithium and vitamins. These all make fundamental contributions to the restoration of biological energy. Antibiotics, for example, lower endotoxin formation in the intestine, protect against the induction by endotoxin of serotonin, histamine, estrogen, and cortisol."
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