4 ms·

In my opinion we have a long way to go before we actually understand many many of the skin diseases. Dermatologists appear to me as the most clueless doctors ou

by n1000 7y ago

In my opinion we have a long way to go before we actually understand many many of the skin diseases. Dermatologists appear to me as the most clueless doctors out there. Their only weapons seem to be cortisol and biopsies. Maybe I was also just unlucky.

SCUSKU 7y ago
I live with a eczema with fluctuating severity and have to agree. I have been prescribed triamcinolone acetonide steroidal cream, which helps, but doesn't keep me from scratching. I am legitimately waiting for genetic editing to solve this problem for me.
- bitL 7y ago
  Try sauna with multiple heat (~10 minute) - cold (1-2 minutes; immersed) cycles; some of my friends with various skin disorders reported significant improvement after 3 sessions and I could see myself their skin first dried on affected areas that then quickly recovered to almost perfect state after 3rd session. YMMV ofc.
  - lallysingh 7y ago
    Do you have more information on this? A link perhaps?
    - bitL 7y ago
      I don't see any medical journal report, however there seem to be many people discussing the same online; just a quick search led to this Reddit thread that describes what I saw on my friends (i.e. damaged skin peeling off with healthy one underneath): https://old.reddit.com/r/eczema/comments/6cci0h/infrared_sauna_holy_cow/ https://old.reddit.com/r/eczema/comments/6cci0h/infrared_sau... I believe the "cold shower" mentioned later is necessary for any effect; my friends usually spend 1-2 minutes immersed in cold water after a heat cycle (arguably both improved blood circulation and immunity boost).
orbifold 7y ago
That’s clearly nonsense, you just happen to have no interesting skin conditions... Any doctor will treat common cases 90% of their time. The skill is in recognizing and treating uncommon cases.
abhisuri97 7y ago
I think they are objectively the smartest doctors (or at least most knowledgable) out there because of the fact that their step scores need to be the highest in order to even match into derm. The skin is a very complicated organ and its disorders often cannot be diagnosed on an initial look (necessitating biopsies in most cases).
- jazoom 7y ago
  I'm a doctor and I don't know what "step" is, so I guess it's region-specific. I do a lot of skin work. The difficulty with dermatology is that lesions can look very different in different people. It's kinda lucky that many rashes do okay with steroids, but many don't.
  - abhisuri97 7y ago
    usmle step1 exam scores are a determining factor for whether students can match into certain residency programs in the US. Typically individuals who score high on their step 1 match into competitive residency programs (which include surgical specialty residencies, dermatology, and radiology)
    - jazoom 7y ago
      Ok. Here in Australia it's not like that. It's mostly years of arse-kissing, doing research projects and volunteering your time. It's not meant to find the smartest, but the most dedicated to that speciality, and to take advantage of the candidate for as many years as possible. I like the US's method better and wish we would adopt it. Also, you're basing "most knowledgeable" on how they did in 1 test a decade ago in medical school? I'd say a general physician (and also many specialist physicians) is usually more knowledgeable since they learn about all body systems and deal with them all daily. This is what I notice anecdotally, but I don't have evidence to back it up. I also think it doesn't really matter.

by n1000 7y ago

SCUSKU 7y ago

I live with a eczema with fluctuating severity and have to agree. I have been prescribed triamcinolone acetonide steroidal cream, which helps, but doesn't keep me from scratching. I am legitimately waiting for genetic editing to solve this problem for me.

bitL 7y ago
Try sauna with multiple heat (~10 minute) - cold (1-2 minutes; immersed) cycles; some of my friends with various skin disorders reported significant improvement after 3 sessions and I could see myself their skin first dried on affected areas that then quickly recovered to almost perfect state after 3rd session. YMMV ofc.
- lallysingh 7y ago
  Do you have more information on this? A link perhaps?
  - bitL 7y ago
    I don't see any medical journal report, however there seem to be many people discussing the same online; just a quick search led to this Reddit thread that describes what I saw on my friends (i.e. damaged skin peeling off with healthy one underneath): https://old.reddit.com/r/eczema/comments/6cci0h/infrared_sauna_holy_cow/ https://old.reddit.com/r/eczema/comments/6cci0h/infrared_sau... I believe the "cold shower" mentioned later is necessary for any effect; my friends usually spend 1-2 minutes immersed in cold water after a heat cycle (arguably both improved blood circulation and immunity boost).

orbifold 7y ago

That’s clearly nonsense, you just happen to have no interesting skin conditions... Any doctor will treat common cases 90% of their time. The skill is in recognizing and treating uncommon cases.

abhisuri97 7y ago

I think they are objectively the smartest doctors (or at least most knowledgable) out there because of the fact that their step scores need to be the highest in order to even match into derm. The skin is a very complicated organ and its disorders often cannot be diagnosed on an initial look (necessitating biopsies in most cases).

jazoom 7y ago
I'm a doctor and I don't know what "step" is, so I guess it's region-specific. I do a lot of skin work. The difficulty with dermatology is that lesions can look very different in different people. It's kinda lucky that many rashes do okay with steroids, but many don't.
- abhisuri97 7y ago
  usmle step1 exam scores are a determining factor for whether students can match into certain residency programs in the US. Typically individuals who score high on their step 1 match into competitive residency programs (which include surgical specialty residencies, dermatology, and radiology)
  - jazoom 7y ago
    Ok. Here in Australia it's not like that. It's mostly years of arse-kissing, doing research projects and volunteering your time. It's not meant to find the smartest, but the most dedicated to that speciality, and to take advantage of the candidate for as many years as possible. I like the US's method better and wish we would adopt it. Also, you're basing "most knowledgeable" on how they did in 1 test a decade ago in medical school? I'd say a general physician (and also many specialist physicians) is usually more knowledgeable since they learn about all body systems and deal with them all daily. This is what I notice anecdotally, but I don't have evidence to back it up. I also think it doesn't really matter.