Heat Rash City
August 19, 2010 8:04 AM Subscribe
I went to two different types of doctors for my heat rash, which has lasted a month so far. Both offered different diagnoses and different treatment plans. Who do I listen to?
I made both appointments because my primary care doc said to see both, since she wasn't certain what it was. I went to dermatologist at 1 pm, and he thinks it's some kind of urticaria. He prescribed me a topical steroid cream (I'm looking at the scrip and can't read what it says -- I think it says Topicort).
At 3pm, I went to the allergist, who did a full allergy panel, and reached the conclusion that it is atopic dermatitis. She prescribed me Elocon Cream and EpiCeram.
Based on what I see on the internet, it seems like the diagnoses are similar. I was going to mention what the dermatologist said to the allergist, but I didn't want her to think I was questioning her expertise or her just saying I should choose what to go with. The allergist seemed to be a little more familiar with this (and in the full allergy test panels, I learned I'm allergic to all the trees and grasses in our heavily woodsy area).
I'm leaning towards the allergist's but the dermatologist is extremely well-regarded in this area, though he only spent 20 minutes with me and said he thought it was urticaria, and the allergist seemed fairly certain it was atopic dermatitis.
How do I pick whose treatment plan to go with?
I made both appointments because my primary care doc said to see both, since she wasn't certain what it was. I went to dermatologist at 1 pm, and he thinks it's some kind of urticaria. He prescribed me a topical steroid cream (I'm looking at the scrip and can't read what it says -- I think it says Topicort).
At 3pm, I went to the allergist, who did a full allergy panel, and reached the conclusion that it is atopic dermatitis. She prescribed me Elocon Cream and EpiCeram.
Based on what I see on the internet, it seems like the diagnoses are similar. I was going to mention what the dermatologist said to the allergist, but I didn't want her to think I was questioning her expertise or her just saying I should choose what to go with. The allergist seemed to be a little more familiar with this (and in the full allergy test panels, I learned I'm allergic to all the trees and grasses in our heavily woodsy area).
I'm leaning towards the allergist's but the dermatologist is extremely well-regarded in this area, though he only spent 20 minutes with me and said he thought it was urticaria, and the allergist seemed fairly certain it was atopic dermatitis.
How do I pick whose treatment plan to go with?
(FWIW, Topicort and Elocon are similar in strength, so it's not likely that one would work way better than the other or anything.)
posted by kataclysm at 8:25 AM on August 19, 2010
posted by kataclysm at 8:25 AM on August 19, 2010
this may not be relevant to your case, but...
I had a rash which was first diagnosed as heat rash, then as urticaria, then (when it didn't go away for months) as chronic urticaria. Now, more than a year later and still with the rash, there's some indication (just in the last couple of days, so I'm still not sure and trying to understand it all, and ultimately further tests need to be done) it my be a result of a thyroid problem, possibly Hashimoto's. I mention this not to scare you, but just to suggest you keep it in mind if you get further down the road and haven't found relief. I had to insist that my dermatologist do a blood test for thyroid levels; you may eventually consider the same.
Good luck! (and I hope it's just common urticaria that goes away in a week!)
posted by segatakai at 9:08 AM on August 19, 2010
I had a rash which was first diagnosed as heat rash, then as urticaria, then (when it didn't go away for months) as chronic urticaria. Now, more than a year later and still with the rash, there's some indication (just in the last couple of days, so I'm still not sure and trying to understand it all, and ultimately further tests need to be done) it my be a result of a thyroid problem, possibly Hashimoto's. I mention this not to scare you, but just to suggest you keep it in mind if you get further down the road and haven't found relief. I had to insist that my dermatologist do a blood test for thyroid levels; you may eventually consider the same.
Good luck! (and I hope it's just common urticaria that goes away in a week!)
posted by segatakai at 9:08 AM on August 19, 2010
A couple of times when I've had some sort of dermatitis, my doctors admitted they didn't know exactly what was causing the itchy patches. Each one said, "Try this cream. If it doesn't work, switch to the other one." The cause of your rash isn't obvious, so the docs are each making their best guess. I'd pick one based on price or mildness or other appealing aspect, and see what happens.
posted by wryly at 9:13 AM on August 19, 2010
posted by wryly at 9:13 AM on August 19, 2010
As a patient, I would have mentioned that I had seen the dermatologist at the allergy appointment and their recommendation was XYZ, what do you think Dr. Allergist? Problem solving is collaborative, and if the allergist doesn't appreciate the input, they can document that.
There's not much to comment here since the details are sketchy and, obviously, random Intarweb comments do not replace the professional opinion of a physician. That said, I would go with the dermatologist's plan esp since they are experts at diagnosing & treating skin disorders.
posted by scalespace at 9:42 AM on August 19, 2010
There's not much to comment here since the details are sketchy and, obviously, random Intarweb comments do not replace the professional opinion of a physician. That said, I would go with the dermatologist's plan esp since they are experts at diagnosing & treating skin disorders.
posted by scalespace at 9:42 AM on August 19, 2010
This thread is closed to new comments.
Urticaria and atopic dermatitis are both allergic skin reactions, so it's not surprising that the treatments are similar. IANAD, but I might go with the allergist's script based on the fact that you've been diagnosed with one of two different types of allergic reaction and she is, after all, an allergist. (Next time, don't worry so much about offending the doctor -- if they get offended, piss on 'em! It's your skin that's itchy, not hers, and she could probably clear up why she thinks it's AD and not urticaria.)
Good luck, and I hope your rash clears up :)
posted by kataclysm at 8:20 AM on August 19, 2010