If you have a regular pharmacist you trust I would ask them about all this and see what they say. I would also see if my health/pharmacy plan person could explain.

And I'd look for another dermatologist. Some practices focus more on the cosmetic and some on the medical.

sushi, I was thinking the same thing before I went. I was thinking I hope they don't try to sell me their products and expensive treatments. I was a little thrown with the prescription thing but one of my coworkers who went to another dermatologist I was considering said they did the same thing there at that office.

I don't blame you for feeling uneasy about it. Eczema and acne are mainstream skin issues treated by dermatologists all the time, so you just wonder why these meds which have to be obtained from certain places not your regular pharmacy. And the phone calls......?

Have you tried over the counter Cortisone cream for your son's eczema? If not, I'd try that first. It is certainly a lot cheaper. I have had eczema since I was born, and Cortisone 10 cream (not the ointment for whatever reason) is quite helpful. The rashes were quite bad when I was a child and before cortisone was available.

Holy crap that Elidel is expensive there! I'm sure it's just a few dollars at my drugstore. I'm going to check out of curiosity tomorrow now. Why didn't the dr just prescribe Benzagel? My daughter used that along with an antibiotic (I do believe) and it cleared her skin up nicely until the Rx ran out.....

I would seek more advice before you order Elidel. I don't know how old your son is, always,...but I'm assuming he's at or about to be in the throes of puberty. I'm a 78 year old woman with eczema issues and I elected not to use Elidel because of some of its side effects. If your son is at all immuno challenged, I would suggest you talk to a trusted pharmacist or another doctor before using the Elidel. It's far too expensive to order and then find out it may have an adverse effect on your son. If his eczema is mild, it may go away once he's through puberty. Plus...it may be due to an allergy to some product, food or vegetation. If he hasn't been "patch" tested for allergies, I'd make that the next step before using Elidel.

In my case, I've just discovered that my eczema is triggered by a severe allergy to Sucralose. In this day and age...with everything that is food related carrying a "Lite" label...try finding a product that doesn't have Sucralose as an ingredient. Groan! It's driving me bonkers!

These are all questions you should have asked your dermatologist. Call the physician and ask why these meds and their possible adverse reactions. This is NOT info to get from a list of lay people.

Anglo...I'm asking here because you never know who else had dealt with something like this and see what their experience may have been. I'm sure 95% of what is asked on these boards should be answered by someone else.

We are using the sample they gave us of the Elidel. 1 to 1 ratio mixed with Cera Ve cream. Thanks for the tips on eczema, I was going to start another thread asking what others use.

It's not a compounded drug. And you can get it through most pharmacist just Google for it. The price you quoted is extremely high. It is a drug with lots of warning labels and I suggest that you read them all before use. It is not for anyone who is immune suppressed. It can burn when applied, putting it in the fridge can help some.

Look for the Gold Bond eczema lotion at your pharmacy they have a special lotion just for it.

I would avoid the phone calls!

This may be helpful

http://elidel-us.com/hcp/rebate-offer.php

Virtually ALL skin problems are 'eczema'. All I know to do is to keep the skin clean; combat oil; avoid touching; watch for infection.

How did these pharmacies *know* you had been prescribed these meds? Does this MD need to be reported?

It's all about the money. Bottom line. Research the medications for side effects etc. before you fill them. You are smart to be asking questions. Many drs offices are doing things to add to the bottom line and make more money. some here are having you come in to tell you the results of blood work and get another office visit $$$ from you. Mine sends me an email to tell me everything is fine, my friend has to go in and get billed.

I just checked our price on the Elidel. You guys are being robbed! Our markup is about a dollar plus dispensing fees. Still under $100 and if you have coverage it'll be free to maybe $20.

chisue: the dermatologists office contracted the 3 pharmacies to let them know what they prescribed son. It was all very odd to me how they worked the prescriptions. But it must benefit them somehow.

Always, did the doctor give you a diagnosis? That's where I would start. Find out what the diagnosis is and if you're not comfortable with the medications he's prescribing, ask about alternative treatements.

In regards to the pharmacy, honestly? It's of no consequence to the doctor which pharmacy is dispensing. The insurance company has probably directed them on which pharmacies to use and that's not uncommon now especially when a specific treatment requires prior authorization. Many insurance companies now even have their own pharmacy programs to save costs (and get more profit) Cigna for example does.

What would have me concerned is the fact that none of this was seemingly(?) discussed with you during the consult. As his parent, you need to have more information than what it seems you've been told.

There's also no need to avoid the pharmacy calls. If you don't want to fill the prescription yet just let them know and be sure to get their number so if you decide to go ahead with it, you can call them back.

The reason for the appointment was for my sons acne. But he has had these red patches that flair up every once in awhile and he happened to wake up the morning of the appt with the red patches above his eyelids so it worked out that the Dr. could also take a look at that too. Dr. said the salicylic acid in his face washes was causing the eczema...(??) so he prescribed the Elidel for the eczema, and a face wash and gel for the acne. Suggested to wash with Dove unscented soap, use Cera Ve cream and also an antibiotic for the acne (which was optional) well all were optional...but you know what I mean.

I've only experienced either taking a prescription in to your own pharmacy or the dr calling in a prescription in to your own pharmacy so it was odd to me is that these weren't local pharmacies and I believe PruGen is out of Arizona..Everything would be shipped to us. Never dealt with anything quite like that, that's all I'm saying.

Oh, I understand. I'm not a fan of the mail order either, but don't be alarmed by it.

Does your son eat much fast food? Sometimes fast food, junk food and/or soda can cause acne. You know how teens are so it's not uncommon to see it. I'm not suggesting you change what the doctor has prescribed but it may help if he can refrain from those types a foods for a while.

Maybe you should at least look up what standard treatments for acne are these days, then you can decide if you need a second opinion or if you should try an OTC that does not have salicylic acid.

He received four (4) prescriptions (sulfacleanse, prescription gel, acticlate, Elidel)? Has his acne been resistant to other medications and difficult to treat? Treatment for acne depends on if it is mild, moderate, or severe, and if inflammation is present.

OTC "Differin" is "Adapalene" which is a "retinoid."

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114605/ Conclusions: In the treatment of mild acne, benzoyl peroxide is an effective first-line treatment. If results are unsatisfactory, topical tretinoin or adapalene should be added. In moderate acne, combination therapy has shown the most favorable results and typically consists of a regimen including benzoyl peroxide, topical antibiotics, and a topical retinoid (tretinoin, adapalene, or tazorotene). Tretinoin, adapalene, and tazorotene demonstrate similar effectiveness in the reduction of inflammatory, noninflammatory, and total lesion counts after 12 weeks of treatment. Oral antibiotics may be tried for patients with a predominance of inflammatory lesions who have not responded favorably to the above topical treatments.

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Management of acne: Canadian clinical practice guideline. Canadian Medical Association Journal. 2016 Feb 2; 188(2): 118–126.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4732962/

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Guidelines of care for the management of acne vulgaris. Journal American Acadademy of Dermatology. 2016 May;74(5):945-73.e33.

http://www.jaad.org/article/S0190-9622(15)02614-6/fulltext

This is our first time seeing anyone for his acne. We've only been using drugstore type acne wash etc.. stridex pads, that type of thing. I don't think his acne is any worse than what you see other kids his age. Yes, mdln those are the 4 presciptions the dr. prescribed. My son has only been using the Elidel so far on his eczema patches and it's working well. We haven't received the sulfacleanse or adapalne gel yet. He's been using the dove bar soap since Monday since we don't have the acne wash stuff yet. I don't think we are going to fill the antibiotic prescription.

Has he tried more gentle products? The acne products can be very irritating to the skin and can actually cause more oil production. I had horrible acne as a teenager so I can relate!

One product that did help me a lot was Differin. Insurance covered it with no problem.

I dread going to dermatologists now. It's hard to find one that focuses on just the medical components. Many are on the anti-aging bandwagon. I don't necessarily blame them, as that's what many people are after, but it's frustrating. I tried a private practice one in my area and he barely glanced at my skin and then started pushing Botox and other cosmetic procedures. I found a dermatologist that I like at my closest university but it's a bit of a drive and not very convenient, but at least she doesn't push unwanted procedures at me.

@ chi, Many become dermatologists (instead of family physicians) because of better hours, income, and lifestyle. Many derm visits are not covered by insurance, so pts are cash paying who can afford expensive anti-aging treatments - that are profitable to the practice.

Most dermatologists practicing in the university setting are salaried; thus, they don't make more money/profit by pushing unwanted procedures.

Thanks, mdln. That makes a lot of sense! I will keep going to the university dermatologist. She spent a lot more time looking at my skin concerns and didn't suggest I start a Botox regime in my 20's! I understand it's the most effective time, before too many fine lines and wrinkles, but still! Hard to hear.

Mdln, this is off topic, but I wanted to thank you for your input in the thread a week or so ago about double medicating. My sinus/allergy headaches were a constant battle for years. After reading your post, I decided to give the Flonase a try and now, I'm off all other allergy medications and am now pain free. I can't thank you enough!

@ lukkiirish, Happy to hear it helped you. So many on GW helped me with info I knew nothing about (framing, roofs, floors, windows, insulation, etc.) during the rebuild of my house, I am happy to "give back" in areas I am more familiar with.

Mdln, I literally tear up at the shear thought that I finally have relief. The headaches have been almost daily for years and relentless. Sharing your knowledge is truely a gift. :c) Have a great 4th!

Mdln, I just wanted to say thank you for how generously you share your knowledge as well. It would be so easy not to do that.