FAQ

This FAQ page contains many common questions you may have about our processes, services, medications, and how Dr. Van Wagoner uses the Aron Regimen for your benefit.

Questions Regarding Who May Use Our Services

We are the only online practice in the United States specifically dedicated to treat adult and pediatric patients with difficult to control eczema. Our services are available to patients throughout the Entire United States. Dr. Van Wagoner is able to directly manage your skin condition if you live in the state of Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Texas, Utah, Virginia, Washington, West Virginia, or Wisconsin, USA.  

For patients that live in the other states of the United States OR outside of the United States, he is only able to make general recommendations about your care – these general recommendations will include a treatment plan and, if needed, a recommendation regarding the needed prescription medications that will help your condition. In these situations, you will need to discuss this entire treatment plan with your primary care provider. You will also need to have your Primary Care Provider provide the recommended medication prescriptions that we recommend for you since we are unable to provide valid medication prescriptions to our internet-based clients that live in states we are not currently licensed.  Please do not sign up with our service if you do not believe that your primary care provider will be able to sign off on the treatment plan and more importantly approve and provide the recommended medication prescriptions that you will need. No refunds are provided if you are unable to get the medication prescriptions converted by your own local primary care provider.

Yes, but the patient will need a parent or legal guardian to provide consent, oversee the online visit and handle payment details.

We welcome helping those patients who are not capable of caring for themselves or are perhaps uncomfortable using technology. We can only provide these services through a guardian or surrogate contact who is legally authorized to act on behalf of a patient. All that is required is the surrogate’s relationship to the patient, the surrogate’s contact information, the patient’s name and the surrogate’s electronic signature to attest that the surrogate is legally authorized to act on the patient’s behalf.

Questions Regarding How our Services Work

Yes! For Dr. Van Wagoner, looking at digital photos uploaded by online patients mimics what he is already experienced in doing during his education and training.  He is very familiar with analyzing and diagnosing many conditions based on just images and a written history – which makes an online eczema practice such a natural extension of his practice.

At this time, Dr. John Van Wagoner is the sole consulting physician. Dr. Van Wagoner has been hand-picked by Dr. Richard Aron to bring this revolutionary eczema treatment to the U.S. Please note that Dr. Richard Aron is no longer taking new patients from the United States.

An online visit with Dr. Van Wagoner will ask for much of the same information needed for an in-office visit. You will be asked about your current condition, include photos of your skin condition and provide a brief medical history.

For those that purchase the Premium Consultation Service, you will receive your completed consultation within 2 Business Days.  For those that purchase the Advanced Consultation Service, you will receive your completed consultation within 3 Business Days. For those that purchase the Basic Consultation Service, you will receive your completed consultation within 7 Business Days.

You can begin the process of finding freedom from your eczema ANYTIME. We are available 24/7/365. You can send your information and pictures from anywhere,  at any time, and get an accurate diagnosis and complete treatment plan with 7 business days or less in all cases, depending on the service plan you purchase.

Dr. John Van Wagoner will review your case and then provide you with a diagnosis and personalized treatment plan. You will be notified by email and/or text message when this plan is available for you to review. Your complete diagnosis and treatment plan will be sent to you in a secure email. From that email, you may then print, email or fax a copy of this information for your records and or for your primary care physician to review. A copy of this record will be securely stored in your Eczema Specialist account to access at a later date.

Your visit with the eczema specialist covers only the online visit. Depending on your case, Dr. Van Wagoner may determine that an in-office diagnostic or therapeutic procedure is needed to best address your condition. That in-office visit would be outside of the visit completed online through this service, and payment for those services would be separate. 

Your treatment plan will be very thorough and should provide you with all the information you need. A very useful Eczema Guide of common recommendations will be sent with your treatment plan and should be reviewed thoroughly by all patients. This guide answers most questions patients may have about their eczema and its treatment. However, if you have an additional question for the doctor, you may ask for a “Follow up Consultation” or “Ask a General Medical Question”- all for NO additional fee for those that purchase the Premium or Advanced Consultation Service Plans.  For those that purchase the Basic Consultation Service, asking a “General Medical Question” will cost an additional $10 each and “Follow-Up Consultation” will cost $50 each.

 

Each visit covers the thorough review, diagnosis and treatment recommendations for only 1 condition.

Seeing your skin condition from different angles and distances helps our eczema specialists make more accurate diagnostic and treatment decisions. For best results, make sure the photos are also taken where there is good light and that they are in focus. Do not alter the photos in any way (i.e. no filters or effects). Parental consent is needed for photos of underage patients.  The photos must be jpeg format and under 400kb per photo.  

We adhere to the national patient information security standards found in both HIPAA and HITECH regulations. Your photos, personal and medical information, video chat, or diagnosis will never be made public.

You can use your desktop computer, tablet computer, or smartphone to access our destination website at www.eczemaspecialist.com to start your request for consultation. A mobile app is not required.

We always strive to give our patients the best possible medical advice from the information we are provided. You will receive an answer; however, our doctors may be less certain if the information provided was bad, blurry, vague, inadequate or hard to interpret.

Questions Regarding Medications

Dr. Van Wagoner is only able to provide valid medication prescriptions for patients that live in the state of Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Texas, Utah, Virginia, Washington, West Virginia or Wisconsin, USA.

Dr. Van Wagoner is NOT able to provide the recommended medication prescriptions for you if you live in Alaska, Hawaii, North Dakota, Tennessee, Vermont, or Wyoming, or are an international patient. You will need to discuss what medications you need with your own local primary care provider. Dr. Van Wagoner is only able to provide general recommendations about your condition. All necessary medication prescriptions will need to originate from your own local primary care provider. Dr. Van Wagoner will be able to suggest what those medications should be but is unable to provide valid prescriptions for you. Only your own local primary care provider can provide those valid prescriptions for you.

*Kentucky, Mississippi, Montana and South Dakota residents are currently eligible to have prescriptions sent by Dr. Van Wagoner during the Covid-19 State of Emergency.

All cases are different. Typically Dr. Van Wagoner will require a paid follow up consultation request if you have not been seen in over 6 months and need a refill. Sometimes, Dr. Van Wagner will require a paid follow up consultation request before refilling your medications even if it has been less than 6 months since your last visit. Some patients need close monitoring for side effects and response to medications and Dr. Van Wagoner may require you to submit a follow up consultation request before blindly refilling your medications.

It is important that patients follow-up as recommended. If the patient does not follow-up within 12 months, they will NOT be considered an established patient and will need to start over as a new patient. The Aron Regimen compound is relatively safe to apply long term, but it still does not come without risks and needs to be monitored appropriately.

We now use a professional licensed pharmacy (Beaker Pharmacy) to securely prepare and home deliver the Aron Regimen Compound medications for patients that live in the following states:  Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Texas, Virginia, Washington, Wisconsin.  More states added frequently.

If you do not live in a state mentioned above, we will send you specific instructions on how to mix the required Aron Regimen medications in the convenience of your home. This process is simple and very straightforward. Typically, it will take about 20 minutes to complete this mixing process. You are always welcome and encouraged to ask your local compounding pharmacy to mix these medications for you if you are not comfortable mixing the medications. Typically there is a fee charged by the pharmacy for that process. This fee is not part of the fee paid to this website.

No. Dr. Van Wagoner does not have access to any medical record you may have established with Dr. Richard Aron. Former and or current patients of Dr. Richard Aron that need a medication refill must contact his website directly at www.draron.com. Alternatively, you always have the option of requesting a New Patient Consultation with me. See our package list here. 

1.  Compounding by Beaker Pharmacy is beneficial because you will have a professional pharmacist mix your Aron regimen compound for you, which ensures that the mixing process is done correctly. Often times, when patients do not initially respond well to the Aron regimen compound it may be related to improper mixing the compound at home. By using a professional compounding pharmacy, you eliminate this variable from the very beginning. 
2. In addition, the cost of having your Aron regimen compound professionally mixed AND mailed to you through priority mail is relatively inexpensive when using Beaker Pharmacy compared to paying for separate ingredients at your local pharmacy. Some ingredients in the Aron regimen compound can become expensive, depending on what adjustments may be needed for your specific Aron regimen compound. Beaker Pharmacy has a flat rate of $45 for the majority of the Aron regimen compounds. 
3. By having your Aron regimen compound professionally mixed with Beaker Pharmacy, you can ensure that the entire mixing process is completed in a sterile environment. This eliminates the possibility of your Aron regimen compound being contaminated with bacteria that could cause eczema to worsen. This is usually not possible when you mix the compound at home.
4. Your Aron regimen compound will also be mailed to you in an air-tight container, which is another step towards minimizing the risk of bacteria and mold growth.
5. By using Beaker Pharmacy, we can ensure that the exact ingredients needed for the Aron regimen compound are available for you. This eliminates the need for using other suboptimal ingredients that are often substituted by local pharmacies when the preferred ingredients are not available.

No, unfortunately Dr. Van Wagoner and Dr. Aron do not share patient information. As such, Dr. Van Wagoner is unable to “convert” Dr. Aron prescriptions. Dr. Van Wagoner is also unable to honor and or apply any money already paid to Dr. Richard Aron.

Not typically because most cases of Seborrheic Dermatitis are a localized inflammatory response to an infection on the skin with a yeast called Malassezia that responds better to an antifungal medication, which is not found in the Aron Regimen. There are some cases of difficult to treat Seborrheic Dermatitis that may benefit from the addition of the Aron Regimen of medications if it does not initially respond to topical antifungal therapy.

While most cases of moderate to severe atopic eczema do respond to the Aron Regimen of medicines we may prescribe, there are definitely cases that may need additional and/or alternative therapies. We recommend that you complete the recommended Follow-Up Consultation Request and describe the issue and or issues that you are still having. Dr. Van Wagoner will review all previous therapies, your updated photos of the difficult areas and will make appropriate adjustments that hopefully will provide the freedom you are looking for. Please note that Atopic Dermatitis found on the face, hands, and or ankles can be uniquely challenging and may need stronger therapy that Dr. Van Wagoner can recommend.

In most cases, the steroid in the Aron Regimen will not cause clinically significant thinning of the skin because it is significantly diluted by the addition of the moisturizer cream and the antibiotic ointment. Frequent follow up with our service is required so that we may monitor your skin and look for any side effects and/or complications that may result from using the Aron Regimen. When the eczema is controlled, the frequency of applications may be reduced and even the strength of the steroid may be reduced. Dr. Van Wagoner will notify you when those changes can take place.

Bacteria can and do become resistant to the antibiotic ointment but the use of the mupirocin ointment in the mixture produces such an incredibly rapid degree of relief from the itch and burn and redness that any such risk is typically worth taking. When control is achieved the antibiotic element in the mixture may be removed.

If you need a refill outside of a Follow-Up Consultation, please use our secure “Refill Request” form: Refill Request

Beaker pharmacy will supply and deliver all your compounded medication needs if you live in the following states: Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Texas, Virginia, Washington, and Wisconsin.  More states are added frequently.  Beaker Pharmacy charges $45-$55 for each refills of the Aron Regimen Compounded Medication.

 We will send in the required refill requests for the Aron Regimen Medication Compound to your local pharmacy except for the states of Alaska, Hawaii, Kentucky*, Mississippi*, Montana*, North Dakota, South Dakota*, Tennessee, Vermont, and Wyoming. 

You will need to obtain prescription refills for the required Aron Regimen Compound from your local physician if you live in any of the states mentioned above.  

 *During the COVID-19 State of Emergency, we will temporarily be able to send in medications to pharmacies in states marked with an asterisk (*)

It is important that patients follow-up as recommended. If the patient does not follow-up within 12 months, they will NOT be considered an established patient and will need to start over as a new patient. The Aron Regimen compound is relatively safe to apply long term, but it still does not come without risks and needs to be monitored appropriately.

Questions Regarding Payment for our Services

If you live in a state we are not licensed, we strongly suggest you get pre-authorization from your local provider before signing up for our services.  Unfortunately, we are unable to refund your money if your local provider is unable to provide the recommended prescriptions.  

 Please email us at info@eczemaspecialist.com and let us know about the issue you are having.  We will help you make the necessary payment.  

Contact Dr. Van Wagoner at info@eczemaspecialist.com to receive your link to the New Patient Questionnaire

No. Unfortunately, we do not accept payments from third party insurance companies for this services we offer. We only accept payment directly from the patient. We accept Visa, Mastercard, Discover Card and American Express credit cards and debit cards. Checks and cash are not accepted.

No. Unfortunately, we do not accept payment in the form of cash or a personal check. We only accept Visa, Mastercard, Discover Card and American Express credit cards and debit cards.

  • Cancellation Policy: If an appointment is not cancelled at least 24 hours in advance you will be charged a twenty five dollar ($25) fee.
  • Missed Appointment Policy: If we do not receive the follow-up form by 5:00pm CST the day of the appointment, it will be considered missed and you will be charged a twenty five ($25) fee.
Questions Regarding The Aron Regimen Treatment Program

Dr. Van Wagoner and Dr. Richard Aron do work very closely with one another but are not partners in a formal way. Dr. Van Wagoner is the preferred and only formally authorized medical provider for the Aron Regimen in the United States. Dr. Van Wagoner’s intent is to replicate the Aron Regimen as best he can with regards to the same medications prescribed and the amounts of each used in the Aron Regimen.

This depends on how long the patient has had atopic dermatitis and its severity. Most of the patients I treat are in the severe category,  so a minimum period of 6 months is likely, but can not be guaranteed.  

Most patients with eczema, perhaps as high as 90%, are infected or colonized with bacteria (staphylococcus aureus) and the use of additional moisturizers in the bath or directly on the skin, far from helping, may make matters worse.

Usually with the same cream as for other areas. Dove Cream Bar Sensitive lather may also be used as a shampoo.

It is important to eliminate all colorings, preservatives and processed foods from the diet. In addition, avoid foodstuffs that allergy testing has indicated you are clinically allergic to. This may include dairy, wheat, eggs etc. We may advise allergy testing from your local allergist to help us determine what you may be sensitive to.

 

Bleach baths are not typically recommended.

All physical activity including any sporting activities which produce sweat and friction are not recommended until a significant improvement in your skin is achieved. Swimming should also be stopped.

Most patients tolerate Dove Cream Bar Sensitive, my preferred product.

Questions Regarding Topical Steroids

Yes, mild cases can be treated with moisturizers and avoidance of common triggers.  Some prescription nonsteroidal medications are available for mild cases and can be effective.  Most other moderate to severe cases of eczema require more effective treatments and would require the use of topical steroids and some other new systemic nonsteroidal biological medications for patients 6 and older.

There are many POTENTIAL SIDE EFFECTS OF TOPICAL STEROID USE.  Most of the well-understood and experienced side effects of steroids occur with ORAL AND/OR SYSTEMIC use of steroids and not from the proper use of TOPICAL steroids.  Under proper guidance and monitoring, these side effects can be minimized and/or avoided.  Improper use of topical steroids can RARELY lead to skin thinning, excessive hair growth, increase in blood vessel appearance, decreased bone growth, acne, rosacea, endocrine suppression, or ocular changes.

No formal long-term studies have been performed with the Aron Regimen, but Dr. Richard Aron’s 50 year clinical experience of treating patients with atopic dermatitis has revealed an excellent safety record using this method of treatment.

Listed below are some of the potential problems that can occur with the improper use of topical steroids.  These issues are less likely to occur with proper management and close follow-up with your provider.  In addition, these issues are much more likely to occur with the use of a potent or superpotent class of topical steroids and are less likely with less potent topical steroids.

Potential side effects can include some of the following:  

  • Skin related:  thinning of the skin, bruising, redness, acne, stretch marks, rosacea, infection, increased hair growth, appearance of blood vessels, skin discoloration, etc.  
  • Body related:  increases in blood sugar, bone abnormalities, growth issues, adrenal suppression, hypertension, diabetes, cataract, glaucoma, weight gain, etc.

It is very rare for low and/or medium dose topical steroids to get into the bloodstream.  Potent and superpotent topical steroids are more likely to be measured in the blood with their use.

It is rare for topical steroids to compromise the immune system, but it has been seen.  It would be important to rule out other causes of immune deficiency before attributing the issue to topical steroid use in general though.

No, most properly used topical steroids do not cause long-term toxicity and/or weight gain in children.  

Most cases of AD are chronic in nature and require chronic treatment. The goal is to achieve control of AD using safe and effective treatments.  We do always aim to use less frequent applications of topical steroids and or less potent forms of topical steroids once control is achieved. Once long-standing control and or remission is achieved, it is much easier to remove the chronic treatment and or reduce the frequency of application overtime to maintain that control.    This removal and or reduction in the topical steroid is achieved by applying less frequent apps of the compound and or by removing and or lowering the gram amount of the topical steroid.

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