Acne (Retinoid) and ROTC

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SoCal_Dad

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Mar 9, 2018
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I have looked at just about all the threads on here related to accutane, acne, etc and still have question. I understand this should also be talked to with the Cadre, but hoping to hear from someone that was in similar situation to see how it turned out.

My DS is on 4-year scholarship for AFROTC. He is starting is 200 year this month (CSU Fort Collins). He was just prescribed a topical retinoid cream (mild acne) and has yet to fill it knowing that retinoids can be disqualifying. He asked his Cadre, who went to DoDMERB (via some help email) and returned what we already knew - the DoDMERB regulation stating, "Applicants under treatment with systemic retinoids, including, but not limited to isotretinoin (e.g. Accutane®), do not meet the standard until 4 weeks after completing therapy."

The questions we have are:
- what does "do not meet the standard" actually mean for a current (not "Applicant") AFROTC Cadet?
- could it negatively affect his scholarship?
- I have read here in on thread that as long as the treatment is complete 4+ weeks before commissioning or field training (or any additional DoDMERB physical) it would be fine.
- knowing he should (has to) advise Cadre and DoDMERB of this change to his health (or new Rx that is), he doesn't want to even do that until he knows he won't lose his scholarship or get kicked out of ROTC.

The wording of the DoDMERB standards are not very easy to understand and you don't want to assume anything....

Anyone that has been in similar situation with knowledge of how something like this works for current ROTC Cadet?

Thank you!
 
SoCal_Dad said:
He was just prescribed a topical retinoid cream (mild acne) and has yet to fill it knowing that retinoids can be disqualifying
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I am no expert, but I see that your post says topical retinoid cream.

DODI 6130.03 says systemic retinoids. "Systemic" means taken internally. So, use of a topical retinoid cream is not a disqualifying condition as set forth in DODI 6130.03

5.21. SKIN AND SOFT TISSUE CONDITIONS.
a. Applicants under treatment with systemic retinoids, including, but not limited to isotretinoin (e.g. Accutane®), do not meet the standard until 4 weeks after completing therapy.

https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/613003p.pdf?ver=2018-05-04-113917-883
 
NJROTC-CC said:
SoCal_Dad said:
He was just prescribed a topical retinoid cream (mild acne) and has yet to fill it knowing that retinoids can be disqualifying
Click to expand...

I am no expert, but I see that your post says topical retinoid cream.

DODI 6130.03 says systemic retinoids. "Systemic" means taken internally. So, use of a topical retinoid cream is not a disqualifying condition as set forth in DODI 6130.03

5.21. SKIN AND SOFT TISSUE CONDITIONS.
a. Applicants under treatment with systemic retinoids, including, but not limited to isotretinoin (e.g. Accutane®), do not meet the standard until 4 weeks after completing therapy.

https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/613003p.pdf?ver=2018-05-04-113917-883
Click to expand...

Ahhh.... I didn't even realize that "systemic" meant taken internally. If that is the case then we are fine, but this is great info as I can have my DS ask that specific question (i.e. does a topical retinoid cream = systemic retinoid ... so he then has an answer in writing from the Cadre/DoDMERB).

Oh and follow-up. I found this email address noted here as well as in other locations, usaf.usafa.dodmerb.mbx.helpdesk@mail.mil. Would my DS be able to email this question directly to them so he has a true official answer from them (again in writing)? Thank so much!
 
SoCal_Dad said:
Would my DS be able to email this question directly to them so he has a true official answer from them (again in writing)? Thank so much!
Click to expand...

I don't think it would hurt to ask. However, I am not sure if the folks that answer the e-mails are medically qualified to provide a correct answer to the question. Nor, am I. I just wanted to point out the wording of the regs.
 
Could DS call and inquire if there is another topical that would work as well? Make it even a non-issue?

Another element to this situation, is the question about ‘any acne’. Now that DS has been diagnosed by a doctor with acne, it’s something to disclose. Use the search box and you will find much discussion about ‘disclosing acne’, but beyond the actual use of a medication, is the record and diagnosis of the condition called ‘acne’ (if he was actually diagnosed with it ).

I don’t have DS’s forms to refer to as to what the actual related DODMERB question is. Maybe someone else does?
 
He noted acne and another med (non-retinoid cream) he was on already prior to his DoDMERB physical for his scholarship, but good to point that out. Should always be truthful for sure. It was never an issue and I am guessing since it's not bad and only ever prescribed topical creams, it must not have risen to the level of "systemic" for them to even ask about.

Thanks
 
That’s awesome. I didn’t read that he already had his exam. So this is a treatment he is considering after being qualified medically?

Curious, after one is qualified and awarded a scholarship, how are medical issues handled? DS is USNA so it’s all handled through them. Is there a medical program for ROTC scholarship? Or do they go to their college medical facility? Who oversees their healthcare once on scholarship?
 
Yes, sorry I didn't include that as I thought it was known when in scholarship they have to get their DoDMERB physical passed to be eligible. Similar as the academies I presume.

He worked directly through AFROTC and DoDMERB to fill out questionnaire and do physical exam via appt DoDMERB/AF set up for him. Once that was done he was waiting until he got word of his scholarship (Type 1 - we are from Southern California and he attends CSU Fort Collins).

So the approval was all done via AFROTC and DoDMERB. Ongoing medical is personal (he's still on our insurance) but has to update DoDMERB with changes to his medical condition (or changes to any Rx).

I'll report back once he gets formal answers. Thanks again for everyone's help and guidance.
 
@justdoit 19, I am thinking that you are asking about medical treatment and care once under the scholarship and attending school? If that was your question, I do not believe ANY ROTC Unit provides Tricare or in house medical services. Any medical issues are the responsibility of the student's insurance whether or not parents, individual, or college sponsored, and any reporting would be the responsibility of the cadet/midn, whereas at the Academies, there is no choice everything is reported and noted. If I incorrect in this someone with better knowledge please let everyone know. I only know our DS's situation with ROTC, medical was not offered or available.
 
Impulsive said:
@justdoit 19, I am thinking that you are asking about medical treatment and care once under the scholarship and attending school? If that was your question, I do not believe ANY ROTC Unit provides Tricare or in house medical services. Any medical issues are the responsibility of the student's insurance whether or not parents, individual, or college sponsored, and any reporting would be the responsibility of the cadet/midn, whereas at the Academies, there is no choice everything is reported and noted. If I incorrect in this someone with better knowledge please let everyone know. I only know our DS's situation with ROTC, medical was not offered or available.
Click to expand...

I agree and was trying to state that as well, but you did it much better. Outside of the DoDMERB physical exam, cadets are on their own for medical care/reporting.
 
Just thought I would provide update on what my DS found while investigating this. On the DoDMERB Secure Applicant Site (login required), there was a form for Acne and systemic retinoid usage which appears to be the follow-up questionnaire used for anyone that identified Acne with systemic retinoid use. Here is what the top of that form stated:

"This questionnaire is an addendum to your DoDMERB history (DD Form 2492) and physical; (DD Form 2351) the same Privacy Act law applies to this questionnaire.

This questionnaire pertains to the use of systemic (oral) retinoid medication (isotretinoin and similar compounds) such as Accutane®,
Roaccutane®, Claravis®, Amnesteem®, Zentatane®, and others for the treatment of acne."

Note this part, "systemic (oral)"... I think this confirms NJROTC-CC was correct above in that the regulation is only for "systemic" retinoid use meaning oral, not just topical cream (which would not be systemic). I think this is also why when my DS noted he was diagnosed with mild Acne initially and noted the cream he was used (Rx) there was no follow-up or issue with those answers.

Again thank you to everyone on this forum. This site is a wealth of info and truly appreciate the help everyone provides each other.
 
I would always ask the horse's mouth. I don't think the horse's mouth is a member of this forum. I do seem to recall folks who had problems with AFROTC because of accutane use, or so they told me.
 
kinnem said:
I would always ask the horse's mouth. I don't think the horse's mouth is a member of this forum. I do seem to recall folks who had problems with AFROTC because of accutane use, or so they told me.
Click to expand...

Totally agree and have read the same. Accutane is generally administered via a pill (oral) which would mean it clearly fits into the "not meeting requirements" around the use of systemic retinoids. I do think I have seen on the forums maybe 1 person mention use of Accutane topical cream and didn't have an issue, but either way my DS will be talking more with the Cadre (first person didn't really know much and pointed him to DoDMERB help line). The fact my son had mild acne listed on his original DoDMERB questionnaire, and use of a topical cream Rx, and that the new Rx is also a topical cream (a retinoid cream) makes us feel good. However, it is important to be sure when so much is riding on the answer. I'll report back final outcome once we have it so it may help others in the future.
 
@SoCal_Dad Thanks. I'm only familiar with it as a topical cream and didn't know it also came as a pill. Once again, context matters.
 
I’ve had two kiddos us Accutane (or generic). The issue is DODMERB wants a person off of it for a certain amount of time to make sure there are no lasting side effects to the liver. Maybe other things too but the bloodwork looking for liver issues is what I am familiar with. And what the dermatologist has to sign off on. Normal bloodwork regarding liver function.

You don’t have that issue with a topical cream for acne. But Accutane (a pill) has side effects that can be intense.

I actually thought my current applicant would be DQ’ed until he had completed his course of meds, but he had an AMI to have his dermatologist sign off the bloodwork, and date of completion (well before IDay).
 
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