Sorry, that wasn't a personal accusation at all. I'm saying that I've heard a lot of patients say they haven't felt listened to. I've been in that situation in the past.

(My derm right now is great, she's very understanding and also open to my thoughts on what is working and what isn't; also explains everything very comprehensively. I appreciate that she's happy to share information like that with me.)

I'm not sure why you find my opening words patronizing... You see patients in the office. They are not necessarily telling you everything at those appointments, for one reason or another, many people are intimidated by doctors. And you're obviously not seeing them between appointments, while they're actually adjusting dealing with side effects or adjusting to medications.

you asume that topical and soft (or what you asume is soft just because you don´t peel) is always better.

No I didn't, I said that was true for me, and probably some people who have mild to moderate acne. Some people do find their derms are using hammers to treat flies. I know for sure that people with severe acne need more than that.

I'm sure your treatment is justified, you don't need to justify it to me. I'm saying I definitely didn't need tetracycline when I was a teen. My uncle (who's a doctor) was shocked when he found out that's what was prescribed for a case as mild as mine was. There are probably others who are over-treated. Again not saying you're doing that.

My point is that the person you replied to was probably coming from some experience like that.