No one can make that decision except you. The oral medications have a lot of side effects to consider - bone density issues, birth defects, etc. The topical ones don't have the systemic problems, but they are newer and less understood. If you're only treating shins and forearms, you might want to look at the topical creams. They work, but you may find that they work too well. Like everything else, it's all trial and error around here.
My husband uses a little Tazorac on just his armpits about every 6 weeks. One little dab does nothing for 3 days, then suddenly on day 4 (with no additional treatment) everything starts peeling off. It itches and leaves bits everywhere, and sometimes gets pretty raw. It takes about 3-4 days to heal, then the skin is sort of normal for a few weeks until it builds back up again. He has tried it in other places, too. It works in spots at the back of the knee and makes the back of the neck VERY raw. It doesn't do anything to the palms and soles, which are his worst areas. We don't use it at all on the kids.
Reticular Ichthyosiform Erythroderma with white spots.
Husband, Nathan - 4, Elliot - 1, all affected.
Ichthyosis-en-Confetti Type 2
Husband, Nathan - 10, Elliot - 7, Oliver - 4, all affected.
I also have an unaffected daughter, age 8.
email: jennifer at confettiskin dot com
facebook - find me on "ichthyosis mommy spot" or "friends of ichthyosis"