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neurogenic rosacea -- my battle.

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  • #91
    This might be already known to you - but as I read about rosacea more:

    1) I did not realize doxy helps against the blood vessel remodeling that comes with repeated rosacea insult, as well as skin remodeling and bumps. Doxy is also used in other vascular processes that need blood vessel remodeling (damage done by MMP's, and doxy being an MMP inhibitor). I was told by NYU doc that doxy is the best antibiotic for this. I don't think most clinicians know about this - if they did, then I should have been kept on 40 mg doxy even if I didn't think my initial 8 week trial worked for me (or titrated me up).

    2) Carvedilol blocks a1, b1, and b2 adrenergic receptors So it is a vasodilating beta blocker. I know some people on here who tried it and were worse off (caused flushing). FWIW my NYU derm said he never had a patient in his decades of experience where carvedilol made a rosacea patient worse. But to the point, what I didn't know is that carvedilol also has anti-inflammatory properties

    generally - Repositioning of the β-Blocker Carvedilol as a Novel Autophagy Inducer That Inhibits the NLRP3 Inflammasome
    (NLRP3 inflammasome also in rosacaea pathology)

    in context of rosacea - A Novel Mechanism of Carvedilol Efficacy for Rosacea Treatment: Toll-Like Receptor 2 Inhibition in Macrophages
    "In conclusion, we present the first report that carvedilol can alleviate the inflammatory reaction in rosacea via the TLR2/KLK5/cathelicidin pathway in macrophages. Additional studies are needed to further clarify the intrinsic mechanism and the relationship between inflammatory status, adrenergic receptors, TLRs, and inflammatory status in rosacea."

    Other - My doc also wants me to try carvedilol because he says it is good for water collection properties. I've noticed a 1:1 correspondence between glimmers of pain relief that feel "right" and "deep feelings of water trickling down". When I feel it in my scalp, the scalp pressure and itch is reduced. When I feel it in between my eyes and nose, my nose pain/pressure is reduced, eye burning/pressure is reduced, I can see better, and liquid visually comes out of that eye and that nostril. I When I feel it in front of my ear, the ear pressure and burning are reduced. I think the answer is in there somewhere. In the extreme, it feels like a water balloon has burst and I am 100% temperature tolerant and pain free. I don't know if tissues deeper than the skin are involved (inflamed / mired by water) - I'm curious to ask my doc at next appt. It feels like when the skin can glide over the muscles, I am pain-free and temp tolerant. (fascia being a problem?) In particular there is nothing to see on my scalp (ie it doesn't flush or get red, but still feels "stuck" and itches).
    Would be curious if anyone else notices similar - like a pressure, "stuckness", "feeling water trickle down and it feels good" sensation? Stanford, UCSF, Tulane, and Louisville each did not have an explanation for me - saying they rarely hear that in the context of the face. I've actually gone to the ER for scalp pressure pain ("bone crushing") so I could get imaging (was clear, thank goodness). To me this is MUCH more excruciating than any burning or heat, and developed slowly after my 4th yr.
    Last edited by laser_cat; 12 October 2021, 08:45 PM.