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Trying to Identify the Root Cause of my P&P.

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  • Trying to Identify the Root Cause of my P&P.

    One prevailing theory is that P&P occur due to inflammation. I have heard this for over a decade now, but it does not seem consistent for me.

    Before I went for vacation, I wanted to have a tan. So I gave my face some exposure, little by little in a tanning bed. Now, of course this is risky, and lets not get into the negatives about that...its a whole topic by itself. It was somewhat of an experiment to see how much I could tolerate so I know my limits. As I pushed it a minute more each day, I eventually got red at about the 10-11 minute mark and it stayed red for about 48 hrs then subsided. However, one important note was that I had zero P&P at this time. After about a week away from the tanning bed, I noticed some P&P coming back and tried my tanning experiment again, just one session. It immediately cleared the P&P...gone.

    So you might think, well this is just regular acne since uv light kills acne bacteria, but it definately is not. I have been using a salycilic acid face wash that has kept me acne free for over 6 months, not a single spot. So this makes me wonder, I was more red than normal, but yet P&P free. So is this really consistent or is it something else like a bacteria, dust mite, demodex mite, etc.?

    While on vacation, I had very few (if any) P&P for almost 2 weeks, but when I got back they have returned. But no change in redness or vascular symptoms. This got me thinking of these variables:

    1. Diet. Was pretty bad consisting of mainly cheeseburgers and beer.
    2. Airborne allergens, dust mites, etc.
    3. Other items that do not seem as reasonable.

    So at this point, my main question is if anyone has directly correlated P&P to something other than underlying vascularity. My P&P do not seem to be activated by vascular problems and I have observed this for years now.

  • #2
    mine are worsened by red meat, any dairy product, sugar or honey, and white flour. These foods seem to increase inflammation in my face and consistently torment me.
    • 58 yr old woman
    • Rosacea at 48, debilitating at 52
    • Clonidine 100mgc ev. 8 hrs;
    • Remeron 15mg nightly;
    • Zebeta=Bisoprolol=Beta blocker 5mg nightly;
    • Brimonidine worked well initially, then MASSIVE rebound flushing and damage;
    • Countless IPL with Lumenis One;
    • Now purpuric V Beam with Candela Perfecta; more clearance, less downtime than IPL;
    • Botox (with mesotherapy needles), good not great results;
    • Monthly Kenalog injection to blunt debilitating flushing.


    • #3
      THis is my understanding, seems to make sense but who knows !

      The P&P's are a vascualr problem, that's why the spots keep returning in the same spot or spots (which was true for me - maybe not with you?) So this makes sense to me why i get the P&P's in the same locations all the time.

      Now if I use a tanning bed shortly like you explained, the same thing happens for me as it did for you. I think that with a small amount of tanning it strengthens your skin enough to allow your body to fight off the new p&p's and when you are away from it long wnough they come back.

      My face gets a bit redder when I tan but the p&p's go away.

      Just a thought, but it seems to make sense to me from everything I've read. So I still think its a vascular problem and the weaker spots are the trouble areas.


      • #4
        oh man this has been the number 1 question for me too. what causes those darn p and p! I mean i can leave home and a few hours later BAM a couple new tiny ones... what changed?

        personally ive ruled out diet because i stopped all sugars, msg, chemicals, etc. for 6 months and honestly, there was no change. i look better now (not on a diet) after my PDT treatments, still getting them though they seem to be smaller, clear up faster and less of them. I wish we could find out what causes them so i could get rid of them!


        • #5
          I suffered from P&P's intermittently for about 5 years. In that time (especially when I was pregnant) I had some huge flare ups when my face was almost completely covered with them. It was at that time especially that I experienced severe flushing burning and stinging.

          It is my belief now that in my case that I was having an allergic reaction to the Demodex mite. Most of the population have them but only a small percentage actually react to them.

          About 5 months ago I started on a trial of Topical Ivermectin and my face cleared up within a week. I approx had 20 papules on each cheek and on my forehead and neck. Apart from the very rare one I am completely P&P free. This Christmas I have indulged in everything bad from chocolate, to ice cream, a completely different diet and lots (for me) of wine. I don't have one papule to show for it (my hips tell a different story).

          I also did not get any rebound P&P's that the ZZ cream users describe either.

          Today I am P&P free, can not tell you the last time I had a flush or blush for that matter. I also have not taken any Propanalol or used any Metrogel since starting. I have absolutely no symptoms of Rosacea.

          The real test will be when I stop using it next week. They want me to stop and see what happens next.

          By the way as I mentioned on previous posts this has been the result for almost everyone on the trial worldwide.


          • #6
            Hi, that is wonderful and thanks for sharing your positive experience with us.

            Would you be able to tell us the dose and application frequency?
            Did anyone try to clear their p&p's up with oral ivermectin or only topical?

            Since many rosaceans cannot tolerate topical I wonder if oral would have the same beneficial effect?




            • #7
              Hi Melissa,

              I have spoken to the Derm that was running the trial and asked him all the questions that you just did. He is unable to give me the topical dose I only know that it is a 1% preparation, there is a patent on the product. I also asked him about taking it orally, I work as a nurse so I wondered why you couldn't just take an oral dose and be done with it. He believes that taking it orally dilutes the Ivermectin and it doesn't work on the surface of the skin which is where the mites are. From what I have read here and on other forums no one has had a positive experience with oral Ivermectin.

              I read on another post that Mistica has had a preparation made up by a Pharmacist using Ivermectin. It would be really interesting if there were others in Australia who suffered from the P&P's that could get some of that preparation. Like I said the results almost happened overnight.

              The topical preparation is really soothing, I do not use another moisturiser. Prior to this my skin was extreemly sensitive, I could only tolerate Cetaphil as a cleaner and Dr Hauskcha products to moisturise. I would love to know what they use as a base as it would make a wonderful moisturiser on it's own.


              • #8
                Thanks for the reply and it is sounds like a hopeful treatment for the future for many rosaceans


                • #9
                  The other thing I noticed is that I don't seem to develop anything during the day. However, the morning sometimes shows a different story. Only thing I can think (asside from the prevailing inflammation thoery), is it something in the air/bed. Also, I believe the demodex do not like light. Shucks, I don't hard to pinpoint these things.

                  At this point, I really only average about 3-5 spots about the size of a pinhead...but that is enough to drive me crazy. Needs to be ZERO one way or another.
                  Last edited by hozer2k; 8 January 2009, 12:32 AM.


                  • #10
                    Perhaps you have seb derm along with rosacea? That could account for the mysterious P&Ps that don't seem to follow along with your other symptoms. Sun exposure is supposed to be good for seb derm from what I've heard. I know I have seb derm and I frequently have tiny red spots like those you describe that seem to come and go at random - or I did until I started using coconut oil. But that's another topic for the ongoing coconut oil thread I have going.


                    • #11
                      so what is this topical you're talking about and how can i get it?


                      • #12
                        The Topical Ivermectin that I have been using is actually a Trial Drug so it isn't available commercially. It is currently being trialled world wide as to its long term systemic effects.

                        You could try to pm Mistica as she has been in contact with a private Pharmacist who is trying to make her up a preparation with Ivermectin in it.


                        • #13
                          I am considering trying out the zz cream again, which goes after mites as well. My main problem is still diffuse overall redness with very tiny P&P so I am not sure if mites really play a part. I am wondering if the topical ivermectin would be more effective than the zz cream. That initial breakout period is tough to go through and that is why I am dreading trying it again.


                          • #14
                            With the Ivermectin there was no break out period. They just started to disapear almost overnight. When the P&P's disappeared so did the redness, peeling, inflammation, burning and pain.


                            • #15
                              I received my formula of topical Ivermectin the day before yesterday. I have performed some test patches to see if I have any reaction to them.
                              24 hours on and all seems ok.
                              I didn't experience any stinging nor additional redness upon application.

                              Recently I have had a pretty bad outbreak of pustules over the bridge of the nose and down the sides. You couldn't have stuck a pin in between them. Densely packed. They itched. I seem to get three kinds of outbreaks. Ones which come up during the day or night and I am not aware of their presence until I look in the mirror. Ones I can feel as a tingle or itch and ones which hurt.
                              I wonder if the non itchy ones are due to inflammatory causes, rather than that of demodex?
                              I can see tell tale signs of another round of outbreaks about to start, so I am hoping the topical will put a halt to that.

                              Just to clarify, my pharmacist was given permission by the research doctor to make up a formula for me. My own dermatologist diagnosed me as having severe recalcitrant rosacea and I have failed every treatment modality I have tried. There is nothing else, barring flying to Sydney and trying the Lumenis One. I can't fly at this stage. I have been housebound for one year. Additionally, I have to be able to reduce the inflammation first.
                              I believe it was for this reason that I was given the okay to trial the Ivermectin.
                              Updates of my response will be passed on to the research doctor.
                              As I have mentioned before, I have vascular rosacea, with additional P&P's at times. Ivermectin will unlikely help me, but if it does, it will be great for me and everyone else.
                              I Intend to start a thread on my progress ( or lack of it), when I start using it all over my face.
                              The formula was tailored for my skin. It is different to Rachel's.

                              To answer the question all other Australian rosaceans must be wondering, ... will they be allowed to purchase the formula?, .... I have asked this question, and now await the answer. He is currently away on holiday for a few weeks, but will hopefully reply when he returns.

                              He has spent months helping me, so I believe he has a sincere desire to help. If he is able to supply others the formula, with no red tape he will, so please just give it a little time and let him sort it out. We don't want to rock the boat, so to speak.
                              Previous Numerous IPL.
                              Supplements: High dose Niacinamide, Vit K2, low dose Vit A. Moderate Dose Vit C, Iodine, Taurine, Magnesium. Mod- dose B's. Low dose zinc. Testing Quercetin.

                              Skin Care: No Cleanser, ZZ cream mixed with Niacinamide gel 4% and LMW HA 2%, ethyl ascorbate 2%.

                              Treating for gut dysbiosis.(This is helping).
                              Previous GAPS diet. Have now introduced lots of fibre.
                              Fermented Foods. Intermittent fasting -16-18 hours.
                              Oral Colostrum. Helps reduce food reactions.