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Papulopustular Rosacea - Cleansers, Moisturizers & Metro Gel care instructions needed

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  • Papulopustular Rosacea - Cleansers, Moisturizers & Metro Gel care instructions needed

    Hi there, I am new to this forum and looking for a lot of guidance.

    I have type 2 Rosacea. I am not newly diagnosed but I have recently had an increase in pustules. I'm taking a closer look at my nonchalant facial routine an revisiting forums looking for help from people who have already sifted through the research.

    Current Routine
    1.I was my face in the morning with cetaphil gentle cleanser (I haven't been consistent, that is a new trial one for me).
    2. I wait 10ish minutes then put on my 1% Metro Gel (I've been using once daily for over a year and it seemed to keep the pustules away, at least on my nose but now then are appearing daily on my chin)
    3. I wait 10-30 minutes then apply my cetaphil gentle moisturizer diluted with water (I find it too heavy otherwise).
    4. I use powdered Estee Lauder makeup, tarte bronzer and blush. (The powder is the only thing that contacts my chin where most of the pustules are).

    Full Disclosure: Because my rosacea was fairly mild and I've only ever had small pustules in my nose creases and mild redness and rare flushing I have let my care routine be very carefree. I switch cleansers and moisturizers every few months when one runs out and don't always wash my face at night depending on if I've worn makeup.

    I've had these pustules on my chin for a two months now they pop up.. I pop them.. they eventually go away and then reoccur again in I swear the exact same spot. I realize what I'm doing isn't working and I'm ready to revamp my skincare routine. I just read about mites and microbes being one of the main cause of the type 2 rosacea. Is antibiotics the only solution? I read on one of the forums Sulphur soap for washing, is that for type 2?

    I have been reading for hours and I feel so defeated. Fellow type 2'ers please guide me!

  • #2!-(w-pics)
    How I was cured from Demodectic / Demodex Rosacea (Types 1 & 2 & nearing 3), Seborrhoeic Dermatitis and Eczema

    Got a smartphone? Then please post a non-revealing pic of your face/skin to, instead of using walls of text to describe it to us. It may be the best thing you've ever done!


    • #3
      Your symptoms sound like a classic case of microscopic demodex skin mites. Demodex is found on most people by the time they reach the age of 18. A healthy immune system keeps the mite population in check. If the mites get overpopulated they can cause a variety of skin problems. The mites are a common cause of type 2 Rosacea when they get overpopulated. A dermatologist can test for demodex to verify it.

      The nose and chin are 2 of their favorite locations to hang out. They eat oil and possibly skin cells in the pores. The mites live on a 14-24 day cycle. Demodex can live anywhere on your body where there is an oil gland. The palms of your hands and the soles of your feet are the only part of your skin they cannot live on. The pustules occur when the mites die off. The mites do not like light. Night time is when the mites are active and come out to breed.

      Its important to cleanse your skin 2-3 times a day. Its especially important to cleanse your skin at night. The eggs are generally resistant to known treatments for the nymphs and adults. So it is important to keep treating the condition through at least 2-3 mite life time cycles to make sure that the last batch of eggs hatches and are killed off before they can reproduce.

      In my case, I had a severe case of demodex that was misdiagnosed for decades as acne and allergic conjunctivitis (red eyes). It finally developed into a severe case of ocular rosacea. Due to the severity of the eye condition, I took the oral treatment with Oral Ivermectin and Oral Metronidazole. Researcher have found that topical metronidazole (i.e. Metro Gel, or Metro Cream) is not effective at killing the mites. The oral version of metronidazole works.

      Here's some treatment options that I posted for Brady over on the RRdi web page:

      Hope this helps.
      Last edited by ElaineA; 22 January 2019, 09:42 PM.


      • #4
        Hi Courtney

        Some good advice above.

        My first rosacea symptoms to develop were P&Ps, much like you. I eventually managed to control these through a combination of metronidazole cream, Finacea cream and oral minocycline.

        Unfortunately, everyone's rosacea is different and responds to differently to different treatments. However, I would say that a fundamental component of any treatment regime for P&Ps is wearing at least SPF30+ (preferably SPF50+) sunscreen on problem areas every single day, even if you are working in an office etc.

        In my view, without doing this, you will have difficulty controlling your symptoms.

        Hope this helps!