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Thread: Quick question about the Pustules/papules associated with rosacea

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    Senior Member Rand627's Avatar
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    Default Quick question about the Pustules/papules associated with rosacea

    Ok guys, as many of you know I have the flushing/red type of rosacea. However, I have a question. I had severe acne as a kid. I got a few cysts now and then but for the most part I got whiteheads. They would last for a week or two after they had been 'popped' (hate that word).

    Anyway, how does the acne associated with rosacea look? Is it like a whitehead or is it more cystic? Are they generally large or small? Inflamed? And what exactly is the difference between a pustule and a papule?

    I ask because I've been getting some weird pimple like things around my mouth as of late. They also come on the top edge of my cheek where the skull sinks in for the eye. They are extremely small and once popped (use a sewing needle..try my best to keep it as clean as possible) they go away really fast, less than 3 days usually. They look like whiteheads but generally are not raised almost at all. It's almost like a non inflamed smaller version of a regular whitehead.

    Thanks guys!

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    thanks for asking these questions - i often wonder whether the tiny whitehead-like things i get are what other people mean by pustules. mine are almost always one-pore deals that usually disintegrate in the process of washing/drying my face. the main trouble is that they often appear in clusters, in awkward places like the end of my nose, where the redness they leave behind is hard to ignore

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    I get 3 different types of bumps mostly on my forehead.

    Bump type 1 is like a typical acne pimple that eventually gets a white head and can be popped. I don't get a lot of these.

    Bump type 2 looks like a single plugged pore, it gets a bit of a white head that is really more like a scab. These can not be pooped, nothing inside them, they last 4 or 5 days and eventually flake off. I get quite a few of these.

    Bump type 3 is just a slightly raised red bump that never comes to a head, can't be pooped, lasts a week or two and eventually goes away. These tend to leave a red mark that takes a long time to fade. I don't get too many of these.

    -Dave-

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    Senior Member Rand627's Avatar
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    Quote Originally Posted by dora View Post
    thanks for asking these questions - i often wonder whether the tiny whitehead-like things i get are what other people mean by pustules. mine are almost always one-pore deals that usually disintegrate in the process of washing/drying my face. the main trouble is that they often appear in clusters, in awkward places like the end of my nose, where the redness they leave behind is hard to ignore
    The one pore thing describes it perfectly. Is this associated with rosacea then? The bumps come around my mouth where I don't even get red. Only my cheeks and up the bridge of my nose are red. They can oftentimes get on my nose, however, and that can get red as well.

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    Quote Originally Posted by Rand627 View Post
    The one-pore thing describes it perfectly. Is this associated with rosacea then?
    yes - at least that's what all my dermatologists have said.
    in fact it was when i started getting those things that i went to a dermatologist and got diagnosed.
    (i did have spider veins before the micro-whiteheads started showing up, but not to a degree that bothered me)

    but since my dermatologists aren't English-speakers, i'm still not sure those bitty things are what people refer to as pustules
    Last edited by dora; 5th December 2010 at 06:41 PM.

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    Senior Member Rand627's Avatar
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    Hm..interesting. Found any helpful things to do to get rid of them? When I shave I usually end up bleeding in 3 or 4 spots cause of them.

    Also, I'm an accutane induced rosacean. Not entirely sure if i should even call it rosacea or not as its cause is completely different.

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    Quote Originally Posted by Rand627 View Post
    Hm..interesting. Found any helpful things to do to get rid of them? When I shave I usually end up bleeding in 3 or 4 spots cause of them.

    Also, I'm an accutane induced rosacean. Not entirely sure if i should even call it rosacea or not as its cause is completely different.
    yeah, who knows whether all these things bunched together under the term "rosacea" are related -
    someone around here once said very aptly that it seems like all the diagnosis "rosacea" really means is
    "the doctors don't know what the heck it is, but it's red!"

    anyway! tetracycline definitely helps keep my micro-whiteheads at bay, but a body can't be on antibiotics all the time.
    washing with diluted apple cider vinegar is probably the second-best way of controlling them i've found.
    i use unrefined organic apple cider vinegar diluted to 10% in natural spring water, and apply it with a cotton pad once or twice a day.
    some people apparently use stronger dilutions than that quite happily, but i think it's wise to start with a low dilution.
    and apparently some people's skin reacts badly to the vinegar, so spot test it somewhere discreet before going all out.

    hope that helps some!
    Last edited by dora; 5th December 2010 at 08:03 PM.

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    Quote Originally Posted by dora View Post
    washing with diluted apple cider vinegar is probably the second-best way of controlling them i've found.
    i use unrefined organic apple cider vinegar diluted to 10% in natural spring water, and apply it with a cotton pad once or twice a day.
    i also use a 20% azelaic acid cream diluted 50/50 with a moisturizer two or three times a week,
    and i reckon that helps too.

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    Senior Member Rand627's Avatar
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    Hm, interesting. It seems like more and more pop up around the original site especially when I aggravate them. I will oftentimes use astringent once the pimple is actually open..which seems to help it dry out. I've also started to change my pillow every 3 days or so and more often than not, when I see one, I just leave it alone. Since I leave it alone not many more pop up and they usually disapear within a few days.

    And yeah, any type of acne antiboitic is a pretty big nono for me. I know they are different in many ways, but accutane is what got me into this mess and I don't feel like potentially aggrivating it with more internal medicine. I'm on mepacrine right now. It will be interesting to see when the mepacrine starts to help with the redness whether or not the pimples will go away. If they don't I'll definitely end up trying some of your tips.

    Thanks a bunch!

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    Senior Member windsor90's Avatar
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    You mentioned your pillow, Rand. Simple but perhaps something to consider!
    My right side is much, much worse than my left side and I attribute (part of) that to sleeping on that side of my face. I eventually flip over and sleep on my stomach at night and always on that one side. That's the side that I have the "never quit" papules. Though, recently I have gotten them under control (shhhhh....don't tell them!).

    About 6 months ago, I switched to one of those dense foam pillows that are meant for people with neck problems. That keeps me sleeping on my back and now I'm finally used to it. I've always maintained that this is one of those disorders/diseases that requires a multi-pronged treatment approach. Simple changes such as the way you sleep can be an important link just like making changes in your diet. It occurred to me last year just how hot that side of my face must get when I sleep on it, the pressure of smooshing my skin and....well..who doesn't drool! ....It can't be good!

    My p&p's have an itchy type feeling when I run my finger across them. They don't hurt typically. I can absolutely tell the difference between a pimple and a p&p which usually is around for at least a week or two and then the red spot/stain remains for a few weeks after that as a wonderful reminder. They do have a tendency to spread so once I get one I know I am doomed to get more.
    Mild Subtype 2
    Metrocream 2x/day until 8/2010
    Over the counter Prosacea....this dries out my p&p's when all else fails.
    Dermalogica's Sensitized Line
    Sunscreen: Clinique's City Block
    VBeam: 9 joules/cm2@ 10ms pulse duration
    Plaquenil 400mg/day

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