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Thread: lidocaine mixed with a topical?

  1. #1
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    Default lidocaine mixed with a topical?

    Has anyone ever tried lidocaine powder mixed directly into a medicated topical, when there skin was too sensitive to use the topical on its own? I've been suffering from severe flushing but also severe, persistent, worsening dermatitis that involves flakey buildup, small pustules with white almost blistery heads, and also rash-like red bumps with no head that are spreading all over my face. Biopsies have indicated seborrheic dermatitis and presence of demodex mites. Because my skin is so sensitive, I've tried a lot of oral medications (antifungals, antibiotics, ivermectin, accutane, etc) to see if it can bring the inflammation, redness and bumps under control, but without much success. My skin burns intensely whenever I try to put a topical on it (soolantra, metro gel, elidel, low potency steroids, lidocaine creams). I was wondering if anyone has ever had lidocaine powder compounded directly into a medicated topical so they could tolerate the topical long enough to see if it helps? Since my oral meds aren't working on the dermatitis issues, which always come back, I wonder if I need to just get a topical on there somehow--whether through lidocaine or taking a strong pain medication for awhile. My compounding pharmacists said he could do the compound of lidocaine and medicated topical. Have others tried the lidocaine route or had other ways they dealt with the too-sensitive-for-a-topical problem when oral meds weren't working? I've been considering laser too but worry that my skin is just too rashy and sensitive right now for it. Thanks!
    Last edited by AEB; 24th February 2016 at 12:47 AM.

  2. #2
    Senior Member Mistica's Avatar
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    Hi,

    The last few times I had IPL treatment, the doctor applied Lidocaine first to induce vasodilation. It certainly did the trick, but in my case it didn't wear off. I don't think he had treated many rosaceans and certainly not any flushers such as myself.

    I realise you want to diminish your pain, but I honestly don't see Lidocaine being appropriate in your case. It will worsen your flushing and perhaps it could cause permanent nerve signalling changes in your face creating a state much like the brimonidine/mirvaso victims. (I am one of those). You'll want to avoid that.

    Here is a pubmed study about Lidocaine.
    http://www.ncbi.nlm.nih.gov/pubmed/17223807

    It sounds like your facial skin has been traumatized by all the topicals you have used on it. The accutane likely further compromised your skin.

    The first thought is to stop applying anything to give it a rest. This sometimes works, but I expect you have been down that road and found it doesn't.

    This may sound unreasonable, but a topical sulphur, whilst irritating at first, might calm things down.
    When I first used sulphur, it caused so much irritation I thought my face might burst into flames. Needless to say, this ramped up my level of distress to great heights which only served to fuel my extreme flushing/swelling. I swore to never touch the stuff again. Then I tried a compounded 3% sulphur/sulfacetamide 10% in a vehicle of cetaphil cleanser. It had to be left on for 7 to 15 minutes. After some days, a week perhaps, the vascular rash effect started to dry out and symptoms reduced, but it only did so much.

    Some years later, I decided to give ZZ cream (from demodex solutions) a go. ZZ cream is also a sulphur cream, and is designed for treating demodex and seb derm.
    I found I tolerated it well. As ZZ contains Menthol, this provided pain relief.
    Because ZZ cream dried my skin out like old leather boot, this reigned in some of my flushing. It acted like a brace to the more superficial vessels. And while they were getting a rest, the process for flushing down regulated. I used a lot. You don't have to dry out the skin as much as I did. In fact, the advice on the pot is to only apply a tiny bit in a very thin layer.

    At the same time as using a topical, you need to treat the underlying cause and this often involves the gut and addressing any nutritional deficiencies. I was on antibiotics when I first started using ZZ cream, which likely helped eliminate the common outbreak stage that many users report. So, if you decide you are interested in using this cream, I recommend you browse through old posts here and also posts on the demodex forum.
    Some people only experience minor side effects. Some wish they had never touched the stuff.

    I won't go into detail with diet and gut flora modification here. There are plenty of posts about this already and you can browse those.

    You may find oral and topical niacinamide helpful. It is anti inflammatory, reduces oxidative stress, it has a sedatory action on nerves, including those involved in flushing. There's quite a lot of information about niacinamide on this forum. Your face is under extreme oxidative sress.
    I use both successfully. I am not cured, but I do find them helpful. I transitioned from full face ZZ cream to niacinamide, with further improvements, but I continue to apply ZZ on my nose and upper lip area, mixed with niacinamide gel.
    My skin is no longer buzzing and burning and rarely breaks out any more. I still flush, and part of the reason for this is the brimonidine induced damage. I have other health issues and over all, I am still a work in progress, much like everyone else here.

    You have a compromised skin barrier as you know, so if you can eliminate the fungal infection, and reduce the population of demodex first, you should find it easier to rebuild it.

    Niacinamide has antifungal properties, which is another bonus and it has been shown in studies to help repair the skin barrier. In high doses it can be irritating.
    4% is the ususl starting dose and even that can cause some irritation at first.

    I've heard a few good reports about the product Dermalex. This too supposedly works to repair the skin barrier.
    If you have active infection in your face though, you'll probably need to address that as well.

    Tom Busby is our resident expert on topical seb derm treatments. Perhaps he could offer suggestions for your particular case.

    No matter what topical you apply, you still have to address systemic causes. Topicals are just one tool.
    You have to reduce oxidative stress and calm down your CNS.

    Vitamin C might help you as well, but in oral form.
    I love the stuff and start my day off with 1000mg ascorbic acid +250mg niacinamide.
    I repeat this again 7 hours later and before I go to bed at which time I take sodium ascorbate.
    Sodium has an added benefit of being calming on the nerves. The most common side effect of all this is an upset gut for a few days.
    This is not necessarily a bad thing.
    I've taken up to 30 grams per day/in divided doses when my face was at it's worse. Oddly, while the initial doses reddened me somewhat, eventually, my face always calmed right down.
    Other people here have found Vit C a useful tool, but some can't tolerate it.

    Selenium, low dose iodine, zinc are all antioxidants. Speaking of zinc, have you tried applying it topically? Some people find it calming.
    (There is zinc, sulphur and menthol in the ZZ cream. Along with antimicrobial herbs).

    Gelatin made into a jelly/o, or stirred into a warm beverage is therapeutic for a variety of reasons, particularly for flushers. It has a sedatory effect on nervous system. It also contains glycosaminoglycans which improve gut integrity and glycine and proline which promote collagen/good skin health.

    What is your history? Did something in particular set off your facial symptoms?

    I am sorry this post is so disjointed. My dog is persistently trying to get my attention. He has a doggy emergency. A stuck puff in his mini kong. Oh how I wish all our worries were so trivial and amusing.
    Previous Numerous IPL.
    Supplements: Niacinamide, Vit K2, low D3, Moderate Dose Vit C, Iodine, Taurine, Magnesium. Very low dose B's. Low dose zinc (to correct deficiency).
    Skin Care: No Cleanser, ZZ cream mixed with Niacinamide gel 4% and LMW HA.

    Treating for gut dysbiosis under specialist care. (This is helping).
    Previous GAPS diet. Testing tolerance of resistant starch.
    Fermented Foods. 2 to 3 days per week, Intermittent fasting -16-18 hours.

  3. #3
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    Default

    Mistica, Thanks so much for your reply--it's great to get all these suggestions and hear your experience! And I can relate to the distracting dog--my little one is always trying to get my attention and get more treats! I didn't know that topical lidocaine was a vasodilator! It's good to know that--I definitely want to stay away from any vasodilation. I've been trying out a test spot of klaron lotion (with sulfacetamide) and so far it seems to be irritating. Maybe a compound in cetaphil, like you suggested, might be a better option. I've thought about trying lidocaine infusions, but it seems daunting and could possibly make things worse. Has anyone tried that? I haven't found any old posts on it.

    As far as my history goes, I went off metrogel and tried finacea, and almost immediately my skin went crazy with constant flushing, followed by rashes, breakouts, etc. that have persisted for over a year. I was then on a high dose of doxy for a few months which helped with the pustular breakouts, but eventually my skin got really red with a lot of flaky and crusty buildup (it was like I had a second layer of shiny crusty skin on my whole face). A couple of doctors thought it was contact dermatitis--I was patch tested and it seemed to actually be either bad seborrheic dermatitis and/or mites (mites showed up in my facial biopsy eventually). Nothing oral has really worked to permanently get things under control (dermatitis or flushing) and I can't tolerate any topicals now (even metro gel made my face burnt looking and inflamed and elidel/proptopic burn when I apply it). So I'm trying to figure out where to go from here, as the pustular breakouts and rashiness (little red bumps everywhere) are getting worse, as is the flushing. My doctors seem inclined to try hight dose antibiotics again but I'm also trying to think of the alternatives, since as you say, the gut can become a real issue then. I've considered the nothing route (no soap or lotions or anything) but when I tried that before the buildup/possible seborrheic dermatitis seemed to get a lot worse. Vbeam has also been suggested but I'm not sure my skin can handle that right now with the other issues and sensitivity and skin barrier problems.

    I really appreciate hearing your suggestions and would welcome those from anyone else who has had similar problems. It's hard to know what to do when you can't tolerate any topicals but oral meds aren't getting you anywhere. Any I'm just so scared to try anything new at this point and possibly get worse, while what I'm doing now clearly isn't working. Looking further into nutrition and the gut (and also niacinamide and some of the other things you suggested) definitely seems promising! Oddly the one contact irritant I have is mint, so anything with menthol won't be possible. Dermalax looks like an interesting possibility though!

  4. #4
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    Quote Originally Posted by Mistica View Post
    Hi,

    The last few times I had IPL treatment, the doctor applied Lidocaine first to induce vasodilation. It certainly did the trick, but in my case it didn't wear off. I don't think he had treated many rosaceans and certainly not any flushers such as myself.

    I realise you want to diminish your pain, but I honestly don't see Lidocaine being appropriate in your case. It will worsen your flushing and perhaps it could cause permanent nerve signalling changes in your face creating a state much like the brimonidine/mirvaso victims. (I am one of those). You'll want to avoid that.

    Here is a pubmed study about Lidocaine.
    http://www.ncbi.nlm.nih.gov/pubmed/17223807

    It sounds like your facial skin has been traumatized by all the topicals you have used on it. The accutane likely further compromised your skin.

    The first thought is to stop applying anything to give it a rest. This sometimes works, but I expect you have been down that road and found it doesn't.

    This may sound unreasonable, but a topical sulphur, whilst irritating at first, might calm things down.
    When I first used sulphur, it caused so much irritation I thought my face might burst into flames. Needless to say, this ramped up my level of distress to great heights which only served to fuel my extreme flushing/swelling. I swore to never touch the stuff again. Then I tried a compounded 3% sulphur/sulfacetamide 10% in a vehicle of cetaphil cleanser. It had to be left on for 7 to 15 minutes. After some days, a week perhaps, the vascular rash effect started to dry out and symptoms reduced, but it only did so much.

    Some years later, I decided to give ZZ cream (from demodex solutions) a go. ZZ cream is also a sulphur cream, and is designed for treating demodex and seb derm.
    I found I tolerated it well. As ZZ contains Menthol, this provided pain relief.
    Because ZZ cream dried my skin out like old leather boot, this reigned in some of my flushing. It acted like a brace to the more superficial vessels. And while they were getting a rest, the process for flushing down regulated. I used a lot. You don't have to dry out the skin as much as I did. In fact, the advice on the pot is to only apply a tiny bit in a very thin layer.

    At the same time as using a topical, you need to treat the underlying cause and this often involves the gut and addressing any nutritional deficiencies. I was on antibiotics when I first started using ZZ cream, which likely helped eliminate the common outbreak stage that many users report. So, if you decide you are interested in using this cream, I recommend you browse through old posts here and also posts on the demodex forum.
    Some people only experience minor side effects. Some wish they had never touched the stuff.

    I won't go into detail with diet and gut flora modification here. There are plenty of posts about this already and you can browse those.

    You may find oral and topical niacinamide helpful. It is anti inflammatory, reduces oxidative stress, it has a sedatory action on nerves, including those involved in flushing. There's quite a lot of information about niacinamide on this forum. Your face is under extreme oxidative sress.
    I use both successfully. I am not cured, but I do find them helpful. I transitioned from full face ZZ cream to niacinamide, with further improvements, but I continue to apply ZZ on my nose and upper lip area, mixed with niacinamide gel.
    My skin is no longer buzzing and burning and rarely breaks out any more. I still flush, and part of the reason for this is the brimonidine induced damage. I have other health issues and over all, I am still a work in progress, much like everyone else here.

    You have a compromised skin barrier as you know, so if you can eliminate the fungal infection, and reduce the population of demodex first, you should find it easier to rebuild it.

    Niacinamide has antifungal properties, which is another bonus and it has been shown in studies to help repair the skin barrier. In high doses it can be irritating.
    4% is the ususl starting dose and even that can cause some irritation at first.

    I've heard a few good reports about the product Dermalex. This too supposedly works to repair the skin barrier.
    If you have active infection in your face though, you'll probably need to address that as well.

    Tom Busby is our resident expert on topical seb derm treatments. Perhaps he could offer suggestions for your particular case.

    No matter what topical you apply, you still have to address systemic causes. Topicals are just one tool.
    You have to reduce oxidative stress and calm down your CNS.

    Vitamin C might help you as well, but in oral form.
    I love the stuff and start my day off with 1000mg ascorbic acid +250mg niacinamide.
    I repeat this again 7 hours later and before I go to bed at which time I take sodium ascorbate.
    Sodium has an added benefit of being calming on the nerves. The most common side effect of all this is an upset gut for a few days.
    This is not necessarily a bad thing.
    I've taken up to 30 grams per day/in divided doses when my face was at it's worse. Oddly, while the initial doses reddened me somewhat, eventually, my face always calmed right down.
    Other people here have found Vit C a useful tool, but some can't tolerate it.

    Selenium, low dose iodine, zinc are all antioxidants. Speaking of zinc, have you tried applying it topically? Some people find it calming.
    (There is zinc, sulphur and menthol in the ZZ cream. Along with antimicrobial herbs).

    Gelatin made into a jelly/o, or stirred into a warm beverage is therapeutic for a variety of reasons, particularly for flushers. It has a sedatory effect on nervous system. It also contains glycosaminoglycans which improve gut integrity and glycine and proline which promote collagen/good skin health.

    What is your history? Did something in particular set off your facial symptoms?

    I am sorry this post is so disjointed. My dog is persistently trying to get my attention. He has a doggy emergency. A stuck puff in his mini kong. Oh how I wish all our worries were so trivial and amusing.
    Hi Mistica

    There has been a lot of interest in the forum recently about ZZ cream - but it's interesting that you report here that niacinamide cream has helped you even more. What brand did you find helpful - is this available on Amazon? Thank you. I actually have some Dermalex cream ready to try! In terms of gut, the main issue that was identified by tests I had was a b hominis infection.

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