Quote Originally Posted by laser_cat View Post
In the US - my experience is that most derms will not be able to offer much more than PCP. I began by asking PCP to trial medications mentioned here or in literature (clonidine, beta blockers). Eventually I landed on 2 derms who have an interest in neurovascular rosacea, but even they realize a large part comes down to trial and error per patient. My therapist had an "in" at my local teaching hospital and asked around for doctors who would specialize in flushing (how I found one of my derms). I found my other derm by looking up authors of rosacea publications. What I am able to get from these 2 derms I am not able to get from PCP or myself - how long to trial a given medication before I give up, why I wouldn't be a candidate for laser, how to titrate medications, medications that aren't typically "thought of" (calcium channel blockers, Xolair, birth control, IVIG, baclofen, ..), pathophysiology behind my symptoms and similar patients. There are derms who are very interested in neurovascular stuff and who realize that flushing conditions can be anywhere from mild to disabling, but these derms are far and few between I think, most derms will try to rx soolantra, antibiotics etc.
That's quite discouraging. I don't have such a big issue with flushing in general, but it seems to creep up at certain times of the month, if you know what I mean, and also sometimes when I lie down for long periods of time. (Like when I sleep) vBeam has improved it quite a lot, but I would rather it just not happen EVER, and give my vessels a rest, if possible.

I have anxiety that sometimes can induce a flush. Would that be a good enough reason to get my GP to prescribe it, do you think?