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Thread: Advice Please - Burning Without Flushing

  1. #1
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    Default Advice Please - Burning Without Flushing

    Hello everybody.

    My name is Pete and I’m posting on here as my partner has been suffering with unusual facial skin complaints. Almost like Rosacea yet without the rash. She doesent seem to suffer with any pustules, flushing and or flaky skin, however... her face feels as if if is constantly ‘on fire’ and is ‘dry and tight’. Furthermore, her eyes are becoming extremely dry and she is becoming incredibly depressed. She is convinced that she may have type 1 or occula rosacea.

    We have visited the GP several times and have even seen a dermatologist in a local clinic. Despite antibiotic therapy, and different soaps and creams her symptoms remain and have been exacerbated by anxiety and recent stresses.

    She is hoping to try mirtazapine and clonadine as suggested by a dermatologist in the U.K. named Professor Chu. But she’s extremely depressed and in a lot of pain.

    Does anybody have any experience or success stories. She feels there is no hope and this ‘neuropathic’ pain will never end.

    Thank you all for reading,
    Any help would be appreciated.

    Kind regards,
    Peter
    Last edited by pjc5150; 3rd March 2019 at 07:30 AM.

  2. #2
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    Default Advice Please - Burning Without Flushing

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    Last edited by OwO1777; 28th September 2019 at 06:53 AM.

  3. #3
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    Standard neuropathic pain meds are gabapentin, lyrica, amitriptyline, cymbalta. Maybe bring a copy of the "neurogenic rosacea" paper by Steinhoff, Berger, et al to future doc visits

    Mirtazapine + clonidine are really to control the blood vessel / flushing component I think (though mirtazapine might help with sleep). So she may not benefit from these (though generally the more sleep I get, the better my neuropathic pain / flushing symptoms are).

    There are more neuropathic pain options but my sense is gabapentin and/or lyrica needs to be tried sort of as a "rite of passage", along with amitriptyline and/or cymbalta.
    I think a primary care doc can help with dosing/ramp-up.
    If your partner fails these options then I would ask for a referral to a pain doc.

    edit -

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3692271/ (link of paper i mentioned)
    The derm I see, one of the coauthors in that paper, said 80% of his neurogenic rosacea patients (with burning out of proportion to flushing) get relief with some combination medications he mentioned (trial and error).
    Last edited by laser_cat; 1st March 2019 at 07:21 PM.

  4. #4
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    I recommend going to see Dr Tony Chu. He has helped a lot of members of the forum and is aware of a wide range of medicines that can be used to help the different components of rosacea. Different people will respond better to different medications, and it's helpful to have a doctor who can help you investigate the options available.

    Soolantra cream may help a little with the dry and tight feeling, particularly if there is an infestation of demodex mites.
    Last edited by antwantsclear; 1st March 2019 at 07:19 AM.

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    Quote Originally Posted by pjc5150 View Post
    Hello everybody.

    My name is Pete and I’m posting on here as my partner Louise has been suffering with unusual facial skin complaints. Almost like Rosacea yet without the rash. She doesent seem to suffer with any pustules, flushing and or flaky skin, however... her face feels as if if is constantly ‘on fire’ and is ‘dry and tight’. Furthermore, her eyes are becoming extremely dry and she is becoming incredibly depressed. Louise is convinced that she may have type 1 or occula rosacea.

    We have visited the GP several times and have even seen a dermatologist in a local clinic. Despite antibiotic therapy, and different soaps and creams Louise’s symptoms remain and have been exacerbated by anxiety and recent stresses.

    She is hoping to try mirtazapine and clonadine as suggested by a dermatologist in the U.K. named Professor Chu. But she’s extremely depressed and in a lot of pain.

    Does anybody have any experience or success stories. She feels there is no hope and this ‘neuropathic’ pain will never end.

    Thank you all for reading,
    Any help would be appreciated.

    Kind regards,
    Peter
    Hi Peter,
    I understand how she feels, I had constant burning pain in my face, it felt on fire. My family couldn’t understand because at the time I looked ok. I’ve never been so low in my life...it was no life.

    My Rosacea has developed but I’m no longer in pain and that was/is massive for me. I went to see Prof Chu and we tried cloindine, it didn’t work, Hrt it didn’t work and numerous other meds, none of which worked.

    The game changer for me was citalopram. For social occasions I use an antihistamine and sometimes propranolol. I also use factor 50 make up, the sun and Rosacea do not mix. Finding one that does not burn is really difficult.

    Things can and will get better.

  6. #6
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    Quote Originally Posted by pjc5150 View Post
    Hello everybody.

    My name is Pete and I’m posting on here as my partner Louise has been suffering with unusual facial skin complaints. Almost like Rosacea yet without the rash. She doesent seem to suffer with any pustules, flushing and or flaky skin, however... her face feels as if if is constantly ‘on fire’ and is ‘dry and tight’. Furthermore, her eyes are becoming extremely dry and she is becoming incredibly depressed. Louise is convinced that she may have type 1 or occula rosacea.

    We have visited the GP several times and have even seen a dermatologist in a local clinic. Despite antibiotic therapy, and different soaps and creams Louise’s symptoms remain and have been exacerbated by anxiety and recent stresses.

    She is hoping to try mirtazapine and clonadine as suggested by a dermatologist in the U.K. named Professor Chu. But she’s extremely depressed and in a lot of pain.

    Does anybody have any experience or success stories. She feels there is no hope and this ‘neuropathic’ pain will never end.

    Thank you all for reading,
    Any help would be appreciated.

    Kind regards,
    Peter

    Hello Peter

    Sorry that your partner is suffering have a look at My Low Dose Naltrexone Journey (so far) thread (under Prescription medications).

    Where are you based?

    J
    SUFFER FROM NEUROPATHIC ROSACEA & OCULAR ROSACEA SINCE 2002.


    *Vit D3,Theratears Omega 3.



    *LDN since October 2018.

    *REN skincare range. TARTE cosmetics.

    *Tried Clonidine, Moxonidine & Atenolol (None being taken at present ).

    *Yearly IPL treatments until 2009.

    * RLT Journey!" (Sept 09) **Using Britebox Revive..(Stopped ).



    History of Hyperthyroidism (Graves) Lichen Planus (oral)
    PROUD TO BE DIFFERENT






    .

  7. #7
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    Thank you all for such informative and caring replies!

    I really do appreciate it guys. Sorry about the delay in reply. I work shifts and I’m not always able to respond quickly.

    So is the general consensus to start with analgesia for neuralgia type pain and combat it on the other side with an SSRI?

    Does anyone have any success stories with LDN and this type of pain?

    My partner is hoping to see a ‘top’ dermatologist soon so hopefully things will improve. At the moment she is depressed and in pain. I wish there was more I could do for her

    Thanks guys x
    Last edited by pjc5150; 3rd March 2019 at 07:29 AM.

  8. #8
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    Quote Originally Posted by Judworth View Post
    Hello Peter

    Sorry that your partner is suffering have a look at My Low Dose Naltrexone Journey (so far) thread (under Prescription medications).

    Where are you based?

    J
    Hi Judworth!

    I shall read that now my friend, thank you

    We are based in North East Lincolnshire in the UK. A small town called Cleethorpes/Grimsby. Not sure if you are aware of it?

    Regards,
    Peter

  9. #9
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    Quote Originally Posted by Countrygirl View Post
    Hi Peter,
    I understand how she feels, I had constant burning pain in my face, it felt on fire. My family couldn’t understand because at the time I looked ok. I’ve never been so low in my life...it was no life.

    My Rosacea has developed but I’m no longer in pain and that was/is massive for me. I went to see Prof Chu and we tried cloindine, it didn’t work, Hrt it didn’t work and numerous other meds, none of which worked.

    The game changer for me was citalopram. For social occasions I use an antihistamine and sometimes propranolol. I also use factor 50 make up, the sun and Rosacea do not mix. Finding one that does not burn is really difficult.

    Things can and will get better.
    Thank you so much CountryGirl.
    Fantastic advice!

    Is Dr Chu good? He is one of the specialists we might be seeing.
    When you say your rosacea has developed, what do you mean?

    My partner has been stared on Citalopram so hopefully it will help

    Peter x
    Last edited by pjc5150; 3rd March 2019 at 08:13 AM.

  10. #10
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    Quote Originally Posted by laser_cat View Post
    Standard neuropathic pain meds are gabapentin, lyrica, amitriptyline, cymbalta. Maybe bring a copy of the "neurogenic rosacea" paper by Steinhoff, Berger, et al to future doc visits

    Mirtazapine + clonidine are really to control the blood vessel / flushing component I think (though mirtazapine might help with sleep). So she may not benefit from these (though generally the more sleep I get, the better my neuropathic pain / flushing symptoms are).

    There are more neuropathic pain options but my sense is gabapentin and/or lyrica needs to be tried sort of as a "rite of passage", along with amitriptyline and/or cymbalta.
    I think a primary care doc can help with dosing/ramp-up.
    If your partner fails these options then I would ask for a referral to a pain doc.

    edit -

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3692271/ (link of paper i mentioned)
    The derm I see, one of the coauthors in that paper, said 80% of his neurogenic rosacea patients (with burning out of proportion to flushing) get relief with some combination medications he mentioned (trial and error).
    Thank you so much lasercat!

    You seem to be such a fountain on knowledge with all this stuff.
    Although I’m a Paramedic, this really isn’t my area of expertise and I feel a tad out of my depth!

    I shall read the paper and I intend on printing off your advice and taking some notes with us to whoever we have a proper consultation with

    Are these symptoms in keeping with yours?
    I’m yet to speak to somebody who has seen or heard of Rosacea without any flushing or pustules.
    We are just trying to find out what it is?

    Thanks again,
    Pete x

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