Summary of basic preventative measures for P&P

[PorridgeMan]

Hi Team,

Excuse my ignorance if this information already exists, but I'm wondering if fellow P&P sufferers could summarise what they've found effective, especially if they live in a very sunny and windy place like Perth, Western Australia, and especially if they suffer mostly pustules.

I have really struggled with pustules this year. I have seen several dematologists over the years and they have variously diagnosed me with adult acne, rosacea and most recently perioral dermatitis. I have used a large number of medications and only ever found the oral antibiotics and topical Clindamycin to do anything. Ro-accutance also worked fabulously, but had severe side effects too. I have now been on oral Minocycline for 3 months and been advised by my dermatologist that I'll have to come off it soon. Just prior to that I tried Metrogel and Finacea over several years, but saw little efficacy. I'm very anxious about returning to the condition I was in, as I found it very difficult to go out in public and function effectively at work. The Minocycline worked so well I almost forgot about how bad things could get until I ran out the other day. The pustules returned within 24 hours of my last dose and I realised nothing had changed.

So, I came back to this forum and started thinking that maybe I'm missing out on something. I generally read that people eventually find a regime that manages their rosacea so that it becomes only a minor incovenience. I would love to get to that place, but I don't know what else to do or try. My regime is a low GI diet, cleanse with Cetaphil and take anitbiotics. Take away the latter though and my regime falls over. I read that some people find the use of moisturiser and sunscreen in addition to gentle cleansing works for them, but would that work for someone with very oily skin like me? I've always avoided putting anything on my face after cleansing, because I just expected it to make the oiliness and therefore pustules worse. Is anyone in my boat? Would love to hear about your successes or failures.

P.S. Interesting news today about a link between the rise of inflammatory diseases and a lack of fibre in the Western diet.

[Rubicund]

Hiya

What dose of Roaccutane were you on? I too did the full course of Minocycline (over 10 years!) which mostly kept the pustules at bay as long as I did most other things right as well. Eventually I transitioned to low dose Roaccutane with almost zero side effects. I'm wondering whether a lower dose for you might deliver the benefits without the nasty side effects.

[Aurelia]

Hi PorridgeMan,

That was a very interesting post.

Have you ever had any luck with sulphur? Quite a few people have reported success against pustules, whether from acne or rosacea, when treating them with sulphur-based topicals and/or taking health supplements that contain sulphur, for example MSM. Might it be worth a shot?

http://rosacea-research.org/wiki/index. ... e_Topicals

Would you mind please providing a link to the news you mentioned about "a link between the rise of inflammatory diseases and a lack of fibre in the Western diet"? It seems highly likely to me, but it would be interesting to read whatever you were reading, thanks.

Kind regards,

Aurelia

[David Pascoe]

Hi PorridgeMan,

Have you already tried the 50mg a day of doxcycline path ? This might be a better option especially medium to longer term. My GP was happy to let me stay on this dose for a few years because it continued to show me a benefit and was finding it hard to wean off antibiotics. I found it hard to get to a point where the P&Ps wouldn't return as soon as the dose dropped - similar to you by the sound of it.

How about rosacea-ltd ? This was a good option for me too, it definitely helped my P&Ps.

davidp.

[Naturaltreatments]

Hi there

It's good that you know that you can get some relief from the pustules, even if it's with antibiotics which are clearly not an ideal long term solution. I have found significant relief from the pustules, and a little relief from flushing with the oral version of sulphur, MSM - (I use Solgar MSM 1000mg per day). Sulphur, orally and topically, may help though some people do have reactions to sulphur (but then that's the case for antibiotics too). You might find some of the Sher System products helpful, in particular the nutritional supplement they offer (Sher Skin Support formula). I found that the pre-wash they offer didn't help with pustules, but the gentle cleanser they offer is helpful and I still use it. Their moisturiser is also good in general if you have any dry skin/irritation from shaving as it is created for acne/rosacea prone skin, though I would still be wary of using it on very oily/pustule prone areas (the nose in my case) - but in general it has helped me as well. The Sher products are quite expensive and you have to pay for an online consultation too, but Helen Sher is pretty knowledgable about rosacea, so it's worth talking to her to see if the products could work for you (www.sher.co.uk). If there was just one product that would help, though, from my personal experience I'd suggest maybe oral MSM - hopefully you would see an immediate impact on the pustules with this, as some other members of the board have too.

[PorridgeMan]

Hello All,

Sorry to take so long to reply. I was ill with flu-like symptoms for a few days. Interestingly, my skin improved wonderfully while I was in bed for 2 days - almost no redness and not a spot in sight. Maybe I should get sick more often!

To answer you all in order:

Rubicund - yes I did try standard and low dose Ro-accutane, although I can't remember what the doses were (5 years ago and in a different state, different dermatologist). The main problem I had was a headache that lasted from start to finish, on each dose. It was incessant and so bad that my memory and cognitive functions were impaired. I also became severely depressed and coupled with the headaches, started having very 'negative' thoughts. I later learnt that the headaches are due to swelling of the brain and the depression due to depletion of lipids in the brain, both known effects of Ro-accutane. On the up-side though, I had skin that could have passed for a magazine cover.

Aurelia - I haven't used anything containing sulphur since I was a teenager (37 now). Back then, I was using Clearasil, which I believe has sulphur in it. I'll have a look at this MSM. The news item I referred to is here:
http://www.abc.net.au/news/video/2009/10/29/2727518.htm

David Pascoe - I was prescribed a product called Vibra-tabs for several years in my late teens, which I believe is Doxycycline. I had mild acne as a teenager before using this, but my Mother was afraid I'd develop cystic acne like my Father had, so pushed the doctor into prescribing antibiotics. It worked, but was the regrettable start of a drug dependence. I've not heard of Rosacea-Ltd before, so will have to investigate.

Naturaltreatments - sounds like you and Aurelia both recommend MSM, so I'll probably try that first.

Does anybody have any comments on sunscreens? If you do use them, do you do so everyday, or only when you're out in the sun for a while? Do you moisturise as well as using a sunscreen? Recommend any particular products?

Thanks to all.

[Lisamouries]

Hi Porridgeman.
Sunscreen is essential, rain or shine. I tend to use moisturisers which contain spf's in the winter. Of course if you are skying or anything like that than you need to have STRONG sunscreen as well as moisturiser. I've been using Laura Mercier tinted moisturiser 20spf. I also use clinique city block sheer which is 25. I tend not to stay in the full 12.00 noon to 3.00pm summer sun that much as it's way too hot for me so this strength of spf's suits me fine.

[Aurelia]

Hi PorridgeMan,

Sorry that you have been ill. Rosaceans often find their symptoms improve at such times, possibly just because they eat little and their digestive systems don't generate much heat. Perhaps they are also less likely to eat trigger foods?

Thanks for the news link. I will check it out.

I've not tried MSM or the rosacea disks but have heard some great reports, especially of success against pustules. One or both seem worth a try, as long as the individual doesn't have problems tolerating sulphur.

Best of luck,

Aurelia

[CrabbyCathy]

It's good that you know that you can get some relief from the pustules, even if it's with antibiotics which are clearly not an ideal long term solution

If the antibiotic prescriped is a low dose, such as generic doxycycline 50 mg daily, or Oracea (40 mg), it does not provide an antimicrobial effect, rather an anti-inflammatory effect, with no nasty side effects.

Lisa, I cannot find the active sunscreen ingredients for the Clinique! Can you list them for me? I tend to react to chemical ones lately.

[Lisamouries]

Hi Cathy.
Here's the ingredients for the Clinique City Block Sheer 25 SPF

Active: Titanium Dioxide (7.3%), Zinc Oxide (6.9%)
Inactive: Water, Trioctyldodecyl Citrate, Butylene Glycol, Cyclopentasiloxane, Dimethicone, C12-15 Alkyl Benzoate, Steareth-2, Stearyl Heptanoate, Aluminum Stearate, Silica, Lecithin, Gentiana Lutea (Gentian) Root Extract, Rosmarinus Officinalis (Rosemary) Leaf Extract, Hordeum Vulgare (Barley) Extract, Rosmarinus Officinalis (Rosemary) Extract, Betula Alba (Birch) Bark Extract, Cucumis Sativus (Cucumber) Fruit Extract, Laminaria Saccharina Extract, Saccharomyces Lysate Extract, Helianthus Annuus (Sunflower) Seedcake, Sodium Hyaluronate, Sorbitan Tristearate, Linoleic Acid, Polyquaternium-51, Caprylyl Methicone, Sorbitol, Sodium Rna, Phospholipids, Peg-40 Stearate, Magnesium Aluminum Silicate, Caprylyl Glycol, Tocopheryl Acetate, Phytantriol, Stearic Acid, Hydrogenated Lecithin, Cellulose, Magnesium Ascorbyl Phosphate, Stearyl Dimethicone, Ascorbyl Tocopheryl Maleate, Nordihydroguaiaretic Acid, Linolenic Acid, Pantethine, Bisabolol, Hydroxyethyl Urea, Ceteth-2, Peg/Ppg-18/18 Dimethicone, Polyglyceryl-6 Polyricinoleate, Steareth-20, Isopropyl Titanium Triisostearate, Propylene Glycol Dicaprate, Sodium Stearate, Nylon-12, Citric Acid, Nylon-6, Hexylene Glycol, Xanthan Gum, Disodium Edta, Bht, Phenoxyethanol, Titanium Dioxide, Iron Oxides.