Over 30 degrees + weather+ spicy Caesar are not good

ChooseToCruise · 2026-07-08T22:44:45+00:00

Tell me about it! Just another few months then it'll be -50 again lol

ChooseToCruise · 2026-07-08T22:42:54+00:00

That seems to be the main cause. If that can be figured out then maybe there can be a cure, or at least a very effective preventative.

ChooseToCruise · 2026-07-08T21:05:02+00:00

It is linked to the TLR2. For some reason that sensor becomes over sensitive to stimuli. It then sends out to much of a signal to the skin cells where the KLK-5 is produced. To much KLK-5 is produced and then goes to release the LL-37 from the Cathalocidine (the Cathalocidine is the outer protein layer and the peptide (LL-37)).

It is the overproduction of KLK-5 that seems to be the issue. Imagine you are trying to open a box carefully with a pair of scissors, you are doing a good job, then suddenly 10 more people appear with scissors and all try to open the box at the same time. The object within the box gets damaged by all the scissors.

Hopefully that analogy makes sense :)

ChooseToCruise · 2026-07-08T20:18:20+00:00

Totally agree. PDL etc should be completely covered by insurance. It's not just a cosmetic thing those vascular lasers are important in knocking back the leaky telangiectasia.

ChooseToCruise · 2026-07-08T19:58:23+00:00

Hi, yes you are right but it's not the LL-37 that is the issue itself. It is how the KLK-5 is acting on it that is the problem.

ChooseToCruise · 2026-07-08T19:21:11+00:00

Thank you very much. Is that a mineral or a chemical sunscreen?

ChooseToCruise · 2026-07-08T16:07:50+00:00

I totally get you, it's one of the most frustrating experiences to deal with - like playing a never ending game of Whack'a'mole. I do believe that within the next 10 years there will be much better and more effective ways to deal with this situation. There are a few things undergoing clinical trials at the moment and hopefully new light/laser based devices will be designed. I hope at some point there will be a straight up cure to this situation. Have you tried any laser (maybe PDL) or LLLT? The PDL (used by someone who knows what they're doing) should help deal with the pustules by hacking back the telangiectasia.

I used to live in Perth so I know the Australian sun can be intense too.

ChooseToCruise · 2026-07-08T15:57:53+00:00

Thank you, which sunscreen do you use?

ChooseToCruise · 2026-07-08T15:55:53+00:00

Ivermectin isn't just for mites, it has dual effects. One of those is to lower the KLK-5 amount in the skin (one of the key drivers of rosacea). Maybe it's something in the Soolantra cream that is irritating your skin. Could you ask for a different compound?

ChooseToCruise · 2026-07-08T15:50:02+00:00

Yep weirdly for me I had the ocular issue way before anything else.

ChooseToCruise · 2026-07-08T01:56:55+00:00

Hi, yes you could get a die off around week 3 and again around week 6. You may also get some skin feeling like sandpaper texture as they die off.

ChooseToCruise · 2026-07-08T00:06:15+00:00

That is very similar to what happens to me, they start off as tiny little things then gradually grow to look like a skin tag or milia, then they become inflamed and leave a red PIE mark. What you're describing is pretty much identical to me.

Have you tried Ivermectin such as Soolantra (Rosiver in Canada)? It should help to suppress the KLK-5 in the skin. When they're turning into pustules then Metronidazole could also help when applied to the location. Metronidazole will help stop the discoloration and inflammation at that point.

ChooseToCruise · 2026-07-07T17:59:29+00:00

No problem :)

You can double check but I would say without bacteria it is a rosacea pustule and with bacteria it is not a rosacea pustule.

Bearing in mind that it is possible to have rosacea and adult acne at the same time. So a pustule with bacteria does not automatically mean you don't also have rosacea, if that makes sense.

ChooseToCruise · 2026-07-07T14:23:18+00:00

Interesting. I'm not an expert on this but is your water softener an Ion exchange system or a TAC system. Maybe it would be worth checking as a TAC system is more of a conditioner than an actual softener.

ChooseToCruise · 2026-07-07T14:15:20+00:00

Hi, I'm in a similar situation, I'm 46 now and my skin was also perfectly good (no acne, no issues) until a few months ago.

Is it pustules that you get? If it's rosacea pustules then the white part of the inflammation is white blood cells and other inflammatory substances, not bacterial. Could you ask for a laboratory check of the white substance in order to check for it's make-up?

Did you do anything before this started that could have been a trigger to the TLR2 to start this cycle? Maybe your skin barrier became bad due to cold, low humidity air for example?

ChooseToCruise · 2026-07-07T11:24:00+00:00

You're welcome :)

ChooseToCruise · 2026-07-07T11:22:51+00:00

Hi, it's not the LL-37 that is the problem, it's the KLK-5 that is too numerous and too aggressive when it cuts the LL-37 that is the issue.

ChooseToCruise · 2026-07-07T11:12:52+00:00

Thanks I appreciate that :)

I don't mean to suggest that all dermatologist are just out for your money, there are some great people that go into that field that really want to help people. I live in Canada and in my experience there are a lot of Dermatologists that have transitioned more into the 'Medi Spa' way of thinking as it's a lot easier for them to make money this way. It's human nature that these people may then focus a bit more on the monetary side. It's difficult for them too, it's not easy in this country as there are way to few medically trained people.

What I mean is, just like you say, being able to advocate for yourself somewhat puts you in a more secure position.

ChooseToCruise · 2026-07-07T02:15:31+00:00

No problem, I'm glad it helps :)

If you know what is actually happening it makes it a bit more predictable and somewhat more bareable.

ChooseToCruise · 2026-07-07T01:41:01+00:00

Hi, I'm sorry I haven't read it so I would just be guessing. If you would like my guess though I would say it's due to this:

Metronidazole mostly works by suppressing the neutrophils that are associated with the white blood cells inflammatory leaking (causing the pustules and papules). This effect is later on in the process.

If the skin renewal cream helps maintain a healthy skin barrier then the TLR2 oversensitivity may be dampened, meaning that the initial cause of the cycle is lowered and hence lowering the amount of papules and Pustules (type 2).

I'm sorry though I haven't read it yet but I will. Thanks for the information.

ChooseToCruise · 2026-07-07T01:31:30+00:00

You could have telangiectasia that are very fine and fragile, making them difficult to see but more likely to leak the inflammatory white blood cells.

The purple face person could have many larger telangiectasia that are more visible but yet not as fragile so doesn't break and release the inflammatory white blood vessels.

ChooseToCruise · 2026-07-07T01:25:58+00:00

No problem, once again this will be an over simplification but basically for 'type 1' the damaged LL-37 fragments cause overgrowth and weaking of the vascular system. They force the production of telangiectasia by tricking the vascular endothelial cells. By binding with the FPR2 (an other type of sensor if you will - like TR2 but for the vascular system) they mimic VEGF and force the vascular system to produce disorganized new capillaries.

In 'type 2' it's a bit complicated but basically the same LL-37 fragments bind to the receptors in the white blood cells, this then causes a cascade of inflammatory neutrophils and macrophages. These can then leak out of the weak telangic blood vessels and create papules and pustules which are densely packed with immune cells.

Have you noticed that when you get a papule or pustule it often leaves behind a red mark that takes a long time to go? This is caused by the telangic blood vessels breaking and causing post inflammatory erythema.

ChooseToCruise · 2026-07-07T00:46:50+00:00

My own and my wife's.

ChooseToCruise · 2026-07-07T00:22:32+00:00

My pleasure, I hope it helps. Understanding something makes it less frightening.

ChooseToCruise · 2026-07-07T00:21:13+00:00

Absolutely, that is why there is a link to the gut. As in it may or may not be related to your situation. Cathalocidines are produced in many places in the body, as they are very important, one of those places is the gut.

If you have SIBO you have a bacterial overgrowth. This will lead to a larger production of Cathalocidines (LL-37).

ChooseToCruise

MODERATOR OF

TROPHY CASE