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Wellness Wednesday for November 15, 2023

The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:

  • Requests for advice and / or encouragement. On basically any topic and for any scale of problem.

  • Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.

  • Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.

  • Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).

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Based on the extensive list of treatments the obvious "See a dermatologist" I suppose has already been covered?

I've been to many dermatologists, as well as two plastic surgeons, one of whom is considered one of the best laser surgeons in the world. On the whole, my experiences with them have been fairly negative. Not that their advice is bad, just that it tends to be very typical (retinoids + sunscreen + moisturizer), and they seem to lack the means or inclination to seriously deal with extremely bad cases like mine.

I don't really blame them, dermatological responses to treatments are incredibly varied on an individual basis, and there isn't really much derms can do about it at a certain point.. There are people who have dry skin and put on an OTC moisturizer for a few weeks and then they're fine. Then there are people with dry skin who will spend literally years juggling multiple moisturizers, toners, cleansers, and serums trying to find the right combo that properly protects the skin barrier without causing break outs.

Usual medical treatments for acne vulgaris include...

I've used azelaic acid and dapsone, both work decently well, but always seem to loose effectiveness for me, and of course, both cause irritation for me. I've considered oral antibiotics, but I'm scared of their long-term side effects, IIRC there isn't a lot of good research on what happens when people take daily antibiotics for months and there are plenty of horror stories of people developing IBS from them.

What's up with the hot showers? Cholinergic urticaria is when you break out in hives from contact with hot water (but also an increase in body temperature and sweating), but is that what you experience?

The experience is exactly that. If I take a hot shower, I get hives on my chest. If I put my head under the water of a hot shower (which I haven't done in years), my face turns red and swells up. Even with lukewarm showers, I get some redness in my face and chest, and if I make the water a little too warm, I get hives.