A different form of vitamin C
Around the same time, Dr. Mitchell came across research on a vitamin C derivative called AAP - Aminopropyl Ascorbyl Phosphate.
Unlike LAA, AAP is stable at pH 5.5. The same pH as skin.
"I was skeptical at first," she says. "If this worked, why wasn't everyone using it?"
The answer, she learned, was mostly commercial.
LAA has been around for decades. It's cheaper to formulate.
Most brands are targeting the general anti-aging market, not people with inflammatory skin conditions.
For someone without rosacea, LAA works fine.
"But for my rosacea clients, LAA was never going to work. It couldn't. The chemistry was wrong."
Dr. Mitchell began recommending AAP-based products to her most reactive clients - the ones who had given up on vitamin C entirely.
The ones who described their skin as "too sensitive" or said vitamin C "just wasn't for them."
What her clients are saying
Emma, 58, had tried vitamin C three times before giving up.
"Every time was the same. I'd put it on, my face would sting, and by morning I'd be redder than before.
I spent probably $200 on serums that made my skin worse. I honestly thought my skin was just broken."
After switching to an AAP formula, her experience was different.
"The first thing I noticed was nothing happened. No burning. No stinging.
I actually thought it wasn't working because I was so used to that reaction.
Then about three weeks in, I looked in the mirror and realized my face was calmer. Less red.
It sounds dramatic but I actually got a bit emotional."