Tim,
Gosh, this is like the 64,000 dollar question, or if I knew where I was going to die I would avoid that place like the plague!
My P started in 1998 when I was 46 years old. I have no idea why it started as nothing out of the ordinary happened at that time. It progressively got worse over the next couple of years until (through my GP) I made an appointment with a Derm. By the time I attended that appointment, my P had all but gone. Gosh did I feel stupid!
And that has been pretty much the roller coaster ride ever since. Here - gone - here - gone - but never gone as far as before and always comes back worse.
Flare-ups - treatment, but the order hasn't been logical.
If shares in P and Derms were floated on the stock market, then I would invest in the P. It has all the answers! The Derms are just still in guessing mode.
Regards,
D