• The Only Non Profit Organization Founded by Rosaceans [rosacea sufferers] for Rosaceans

    Welcome to the RRDi official web site.

    The Rosacea Research & Development Institute [RRDi] is the first 501 (c) (3) non profit corporation established June 7, 2004 in the State of Hawaii, USA for the purpose of finding a cure for rosacea, researching rosacea, and to form a patient advocacy organization established by volunteer rosaceans for rosacea sufferers. State of Hawaii Certificate of Good Standing.

    Please take our 2016 Rosacea Survey now. This will take you 10 to 15 minutes. If you have any issues with taking the survey please contact us letting us know what issue you experienced.

    In 2015 we polled our members and the general public with a survey about their rosacea experience and you can view the results by clicking here.

    What is Rosacea?

    Rosacea is a chronic and sometimes progressive disorder of the face, characterized by some or all of the following symptoms:

    Extremely sensitive skin, blushing, flushing, permanent redness, burning, stinging, swelling, papules, pustules, broken red capillary veins, red gritty eyes (which can lead to visual disturbances) and in more advanced cases, a disfiguring bulbous nose. Men and women of all ages can be affected, with over 45 million estimated sufferers of Rosacea worldwide. For more info click here.

    "Rosacea is a multifactorial, hyper-reactivity, vascular and neural based disease with a broad range of facial and manifestations where normal vasodilation is greater and more persistent and involves an autoimmune component where microscopic amounts of extravasated plasma induce localized dermal inflammation where repeated external triggers lead vasodilation, telangiectasias, redness with eventual fibrosis and hypertrophic scarring of the dermis." Sandra Cremers, M.D., F.A.C.S., RRDi MAC Member.

    "Rosacea is probably a collection of many different diseases that are lumped together inappropriately." Zoe Diana Draelos, MD. Dr. Draelos is a member of the ROSIE [ROSacea International Expert] Group that says the current classification of rosacea is controversial. Dr. Draelos is also a member of the RRDi MAC. Just because you have a red face might mean you have another skin condition besides rosacea. Your physician should differentiate rosacea from a plethora of other skin conditions (for more info click here). If you need photos of rosacea click here.

    Sometimes rosacea is misdiagnosed. No one really knows what causes rosacea and there are a number of theories for your consideration. Rosacea, therefore, can be confusing, a bewilderment and a mystery (for more info click here).

    Check our FAQs about rosacea.

    What will the RRDi Do For Me?

    The RRDi is in the forefront of other rosacea non profit organizations with the digital medical revolution. Your rosacea is an individual case and you need to find what treatment will work for your rosacea and not a treatment aimed at the masses. Individuals can come together and share data, using collaboration tools that the RRDi offers for free. If you have the volunteer spirit and want to become part of this innovative non profit, learn how you can volunteer and be part of this digital medical revolution. You can post in our member forum if you register.

    Once you join you have a number of tools to collaborate with other members. You can create your own rosacea blog with our tools once you join, with easy step by step directions on how to do this. Our Gallery application lets members share photos and videos with the community. We have a chat tool available to members. Volunteers who contribute their time and energy may receive a free Google Apps for Work account.

    RRDI_Vol1No1_Journal-Cover300.jpg

    The inaugural edition of the Journal of the Rosacea Research & Development Institute is available at iUniverse and Amazon. We will continue to publish more editions of the journal with volunteers and print on demand publications if we receive donations or we receive enough volunteer articles to publish. You can become part of this if you have the volunteer spirit or if you donate. One of our goals is to offer $1,000 to the author of each published article in our journal, including any professionals, who submit articles to us, but also any rosacea sufferer could receive the $1,000 if an article written by one of our members is published in our journal. So, if enough volunteers write rosacea articles for us to publish we will continue to publish using volunteers as we did with our first publication of the Journal of the RRDi. All you need to do is to post an article in our member forum. We have the ability to upgrade the post to an article for consideration to be published later.

    The RRDi is a volunteeer member driven organization and invites rosacea sufferers to become involved. Volunteering is the force that drives the organization and is an integral spirit of the RRDi philosophy. The RRDi warmly invites rosacea sufferers to participate in this non profit which you can become a part of. You are not required to volunteer when you join, since we still want you to join even if you can't volunteer. If all you can do is become a member, that will increase our membership which is helpful in itself. But if you can volunteer, let us know on the application. Please join. For a limited time you may receive a free ebook, Rosacea 101: Includes the Rosacea Diet as a free gift from the founder/director. Just mention in the application that you want the free ebook (write in the volunteer box).

    If you can't volunteer and simply want to join to increase our membership that could be the least you do. Imagine if we had tens of thousands of members we might get the attention of the medical community and the public to our mission.

    Your donation will assist us to continue to publish our journal, keep this web site going and sponsor rosacea research. Mahalo for your donation..

    If you would like to help us reach our goals and continue to publish rosacea articles and keep this web site going, or write an article for our journal please join and post your article in the member forum. We would be happy to consider your article for publication. Members may submit articles in our forum. There are a number of posts on rosacea for your consideration in our member forum to browse through.

    How to Join

    You can browse our web site and learn about rosacea. To post in our Member Forum or submit articles for publication you must register to join to become a member. The RRDi requires that you provide us with your contact info and mailing address and agree to our policies since you become a corporate member of the RRDi. Your privacy is our utmost concern and we will take precautions to ensure your privacy will not be violated. Our Privacy Policy is solid.

    Once you have joined you can post in our secure members forum which will allow you to post questions to the Medical Advisory Consultants (MAC) and to fellow members or to submit articles for our journal. Yes, members may have an article published in our journal. You may receive a free Google Apps account with our organization if upon approval.

    The Charter of the Corporation states the purpose and Mission Statement which clearly outlines the goals of the non profit corporation. If you are interested in the history of how and why this non profit organization was formed click here for more information. Please take our Rosacea Survey.

    The RRDi is registered at GuideStar

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    • Related Articles Assessment of the risk of cardiovascular disease in patients with rosacea. J Am Acad Dermatol. 2016 Aug;75(2):336-9 Authors: Egeberg A, Hansen PR, Gislason GH, Thyssen JP Abstract
      BACKGROUND: Recent studies have shown a higher prevalence of cardiovascular (CV) risk factors in patients with rosacea. However, it remains unknown whether rosacea represents an independent CV risk factor.
      OBJECTIVE: We evaluated the risk of myocardial infarction, stroke, CV death, major adverse CV events, and all-cause mortality, respectively.
      METHODS: Between January 1, 1997, and December 31, 2012, a total of 4948 patients with rosacea were identified and matched with 23,823 control subjects. We used Poisson regression to calculate incidence rate ratios.
      RESULTS: Adjusted incidence rate ratios were 0.75 (95% confidence intervals [CI] 0.57-1.00) for myocardial infarction, 1.08 (95% CI 0.86-1.35) for ischemic stroke, 1.01 (95% CI 0.61-1.67) for hemorrhagic stroke, 0.99 (95% CI 0.80-1.24) for CV death, 0.99 (95% CI 0.86-1.15) for major adverse CV events, and 0.95 (95% CI 0.85-1.06) for all-cause mortality.
      LIMITATIONS: We were unable to distinguish between the different subtypes and severities of rosacea.
      CONCLUSIONS: In this population-based study, rosacea was not associated with increased risk of adverse CV outcomes or death.
      PMID: 27444070 [PubMed - in process] {url} = URL to article
    • Rosacea is a common chronic skin condition that manifests as recurrent inflammatory lesions. Long-term treatment is required to control symptoms and disease progression, with topical treatments being the first-line choice. Ivermectin 1 % cream is a new once-daily (QD) topical treatment for the inflammatory lesions of rosacea, and it is important to compare the efficacy, safety, and tolerability of ivermectin with other currently available topical treatments.  Methods: A systematic literature review was performed from January 2011 to June 2015, with articles published prior to 2011 retrieved from a Cochrane review on rosacea. Randomized controlled trials of the topical treatment of adult patients with moderate-to-severe papulopustular rosacea were identified from electronic databases and trial registers, and supplemented with data from clinical study reports. Mixed treatment comparisons (MTCs) were conducted to compare different treatments according to Bayesian methodology.  Results: 57 studies were identified, with 19 providing data suitable for MTC. Ivermectin 1 % cream QD led to a significantly greater likelihood of success compared with azelaic acid 15 % gel twice-daily (BID) [relative risk (95 % credible interval): 1.25 (1.14–1.37)], and metronidazole 0.75 % cream BID [1.17 (1.08–1.29)] at 12 weeks. Ivermectin 1 % cream QD also demonstrated a significant reduction in inflammatory lesion count compared with azelaic acid 15 % gel BID [?8.04 (?12.69 to ?3.43)] and metronidazole 0.75 % cream BID [?9.92 (?13.58 to ?6.35)] at 12 weeks. Ivermectin 1 % cream QD led to a significantly lower risk of developing any AE or TRAE compared with azelaic acid 15 % gel BID [0.83 (0.71–0.97) and 0.47 (0.32–0.67), respectively].  Conclusions: Ivermectin 1 % cream QD appears to be a more effective topical treatment than other current options for the inflammatory lesions of rosacea, with at least an equivalent safety and tolerability profile, and could provide physicians and dermatologists with an alternative first-line treatment option. 7thSpace Headlines Full Article Springer Open
    • A recent paper stated the following:  "More women than men seek dermatological consultation for skin disease; our analysis of 149,614 patients seen for cutaneous issues (based on ICD-9 diagnosis codes) in outpatient clinics at Northwestern Medicine revealed a female to male ratio of 1.8:1." "We surveyed 802 dermatological research articles from 2012 through 2013. No information about the sex of studied cells or animals was provided in 60% of papers." J Invest Dermatol. Author manuscript; available in PMC 2016 Jul 19.
      J Invest Dermatol. 2016 Jan; 136(1): 12–14.
      doi:  10.1038/JID.2015.298
      PMCID: PMC4950973
      NIHMSID: NIHMS801795
      Mind the Gap: Sex Bias in Basic Skin Research
      Betty Y. Kong, Isabel M. Haugh, Bethanee J. Schlosser, Spiro Getsios, and Amy S. Paller  
    • Related Articles Very low-dose isotretinoin in mild to moderate papulopustular rosacea; a retrospective review of 52 patients. Australas J Dermatol. 2016 Jul 20; Authors: Rademaker M Abstract
      BACKGROUND/OBJECTIVES: Rosacea is a chronic inflammatory disorder that affects up to 10% of the population. Standard treatments include topical azelaic acid and metronidazole or systemic tetracyclines. Isotretinoin has generally been restricted to severe disease, often at a dose of 0.5-1.0 mg/kg/day.
      METHOD: Retrospective review of open-label isotretinoin (initial dose 20 mg/day, with dose adjustments according to response), in patients with mild to moderate papulopustular rosacea.
      RESULTS: Altogether 52 patients (33 women), mean age 48 years (range 18-86) were treated with isotretinoin over a 5-year period. All patients were commenced on 20-mg isotretinoin/day which was reduced to 10-20 mg once to five times a week (equivalent to 5 mg/day) in 67%, but increased in 15% (who all had additional acne) to 30-40 mg/day. In terms of dose/kg/day, 29% received ≤ 0.1 mg/kg/day, 46% received 0.11-0.25 mg/kg/day and 10% received > 0.5 mg/kg/day. Treatment was continued for 57 weeks (range 9-223). Six patients (12%) did not attend follow up. Of the remainder, in 91% (42/46) the rosacea had cleared or was excellent. One patient stopped isotretinoin because of its adverse effects. Two-fifths (44%) suffered no adverse effect. The most common side-effect was cheilitis in half (52%), which was mild in all but one patient.
      CONCLUSION: Very low-dose isotretinoin (e.g., 10-20 mg once to five times a week, equivalent to 5 mg/day) is an effective treatment for mild to moderate papulopustular rosacea and is well tolerated.
      PMID: 27435665 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Superior Efficacy with Ivermectin 1% Cream Compared to Metronidazole 0.75% Cream Contributes to a Better Quality of Life in Patients with Severe Papulopustular Rosacea: A Subanalysis of the Randomized, Investigator-Blinded ATTRACT Study. Dermatol Ther (Heidelb). 2016 Jul 18; Authors: Schaller M, Dirschka T, Kemény L, Briantais P, Jacovella J Abstract
      INTRODUCTION: Ivermectin 1% cream (IVM 1%) is indicated for the treatment of inflammatory lesions of rosacea. The objective of this subanalysis was to compare IVM 1% vs. metronidazole 0.75% cream (MTZ 0.75%) in the treatment of severe inflammatory lesions of rosacea.
      METHODS: A subanalysis of the investigator-assessed severe subjects from a Phase 3, investigator-blinded, randomized study comparing IVM 1% once daily (QD) with MTZ 0.75% twice daily (BID) over 16 weeks followed by a 36-week extension period was performed. Efficacy assessments were Dermatology Life Quality Index (DLQI) and EuroQol-5 Dimension (EQ-5D) questionnaires, investigator's global assessment (IGA), subject assessment of rosacea improvement, and inflammatory lesion counts. Adverse events (AEs) were monitored throughout the study.
      RESULTS: A total of 161 subjects (16.7% of overall study population; 80 IVM 1% and 81 MTZ 0.75%) had an IGA score of 4 at baseline representing severe papulopustular rosacea. Significantly more IVM 1% subjects had a minimal clinically important difference (MCID, defined as a decrease from baseline of ≥4 points) in DLQI score than MTZ 0.75% subjects at week 16 (65.4% vs. 39.2%; P = 0.001) and week 52 (68.8% vs. 40.4%; P = 0.003). At week 16, the mean EQ-5D score for the IVM 1% subjects was higher (better quality of life) than for MTZ 0.75% subjects (0.941 vs. 0.896). Significantly more IVM 1% subjects were IGA "clear" or "almost clear" at week 16 compared to MTZ 0.75% (82.5% vs. 63.0%; P = 0.005). Incidence of AEs was comparable between groups.
      CONCLUSION: Better efficacy with IVM 1% cream (QD) compared to MTZ 0.75% cream (BID) contributes to an improved quality of life with significantly more patients achieving an MCID in DLQI score at week 16 and higher mean EQ-5D score. IVM 1% cream is thus a better alternative than MTZ 0.75% cream for severe papulopustular rosacea patients.
      TRIAL REGISTRATION: EUDRACT number: 2011-004791-11.
      FUNDING: Galderma R&D.
      PMID: 27432169 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Topical Ivermectin 10 mg/g and Oral Doxycycline 40 mg Modified-Release: Current Evidence on the Complementary Use of Anti-Inflammatory Rosacea Treatments. Adv Ther. 2016 Jul 18; Authors: Steinhoff M, Vocanson M, Voegel JJ, Hacini-Rachinel F, Schäfer G Abstract
      Rosacea is a common, chronic inflammatory skin disease that can present with a variety of signs and symptoms. The potentially simultaneous occurrence of different signs and symptoms is due to different underlying inflammatory pathways, emphasizing the need for complementary treatment approaches. Topical ivermectin cream (10 mg/g) and systemic, oral anti-inflammatory doxycycline (40 mg modified-release) are both approved for the treatment of papulopustular rosacea (PPR). Whether or not a combined therapeutic approach may be more beneficial than monotherapy for patients with PPR remains to be tested. Here, we summarize underlying inflammatory pathways implicated in rosacea and clarify the impact of these two agents on selective pathways during inflammation, due to specific characteristics of their individual mechanisms of action (MoA). Based on the complementary MoA of doxycycline modified-release and ivermectin, a scientific rationale for a combined therapy targeting inflammatory lesions in rosacea is given. We propose that topical ivermectin cream is a promising new candidate as first-line treatment to target the inflammatory lesions of rosacea, which can be used in combination with systemic doxycycline modified-release to provide an optimal treatment approach considering all inflammatory pathways involved in PPR. Funding Galderma.
      PMID: 27432381 [PubMed - as supplied by publisher] {url} = URL to article
    • For a long time, as noted by the late late Dr. Albert Kligman, rosacea was referred to as Acne Rosacea, which he said,"It is interesting that the original term for rosacea was "acne rosacea”, which has more features in common with acne than currently realized. If the “acne” portion had been retained in the later works, rosacea might have received much greater investigative attention." [1]  So what is the difference? Generally, rosacea is accompanied by flushing but not always. Acne (Vulgaris) is generally found in young adults and teenagers. Rosacea usually presents itself in later adulthood. Rosacea usually does not present blackheads and is generally restricted to the nose, cheeks, chin and forehead. Acne can present itself also on the neck, chest and back as well as the facial region. The key difference is that acne treatments tend to exacerbate rosacea. Rosacea sometimes involves the eyes accompanied by redness in the ocular regions.  However, Acne Vulgaris can co-exist with rosacea.  A proper diagnosis needs to be from a physician. [2] End Notes [1] A Personal Critique on the State of Knowledge of Rosacea
      Albert M. Kligman, M.D., Ph.D. [2] Diagnosing Rosacea
    • Wallpaper article states the following:  "For founder Gígja Hlín, creating the line has been the culmination of a life-long obsession to treat her own and her sister’s irritable skin. Acne, rosacea and extreme sensitivity were not only some of the conditions Hlín tried to combat, but also visible scarring in between periods of calm skin. After experimenting with different combinations of over-the-counter products and prescription medications, Hlín became fixed on finding nourishing, natural ingredients that would do the job."
    • Demodex Density, Immune Response and Oxidative Stress in Rosacea Patients Sponsor:
      Istanbul Training and Research Hospital
      Collaborator:
      Bezmialem Vakif University