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    • "And if the machine shows rosacea what would you recommend for that? I heard there is a new cream on the market that works well." Kristin Auble "Yes, it’s called Rhofade and it just received FDA approval. So that’s exciting. We also have a laser called the Vbeam that helps with vascular issue such as rosacea. So I would recommend a combo of the cream and laser treatment." Dr. David Shafer, New York City Tech Alert: 3D Imaging May Be The Secret to Perfect Skin, by Kristin Auble, W Magazine
    • Dermata Therapeutics, a San Diego development-stage biotech advancing new treatments for rosacea, eczema, and related dermatological diseases, said it has secured $5 million in additional funding from private investors and entered into a $5 million credit facility with Silicon Valley Bank. Dermata has developed DMT210 which is for rosacea.  Dermata Secures $10M in Combined Financing for Skin Treatments, by Bruce V Bigelow, Xconomy, San Diego
    • The Dermatologist Forms Collaboration with The National Rosacea Society, PRWeb, Benzinga
    • "A recent study in the British Journal of Dermatology makes a case for treating and managing rosacea based on the clinical presentation, or phenotype." Global Consensus on Rosacea Treatments by Phenotype, by Jennifer Newton, Medical News Bulletin
    • You've probably heard of common skin conditions like psoriasis and eczema, but do you also know about rosacea? If not, you've got to listen up. "Rosacea is abnormal blood vessel growth in all layers of the skin, caused by internal problems and inflammation within the body and skin," says Julia T. Hunter, MD, a dermatologist and founder of Wholistic Dermatology. This abnormal blood vessel growth is the result of low thyroid, fungal overgrowth internally, gut inflammation, and chronic sun overexposure, she says.

      10 Things You Need to Know About Rosacea—Whether You Have It or Not, by AUBREY ALMANZA, Reader's Digest
    • Related Articles Ivermectin therapy for papulopustular rosacea and periorificial dermatitis in children: A series of 15 cases. J Am Acad Dermatol. 2017 Mar;76(3):567-570 Authors: Noguera-Morel L, Gerlero P, Torrelo A, Hernández-Martín Á PMID: 28212765 [PubMed - in process] {url} = URL to article
    • The topical use of oxymetazoline 0.05% solution in the management of rosacea has been primarily limited to data from case series involving fewer than 10 patients and demonstrating sustained improvements in both erythema and flushing. Alhough oxymetazoline is not recognized in national guidelines, an international consensus statement recognizes the possible therapeutic role of oxymetazoline in the management of rosacea, despite the limited evidence. Hosp Pharm. 2013 Jul-Aug; 48(7): 558–559.
      Published online 2013 Jul 9. doi:  10.1310/hpj4807-558
      PMCID: PMC3839519
      Oxymetazoline (Topical): Rosacea
      Joyce A. Generali, RPh, MS, FASHP, (Editor) and Dennis J. Cada, PharmD, FASHP, FASCP
    • I haven't used the Soolantra since February 13, 2017 so for more than 72 hours my skin has been healing and I don't have the burning feeling I had, so I thought I would take three more photos to show my skin condition after using Soolantra for 105 days, just three days later. 
    • Maria, 
      Actually I am cheap, since it costs me around $40/jar for the ZZ cream which I actually prefer. But since I have insurance in my old age now, I would prefer to pay a nominal fee for a sulphur treatment if it works reasonably well. I was using the sulphur butter due to a post made by Joanne Whitehead, PhD, (Assistant Director of the RRDi) since it was cheap and it works sort of ok, but I don't like the oily part of the formula since my skin is already oily. The ZZ cream is so different and it dries up my skin which is wonderful, and it feels cool when you put it on due to the menthol in it. I just love it and have one jar left as an emergency jar. So if the Americans can make a cheaper sulphur topical I am willing to give it a try and apparently there are a number of them. My insurance wouldn't approve the one my dermatologist prescribed yesterday (not sure of the exact Rx that was denied) and it takes days to do the documents to get it approved and my doctor doesn't like having his staff write up these letters (such are the woes of the American Medical System), so I heard he can write a Rx for a generic sulphur drug that my insurance will accept. Time will tell what Rx I get.  As to the demodex population, I think I nuked all those little buggers with the ivermectin. My face is healing nicely each day now and I plan on doing nothing but washing with water for the next few days and then I will take photos of my face to show you the difference. I read a post in RF from Toen (post #684) how he only uses Soolantra occasionally which seems like a good idea to me, like if I get a pustule, since I noticed the Soolantra seems to work rather nicely on them and reduces them quickly, within a couple of days. I think I just over did the Soolantra. You would think that someone would mention this, that Soolantra is powerful, that more is not good sometimes. I can still get more tubes of Soolantra if I want. But I think the one I have which is half gone will last me months. 
    • It could be the case that your demodex is resistant to ivermectin and after all these years of sulpur usage it's also resistant to sulfur, so I wouldn't expect much of this generic sulfur cream. I know you have the feeling that sulfur controls it, but obviously it's not a cure, otherwise you wouldn't search for other options, Brady. Maybe you could try the permethrin cream. I just read an article about permethrin being effective in ivermectin-resistant cases of scabies infection, the same should apply for demodex.
    • Well done Brady. I think you have given Soolantra a fair go. You should have seen something really good by now so I don't blame you for ditching it. I have a similar problem with it and at the moment I need to use Tacrolimus to keep the inflammation at bay. I don't think I'm going to last much longer.  Anyway I'm curious. Your Derm doesn't seem to be having huge success with his patients on Soolantra. 25% is quite a low success rate, especially when compared to the 70% success rate in the one year study. Of course I accept that a certain percentage could have ditched it too early in their treatments, but 1 in 4 is still quite low. You told your Derm that you have good results with sulfur so obviously he prescribed what you wanted. But I'd love to know what your Derm is having most success with treating the 3 out of 4 who failed on Soolantra. 
    • Maria,  You are so kind. My face has been burning where I have been applying the Soolantra everynight, even when I wash it off in the am, the burning continues. I explained all this the dermatologist who said to stop using it. I really did give it a go. There must be something in the Soolantra that irritates my skin. It has been over 24 hours since I applied the Soolantra and my face has already started to calm down and cool off. The burning has almost completely gone. I am going to let my skin rest for a few days to recover from this and then apply the sulphur generic prescription my dermatologist prescribed since I have experienced good results from the sublimed sulphur in the ZZ cream. However, the ZZ cream costs more than my generic prescription since I have insurance. I am now convinced that Soolantra just isn't for me. My dermatologist says one out of four of his rosacea patients gets excellent results with Soolantra. I may in the future use a dab of Soolantra on a zit to see what happens, but no more night applications for me. 
    • Brady, what if you have such a heavy infestation with demodex, that it makes it hard for your skin to deal with the die off by itself? I think you should try taking oral antibiotics along with Soolantra and push through this phase for another month. You have put such an effort to this, it would be a pity if you quit earlier.
    • Went to the dermatologist today and he advised me to stop Soolantra since I am not a candidate for this treatment. After 105 days, I was hoping Soolantra would work for me, but alas, as you can see below, my rosacea seems to inflamed too much from using Soolantra. My dermatologist prescribed a generic sulphur based cream for me to try since I have responded well in the past to similar treatment using the ZZ cream. I have to pick up the prescription and will start another review later. Here are my photos for today: 
    • I conveniently forgot to mention that earlier. For me and my family to buy only on coupon prescription drugs
    • Phymatous rosacea presenting with leonine facies and clinical response to isotretinoin. Australas J Dermatol. 2017 Feb;58(1):72-73 Authors: Wee JS, Tan KB PMID: 28195321 [PubMed - in process] {url} = URL to article
    • I will share my experience. Before I started taking the drug I went online and looked at people's opinions. I noticed that there were several people who had reported problems with rebound flushing. I also noticed that in the clinical trial, the actual success rate compared to placebo was shockingly low. I am not a medical expert so I decided to shrug it off and take use the cream anyway.  My skin looked somewhat unnatural, kind of yellow, since there was no red in it. 
    • Conclusions Combined therapy was superior in decreasing the D. folliculorum count in all groups and in reducing the mite count to the normal level in rosacea and in anterior blepharitis. On the other hand, the two regimens were comparable in reducing the mite count to the normal level in acne and peri-oral dermatitis lesions. International Journal of Infectious Diseases
      Volume 17, Issue 5, May 2013, Pages e343–e347
      Evaluation of the efficacy of oral ivermectin in comparison with ivermectin–metronidazole combined therapy in the treatment of ocular and skin lesions of Demodex folliculorum
      Doaa Abdel-Badie Salema, Atef El-shazlya, Nairmen Nabiha, Youssef El-Bayoumyb, Sameh Salehc
    • Related Articles Friends or Foes? Host defense (antimicrobial) peptides and proteins in human skin diseases. Exp Dermatol. 2017 Feb 13;: Authors: Niyonsaba F, Kiatsurayanon C, Chieosilapatham P, Ogawa H Abstract
      Host defense peptides/proteins (HDPs), also known as antimicrobial peptides/proteins (AMPs), are key molecules in the cutaneous innate immune system. AMPs/HDPs historically exhibit broad-spectrum killing activity against bacteria, enveloped viruses, fungi and several parasites. Recently, AMPs/HDPs were shown to have important biological functions, including inducing cell proliferation, migration and differentiation; regulating inflammatory responses; controlling the production of various cytokines/chemokines; promoting wound healing; and improving skin barrier function. Despite the fact that AMPs/HDPs protect our body, several studies have hypothesized that these molecules actively contribute to the pathogenesis of various skin diseases. For example, AMPs/HDPs play crucial roles in the pathological processes of psoriasis, atopic dermatitis, rosacea, acne vulgaris, systemic lupus erythematosus and systemic sclerosis. Thus, AMPs/HDPs may be a double-edged sword, promoting cutaneous immunity while simultaneously initiating the pathogenesis of some skin disorders. This review will describe the most common skin-derived AMPs/HDPs (defensins, cathelicidins, S100 proteins, ribonucleases and dermcidin) and discuss the biology and both the positive and negative aspects of these AMPs/HDPs in skin inflammatory/infectious diseases. Understanding the regulation, functions and mechanisms of AMPs/HDPs may offer new therapeutic opportunities in the treatment of various skin disorders. This article is protected by copyright. All rights reserved.
      PMID: 28191680 [PubMed - as supplied by publisher] {url} = URL to article
    • "There are many effective treatments for rosacea. Some common topical medications include metronidazole, azalaic acid, ivermectin, or sulfur-based products. Oral antibiotics are commonly used, such as doxycycline, especially when papules and pustules are present. Redness and broken blood vessels are much more difficult to treat with medications. A topical medication that was originally designed to treat glaucoma can be used, providing temporary relief by blanching the superficial blood vessels. This medication, called Mirvaso, is very effective for some people but, unfortunately, not all patients are responsive." Reviewing Rosacea, By Darrel Arthurs, ARNP, DCNP , Dermatology Education & Practice from NADNP, Healthcare POV, Advance Web
    • There are a number of papers indicating niacinamide improves rosacea. You may want to ask your dermatologist about niacinamide. You can purchase niacinamide over the counter (non prescription). Niacinamide eases rosacea inflammation
      June 01, 2010 By Lisa Samalonis, Dermatology Times Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea.
      Cutis. 2005 Aug;76(2):135-41
      Authors: Draelos ZD, Ertel K, Berge C A review of nicotinamide: treatment of skin diseases and potential side effects.
      J Cosmet Dermatol. 2014 Dec;13(4):324-8
      Authors: Rolfe HM
    • There are papers indicating that Niacinamide improves rosacea. For example, Helen M. Torok, M.D. reports in an article in Dermatology Times, "Niacinamide can be an effective treatment for the inflammation related to rosacea"  Several non prescription topicals containing Niacinamide are Acnessential, InstaNatural Niacinamide Serum, Paula's Choice RESIST 10% Niacinamide Booster, The Posh Company B3 Nicinamide Serum, and Luminositie Niacinamide B3 Cream.  
    • I guess some could be sceptical about Soolantra's ability to kill demodex. Especially since there are no studies to prove it. Sometimes oral meds don't work as well, or even not at all, when transformed into a topical device. But I believe there is some proof that Soolantra is as effective as oral ivermectin. You may have read this study http://www.sciencedirect.com/science/article/pii/S120197121201315X It compares oral ivermectin to oral ivermectin and metronidazole in the reduction of demodex and improvement of symptoms in 4 different skin conditions. The author of this study did make one observartion which is very much identical to so many testimonials we read about from users of Soolantra. Here is a paragraph from the study: "In the cases who received ivermectin alone, there was a gradual reduction in the mean follicle mite count at the first week visit . However, rebound elevation in the mite count was evident in the third week in some patients with rosacea and those with anterior blepharitis lesions." This was only a 4 week study so obviously there was no report of a 6th week rebound.
    • Ivermectin is supposed to kill mites. I am simply not having the success that many have reported happens to them using Soolantra. I was hoping the fourth month would really be more of an improvement but so far I am not impressed. I am seeing the dermatologist on Feb 15 and get a professional evaluation on my progress. I can tell you that using the ZZ cream works way better for me than Soolantra. I guess I am one of those who responds better to sulphur treatment than Ivermectin. 
    • Brady, from your last 2 posts would I be correct in saying you're not convinced that Soolantra kills demodex?   
    • Related Articles Ten-year incidence and prevalence of clinically diagnosed blepharitis in South Korea: A nationwide population-based cohort study. Clin Exp Ophthalmol. 2017 Feb 09;: Authors: Rim TH, Kang MJ, Choi M, Seo KY, Kim SS Abstract
      IMPORTANCE: Blepharitis is one of the most common conditions. However, no study has yet evaluated the epidemiology by evaluating a large population-based sample.
      BACKGROUND: To evaluate the incidence and prevalence of clinically diagnosed blepharitis in South Korea.
      DESIGN: Nationwide population-based study.
      PARTICIPANTS: We investigated the Korean National Health Insurance Service-National Sample Cohort, a representative 1 million-sample of the Korean population, for patients diagnosed with blepharitis according to the Korean Classification of Diseases.
      METHODS: Annual and overall incidence and prevalence of blepharitis during the study period (2004-2013) were estimated after excluding chronic blepharitis patients, diagnosed during 2002-2003. Sociodemographic factors and comorbidities associated with blepharitis were evaluated using Cox proportional hazard regression.
      MAIN OUTCOME MEASURES: The first occurrence of blepharitis (Korean Classification of Diseases [KCD], H010, corresponding to the International Classification of Diseases-9-Clinical Modification [ICD-9-CM], 373.0).
      RESULTS: A total of 1,116,363 individuals over 9,698,118 person-years were evaluated (mean follow-up: 8.7 years) from 2004 to 2013. The overall incidence was 1.1 (95 % Confidence Interval [CI], 1.1 - 1.1) per 100 person-years. The incidence increased with time (0.9 versus 1.3 per 100 person-years, in 2004 and 2013, respectively) and was higher in female patients (1.3 versus 0.9 per 100 person-years, respectively). The incidence was higher in both the elderly and children than in adolescents or young adults. The overall prevalence was 8.1% (95% CI: 8.0-8.1) among subjects aged 40 years or older. Chalazion, gastritis, Sjögren's syndrome, pterygium, rosacea, prostatic hypertrophy, atopy, irritable bowel disease, and peptic ulcer were associated with an increased incidence of blepharitis in the multivariable Cox model.
      CONCLUSIONS: We found that blepharitis was a relatively common disease, and is associated with various ocular and systemic conditions.
      PMID: 28183148 [PubMed - as supplied by publisher] {url} = URL to article
    • Trump’s longtime doctor, Harold N. Bornstein, revealed in a New York Times story Wednesday that Trump takes the antibiotic tetracycline to stave off rosacea, which causes redness and bumps on the skin, and Propecia to keep his hair voluminous. Beauty companies selling non-prescription remedies think the president should reconsider his hair-loss and rosacea solutions. “We know there’s a better way than pill popping for rosacea,” exclaimed Alexandra Calvo, founder of the rosacea-fighting brand NuRevealOrganics. “Trump needs to watch his diet and cut out rosacea food triggers such as avocados, chocolate, yogurt and cheese. Living a lavish lifestyle also may not be the best for rosacea since spa days in the sweltering sauna, and long days on the beach under intense sun both cause rosacea flare-ups.” Salvo additionally recommended a skin-care regimen that includes NuRevealOrganics’ Bella Rosa Oil Cleanser and Rosehip Healing Night Face Cream. Beauty Companies Offer Trump Rosacea, Hair-Loss Advice – and Products
      The president's personal prescription drug plan includes medications for baldness and redness.
      By Rachel Brown, Fashion / Fashion Scoops, WWD
    • Drug Therapies for Rosacea Drug  Dosage Form FDA Indication for Rosacea Adverse Event topical metronidazole (Metrogel, Metrocream, Metrolotion, Noritate, Rosadan) gel, cream, or lotion Varies by product -
      Metrogel : inflammatory lesions of rosacea.
       
      Metrocream,  Metrolotion, Rosadan: inflammatory papules and pustules of rosacea.
       
      Noritate:
      inflammatory lesions and erythema of rosacea Pruritus, stinging, irritation, dryness   oral doxycycline (Oracea) oral capsule only inflammatory lesions (papules and pustules) of rosacea nasopharyngitis, sinusitis, diarrhea, hypertension   azelaic acid (Finacea) gel inflammatory papules and pustules of mild to moderate rosacea Stinging, irritation, burning   brimonidine (Mirvaso) gel persistent (non-transient) erythema of rosacea Pruritus, burning, irritation, dryness, erythema   ivermectin (Soolantra) cream inflammatory lesions of rosacea Burning, skin irritation   oxymetazoline (Rhofade) cream persistent facial erythema associated
      with rosacea Irritation, burning, worsening inflammatory lesions of
      rosacea   Treatment Options for Rosacea, Mel Seabright, PharmD, MBA, Pharmacy Times
    • They found rosacea patients were 46% more likely than controls to have celiac disease; 45% more likely to have Crohn’s disease; 19% more prone to ulcerative colitis; and had a 34% higher rate of irritable bowel syndrome. The co-occurrence of Helicobacter pylori infection and small intestinal bacterial overgrowth was significantly higher among patients with rosacea at baseline, but the risk of developing incident Helicobacter pylori infection or small intestinal bacterial overgrowth during follow-up was insignificant, the study’s lead author Alexander Egeberg, M.D., Ph.D., department of dermatology and allergy, Herlev and Gentofte Hospital, Hellerup, Denmark, tells Dermatology Times. Rosacea and gastro disorders possibly related, Large study supports likelihood of yet-to-be-defined link, By Lisette Hilton, Dermatology Times  
    • While there’s no way to cure rosacea, New York City dermatologist Dr. Amy Wechsler knows a few simple ways to help control it in winter. She noted that in addition to seasonal changes, flareups can be triggered by a wide variety of factors like stress, sleep deprivation, spicy food, drinking too much alcohol, travel, trying new products, having a cold or being sick in any way. “People with rosacea often have sensitive skin, so dry, cold weather can exacerbate this,” she said. In addition to whatever medication or regimen your dermatologist recommends, here are three simple ways to manage your redness in the wintertime, according to Wechsler:  3 Tips And Tricks For Defeating Rosacea In The Winter, Carly Ledbetter, Lifestyle Editor, The Huffington Post
    • Related Articles A Report of Two Cases of Solid Facial Edema in Acne. Dermatol Ther (Heidelb). 2017 Feb 06;: Authors: Kuhn-Régnier S, Mangana J, Kerl K, Kamarachev J, French LE, Cozzio A, Navarini AA Abstract
      INTRODUCTION: Solid facial edema (SFE) is a rare complication of acne vulgaris. To examine the clinical features of acne patients with solid facial edema, and to give an overview on the outcome of previous topical and systemic treatments in the cases so far published.
      METHODS: We report two cases from Switzerland, both young men with initially papulopustular acne resistant to topical retinoids.
      RESULTS: Both cases responded to oral isotretinoin, in one case combined with oral steroids. Our cases show a strikingly similar clinical appearance to the cases described by Connelly and Winkelmann in 1985 (Connelly MG, Winkelmann RK. Solid facial edema as a complication of acne vulgaris. Arch Dermatol. 1985;121(1):87), as well as to cases of Morbihan's disease that occurs as a rare complication of rosacea.
      CONCLUSION: Even 30 years after, the cause of the edema remains unknown. In two of the original four cases, a potential triggering factor was identified such as facial trauma or insect bites; however, our two patients did not report such occurrencies. The rare cases of solid facial edema in both acne and rosacea might hold the key to understanding the specific inflammatory pattern that creates both persisting inflammation and disturbed fluid homeostasis which can occur as a slightly different presentation in dermatomyositis, angioedema, Heerfordt's syndrome and other conditions.
      PMID: 28168623 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Activation of p38 and Erk Mitogen-Activated Protein Kinases Signaling in Ocular Rosacea. Invest Ophthalmol Vis Sci. 2017 Feb 01;58(2):843-848 Authors: Wladis EJ, Swamy S, Herrmann A, Yang J, Carlson JA, Adam AP Abstract
      Purpose: Rosacea-related cutaneous inflammation is a common cause of ocular surface disease. Currently, there are no specific pharmacologic therapies to treat ocular rosacea. Here, we aimed at determining the differences in intracellular signaling activity in eyelid skin from patients with and without ocular rosacea.
      Methods: This was an observational, comparative case series including 21 patients undergoing lower lid ectropion surgery at one practice during 2013 and 2014 (18 patients with rosacea, 13 control patients), and 24 paraffin-embedded archival samples from Albany Medical Center, selected randomly (12 patients with rosacea, 12 control patients). Cutaneous biopsies resulting from elective lower lid ectropion surgery were analyzed by Proteome Profiler Human Phospho-Kinase Array, Western blot, and/or immunohistochemistry.
      Results: Samples derived from ocular rosacea patients showed increased levels of phosphorylated (active) p38 and Erk kinases. Phosphoproteins were mainly localized to the epidermis of affected eyelids.
      Conclusions: This finding provides a novel potential therapeutic target for treatment of ocular rosacea and possibly other forms of rosacea. Further testing is required to determine if p38 and Erk activation have a causal role in ocular rosacea. The selective activation of keratinocytes in the affected skin suggests that topical pathway inhibition may be an effective treatment that will ultimately prevent ocular surface damage due to ocular rosacea.
      PMID: 28170535 [PubMed - in process] {url} = URL to article
    • Development and Clinical Validation of a Novel Photography-based Skin Erythema Evaluation System: A Comparison with the Calculated Consensus of Dermatologists. Int J Cosmet Sci. 2017 Feb 08;: Authors: Cho M, Lee DH, Doh EJ, Kim Y, Chung JH, Kim HC, Kim S Abstract
      Erythema is the most common presenting sign of skin conditions [1,2]. Erythema reflects the degree of inflammation associated with various diseases, such as atopic dermatitis, psoriasis, and lupus erythematosus; it is also cosmetically troublesome in subjects with flushing, rosacea, and photoaging [3,4]. In addition, there are vascular disorders that present with erythema, such as nevus flammeus, telangiectasia, and post-acne erythema [5]. Various therapeutic devices, medicines, and cosmetics have been developed to improve these dermatological conditions [6,7]. These modalities need to be validated objectively for dermatologists, patients, and regulatory agencies [8-10]. Various studies are in progress on both improvement of skin conditions and their objective measurement [11,12]. The evaluation of skin condition is highly dependent on dermatologists' judgments based on naked eyes, and the results can vary depending on the dermatologists' expertise and bias [13,14]. It is convenient to perform an evaluation using photographs, but this approach is affected by variation in the environment, such as uneven brightness and light type [15]. This article is protected by copyright. All rights reserved.
      PMID: 28178365 [PubMed - as supplied by publisher] {url} = URL to article
    • Sorry if I was off topic. I wish I could be one of those who could eat or drink anything. I read somewhere (can't find it now) that at a recent dermatologists convention a discussion of the mystery of how Soolanta improves Rosacea with no data on demodex density counts (whether the count is lowered). However there is data that it works better than Mirvaso or Metronidazole. 
    • Sorry Brady but I didn't say that those using Soolantra would notice a better improvement with a low carb diet. I was referring to the 30% of participants in the Soolantra study who failed to see any improvement. 70% of participants were clear/almost clear without any mention of a diet. Also, I have no idea what most of your last post has to do with my previous post. What exactly Soolantra does for Rosacea may very well still be a little up in the air. My previous post was specifically looking at your case, where it seems that Soolantra or ZZ cream will treat your secondary symptoms, and diet addresses the primary cause. Or maybe it's the other way round. I was hoping that Soolantra could have treated both aspects of your Rosacea, but that doesn't seem to be the case so far.  Like I've said, there have been some people on the Soolantra thread who have reported being able to eat and drink whatever they want while using Soolantra. But I guess this may not apply to all of us.  
    • Rory, It has never been proven whether killing the mites improves the rosacea or if the density count is different when using Soolantra. Do the numbers actually go down after using Soolantra? We really don't know for sure. There are no studies done on this.  A paper published by the American Journal of Clinical Dermatology in April 2015 succinctly clarifies the controversy:  “According to Rothman’s model of causality, Demodex mites are probably a non-necessary and non-sufficient cause of rosacea.” What we do know is that Soolantra use with improvement of rosacea implies that treating for demodectic rosacea is warranted. In other words, if it works for some then it is a valid treatment.  As for sugar/carbohydrate avoidance, you will note that physicians rarely if ever mention this as a rosacea trigger. Only the RRDi recognizes sugar/carbohydrate as a rosacea trigger. There are few, if any, clinical papers on this subject. I do agree with you that if those who use Soolantra also avoided sugar/carbohydrate they would notice better improvement. 
    • Not sure, but most reports say demodex folliculorum is the culprit. Never have tested for demodex. 
    • Related Articles Erythroid Differentiation Regulator 1 as a Novel Biomarker for Hair Loss Disorders. Int J Mol Sci. 2017 Feb 03;18(2): Authors: Woo YR, Hwang S, Jeong SW, Cho DH, Park HJ Abstract
      Erythroid differentiation regulator 1 (Erdr1) is known to be involved in the inflammatory process via regulating the immune system in many cutaneous disorders, such as psoriasis and rosacea. However, the role of Erdr1 in various hair loss disorders remains unclear. The aim of this study was to investigate the putative role of Erdr1 in alopecias. Skin samples from 21 patients with hair loss disorders and five control subjects were retrieved, in order to assess their expression levels of Erdr1. Results revealed that expression of Erdr1 was significantly downregulated in the epidermis and hair follicles of patients with hair loss disorders, when compared to that in the control group. In particular, the expression of Erdr1 was significantly decreased in patients with alopecia areata. We propose that Erdr1 downregulation might be involved in the pathogenesis of hair loss, and could be considered as a novel biomarker for hair loss disorders.
      PMID: 28165377 [PubMed - in process] {url} = URL to article