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  • Welcome to the Rosacea Research and Development Institute [RRDi] official web site. The RRDi is a 501 (c) 3 non profit organization. If you suffer from rosacea you are a rosacean. Join us to find the cure. 

    We are rosaceans. Our non profit organization for rosacea patient advocacy web site is a digital data repository of rosacea information which can serve you as an armamentarium of rosacea treatment data. You can add more information to our web site by joining and posting in our member forum becoming a part of 'finding the cure' for rosacea if you join. Our goal is 10,000 members. You can help us reach our goal by joining

    Where to Begin Your Search
    Rosacea Topics • Community Support • About Us • What Causes Rosacea? • What Should I Ask My Physician?Rosacea NewbiesGold Standard for Rosacea Treatment • When Rosacea Resists Standard Therapies • Rosacea X-Factor • Famous RosaceansRosacea in the NewsTapatalk • Contact us
    Suggest you read our FAQs for at least a half hour. After that browse our member forum for another half hour. 

    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 facial skin with 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 415 million estimated rosacea sufferers worldwide

    "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 subtype 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 instead of or with rosacea, since other skin conditions may co-exist with rosaceamimic rosacea or you might have a rosacea variant (over a dozen variants to differentiate).  

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

    If you note, there are different definitions of what constitutes rosacea which is common. Clarity with phenotypes (see below) helps in a differential diagnosis. 

    Phenotypes
    In November 2016, the RRDi endorsed the phenotype classification of rosacea which was announced by the ROSCO panel as a better approach of diagnosising rosacea than using subtypes.

    Rosacea Differential Diagnosis and Misdiagnosis
    Your physician should differentiate rosacea from a plethora of other skin conditions. If you need photos of rosacea click here.

    Sometimes rosacea is misdiagnosed.

    Treatment
    'There are a number of topical, oral and systemic treatments available. Yet, treatment for rosacea remains difficult." Expert Opinion Pharmacotherapy 

    “There’s no one treatment that’s going to work for everybody, but we evaluate each patient individually and try to select the treatments from our armamentarium that we think will be the simplest and safest for long-term control.” John Meisenheimer, MD, Orlando, The City's Magazine

    ""Ultimately, rosacea is a subjective and entirely individual experience." Rosacea: Beyond the visable

    Cause of Rosacea
    No one really knows what causes rosacea and there are a number of theories for your consideration. Our latest article on this subject, Rosacea Theories Revisited is worth your time to consider. 

    What will the RRDi Do For Me?
    If you are a rosacea newbie read this post. You can view the list of prescription treatments prescribed for rosacea. There is a list of non prescription treatments for rosacea to consider. We have an affiliate store dedicated to rosacea books, treatments and odd and ends. You can browse our public member forum and learn about rosacea. The digital medical revolution can assist you in your search for a treatment to improve your condition. Your rosacea is an individual case and you may find what treatment will work for your rosacea and not a treatment aimed at the masses. Rosaceans 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 join and register simply with an email address. If you have concerns regarding your privacy, please consider this post.

    Once you join you have a number of tools to collaborate with other members. You can create your own rosacea blog, with easy step by step directions on how to do this. Our Gallery application lets members share photos and videos with the community. Volunteers who contribute their time and energy may receive a free G Suite account through a generous contribution of Google, one of our sponsors.  

    You may receive a free ebook, Rosacea 101: Includes the Rosacea Diet as a gift from the founder/director if you mention in your registration application that you want the free ebook (write in the volunteer box you want the free ebook).

    You can post in our member forum about your rosacea experience. However, we want real members, not spammers, hackers or trolls. We provide a safe, secure forum for our members, so our membership registration is very secure requiring your accepting our terms for membership.

    Our 2016 Rosacea Survey is completed and available for public viewing.  You may review a list of our education grants. Finally, ask not what the RRDi can do for you, ask.....

    What Can You Do for the RRDi?
    Your joining and registering with our organization will increase our membership. All that is required to join is an email address (your email address is private and members never see your email address nor does the RRDi give your private email address out to anyone). Our goal is to reach a membership of 10,000 members. Think about that, 10,000 rosacea sufferers joined together as a non profit organization and you are member. We need you to join to help us reach this goal!

    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. So if you can volunteer, let us know on the application. Please join

    Please carefully read the next subheading on how to join and if you have concerns about privacy. 

    How to Join
    Members may now join with just an email address and a display name (your first and last name is no longer required to be a non voting member and you can set up a anonymous or cryptic display name so that no one knows who you are). To post in our Member Forum or submit articles for publication you must register to join to become a member. The RRDi no longer requires that you provide us with your contact info and mailing address to be a non voting member. However you still need to agree to our policies, rules, etc., since you become a member of the RRDi whether a voting member or not. If you want to vote, simply include all the profile contact fields. We have over 1000 members who are voting members, so we have plenty. It is your choice if you want to vote or not. 

    If you need assistance contact us. Our volunteers will be happy to assist you. 

    Your privacy is our utmost concern and we will take precautions to ensure your privacy will never be violated. Our Privacy Policy is solid. If you have concerns regarding your privacy, please consider this post.

    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 on our web site or in our journal. You may receive a free G Suite account with our organization if you have the volunteer spirit. 

    Charter and Mission Statement
    The Charter of the Corporation states the purpose and Mission Statement which clearly outlines the goals of our 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

    Of course there are expenses to keep this non profit organization going. Any donation you give will assist us to continue to keep this web site going, publish our journal, and sponsor education grantsMahalo for your donation. even if it is small. Every dollar helps us keep going.  

    The RRDi is registered at GuideStar

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    • Evaluation of the efficacy and tolerance of artemether emulsion for the treatment of papulopustular rosacea: A randomized pilot study. J Dermatolog Treat. 2019 Apr 24;:1-16 Authors: Wang GJ, Gao XY, Wu Y, He HQ, Yu Y, Qin HH, Shen WT Abstract OBJECTIVE: To assess the efficacy and safety of artemether emulsion in patients with papulopustular rosacea. METHODS: A total of 130 (randomized 1:1) were externally administered either artemether emulsion (1%) or metronidazole emulsion (3%) twice daily for 4 weeks with an open-label 8-week follow-up. The primary endpoints included the proportion of patients who achieved clinical effective responses, as well as erythema and papule and pustule score at week 4. RESULTS: Numerically more patients achieved an effective response at week 4 with artemether emulsion (87.1%) than metronidazole emulsion (80.0%) (P > 0.05). Patients with artemether emulsion had comparable baseline erythema score (2.45 ± 0.67 vs 2.42 ± 0.70, P = 0.809) and papule and pustule score (2.11 ± 0.96 vs 2.32 ± 0.83, P = 0.264), but significantly lower papule and pustule score (0.21 ± 0.52 vs 0.42 ± 0.83, P = 0.001) and comparable erythema score (0.53 ± 0.88 vs 0.62 ± 0.88, P = 0.999) compared to patients with metronidazole emulsion at week 4. There was a significantly higher proportion of patients with metronidazole emulsion relapse compared to metronidazole emulsion during the open-label 8-week follow-up period (21.6% vs 2.4%, P < 0.01). CONCLUSIONS: Artemether emulsion improved papulopustular rosacea in the metronidazole emulsion group as early as 4 weeks, but its beneficial effect was maintained through the 8-week follow-up period compared to metronidazole emulsion. PMID: 31017492 [PubMed - as supplied by publisher] {url} = URL to article
    • Open-label study assessing the efficacy and tolerability of topical skin care and sun protection alone and in combination with intense pulsed light therapy. J Cosmet Dermatol. 2019 Apr 24;: Authors: Deaver Peterson J, Katz TM Abstract BACKGROUND: Intense pulsed light therapy (IPL) decreases facial erythema and telangiectasias associated with rosacea. Topical skin care products decrease facial erythema by the action of active ingredients and masking effects. OBJECTIVES: To assess the efficacy and tolerability of combining a topical skin care regimen (TSCR) comprised of a multifunctional three-in-one facial cream and a mineral-based brush-on SPF50 powder sunscreen with a single IPL treatment for treating mild-to-severe facial redness associated with rosacea. METHODS: Twenty female subjects with Fitzpatrick skin types I-III received TSCR monotherapy for 12 weeks. At that time, subjects received a single IPL treatment and continued TSCR for 6 additional weeks. Subjects were evaluated at Baseline and at Weeks 4, 8, 12, and 18. RESULTS: Using a 7-point redness scale, the overall mean (SD) redness score significantly improved from 3.05 (0.97) at baseline to 2.05 (0.76) at Week 18 (P < 0.01). There was a decrease in investigator-rated erythema from baseline (bare skin) to Week 12 (bare skin, before IPL) when TSCR was used as monotherapy which did not achieve significance (P = 0.12). Most subjects (80%) were satisfied or Very satisfied with the TSCR at Week 18. All subjects (100%) agreed that it improved their baseline skin redness and most (85%) would recommend TSCR to others. TSCR was well-tolerated with no significant changes in skin dryness, scaling, or itching. Mild burning occurred immediately following the IPL treatment at Week 12. CONCLUSION: TSCR in combination with a single IPL treatment produced a significant improvement in overall facial redness in patients with rosacea. Longer-term treatment with TSCR may produce continued improvement. PMID: 31017734 [PubMed - as supplied by publisher] {url} = URL to article
    • Warning Concerning Brands of Horse Paste/Gel There are a number of horse paste/gel brands that also contain praziquentel (PZQ), an anthelmintic, which Wikipedia reports "is a medication used to treat a number of types of parasitic worm infections." Some brands are Pfizer Equimax Horse Wormer, Merial Zimecterin Gold, Bimeda Equimax and others. Praziquantel as far as we know has never been used to treat rosacea. Another horse paste, UltraCruz Equine Bio-Absorb Paste contains dioctahedral smectite (dio) which is used to treat acute diarrhoea. There may other horse pastes that contain other active ingredients that you should carefully read the label on the horse paste and know what you are buying. Using treatments for horses or other animals which have not been FDA approved for humans may have some serious risks.  The horse paste that everyone is reporting using is horse paste that only contains 1.87% ivermectin. 
    • A study on 54 patients  who met eligibility criteria with azelaic acid reports, "The biggest concern was cost (11.1%), with a mean importance score (IS) on a 10-point scale of 9.3."  Other than this the report concludes, "Patient-reported side effects were rare. Minor patient-reported side effects and concerns do not appear to affect rosacea-related QoL and medication satisfaction. Compared to a previously conducted study of similar design with patients using metronidazole gel and metronidazole cream, more patients in the current study reported no concerns with their treatment, while the number of patients reporting no side effects, as well as mean SATMED-Q and DLQI scores, were similar."  For more information
    • Concerns and Treatment Satisfaction in Patients Being Treated With Azelaic Acid Foam for Rosacea J Drugs Dermatol. 2019 Apr 01;18(4):381-386 Authors: Williamson T, Cameron J, McLeod K, Turner B, Quillen A, LaRose A, Lott J, Gaiser A Abstract Objective: To describe patient characteristics, concerns, side effects, treatment satisfaction, and quality of life (QoL) of rosacea patients currently being treated with monotherapy azelaic acid foam based on patient-reported data. Methods: The study utilized a non-interventional, prospective, observational design. Patients were recruited in the United States and were eligible if the following criteria were met: diagnosed with rosacea by a medical professional, ≥18 years of age, currently receiving monotherapy with azelaic acid foam, and able to provide informed consent. Patients using other topical treatments for rosacea during enrollment were excluded. An online tool administered a survey of 3 questionnaires including the Rosacea Treatment Preference Questionnaire, Treatment Satisfaction with Medicines Questionnaire (SATMED-Q), and Dermatology Life Quality Index (DLQI). The survey collected demographics, clinical characteristics, treatment history, adverse events, and patient-reported outcomes related to treatment with azelaic acid foam and QoL with rosacea. Results: 54 patients met eligibility criteria. Participants were primarily female (90.7%), ranging from 26 to 63 years of age. The most common subtypes reported were erythematotelangiectatic and papulopustular (74.1% each) with 59.3% of participants reporting mild symptoms (16.7% “absent”; 24.1% “moderate”) in the 4 weeks before enrollment. The majority reported no concerns (74.1%) with their treatment. The biggest concern was cost (11.1%), with a mean importance score (IS) on a 10-point scale of 9.3. A majority (77.8%) of patients reported no side effects. Side effects reported included dryness (13%; IS: 5.3), stinging (7.4%, IS: 2.5), itching (5.6%; IS: 4.7), or burning (3.7%; IS: 7.0). Global satisfaction (SATMED-Q) mean score was 79.0 and treatment effectiveness mean score was 70.8. QoL impact of rosacea was minimal (mean DLQI score: 2.35). In regression models, increasing dryness was significantly associated with worsening outcomes in SATMED-Q and DLQI. Conclusions: Patient characteristics of the study population closely mirror the distribution of rosacea by gender and subtype as in previous estimates. Findings indicate minimal patient concerns with azelaic acid foam and primarily pertained to cost. Patient-reported side effects were rare. Minor patient-reported side effects and concerns do not appear to affect rosacea-related QoL and medication satisfaction. Compared to a previously conducted study of similar design with patients using metronidazole gel and metronidazole cream, more patients in the current study reported no concerns with their treatment, while the number of patients reporting no side effects, as well as mean SATMED-Q and DLQI scores, were similar. Further research is necessary to directly compare the results of these 2 studies. J Drugs Dermatol. 2019;18(4):381-386. PMID: 31013011 [PubMed - as supplied by publisher] {url} = URL to article
    • Clinical picture, diagnosis and treatment of rosacea, complicated by Demodex mites. Dermatol Reports. 2019 Jan 23;11(1):7675 Authors: Kubanov A, Gallyamova Y, Kravchenko A Abstract The article analyzes the clinical picture and course of rosacea in patients with Demodex mites. It presents the advantages of using the method of confocal laser scanning microscopy over the method of light microscopy of facial skin scrapes. The aimes were to study the influence of Demodex mites on the clinical picture and course of rosacea; to compare laboratory and instrumental diagnostic methods for detecting Demodex mites; to evaluate the effectiveness of external therapy aimed at eliminating Demodex mites. 212 people were examined. The study included healthy patients, patients with a diagnosis of rosacea with the presence and absence of Demodex. The presence of Demodex mites was confirmed by two methods of study (light microscopy of skin scrapes and confocal laser scanning in vivo microscopy). Demodex mites promote the development of acute-inflammatory morphological elements, increase the duration of the condition (more than 5 years, P<0.01) and the probability of recurrence (from 1 to 3 relapses in 39.5% of patients, P<0.05), resulting in a decrease in the quality of life of patients (dermatology life quality index is 12.5±4.5, P<0.05). Antiparasitic drug ivermectin, in the form of an external form, at a concentration of 1% has a high therapeutic efficacy (in 93.3% of cases). Demodex folliculorum shows signs of parasitism, while Demodex folliculorum brevis is a saprophyte. The severity of the condition does not depend on the quantitative load of the mites in the scrape. As an antiparasitic drug, it is recommended to use 1% ivertmectin. PMID: 31007879 [PubMed] {url} = URL to article URL to Review and to full article
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