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  • Posts

    • Melasma, (aka, chloasma faciei) can co-exist with rosacea. "The symptoms of melasma are dark, irregular well demarcated hyperpigmented macules to patches commonly found on the upper cheek, nose, lips, upper lip, and forehead. These patches often develop gradually over time. Melasma does not cause any other symptoms beyond the cosmetic discoloration. Melasma is also common in pre-menopausal women. It is thought to be enhanced by surges in certain hormones." Wikipedia Mistca who suffers from rosacea and melasma responded to a post here about what she has done for both conditions which may help you in your quest to find a solution and here are her remarks:  Hi,
      I developed melasma due to taking the progesterone only pill. Attempts to treat the melasma with Retin A irritated the hell out of my skin, and led to rosacea, and later on, severe flushing, due to being given ventolin (which I did not need). I also had gut issues and a bunch of other stuff going on at the same time.
      Lots of disasters happened to me along the way leading to my current state.

      That aside. Melasma. Did you know it is not just a pigment disorder? It actually has a vascular component.
      Here is one article which speaks about it.

      I battled the hideous mess for years and it ruined my life. Trying to treat Rosacea on a background of melasma is a nightmare.

      Later on in years, I discovered I was iodine deficient and supplementation finally rid me of the remnants of the pigmentation issue. I do realise it could still be lurking beneath the skin.

      In addition, pigment issues are often connected to thyroid dysfunction. I went on to develop Hashimoto's disease during the time I was iodine deficient, but hashi's is a complex disease and has many other contributing factors. 

      Currently I am completely free of melasma, but struggle to completely rid myself of rosacea and flushing, although for a couple of years, I was in a pretty decent state. 

      Oral and topical niacinamide (which I take/use), are also beneficial for alleviating melasma. Melasma has an oxidative stress factor which the above help alleviate. I take oral vitamin C, but don't use it topically due to irritation.

      I also use ZZ cream, which I mix with my niacinamide gel and that helps calm and control my subtype 1 rosacea/flushing. I expect it helps with controlling pigment too.

      High dose oral vitamin C, moderate zinc and gut antimicrobials have brought about a reduction of melasma in a number of other women. A quick google should lead you to them. 

      Another thing you might consider is elevating your glutathione levels with NAC. Around 200mg. Any more might cause flushing. 
      Glutathione is considered a master antioxidant and could help relieve both your melasma and rosacea.

      Of course, the above treatments take a fairly long time to work, but I do believe they have merit. I have spent decades researching the subject and applying different methods.

      IPL can make melasma much worse and progressive. Been there, done that.

      Based on what you say, I suspect you do have a form of rosacea/flushing. ----end post 
    • A biopsy is not required to take a demodex density count. All is needed is dermoscopy: 

      Scroll down to this article and look for Dermoscopy for more details. What are the numbers of demodex on normal skin compared to those who have demodectic rosacea? They are reports that the numbers are higher in rosacea sufferers who suffer from demodectic rosacea. One report says, "Instead of 1 or 2 per square centimetre of skin, the number rises to 10 to 20." Another report says, "The mean mite count was 49.8 (range 2 to 158) in patients with rosacea and 10.8 (range up to 97) in control subjects (p < 0.001); the highest density of mites was found on the cheeks. A statistically significant increase in mites was found in all subgroups of rosacea, being most marked in those with steroid-induced rosacea."

      There are reports in RF of simply a taking cellophane tape scraping of the cheek and examining under a simple microscope you can by at Amazon and do it yourself, for example this post. 

      There is evidence that decreasing the demodex density count improves rosacea.  

      Physicians rarely take demodex density counts. In his authoritative book on rosacea, Frank Powell, MD, wrote on the last paragraph of page 82 in his book:

      “There is no laboratory test or investigation that will confirm the diagnosis of PPR. Specific investigations may be required to rule out similar appearing conditions (many of which will be identified by listening carefully to the patient’s medical history and examining the skin lesions). These include skin swabs for bacterial culture, skin scrapings for the presence of demodex mites, scrapings for fungal KOH and fungal culture, skin biopsy for histologic examination, (and rarely culture) skin surface biopsy for demodex mite quantification, patch tests, photopatch tests, and very rarely systemic workup wih appropriate blood tests and radiological examinations.”

      How many dermatologists do you know do such a detailed history and examination? When you were diagnosed with rosacea, did your physician come close to what is mentioned in the above paragraph? So be sure to read HunkeyMonkey's post on Cheap and easy home test for Demodex
    • Just ran a nine day course of Prednisone and thought it appropriate to post this here to see the results. 
    • Just ran a nine day course of Prednisone and thought it appropriate to post this here to see the results. 
    • ElaineA Home Made Ivermectin Cream (Cheaper than Soolantra or Permethrin Creams) How to blend your own Ivermectin Cream for treating Rosacea and possibly Occular Rosacea (eye lids and face only, do NOT put this stuff in your eyes!) Soolantra (1% Ivermectin cream) costs your insurance company or uninsured patients about $455 per 45 gram tube.
      A competing product, Permethrin cream which contains 5% Permethrin is available for as low as $41.21 for a 60 gram tube(GoodRx price quoted today at Walmart). Permethrin is used to treat scabies and lice and is sometimes prescribed for demodex mites as well. Soolantra Ingredients:
      1. Galderma states that Soolantra is 1% Ivermectin in their Cetaphil Moisturizing Cream. Cetaphil is noted for making high quality moisturizers.
      - Cetaphil Moisturizing Cream - 20 Oz available from Amazon for $16.69 (- Amazon rating is 4.5 stars) OR a travel size container may be found for about $2-$3 in the drugstore travel section. 2. Ivermectin - available in inexpensive generic prescription form. The Ivermectin drug has been available since 1975 and is off patent.
      - Amazon sells the Duramectin Ivermectin Paste 1.87% For Horses, 0.21 oz for $5.37 or a 3-pack for $11.24 I wonder if you could make your own Ivermectin Cream? The horse paste is for horses but is edible at least by horses. If there is nothing irritating in it, it might work OK for humans when applied topically. Dilution equation from Wikipedia:
      C1 * V1 = C2 * V2 To dilute the 1.87% horse paste with the cream down to a 1% solution would then work out to:
      0.0187 * 0.21 = 0.01 * V2 V2 = (0.0187/0.01) * 0.21 = 0.3927 oz Total Volume of completed mix. Amount of Moisterizer to Add is 0.3927 - 0.21 = 0.1827 oz. (5.18 grams) of cream per tube of horse paste. That will dilute it to the same 1% solution in Soolantra. One tube of Duramectin paste mixed with a good moisturizing cream would yield about 11.13 grams of ivermectin cream.
      The full 3 pack of Duramectin + 0.5481 oz of Cetaphil moisturizing cream would yield 1.18 oz or about 33.45 grams of ivermectin cream. I don't know if this would be useful or not. The Duramectin paste might be irritating in some way to humans. But it would certainly be cheaper with about $20 or less cost vs. $455 per tube of Soolantra.
    • Marcello, a lawyer, says, "Ten days ago, I bought Lutein-Z with zeaxanthin (10 mg) from Jamieson brand and started to take it with Canola oil (to improve lutein's absorption). That, of course, was to protect my eyes and nothing else. Then a couple of days later I noticed that I had no more new pustules on my face. Not a single new one !!! I was honestly wondering what was happening, then I realized that the only thing that could explain it was my new intake of lutein. It's been 10 days now since I took my first pill and my face is still completely clear." [post no. 1] Also see post no 20 in this thread]
      "Lutein from Latin luteus meaning "yellow" is a xanthophyll and one of 600 known naturally occurring carotenoids." Wikipedia
      "Zeaxanthin is one of the most common carotenoid alcohols found in nature. It is important in the xanthophyll cycle." Wikipedia "Dr Lange also likes to add 6 mg of astaxanthin along with some lutein and zeaxanthin in moderate to marked cases of blepharitis for the additional anti inflammatory properties when used together with omega 3." Natural Treatment for Blepharitis by Dr Michael Lange  If you decide to try Lutein with Zeaxanthin please use our Amazon Affiliate store (we get a small fee if you purchase through our store and you will helping our non profit organization). Please post your experience in this thread. Mahalo. 
    • Related Articles Psychosocial aspects of rosacea with a focus on anxiety and depression. Clin Cosmet Investig Dermatol. 2018;11:103-107 Authors: Heisig M, Reich A Abstract
      Background: Rosacea is a common, chronic skin condition characterized by facial redness and inflammatory lesions. The disease can lead to social stigmatization and may significantly reduce the quality of life of patients. Psychosocial impact of rosacea can be severe and debilitating; however, it is still underestimated.
      Objective: This paper provides a literature review focused on depression and anxiety in patients with rosacea.
      Conclusion: Rosacea patients have an increased risk of developing depression and anxiety and tend to avoid social situations. However, there are still limited data on this condition. Effective treatment of clinical symptoms brings significant improvement in psychological symptoms. Further studies should be conducted to investigate in more detail the psychological impact of rosacea. In addition, improvement of the efficacy of rosacea treatment is still needed.
      PMID: 29551906 [PubMed] {url} = URL to article
    • Related Articles Genome-Wide Analysis Characterization and Evolution of SBP Genes in Fragaria vesca, Pyrus bretschneideri, Prunus persica and Prunus mume. Front Genet. 2018;9:64 Authors: Abdullah M, Cao Y, Cheng X, Shakoor A, Su X, Gao J, Cai Y Abstract
      The SQUAMOSA promoter binding protein (SBP)-box proteins are plant-specific transcriptional factors in plants. SBP TFs are known to play important functions in a diverse development process and also related in the process of evolutionary novelties. SBP gene family has been characterized in several plant species, but little is known about molecular evolution, functional divergence and comprehensive study of SBP gene family in Rosacea. We carried out genome-wide investigations and identified 14, 32, 17, and 17 SBP genes from four Rosacea species (Fragaria vesca, Pyrus bretschneideri, Prunus persica and Prunus mume, respectively). According to phylogenetic analysis arranged the SBP protein sequences in seven groups. Localization of SBP genes presented an uneven distribution on corresponding chromosomes of Rosacea species. Our analyses designated that the SBP genes duplication events (segmental and tandem) and divergence. In addition, due to highly conserved structure pattern of SBP genes, recommended that highly conserved region of microsyneteny in the Rosacea species. Type I and II functional divergence was detected among various amino acids in SBP proteins, while there was no positive selection according to substitutional model analysis using PMAL software. These results recommended that the purifying selection might be leading force during the evolution process and dominate conservation of SBP genes in Rosacea species according to environmental selection pressure analysis. Our results will provide basic understanding and foundation for future research insights on the evolution of the SBP genes in Rosacea.
      PMID: 29552026 [PubMed] {url} = URL to article
    • Related Articles Quality of Life in Individuals with Erythematotelangiectatic and Papulopustular Rosacea: Findings From a Web-based Survey. J Clin Aesthet Dermatol. 2018 Feb;11(2):47-52 Authors: Zeichner JA, Eichenfield LF, Feldman SR, Kasteler JS, Ferrusi IL Abstract
      OBJECTIVE: The objective of the study was to evaluate the impact of rosacea on self-perception, emotional, social, and overall well-being and quality of life in individuals with erythematotelangiectatic rosacea (ETR) and papulopustular rosacea (PPR). DESIGN: We distributed a cross-sectional email invitation for participants in the United States to fill out a web-based survey. PARTICIPANTS: We included adults who reported having previously received a diagnosis of erythematotelangiectatic rosacea or papulopustular rosacea. MEASUREMENTS: Questionnaires measured the psychosocial aspects of rosacea, including the Satisfaction With Appearance Scale and modified Satisfaction With Appearance Scale questionnaires, Impact Assessment for Rosacea Facial Redness, Rosacea-Specific Quality-of-Life questionnaire, and RAND 36-Item Short Form Health Survey. The Impact Assessment for Rosacea Facial Bumps or Pimples was administered to the papulopustular rosacea cohort. RESULTS: Six hundred participants enrolled and completed the survey, with most rating their rosacea as mild or moderate (ETR: 95.6%; PPR: 93.7%). In the erythematotelangiectatic rosacea and papulopustular rosacea cohorts, respectively, 45 and 53 percent disagreed/strongly disagreed that they were satisfied with their appearance due to rosacea; 42 and 27 percent agreed/strongly agreed that they "worry how people will react when they see my rosacea"; and 43 and 59 percent agreed/strongly agreed that they feel their rosacea is unattractive to others. Rosacea-Specific Quality-of-Life total and domain scores indicated negative impact of rosacea for both cohorts. Both cohorts reported worse 36-item Short Form Health Survey overall and domain scores than population norms in the United States. CONCLUSION: Rosacea had wide-ranging, negative effects on self-perceptions and emotional, social, and overall well-being as well as rosacea-specific quality of life. Overall, both erythematotelangiectatic rosacea and papulopustular rosacea cohorts reported a substantial negative impact of rosacea on quality of life on a range of instruments.
      PMID: 29552276 [PubMed] {url} = URL to article
    • "Acne rosacea, or more commonly called just rosacea, affects 14 million people in the U.S., or five percent of the population, and is sometimes said to be an adult version of acne vulgaris." Rosacea affects 5 percent of population, Richard P. Holm, Medical Doctor, Argus Leader, Part of the USA Network, Dec 11, 2017
    • Martin Schaller, MD, from the Department of Dermatology, Eberhard Karls University Tuebingen in Germany has co-wrote a paper that proposes using topical Ivermectin (Soolantra) to treat ocular rosacea. Dr. Schaller is a member of the RRDi MAC.  Br J Dermatol. 2018 Mar 12. doi: 10.1111/bjd.16534. 
      Successful therapy of ocular rosacea with topical ivermectin.
      Schaller M, Pietschke K. This was first announced by David Pascoe at RSG. 
    • A number of reports from patients who have used photo dynamic therapy [PDT] complain of hair loss, particularly males. Here is a list:  samoht  timo  [more will be added if anyone posts in this thread] The main point is that you should be aware that PDT has a risk of hair loss. Apparently PDT can be used to stimulate hair growth or eliminate hair growth, depending on the desired treatment.  "Several new devices (in-office procedures and at-home devices) are being touted to reverse hair loss and restore hair growth..." [1] "Our results suggest that PDT can damage the nonpigmented hair matrix, but not stem cells or dermal papillae. Repeated PDT may impair the hair-regeneration capacity via a bystander effect on bulge stem cells or dermal papillae. In this study, we found it was possible to remove nonpigmented hair using PDT" [2] "Low power CW He:Ne laser and methylene blue (MB) offered a successful PDT system in selectively damaging hair follicles, leaving an intact epidermis. The current PDT system provides better outcome than hair destruction through laser heat transfer procedures and laser-mediated hair removal, due to complete destruction of hair follicles." [3] "Here at WellMedica we treat hair loss and alopecia through Low Level Laser Therapy."  "An experimental method combining chemicals and radiation to induce controlled hair loss or reduction" Hair Facts, Photodynamic therapy hair removal End Notes [1] New generation of laser and light therapies could provide future treatment options for skin, hair and nail conditions
      American Academy of Dermatology’s 70th Annual Meeting by Molly Wanner, MD, FAAD, instructor at Harvard Medical School and dermatologist at Massachusetts General Hospital in Boston.  [2] Lasers Surg Med. 2016 Oct;48(8):748-762. doi: 10.1002/lsm.22570. Epub 2016 Aug 9.
      Nonpigmented hair removal using photodynamic therapy in animal model.
      Shin H, Yoon JS2,, Koh W, Kim JY2,, Kim CH, Han KM, Kim EJ, Kwon  [3] Photodynamic therapy for hair removal
      Mohamed H.M. Ali, Mohamed M. Hashem, Amr Zaher, Soheir Korraa, Farouk Hamouda, Carmen M. Ali, Khalid A. Al-Saad
      QScience Connect 2013:16