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    • Acuri reports using aspirin improves flushing (at RF).
    • I haven’t figured out how to get the full article. Sometimes in the author information it shows an email address and I ask for the full article and one of authors sometimes sends a copy. If anyone would volunteer to figure out how to get copies of articles like this (without paying for it!) that would be most helpful. We are searching for volunteers!
    • Related Articles Effect of in-office samples on dermatologists' prescribing habits: a retrospective review. Cutis. 2020 Jan;105(1):E24-E28 Authors: DeNigris J, Malachowski SJ, Miladinović B, Nelson CG, Patel NS Abstract The relationship between physicians and pharmaceutical companies has caused the medical community to question the degree to which pharmaceutical interactions and incentives can influence physicians' prescribing habits. Our study aimed to analyze whether a change in institutional policy that restricted the availability of in-office samples for patients resulted in any measurable change in the prescribing habits of faculty physicians in the Department of Dermatology and Cutaneous Surgery at the University of South Florida (USF)(Tampa, Florida). Medical records were retrospectively reviewed for common dermatology diagnoses-acne vulgaris, atopic dermatitis, onychomycosis, psoriasis, and rosacea-before and after the pharmaceutical policy changes, and the prescribed medications were recorded. These medications were then categorized as brand name, generic, and over-the-counter (OTC). Statistical analysis using a mixed effects ordinal logistic regression model accounting for baseline patient characteristics was conducted to determine if a difference in prescribing habits occurred. PMID: 32074163 [PubMed - as supplied by publisher] {url} = URL to article
    • Hi Steven, I read your post, and I sympathize. We are all part of this community trying to help each other with trial and error solutions. After 20 years of rosacea, I decided to research everything I could about the disease. Most of what I learned came from the rosaceagroup.org website and this one. Together they are a fantastic resource and you can read about things you never would have thought of. I am one of the lucky ones who had great success with finding a "cure" which involved multiple components: gut health, (I did a cleanse, a fast and a heavy metal detox), adding specific supplements, changing/reducing the products I used on my face, and treating my skin for demodex mites. I never took oral antibiotics and since November I have not used any medications on my face. Your answers will likely be different than mine, but reading and researching are key. I'm always interested when people say their rosacea came on suddenly. What changed? Environment? Job? Housing? Diet? Lifestyle? Chemical exposure? Relationship? There was probably something; you just have to put the pieces together. That will help you to address the cause, not just treat the symptoms.  Keep us posted!
    • Related Articles Ecological niche differences between two polyploid cytotypes of Saxifraga rosacea. Am J Bot. 2020 Feb 17;: Authors: Decanter L, Colling G, Elvinger N, Heiðmarsson S, Matthies D Abstract PREMISE: Different cytotypes of a species may differ in their morphology, phenology, physiology, and their tolerance of extreme environments. We studied the ecological niches of two subspecies of Saxifraga rosacea with different ploidy levels: the hexaploid Central European endemic subspecies sponhemica and the more widely distributed octoploid subspecies rosacea. METHODS: For both cytotypes, we recorded local environmental conditions and mean plant trait values in populations across their areas of distribution, analyzed their distributions by niche modeling, studied their performance at two transplant sites with contrasting conditions, and experimentally tested their cold resistance. RESULTS: Mean annual temperature was higher in hexaploid than in octoploid populations and experiments indicated that frost tolerance of the hexaploid is lower than that of the octoploid. Reproduction of octoploids from Central Europe was higher than that of hexaploids at a transplant site in subarctic Iceland, whereas the opposite was true in temperate Luxembourg, indicating adaptation of the octoploids to colder conditions. Temperature variables were also most important in niche models predicting the distribution of the two cytotypes. Genetic differences in survival among populations were larger for the octoploids than for the hexaploids in both field gardens, suggesting that greater genetic variability may contribute to the octoploid's larger distributional range. CONCLUSIONS: Our results support the hypotheses that different cytotypes may have different niches leading to spatial segregation, and that higher ploidy levels can result in a broader ecological niche and greater tolerance of more extreme conditions. PMID: 32067225 [PubMed - as supplied by publisher] {url} = URL to article
    • The RRDi financial report shows clearly how we are spending member donations. If the over 1300 members would each donate ONE DOLLAR that would keep us going for another year. If you appreciate the amount of rosacea data preserved on our website and forum would you consider donating one dollar so we can keep this non profit organization for rosacea patient advocacy going? If you have the volunteer spirit you could read our current financial situation and with some math figure out how long our current spending will last. As you can see our funds our meager compared to the other non profit organizations for rosacea which will be the only ones left if the RRDi doesn't receive donations to continue its operation. 
    • A new paper states the following, 'A Western diet rich in fat and sugar may lead to inflammatory skin diseases such as psoriasis, a study by UC Davis Health researchers has found."  The article mentions that "cholestyramine, a drug used to lower cholesterol levels by binding to bile acids in the intestine, helped reduce the risk of skin inflammation.' Western diet rich in fat and sugar linked to skin inflammation, Science Daily, February 18, 2020
    • Trevi has a post that he says just using warm to hot water for three months and he has clearance. He does mention in the initial post he has been using some boric acid as well. We will follow up and see if anyone else confirms that this helps improve SD/Rosacea or not.  Using just warm water to hot water is about as natural as it gets.  You be judge whether boric acid is natural or not. 
    • I am so happy to hear the Borax - Epsom Salt soak is helping you!   Thank you for letting us know.  It is also helpful to know that the Equate Brand Epsom Salt works - always good to save money.  Please keep us posted as to how this works out for you.  That shared knowledge can help us all.
    • Welcome Steven Zeigler to the RRDi.  As Apurva points out you are correct in your research. You can take time in this forum category you posted in, PSYCHOLOGY AND ROSACEA, to continue your research by reading all the posts. One of the many theories on rosacea is the Nervous System Theory which is worth some of your time to investigate since it is related somewhat.  However, your doctor isn't acquainted with the Gold Standard of treatment for rosacea and is old school prescribing [probably] topical metronidazole and doxycycline. What exactly did your doctor prescribe?  There are a number of rosacea theories on the cause of rosacea, but this post is worth considering.  If you want a free copy of Rosacea 101 which includes the Rosacea Diet, just use the contact form [request a copy]. Avoiding sugar and carbohydrate may improve your skin. You may want to read this post about alcohol and rosacea. The RRDi official trigger factor list has a number of environmental triggers.  As for everyone being different with regard to rosacea, we have dubbed this the X-Factor in Rosacea. 
    • Thanks Ruby, keep us posted. 
    • Yes what you have pointed out above is correct. There are more interconnected and internal factors or subordinate factors though which enhance the condition but you sometimes never know what activated this condition and have to go through all the loops. Yes sunscreen is important if you are a very fair skinned person but it all depends on skin makeup (from makeup I am saying composition) because skin of color people like me have more melanin production that kind of gives protection from sun rays and that also depends on how your skin reacts to sunscreen if you have dry or oily skin . I use my homemade zinc sunblock on top of lathered moisturizer since I have a dry skin but you just give it a try buying something. There are recommendations of sunscreens in our rosacea topics. you can read what suits you best.
    • Hi All, Thanks to everyone that has contributed to this community. I have a story I want to share about my journey towards a Rosacea diagnosis and learning about and dealing with the disorder. In my late twenties I began to have symptoms beyond what I thought was just a little localized acne and redness. I had a nurse friend that suggested hydrocortisone cream for the redness and it actually worked for me. Around the same time I developed a temporary skin condition that was diagnosed as eczema. It was on my hands and the doctor said it was stress induced eczema and gave me a cream that cleared it up, never to return. Twenty five years later (6 months ago) my face...caught fire. I had what I would call sudden onset rosacea. It was bad. The red butterfly came on strong. I went to the doctor and she diagnosed it as rosacea and put me on that standard old school anti-microbial cream (now she wants me on oral antibiotics) and I am now looking for a regimen (and products) that work for me and....to understand the condition better and manage it somehow. A few thoughts and insights I have gained in my research and in understanding my body and it’s reactions that I would love input on. 1. It is complicated and there is no one cause or cure but a large complicated web of interconnected factors. 2. Stress and mental health plays a HUGE role. I still have hopes that when my life situational stress and depression settles down, I may find more relief. 3. Over all health plays a huge role. Diet. Exercise. My diet has been horrible as I have been eating out a lot and drinking more and exercising less since it “came on strong”. 4. Environment (for example it is winter and I have been using a space heater to heat my room but the house is freezing) could play a role.  5. Every individual is different.   Does my thinking seem correct or on the right tract to those that have more experience?   Is sunscreen important? I am very fair skinned but not outside a lot but I have not been using sunscreen. Beyond affirmation and question answering. My hope is that insights I have and my sharing will help others in some small way.          
    • I’m taking it not had great results yet . But I got my sister on it who has fibromyalgia and it’s worked wonders for her. I’ve been up to 4.5 but i couldn’t sleep so I’m on my way back down. 
    • Thanks ElaineA for your bath recipe. I have now been doing your bath recipe for about five days each evening and notice it does indeed help my scalp SD issues and I use a wash cloth and wash my face with the bath water and my face seems to really be better with this bath. I think totally soaking in your bath recipe is worth it and recommend others try it. I am using the Equate Brand Epsom Salt since it is cheaper than Dr. Teals. I do use the 20 Mule Team Borax soap. 
    • Addendum Post on NRS Form 990 2018 Since basically I am the lone watchdog of the NRS in how it spends its donations and generally speaking, the vast majority of rosaceans could care less how the NRS spends its donations, I will continue to raise red flags and point out some juicy facets of how the NRS spends its donations (i.e., in the second to last paragraph of the previous post in this thread did you notice how the NRS spends $74,814 on advertising just in the year 2018?). I thought it would be pertinent to point out how much the NRS spends on 'Information Technology' just in 2018 which was $60,377. Not sure what you think IT is but it could include the NRS website or possibly an IT geek who takes care of their computers and network in the office. You can find where this is listed in Form 990 for 2018 (available for your download and inspection at the beginning of the previous post) at Part IX, Statement of Functional Expenses, page 10 (see screen shot below).  ' Now think about the amount spent on Information Technology ($60K) and then compare what the NRS spent for rosacea research ($25K) or as already pointed out $74K for advertising. What do you think about any of this? What do you think a non profit organization for rosacea should spend on rosacea research when considering 'functional expenses'? Any comments?   
    • it is quite odd that with over five hundred views of this post that no one has made one reply to this topic. To me this is a fascinating subject that should be investigated more and should be done by rosaceans independent of the pharmaceutical backed research which predominates the clinical papers on rosacea. Why rosaceans don't want to come together as a group and support their own independent research baffles my mind. If we could just get $1000, we could offer one of the RRDi MAC members to investigate a rosacea subject that the RRDi wants investigated and publish the results ourselves as an independent, non profit organization for rosacea. All it would take is for each member to donate ONE US DOLLAR. If you would like to start this project, please donate. 
    • image courtesy of Wikimedia Commons "Mast cells are innate immune cells that can be found in virtually all tissues. Recently, increasing evidence has indicated that mast cells have important effects on the pathogenesis of rosacea."  Front Med (Lausanne). 2019;6:324 The Theranostics Role of Mast Cells in the Pathophysiology of Rosacea. Wang L, Wang YJ, Hao D, Wen X, Du D, He G, Jiang X
    • Related Articles New Herbal Biomedicines for the Topical Treatment of Dermatological Disorders. Biomedicines. 2020 Feb 08;8(2): Authors: Hoffmann J, Gendrisch F, Schempp CM, Wölfle U Abstract Herbal extracts and isolated plant compounds play an increasing role in the treatment of skin disorders and wounds. Several new herbal drugs, medicinal products and cosmetic products for the treatment of various skin conditions have been developed in recent years. In this nonsystematic review, we focus on herbal drugs that were tested in controlled clinical studies or in scientifically sound preclinical studies. The herbal biomedicines are intended to treat atopic dermatitis (St. John's wort, licorice, tormentil, bitter substances, evening primrose), psoriasis (araroba tree, lace flower, barberry bark, indigo, turmeric, olibanum, St. John's wort), actinic keratosis (birch bark, petty spurge), herpes simplex (lemon balm, sage and rhubarb), rosacea (green tea, licorice, tormentil) and acne vulgaris (tea tree oil, green tea, hop), or to improve photo protection (green tea, Dyer's weed, cocoa tree, carotinoids, licorice), aesthetic dermatology (licorice, pine bark, gotu kola) and wound healing (birch bark, onion). PMID: 32046246 [PubMed] {url} = URL to article
    • Related Articles The Theranostics Role of Mast Cells in the Pathophysiology of Rosacea. Front Med (Lausanne). 2019;6:324 Authors: Wang L, Wang YJ, Hao D, Wen X, Du D, He G, Jiang X Abstract Rosacea is a chronic inflammatory cutaneous disorder that adversely affects patient's health and quality of life due to the complex course and the need for repeated treatment. The exact molecular mechanisms of rosacea are unclear. Mast cells are innate immune cells that can be found in virtually all tissues. Recently, increasing evidence has indicated that mast cells have important effects on the pathogenesis of rosacea. In this review article, we describe recent advances of skin mast cells in the development of rosacea. These studies suggested that mast cells can be an important immune cell that connected innate immunity, nerves, and blood vessels in the development of rosacea. Moreover, we review the inhibition of mast cells for the potential treatment of rosacea. PMID: 32047752 [PubMed] {url} = URL to article
    • Related Articles Multimorbidity and mortality risk in hospitalized adults with chronic inflammatory skin disease in the United States. Arch Dermatol Res. 2020 Feb 11;: Authors: Narla S, Silverberg JI Abstract Chronic inflammatory skin diseases (CISD) represent a significant burden of skin disease in the United States, and a growing number of studies demonstrate that CISD are associated with multiple comorbidities. However, few studies examined multimorbidity in adults with CISD. We sought to determine whether hospitalized US adults with chronic inflammatory skin disorders have increased multi-morbidity and mortality risk. Data from the 2002-2012 Nationwide Inpatient Sample were analyzed, including a representative 20% sample of US hospitalizations. Charlson comorbidity index (CCI) and mean estimated 10-year survival were calculated. Multivariable linear regression models were constructed with CCI score and mean estimated 10-year survival as the dependent variables and chronic inflammatory skin diagnosis, age and sex as the independent variables. CCI scores were significantly higher in bullous pemphigoid (P = 0.0005) and dermatomyositis (P < 0.0001), lower in hidradenitis suppurativa (P < 0.0001), pemphigus (P < 0.0001), rosacea (P < 0.0001), and not significantly different in atopic dermatitis, alopecia areata, and lichen planus compared to psoriasis. Conversely, the mean estimated 10-year survival was higher in pemphigus (P = 0.0451), lichen planus (P = 0.0352), rosacea (P < 0.0001), lower in bullous pemphigoid and dermatomyositis (P < 0.0001), and similar in atopic dermatitis, alopecia areata, and hidradenitis suppurativa compared to psoriasis. Each CISD had a distinct profile of comorbidities when compared to psoriasis. Hospitalized adults with multiple CISD have increased multimorbidity and decreased 10-year survival. Further studies are needed to develop multidisciplinary strategies aimed at preventing and treating multimorbidity, especially modifiable cardiovascular factors in adults with CISD. PMID: 32047999 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Short pulse intense pulsed light versus pulsed dye laser for the treatment of facial redness. J Cosmet Laser Ther. 2020 Feb 11;:1-5 Authors: Tirico MCCP, Jensen D, Green C, Ross EV Abstract Treating diffuse facial redness with an intense pulsed light (IPL) source usually requires multiple sessions and may not achieve complete clearance. The 595 nm pulsed dye laser (PDL) enjoys a good reputation for reducing facial redness with non-purpuric settings. The objective of this study was to compare facial redness reduction using these two devices. After establishing the lowest light dose able to achieve transient purpura for the same pulse width of 1,5 ms with each technology, right and left sides of the face were randomly assigned for each type of treatment. There were two treatment sessions 4 weeks apart and the final evaluation was performed 8 weeks after thesecond treatment. Four blinded experienced dermatologists analyzed pre and post-treatment photographs, which demonstrated an average of 60% improvement on the segment treated with the IPL as opposed to 45% on the other segment. Pain level was described as mild and the procedure was well tolerated for both types of treatment. In this study we showed that short-pulsed intense pulsed light and PDL are similar in decreasing facial redness when non-purpuric low fluence settings are used. The IPL was faster and did not have consumables. PMID: 32041440 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles The skin microbiota as a link between rosacea and its systemic comorbidities. Int J Dermatol. 2020 Feb 11;: Authors: Thompson KG, Rainer BM, Kang S, Chien AL PMID: 32043275 [PubMed - as supplied by publisher] {url} = URL to article
    • Yes I also have used shea butter a while back and what helped shea butter in that it soothes out the itching sensation and absorbs in skin like I have applied nothing. It really helped a lot. I also had SD and it went with the use of ketoconazole lotion but this time the experience of dry crusty pimple like rough appearance around the mouth and jaw line really indicates the fungus and rosacea play a vital role in inflammatory response and I agree with you that it has not been ruled out and how treating the secondary condition automatically controlled the primary condition with less flushing experience. So we can observe that besides demodex mites other microbial flora this time fungus can play a vital role in aberrant inflammatory response and fungus may play a role in interacting with resident immune cells.
    • This is helpful information on the different ZZ creams available throughout the world: Type 1Original ZZ CreamType 2Cosmetic ZZ CreamType 3ZZ cream UK Version (Amazon UK)Type 4ZZ Cream European Version Cosmetic (Demoderm)
    • Apurva,  My dermatologist told me that I have SD on my forehead and into the hair. For about three months I have now had some issues similar on the back of my head just above the neck that has not responded to my normal shampoo, Coal Tar (I usually use a generic T-Gel from Walmart or CVS), so I tried using Nizorol (Ketoconazole) brand shampoo which did improve the issue but it simply didn't go away. What really helped was using an old jar of Sulfur Butter from a tip Joanne Whitehead posted a while back. We do feature it in our affiliate store but when I tried to purchase another jar it wasn't available on Amazon. So I contacted the Braunfels Labs company website, and it is no longer listed. So I contacted the company asking what happened and got a response from DP Davidson, who explained that the Sulfur Butter is still available but on a different website, sulfursoap.com.  So I ordered another jar since this cream contains the following ingredients:  Your experience and mine indicates that fungus and rosacea has not been ruled out and even though SD and rosacea can co-exist, there is probably some relationship between the two skin diseases. Not sure what ingredient in the Sulfur Butter is improving my fungus issue in my scalp but I think the Shea Butter, Hemp Oil, Avocado Oil and Jojoba Oil may have something to do with it along with the sulfur. 
    • When talking about rosacea there are so many things and factors to consider. Even if you are trying everything to help control this condition, skipping just one thing is enough for its persistency. A few days ago I suddenly had a sandy rough patchy and scaly skin texture on already flushed skin which was aggravating the condition of inflammation altogether. I already have controlled and managed rosacea but only relapse with the onset of fall and continue with winter but If I describe the condition of my skin, it was a skin barrier texture which was not allowing anything if applying topically. It was as if my skin lipids were severely imbalanced. I could not understand what made this condition to appear but I was on with my internal and external cure. It was a little bit resolved but then I examined the pattern of that condition appeared and did a lot of research and found the pattern resembled to yeast infection may be to blame because I had very rough pimple like appearance around my mouth and jawline and again I remembered how I took the treatment regimen when I had seborrheic dermatitis and It was completely gone. Now I considered my severe scalp dandruff and I correlated everything from my scalp flakiness to my intense flushing and on top of that sandy rough flaky skin. Usually I get flare-ups in this season but do not bother much like pain and burning sensation and pruritus but this time it was bothering much and I decided to give it a try the same treatment regimen I had during Seborrheic dermatitis because the treatment regimen for SD and yeast infection are same so I washed my face at night with Ketoconazole 2% with Zinc Pyrithione 1% lotion and the next morning I found a drastic change in my skin as if it is restored to its natural balance and then I washed my hair with that same lotion and I am going to continue this for few days. The major change and outcome I discovered with respect to overall condition : When I treated this condition with ketoconazole the next day I got very mild flare-up and was not flushing for prolonged period but before that I was getting frequent flare-ups and the flushing was prolonged, intense, burning and painful . So I discovered how a yeast or fungal infection can also aggravate the condition of rosacea and even go further can cause the aberrant hyperactive immune function in play. Besides parasites and bacteria how yeast or fungus can play with immune system with respect to rosacea needs to be more discovered.
    • image courtesy of Wikimedia Commons "A 40-year-old Caucasian woman presented to our dermatology clinic with rosacea. She was prescribed oral doxycycline 50mg once daily and metronidazole lotion at bedtime. Seven weeks after starting this regimen without complaint, she contacted the office stating her teeth had become discolored “overnight.” " The article explains that "Chemicals and medications associated with staining of teeth" should be reviewed with rosacea patients and "question patients about their oral hygiene regimen and develop cooperative relationships with our dental colleagues." J Clin Aesthet Dermatol. 2019 Oct; 12(10): 12–13. Published online 2019 Oct 1. PMCID: PMC6937148 Sudden Onset of Tooth Discoloration Brooke A. Jackson, MD, FAAD and Cierra D. Taylor, BA
    • The Journal of the American Academy of Dermatology, February 2020, mentions the new phenotype classification with this statement:  "The new system is consequently based on phenotypes that link to this process, providing clear parameters for research and diagnosis, as well as encouraging clinicians to assess and treat the disorder as it may occur in each individual." J Am Acad Dermatol. 2020 Feb 06;: Standard Management Options for Rosacea: the 2019 Update by the National Rosacea Society Expert Committee. Thiboutot D, Anderson R, Cook-Bolden F, Draelos Z, Gallo R, Granstein R, Kang S, Macsai M, Gold LS, Tan J
    • Related Articles Standard Management Options for Rosacea: the 2019 Update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2020 Feb 06;: Authors: Thiboutot D, Anderson R, Cook-Bolden F, Draelos Z, Gallo R, Granstein R, Kang S, Macsai M, Gold LS, Tan J Abstract In 2017 a National Rosacea Society expert committee developed and published an updated classification of rosacea to reflect current insights into rosacea pathogenesis, pathophysiology, and management. These developments suggest that a multivariate disease process underlies the various clinical manifestations of the disorder. The new system is consequently based on phenotypes that link to this process, providing clear parameters for research and diagnosis, as well as encouraging clinicians to assess and treat the disorder as it may occur in each individual. Meanwhile, a range of therapies has become available for rosacea, and their roles have been increasingly defined in clinical practice as the disorder has become more widely recognized. This update is intended to provide a comprehensive summary of management options, including expert evaluations, to serve as a guide for tailoring treatment and care on an individual basis to achieve optimal patient outcomes. PMID: 32035944 [PubMed - as supplied by publisher] {url} = URL to article
    • It is that time again, after five years, to nominate and approve the RRDi Board of Directors. If you are a voting member, you will be able to nominate or approve the board of directors by following the directions in this post. If you can't access the post, after you login, this means you are a member of the RRDi but do not have voting rights. If you want to change your membership from a member to a voting member follow the directions in this post. 
    • The papers below are discussing ORAL metronidazole, however, you should be aware of these studies with regard to the Central Nervous System, the brain, neuropathy and treatment with metronidazole.   "This microdialysis study describes the steady-state brain distribution of metronidazole in patients and confirms its extensive distribution....These findings demonstrate that the extensive distribution of metronidazole within brain ECF contributes to the CNS toxicity observed occasionally during treatments with this antibiotic. " [1] "Metronidazole is a potential cause of reversible autonomic neuropathy." [2] "Cerebellar toxicity is a rare adverse event in patients treated with metronidazole." [3] "Metronidazole is a commonly used antimicrobial drug. When used excessively, it can cause encephalopathy." [4] "Nevertheless, six cases of peripheral neuropathy with metronidazole have been reported, and we describe here a further patient with peripheral neuropathy due to metronidazole." [5] "Metronidazole is distributed extensively within CSF, with a mean CSF to unbound plasma AUC0-τ ratio of 86% ± 16%." [6] End Notes [1] Frasca D, Dahyot-Fizelier C, Adier C, et al. Metronidazole and hydroxymetronidazole central nervous system distribution: 1. microdialysis assessment of brain extracellular fluid concentrations in patients with acute brain injury. Antimicrob Agents Chemother. 2014;58(2):1019–1023. doi:10.1128/AAC.01760-13 [2] J Child Neurol, 21 (5), 429-31  May 2006 Metronidazole: Newly Recognized Cause of Autonomic Neuropathy Lisa D Hobson-Webb, E Steve Roach, Peter D Donofrio PMID: 16901452  DOI: 10.1177/08830738060210051201 [3] Int J Infect Dis. 2008 Nov;12(6):e111-4. doi: 10.1016/j.ijid.2008.03.006. Epub 2008 Jun 3. Cerebellar ataxia following prolonged use of metronidazole: case report and literature review. Patel K, Green-Hopkins I, Lu S, Tunkel AR. [4] Kalia V, Vibhuti, Saggar K. Case report: MRI of the brain in metronidazole toxicity. Indian J Radiol Imaging. 2010;20(3):195–197. doi:10.4103/0971-3026.69355 [5] Br Med J. 1977 Sep 3; 2(6087): 610–611. doi: 10.1136/bmj.2.6087.610 PMCID: PMC1631560, PMID: 198056 Metronidazole neuropathy. W G Bradley, I J Karlsson, and C G Rassol [6] Antimicrob Agents Chemother. 2014;58(2):1024-7. doi: 10.1128/AAC.01762-13. Epub 2013 Nov 25. Metronidazole and hydroxymetronidazole central nervous system distribution: 2. cerebrospinal fluid concentration measurements in patients with external ventricular drain. Frasca D, Dahyot-Fizelier C, Adier C, Mimoz O, Debaene B, Couet W, Marchand S.
    • sweat pore image courtesy of Wikimedia Commons There are some sources that state that rosacea causes large pores, particularly the pores on the nose. Here are some typical examples:  "Signs of the third stage of rosacea include persistent deep redness and many dilated veins, especially around the nose. An early sign of the third stage is fibroplasia -- growth of excess tissue -- which can produce enlarged pores." [1] "The bumps and pimples, as well as skin thickening, that accompany rosacea causes pores to enlarge and become more visible." [2] "The bumps and pimples, as well as skin thickening, that accompany rosacea cause pores to enlarge and become more visible." [3] If you will note, two different sources state the exact same words! The general consensus among rosacea authorities is that blackheads are not associated with rosacea. While large pores may be a concern to you, what can you do for this issue?  Nose Pores "Unfortunately, there’s nothing you can do to literally shrink large nose pores. But there are ways you can help make them appear smaller." [4] Treatment Natasha Burton has ten natural treatments to reduce or minimize pores. [5] Non-comedogenic skin care products (product won't clog your pores, i.e. oil free). [6] Retinoids [7] Clay Masks [8] Exfoliate Nose Strips Hyaluronic Acid [9] Conclusion Why not volunteer and post what you have done to reduce your large pores so others who are concerned with this issue can benefit. That is what this is all about, rosaceans helping rosaceans.  End Notes [1] A Fine Complexion Need Not Become A Distant Memory, Lynn Drake, MD, Rosacea Review Newsletter of the NRS, Summer 1997 [2] More Than Just a Red Face: Seven Signs of Rosacea, April 12, 2018, DermatologistOnCall  [3] More than just a red face: 7 signs of rosacea, MDLive [4] What Causes Large Nose Pores and What Can You Do?, Healthline [5] 10 Natural Remedies for Shrinking Your Pores, Natasha Burton, StyleCaster [6] What Can Treat Large Facial Pores?, AAD [7] "Certain products that have retinol [a derivative of vitamin A and well-known acne fighter and anti-ager] can make pores appear smaller," says Dr. Jaliman. "The way they work, as do other prescription strength retinoids, is to increase cell turnover so they unclog the pores, making them appear smaller." Can You Shrink Pore Size? A Top Dermatologist Explains The Possiblities, Simone Kitchens, Updated September 21, 2017, Huff Post The following retinol product is an example of reducing pores:  [8] [9] "Overall, the study concluded that intradermal low molecular weight hyaluronic acid fillers do in fact have the potential to reduce pore size — and that's in addition to improving the skin's overall texture and radiance."  New Study Says Hyaluronic Acid Fillers Can Lead to Smaller Pores, Game-changing, BY KALEIGH FASANELLA, Allure Hyaluronic Acid Serum Amazing Formulas Hyaluronic Acid The Ordinary Hyaluronic Acid 2% + B5 Pure Hyaluronic Acid Serum Powder Tree of Life Hyaluronic Acid Serum Cosmedica Skincare Pure Hyaluronic Acid Serum NatureBell Hyaluronic Acid Eve Hansen Hyaluronic Acid Cream
    • BlackMamba24, I had amazing success with ZZ cream and I urge you to keep going. I documented my pics and journey on rosacegroup.org and my name is "redvelvet." I did also do a lot with gut cleanses prior to starting ZZ, and I cut out sugar entirely. I still eat bread though!!! Now I take the following supplements daily: magnesium, B2 and a spleen support product. I also have a lot of pictures that I took weekly during the treatment and they are all posted on my website/blog "rosaceahelp.org". I am so grateful for what I learned on this forum and rosaceagroup. I believe i'd still be walking around with rosacea if it weren't for the amazing stories I read here. Good luck!
    • Related Articles Evaluation of serum uric acid levels in patients with rosacea. Arch Dermatol Res. 2020 Feb 04;: Authors: Karaosmanoglu N, Karaaslan E, Ozdemir Cetinkaya P Abstract Rosacea is an inflammatory skin disease with a chronic course. Although the pathogenesis of rosacea is not completely understood, it is regarded as an inflammatory process. The aim of the present study was to evaluate uric acid (UA) levels in patients with rosacea and to detect the correlation of UA levels with disease activity. A total of 61 patients with rosacea and 64 sex- and age-matched controls were included in the study. Demographic characteristics, medical history, and dermatological examination of the patient and control groups were recorded. Concentrations of serum UA and C-reactive protein (CRP) were evaluated and compared in both groups. This study included 61 patients with rosacea (39 females, 22 males, median age = 30 years) and 64 age- and sex-matched controls. Metabolic syndrome was significantly more common in patients with rosacea than in the control group. Patients with rosacea had significantly higher body mass index (BMI) values compared with those of controls. Serum UA and CRP values were significantly higher in the rosacea group than values in the control group. There was no statistically significant correlation between serum UA level and clinical rosacea severity. This study suggests that rosacea is not only a skin-related disease but also an inflammatory disease that can be related to higher uric acid levels, BMI values, and metabolic syndrome. It may be recommended that clinicians pay careful attention to the clinical follow-up of these patients to avoid missed associated comorbidities. PMID: 32020322 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Challenges and Solutions in Oral Isotretinoin in Acne: Reflections on 35 Years of Experience. Clin Cosmet Investig Dermatol. 2019;12:943-951 Authors: Bettoli V, Guerra-Tapia A, Herane MI, Piquero-Martín J Abstract Acne vulgaris affects more than 80% of adolescents and young adults and forms a substantial proportion of the dermatologist's and general practitioner's caseload. Severity of symptoms varies but may result in facial scarring and psychological repercussions. Oral isotretinoin is highly effective but can only be prescribed by specialists. Side effects are recognized and mostly predictable, ranging from cosmetic effects to teratogenicity. These can affect patients' quality of life and treatment adherence. This article provides a commentary on 4 key areas: the use of oral isotretinoin vs oral antibiotics, including the importance of early recognition of nonresponse to treatment, the psychological effects of acne and isotretinoin treatment, the side effects of isotretinoin therapy, and cosmetic treatment options that can help alleviate predictable side effects. The authors, who have all participated in various international expert groups, draw on relevant literature and their extensive professional experience with oral isotretinoin in the treatment of acne. The aim of this article is to provide an informative and practical approach to managing oral isotretinoin treatment in patients with acne, to help optimize treatment of this skin disease. PMID: 32021364 [PubMed] {url} = URL to article
    • Thank you so much for this insight. I also have to find out what bothered my skin. I always keep the things in check. I think the gut thing resonated with me a lot because skin and gut has some connection in rosacea. I also do fast but it's been a long time I didn't. I think I need to do it. Thank you so much.
    • Related Articles [The Use of Therapeutic and Optical Contact Lenses in Perforated Rosacea Keratitis]. Klin Monbl Augenheilkd. 2020 Feb 03;: Authors: Beuschel R, Messerli J PMID: 32016936 [PubMed - as supplied by publisher] {url} = URL to article
    • Hi Apurva, I know exactly what you are talking about and I experienced it twice in the past two years. The first episode was after we moved into our new house and I had been under a lot of stress and not eating well. I also considered the possibility that a change in environment could have triggered it. Different water, different air, new sheets/bedding, new washing machine. I think all these things can play a role in reactions when we have sensitive skin. It resolved on its own and then came back a year later for a week. I'm not sure what brought on the second episode, but I did a fast for 2 days which seemed to help a lot. I noticed over the years that whenever I would get the flu and not eat for a few days (and my stomach and colon would empty out) my skin would clear up immediately. So even though I've had food sensitivity testing done with no positive findings, I feel there is still a gut connection. When this occurred I also stopped using all facial products except coconut oil. Thinking back, I think my skin was also reacting to the coconut oil which has antiviral, antibiotic, antibacterial and anti fungal properties (the lauric acid in the oil). Since I had untreated demodex mites at the time I'm sure my skin was experiencing die-off from the coconut oil, which caused even more of a reaction. I would advise you to do a one or two day fast (but continue to drink herbal tea or cranberry juice as needed) until your skin heals and then try to think back on the past week or two if anything changed- medications, laundry detergent, facial products, etc.  It's so hard to figure it all out, but I still believe rosacea can be controlled naturally with enough detective work. I would also advise you to keep a journal of foods, creams, medications, and hormonal changes. Good luck!
    • Hi Apurva, I know exactly what you are talking about and I experienced it twice in the past two years. The first episode was after we moved into our new house and I had been under a lot of stress and not eating well. I also considered the possibility that a change in environment could have triggered it. Different water, different air, new sheets/bedding, new washing machine. I think all these things can play a role in reactions when we have sensitive skin. It resolved on its own and then came back a year later for a week. I'm not sure what brought on the second episode, but I did a fast for 2 days which seemed to help a lot. I noticed over the years that whenever I would get the flu and not eat for a few days (and my stomach and colon would empty out) my skin would clear up immediately. So even though I've had food sensitivity testing done with no positive findings, I feel there is still a gut connection. When this occurred I also stopped using all facial products except coconut oil. Thinking back, I think my skin was also reacting to the coconut oil which has antiviral, antibiotic, antibacterial and anti fungal properties (the lauric acid in the oil). Since I had untreated demodex mites at the time I'm sure my skin was experiencing die-off from the coconut oil, which caused even more of a reaction. I would advise you to do a one or two day fast (but continue to drink herbal tea or cranberry juice as needed) until your skin heals and then try to think back on the past week or two if anything changed- medications, laundry detergent, facial products, etc.  It's so hard to figure it all out, but I still believe rosacea can be controlled naturally with enough detective work. I would also advise you to keep a journal of foods, creams, medications, and hormonal changes. Good luck!
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