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    • A paper in 2017 continues to explain the quandary. "Many studies have shown higher density of the parasites in diseased inflammatory skin than in normal skin, but whether it is the cause or result of the inflammation remains unclear." [6]  A paper in 2018 may help to resolve this issue because for the first time it has been discovered that Demodex mites secrete bioactive molecules that reduced TLR2 expression in sebocytes. [7] So while the jury is still out on this subject, What do you think?  Which comes first, the demodex or the rosacea? Does it even matter? With your above statement I highlighted and giving my view on this topic which comes first, I am also stating the same thing that I think demodex came first well it is not experiment or evidence based but with the experience I have had. Human Permanent Ectoparasites; Recent Advances on Biology and Clinical Significance of Demodex Mites: Narrative Review Article With this journal which you quoted in your article , "Many studies have shown higher density of the parasites in diseased inflammatory skin than in normal skin, but whether it is the cause or result of the inflammation remains unclear." So I was elaborating this sentence that higher density might be the result of inflammation (inflammatory immune response) and then subsequently the cause of inflammation. So I explained this with the term “reciprocal correlation”. And let’s say if the higher density is the result of inflammation, so the altered cutaneous immune responses are the cause of persistent inflammation and that is what I was trying to state in my post but then I read the above journal in detail after your question and I found the confirmation of my  expression with these sentences of journal   “ Studies indicate increased number of D. folliculorum in immunocompromised patients”  and “It remains to be determined which kind of cellular immunity may foster mites’ proliferation” and my statement “the false immune response(altered immune response) might be the cause of increasing number of demodex”  state the same thing. Thank you for questions because what I was stating is experience based but after thoroughly reading the reference journals from your article I found the confirmation of the same thing.    
    • That is difficult to follow. In a paper by Powell, et al, it is stated that the mites "secrete bioactive molecules that reduced TLR2 expression in Sebocytes." The 'bioactive molecules' that the mites secrete keep the innate immune system from reacting to the mites when in normal numbers on normal skin, so my question is what causes the demodex to proliferate in greater numbers to what you say,  "cause inflammatory immune response and inflammatory immune response" ?   Could you better explain what you mean by "self-antigen presentation to immune cells rather than non-self which is false immune response? ?
    • In my view, normal skin also has demodex mites but less in number so they can't activate pro-inflammatory cytokines but when the number is more they activate it. so logically when the normal skin flora has demodex before rosacea has occured so demodex apparently came first and because demodex mites cause inflammatory immune response and inflammatory immune response is not just related to mites but self-antigen presentation to immune cells rather than non-self which is false immune response or we call it autoimmune response and attacks to healthy cells and so the false immune response might be the cause of increasing number of demodex .So demodex and rosacea have reciprocity with each other to increase its effects and outcomes.
    • While it has been reported that topical ivermectin has better results than topical metronidazole, there is a paper you should consider reading if you are considering taking oral ivermectin and metronidazole.  A paper published by the International Journal of Infectious Diseases that compared taking 200 micro-grams Ivermectin per Kilogram of body weight of oral ivermectin once a week in one group (1) of sixty rosacea patients with another group (2) of sixty rosacea patients who received a combined therapy of the same amount of ivermectin along with 250 mg of oral metronidazole three times a day. The results were that the second group improved better than the first group. For more information Some may concerned about taking ivermectin orally. It is interesting to note that ivermectin has been around since the late 1970s and half "of the 2015 Nobel Prize in Physiology or Medicine was awarded jointly to Campbell and Ōmura for discovering avermectin, 'the derivatives of which have radically lowered the incidence of river blindness and lymphatic filariasis, as well as showing efficacy against an expanding number of other parasitic diseases' " Wikipedia Ivermectin is "a dihydro derivative of avermectin—originating solely from a single microorganism isolated at the Kitasato Intitute, Tokyo, Japan from Japanese soil...originally introduced as a veterinary drug...has led many to describe it as a “wonder” drug....few drugs that can seriously lay claim to the title of ‘Wonder drug’, penicillin and aspirin being two that have perhaps had greatest beneficial impact on the health and wellbeing of Mankind....But ivermectin can also be considered alongside those worthy contenders, based on its versatility, safety and the beneficial impact that it has had, and continues to have, worldwide—especially on hundreds of millions of the world’s poorest people....Despite decades of searching around the world, the Japanese microorganism remains the only source of avermectin ever found. Originating from a single Japanese soil sample and the outcome of the innovative, international collaborative research partnership to find new antiparasitics, the extremely safe and more effective avermectin derivative, ivermectin, was initially introduced as a commercial product for Animal Health in 1981." [1] While there are no long term clinical studies done on ivermectin use with rosacea, there are papers showing the long term effects of oral ivermectin in school-age and pre-school children treated for helminths. [2] There are also papers written about the long term effects of treating humans with ivermectin on other parasites.  'Intriguingly, IVM has a diverse range of effects in many different organisms, far beyond the endoparasites and ectoparasites it was developed to control. For example, IVM has been shown to regulate glucose and cholesterol levels in diabetic mice, to suppress malignant cell proliferation in various cancers, to inhibit viral replication in several flaviviruses, and to reduce survival in major insect vectors of malaria and trypanosomiasis. Clearly, much remains to be learned about this versatile drug, but the promise of more sustainable strategies for current helminth-control programmes and novel applications to improve and democratise human health, are compelling arguments to pursue this cause." [3] With the craze of rosaceans using horse paste to treat rosacea topically, there is one report of oral horse paste treatment for Lyme disease in Facebook by a poster. [4] So there are a substantial number of humans globally who have taken oral ivermectin.  More information on oral ivermectin. ElaineA has a post worth reading on this subject, Oral Ivermectin, getting diagnosed and a prescription. End Notes [1] Proc Jpn Acad Ser B Phys Biol Sci. 2011 Feb 10; 87(2): 13–28. doi: 10.2183/pjab.87.13 PMCID: PMC3043740; PMID: 21321478 Ivermectin, ‘Wonder drug’ from Japan: the human use perspective Andy CRUMP and Satoshi ŌMURA [2] PLoS Negl Trop Dis. 2008 Sep; 2(9): e293. Published online 2008 Sep 10. doi: 10.1371/journal.pntd.0000293 PMCID: PMC2553482; PMID: 18820741 Impact of Long-Term Treatment with Ivermectin on the Prevalence and Intensity of Soil-Transmitted Helminth Infections Ana Lucia Moncayo,  Maritza Vaca,  Leila Amorim,  Alejandro Rodriguez,  Silvia Erazo,  Gisela Oviedo,  Isabel Quinzo,  Margarita Padilla,  Martha Chico,  Raquel Lovato,  Eduardo Gomez,  Mauricio L. Barreto,  and Philip J. Cooper   [3] Trends in Parasitology Volume 33, Issue 6, June 2017, Pages 463-472 Ivermectin – Old Drug, New Tricks? Roz Laing. Victoria Gillan. Eileen Devaney [4] Post number five in this thread
    • This post has been promoted to an article. 
    • Thanks Apurva for your research and investigation into this. Hope some substantiate your findings. 
    • Have you ever heard of tea tree plant alternative? So my new experiment is on Callistemon Viminalis or Melaleuca Viminalis, commonly known as weeping bottlebrush (1) has quite similarities with Melaleuca Alternifolia or commonly known as tea tree plant  because they both belong to the Myrtaceae family (2). I have come to know about this plant accidentally because it exactly looks like tea tree plant and  when I researched about it, I compared and found that they almost have similar chemical composition so they both have same antimicrobial and antioxidant properties. some of the main active chemical components are : 1,8 cineole, terpinen-4-ol, α-pinene, α-terpineol, p-cymene and limonene are common in both plants but These components have different concentration in both plants (3). So I decided to put it on test and see what are the effects it has on skin so I made infused oil with bottlebrush leaves. I dried the leaves and put it in a jar with coconut oil and kept it under the sun for 10-20 days. This oil has a very strong smell and I have been applying this oil to my face daily and it’s been 5 months, I have been working on it and the results are amazing.Its dry leaves contain more antioxidant properties and We all have known that the antioxidants play an essential role in oxidative stress of cells by donating electrons to free radicals and thereby reducing the inflammation. Antioxidants are like soldiers always protecting our skin cells from the damaging effects of free radicals. So this oil has surprising effects on frequent flushing and reducing the post flare-up red blotches of blood capillaries just like the tea tree oil does but before you use this oil take a patch test on your hand first and see if you have any allergy or sensitivity and if you do make it more diluted with coconut oil. This is good for type I rosacea and try it.It’s all natural.   References : 1. https://en.wikipedia.org/wiki/Melaleuca_viminalis 2. https://en.wikipedia.org/wiki/Melaleuca_alternifolia 3. https://www.sciencedirect.com/science/article/pii/S1995764517303905#bib8
    • It happens sometimes. You know I have been non-vegetarian since childhood and My skin was also flawless now it's been 4 years I have rosacea with some other co-existing conditions and how did I get I do not know so throughout this journey it has been trial and error period.first I left non-veg to see if it has any effects on rosacea and trust me it helped me in reducing my frequent flare-ups. this is just an example, other than that I have systematically managed my diet and routine. What I am trying to tell you is sometimes the things and foods which we had in past that wasn't bothering at all then, sometimes bother now. so you have to keep an eye on things which you consume to see whether it has any increasing effects on your rosacea.
    • @Apurva Tathe I am surprised,cause i took cigaretts for 6 years and drank 2-3 coffees per day, and my skin looked perfect,only this year the rosacea was worse then ever.. anyway ill not smoke anymore,and reduce coffee to one per day.
    • Yes it can, because coffee contains caffeine and cigar contains nicotine and both are chemicals which increase blood pressure. A single full-size cigar can contain nearly as much nicotine as does a pack of cigarettes but coffee is good if you are taking once a day and not more than that.because caffeine and nicotine both can prolong the frequency and period of flushing. 
    • Hi Peter,  This question comes up a lot about coffee and is a FAQ answered here. We hope you continue to post and ask questions. As for cigars, we have no data on cigars and rosacea but obviously is probably not a healthy habit to keep. As for creams for rosacea, suggest you search our non prescription forum or check out our online store. 
    • Does coffee and cigars influence rosacea? Which day cream is the best for it? 🤔😄
    • Related Articles Intense pulsed light therapy: A promising complementary treatment for dry eye disease. Arch Soc Esp Oftalmol. 2019 May 09;: Authors: Mejía LF, Gil JC, Jaramillo M Abstract OBJECTIVE: To propose the Intense Pulsed Light (IPL) therapy as a helpful supplementary treatment in patients with dry eye disease. MATERIAL AND METHODS: Retrospective cross sectional design. Medical records of patients in whom dry eye disease symptoms were not satisfactorily controlled with medical therapy alone and who underwent additional IPL with at least three sessions completed. Data were analyzed before therapy and 3weeks after its completion to asses improvement. Determination of symptoms, through a visual analog scale; tear film stability, through tear Break Up Time (tBUT); measurement of tear secretion, through Schirmer Test; and ocular surface staining with Van Bijsterveld score were evaluated. SPSS software and nonparametric analysis of repeated measures were used. The study was approved by the ethics committee. RESULTS: 50 eyes from 25 subjects were reviewed. There were 9 males (36%) and 16 females (64%), with a median age of 59years (IQR 52-64). The median of the symptoms scale was 8 (IQR 8-9) and 3 (IQR 2-4) before and after the therapy respectively (P<.05). The median of BUT was 4 (IQR 3-5) and 10 (IQR 8-11), Schirmer test was 13 (IQR 12-15) and 15 (IQR 13-20), and Van Bijsterveld score was 3 (RIC 3-4) and 2 (IQR 2-3) before and after the therapy respectively (P<.05, for all measurements). CONCLUSION: IPL treatment has excellent results regarding both: dry eye disease symptoms improvement and in office objective tests such as tBUT, Schirmer test and Van Bijsterveld score; IPL could be considered as an effective adjunct for dry eye disease. PMID: 31079987 [PubMed - as supplied by publisher] {url} = URL to article
    • Image courtesy of Wikimedia Commons The American Academy of Dermatologists is one of the premier, most distinguished organizations that produces a medical journal and sponsors conventions for their prestigious members each year. The AAD is a 501 c 3 non profit organization that in 2015 received $33 million dollars in revenue and spent $34 million dollars in expenses. If you carefully review the total amount of research grants spent in 2015 in its Form 990 you will see it spent a little over $1 million dollars so that amounts to 3 percent of its revenue. What that means, to put this into perspective about research, is that for every dollar received by the AAD three cents is spent on research. What amount went to rosacea research is anyone's guess, but if you have the volunteer spirit you could figure that out and report what you find in this thread. If you have the heart to figure out how much was spent on actual rosacea research by the AAD in 2015 you would probably find that the amount was not very much. The AAD focuses a lot on many other skin diseases, but sometimes has articles on rosacea in its journal. 
    • The skin industry, of course, is the primary sponsor of rosacea research papers published in the medical journals, as Dr. Kligman points out and comments that such papers are "perhaps not the most credible source of unbiased research.' It takes a lot of deep investigation to find the source of funding of a clinical paper published in a medical journal but if you have the time and patience you can discover who funded the research paper published. For example if you check out this article published in the Dermatology Online Journal you can find that one of the authors, Eckert M. Mendieta works at the Department of Dermatology, Clínica Dermitek, which is part of the 'skin industry.' Dermatol Online J. 2016 Aug 15;22(8). pii: 13030/qt9ks1c48n. Treatment of rosacea with topical ivermectin cream: a series of 34 cases. Mendieta Eckert M, Landa Gundin N.  While we have reviewed who is funding rosacea research we are still grateful for ANY rosacea research funding and can glean useful information from these published papers. The status quo research papers are without a doubt funded primarily by the skin industry, included in this are the few non profit organizations for rosacea since with the exception of the RRDi, is funded primarily by the pharmaceutical skin industry. Joel T. Bamford, MD, wrote an article in the Journal of the Rosacea Research & Development Institute, Is it possible for rosaceans to do research?, which encourages his recommendation that Rosaceans should get together and sponsor their own research independent of the skin industry. What a novel idea? And that is why the RRDi was formed so that a non profit organization for rosacea should be established by Rosaceans who suffer from rosacea, and not like the other non profit organizations for rosacea who are established and run by NON rosaceans. If enough rosaceans got together, say 10,000 members, and each donated one dollar, they could sponsor their own double blind, placebo controlled, peer-reviewed rosacea research clinical papers.  
    • Positive Anecdotal Reports of Soolantra MagnificenT, the Rosacea Forum, posts, "I have been using it for 4 weeks now, and I am literally shocked how my skin improved during this time. There are no more discolorations, redness decreased by 70% (I'm pinkish now, but it looks healthy), I can take a shower without going super red, and in general I no longer feel this discomfort, tightness, and dryness. After a disastrous experience with Mirvaso, I need to pay thanks to the creators of this drug, it gave me a relief I needed so much."
    • Related Articles Antimicrobial Peptide LL-37 Facilitates Intracellular Uptake of RNA Aptamer Apt 21-2 Without Inducing an Inflammatory or Interferon Response. Front Immunol. 2019;10:857 Authors: Macleod T, Ward J, Alase AA, Bridgewood C, Wittmann M, Stonehouse NJ Abstract RNA aptamers are synthetic single stranded RNA oligonucleotides that function analogously to antibodies. Recently, they have shown promise for use in treating inflammatory skin disease as, unlike antibody-based biologics, they are able to enter the skin following topical administration. However, it is important to understand the inflammatory milieu into which aptamers are delivered, as numerous immune-modulating mediators will be present at abnormal levels. LL-37 is an important immune-modifying protein upregulated in several inflammatory skin conditions, including psoriasis, rosacea and eczema. This inflammatory antimicrobial peptide is known to complex nucleic acids and induce both inflammatory and interferon responses from keratinocytes. Given the attractive notion of using RNA aptamers in topical medication and the prevalence of LL-37 in these inflammatory skin conditions, we examined the effect of LL-37 on the efficacy and safety of the anti-IL-17A RNA aptamer, Apt 21-2. LL-37 was demonstrated to complex with the RNA aptamer by electrophoretic mobility shift and filter binding assays. In contrast to free Apt 21-2, LL-37-complexed Apt 21-2 was observed to efficiently enter both keratinocytes and fibroblasts by confocal microscopy. Despite internalization of LL-37-complexed aptamers, measurement of inflammatory mediators and interferon stimulated genes showed LL-37-complexed Apt 21-2 remained immunologically inert in keratinocytes, fibroblasts, and peripheral blood mononuclear cells including infiltrating dendritic cells and monocytes. The findings of this study suggest RNA aptamers delivered into an inflammatory milieu rich in LL-37 may become complexed and subsequently internalized by surrounding cells in the skin. Whilst the results of this study indicate delivery of RNA aptamers into tissue rich in LL-37 should not cause an unwarranted inflammatory of interferon response, these results have significant implications for the efficacy of aptamers with regards to extracellular vs. intracellular targets that should be taken into consideration when developing treatment strategies utilizing RNA aptamers in inflamed tissue. PMID: 31068939 [PubMed - in process] {url} = URL to article
    • A comparison of the efficacy and tolerability of topical agents used in facial Demodex treatment. J Cosmet Dermatol. 2019 May 08;: Authors: Sarac G Abstract BACKGROUND: Demodex spp. is the most common ectoparasite in humans. This parasite is believed to play a role in the etiology of many dermatological and ocular disorders. AIM: The aim of this study was to compare the efficacy and tolerability of the sulfur-sodium sulfacetamide combination, crotamiton, and permethrin, which are three topical agents commonly used in Demodex treatment. METHODS: A total of 28 patients with primary demodicosis and 44 patients with Rosacea + Demodex were included in the study. The pretreatment and post-treatment Demodex spp. counts, patient satisfaction, and erythema decrease rates were compared. RESULTS: Analysis of the efficacy of these topical agents on Demodex revealed that all three significantly decreased the number of parasites. The patient satisfaction was higher in the sodium acetamide group than the 10% crotamiton and 5% permethrin groups, and clinical evaluation (erythema/ papulopustules and white plugs) was better in the sodium acetamide group than the other groups but no statistically significant difference was found in terms of patient satisfaction and clinical evaluation. CONCLUSION: The sulfur-sodium combination, crotamiton, and permethrin are the three agents commonly used in the treatment of Demodex spp. and all significantly decreased the Demodex count. The three agents were similar in terms of tolerability. Our study needs to be supported with others on larger patient series. PMID: 31066486 [PubMed - as supplied by publisher] {url} = URL to article
    • Yes I had seborrheic dermatitis and blepharitis both with rosacea. So when  I researched about it thoroughly I found that when you have SD that causes blepharitis it is sometimes combinedly called seborrheic blepharitis.
    • Thanks for you post. Never heard of seborrheic blepharitis. I have heard of seborrheic dermatitis. When I used the search feature at Wikipedia for seborrheic blepharitis, it redirected me to 'blepharitis' and I found this quote, "Different variations of blepharitis can be classified as seborrheic, staphylococcal, mixed, posterior or meibomitis, or parasitic." 
    • I never used horse paste or any ivermectin during my medications. I have type I followed by type 2 rosacea but most of the time type I only with the coexisting condition of seborrheic blepharitis and antibiotics work wonder if you take it orally and apply it topically as well and it completely cured me of seborrheic blepharitis and does not exacerbate the rosacea.
    • Anecdotal Reports of Using Horse Paste for Rosacea - You Decide Positive or Negative? Found one neutral anecdotal report at Rosacea Tips and Support Group, Facebook but you will just have to find it.  The RRDi complies with requests for removal of certain published material on the internet from our website. However, for those of you who may not understand the legality of this issue, you may want to read these two answers to the following two questions:  Can You Quote or Use Someone Else’s Facebook Posting? Question: Is it illegal to quote someone without permission? It is ironic that those who have issues with quoting a neutral report of using horse paste on this website have no issues with Facebook publishing their name and medical issue for all to see in a private group. 
    • Negative Anecdotal Reports of Using Horse Paste for Rosacea There are a few negative reports at Facebook Groups, i.e., Rosacea (English), Rosacea (English), Rosacea Tips and Support Groups, as well as Reddit r/Rosacea,  but you will have to join these groups to find the negative anecdotal reports since they are few are far between. Of course, you will always find negative reports, just like you do with Soolantra and any other rosacea treatment. If there are more negative ones or a significant number of them then you should be wary. So far, with horse paste the negative ones are few.  The RRDi complies with requests for removal of certain published material on the internet from our website. However, for those of you who may not understand the legality of this issue, you may want to read these two answers to the following two questions:  Can You Quote or Use Someone Else’s Facebook Posting? Question: Is it illegal to quote someone without permission? It is ironic that those who have issues with quoting a negative report of using horse paste on this website have no issues with Facebook publishing their name and medical issue for all to see in a private group. 
    • Positive Anecdotal Reports of Using Horse Paste for Rosacea There are many, many positive reports at Facebook Groups, i.e., Rosacea (English), Rosacea (English), Rosacea Tips and Support Groups, as well as Reddit r/Rosacea,  but you will have to join these groups to read the anecdotal reports.  The RRDi complies with requests for removal of certain published material on the internet from our website. However, for those of you who may not understand the legality of this issue, you may want to read these two answers to the following two questions:  Can You Quote or Use Someone Else’s Facebook Posting? Question: Is it illegal to quote someone without permission? It is ironic that those who have issues with quoting a positive report of using horse paste on this website have no issues with Facebook publishing their name and medical issue for all to see in a private group.     
    • So, we suggest that the combined therapy works better than ivermectin alone on cases with different skin lesions and anterior blepharitis. In conclusion, the 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 blepharitis lesions, while 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-shazly, Nairmen Nabih, Youssef El-Bayoumy, Sameh Salehc
    • I just checked this post today, May 6, which has not been a month since I initially posted this vent I am still on, and there has been 68 views of this post totaled up today. So since Apurva Tathe is the only one who replied to this thread (just in case you don't know how to reply to this thread there is a green button at the top of the thread to the right - see below) I thought maybe some of you need some help understanding how a forum works with replying to a post? Or you can scroll all the way to the bottom of the thread and you will see 'Reply to this topic' and just start typing (in both cases you need to be registered and logged in).   Anyway, I thought I would continue my vent. I have been browsing Reddit and Facebook to see where all the rosaceans have gone and have discovered that there are some huge rosacea groups formed and how these are extremely popular to use. For example, at Reddit r/rosacea has 7.9K members (I tried posting there and one of the moderators was extremely rude and would not reason with me and denigrated the RRDi repeatedly so I simply left this group). I joined Reddit r/SkincareAddition (954K members) and am appalled that anyone can try to sort through this group for help with rosacea since it covers so many different skin conditions. Facebook Rosacea (in English) has 6.6K members, while Rosacea Tips and Support Group has 7.4K members. Facebook to me has a friendlier atmosphere over Reddit (for example, I simply recommended that in one of the many inquiries, IS THIS ROSACEA?, to see a dermatologist I was chastised and rudely told to mind my own business). So far, in Facebook the rosaceans there are more respectful and kindlier than the Reddit rosaceans. The most appalling discovery in all this is the lack of rosacea knowledge. Most rosacea newbies, of course, haven't a clue what rosacea is, and the vast majority are trying to learn about it through Reddit or Facebook and the search feature at either one is dreadful. Of course, they don't know what to search for in the first place, but the most FAQs are, Is this Rosacea?, What Moisturizer?, Should I get Laser? (or LED or IPL, etc.), What is Horse Paste?, Asking about Rosacea Triggers, especially IS COFFEE A TRIGGER?, and usually asking about a particularly over the counter treatment for rosacea or a particular prescription treatment. As you can see, the RRDi has been answering these questions since 2004 and has grouped all these questions into logical categories and areas in the member forum or in the research articles. Why rosaceans prefer Facebook and Reddit over having all these questions in a forum in categories boggles my mind. What is it about Facebook and Reddit that appeals to these rosacea newbies?  It is so difficult to find what you are looking for in either one. Total chaos yet rosaceans love it. Your thoughts on all this?   Second, is the fact that since the 1200 plus members of the RRDi simply don't want to volunteer and post or do anything, the funds are dwindling and since our non profit is so transparent you can view the financial situation that the RRDi is in. At the present rate of spending, we have enough to last a little over a year. I am hoping for a donation from Demodex Solutions, but Walter apparently hasn't had the success he used to have when the ZZ cream was one of the more popular demodectic rosacea treatment around (horse paste has taken over), so I can't count on his support. There simply isn't enough members purchasing our Amazon Affiliate items to keep the RRDi afloat. There simply are no donations to speak of in the last few years. Members don't donate. If the 1200+ members each donated a dollar that would keep us going for over a year and half.  Going through the hoops to get a Galderma Education Grant is a huge amount of volunteer time and I may try going through the hoops again but you should try it and see how difficult Galderma makes this process and they only offer the RRDi a $2K grant if you qualify. Would anyone of you want to volunteer to do this and keep half the money (the RRDi has to keep half to keep this ship afloat!!!). However, if you can get one of these education grants from Galderma through the RRDi you can keep half the money which means $1K in your pocket! We have been offering this for a long time and some volunteers have tried and given up rather quickly because you really have to be patient and meticulous to follow all the instructions from Galderma, not to mention the multiple forms and bureaucratic steps required to get the grant. All you do is contact me and I will set you on course on how to do this.  So the handwriting is on the wall. The days of the RRDi are numbered since volunteering is just not popular anymore as it was in 2004 when the RRDi started. There are no Warren Stuarts or other helpful volunteers. The other board members are busy and involved with their own responsibilities to be able to volunteer very much at all. The MAC Members are the same. Actually the MAC Members are one of the Crown Jewels of the RRDi, however, I cannot really bother them since when I do some quit and want their name removed so I have learned to not bother them unless I have something pertinent to their speciality like asking them a question I know they know the answer. It is amazing they have offered to volunteer for the RRDi and give me their personal contact information and I can ask them rosacea questions. What a resource!   Then there is the wealth of rosacea data on this website. Huge amount of rosacea data. All this will be gone unless we either (1) get volunteers to keep this going, (2) get some donations to keep this going, or, (3) you come up with another solution.  This is not to mention why the RRDi was formed in the first place, which a lot of you rosacea newbies haven't a clue about. We do have a history of the RRDi if you are interested. So since I did mention this, yes, this is still a venting session for me, you may need to understand rosacea research and get a perspective on this. First read the post, Rosacea Research in Perspective of Funding and then read Rosacea Research in Perspective of Idiopathic Diseases. Do you really want the NRS and the AARS to keep the status quo rosacea research that the pharmaceutical companies keep funding?  Do you want a non profit organization for rosacea patient advocacy to fund some novel rosacea research? Unless you form another non profit organization for rosacea that is better than the RRDi, at this point, the RRDi is the only choice. So please consider what is in this entire thread, about what I just vented about and please post a comment in this thread. Do you have any thoughts on this?     
    • I am taking ldn, prescribed by an online doctor and processed by a compound pharmacy. It helps my neurogenic rosacea, its not a cure but it works better than anything else I have tried. I have tried many other things, to no avail.
    • image courtesy of WikiMedia Commons Rosacea has been associated with other diseases and the list just keeps growing. This is referred to in medicine as systemic comorbidities. What this means for you to understand is this requires even more research needed to understand why rosacea is associated with these diseases and knowing how confounding factors are used in the investigation. For further investigation and seeing the list, put on your diving cap for a deep dive investigation and click here. 
    • This question comes up a lot since many who have dry skin want a moisturizer that doesn't exacerbate their rosacea, so which moisturizer? The RRDi has collected a number of moisturizers that have been reported to work for some and listed in our non profit store and also in:  Forum Home >  Forums >  Public Forum >  Rosacea Topics > Non Prescription > Moisturizers  Most of the one listed are those who rosaceans report works for them. We hope if you find a moisturizer that works for you that you will post this in this thread by simply clicking the green reply button and share it with fellow rosacea sufferers who are asking the same question. 
    • NOTE: The reports on using horse paste is to apply it TOPICALLY,  and NOT orally.  However there is an anecdotal report posted by woman on Facebook, Rosacea Support, who says her friend ingests horse paste for Lyme disease on the advice of her 'tropical disease consultant.'    
    • Related Articles [Neonatal lupus in an infant of a mother followed up for dermatomyositis: medical images]. Pan Afr Med J. 2018;31:117 Authors: Cisse L, Karabinta Y Abstract Neonatal lupus is rare. It is due to the transmission of maternal autoantibodies across the placenta during pregnancy. We here report the case of a 2-month old female infant treated for erythematous macular cutaneous lesions on the face and the trunk. Her mother was followed up for dermatomyositis diagnosed on the basis of clinical lesions, muscle weakness and elevation in muscle enzyme levels. However she had not underwent antinuclear antibody test (ANA). Clinical examination showed atrophic erythematous lesions distributed like butterfly wings on both sides of the nasal pyramid, satellite lesions on the front, with red hair. The remainder of the physical examination was unremarkable. Laboratory tests were not performed because infant's parents also refused the biopsy. These lesions suggested seborrheic dermatitis, rosacea or atopic dermatitis. However, rosacea is very rare in infants and usually affects fair-skinned people. In seborrheic dermatitis, lesions are not atrophic. The age of onset of atopic dermatitis is usually 3 months. Lesions regressed in 15 days under dermocorticoid therapy. PMID: 31037177 [PubMed - in process] {url} = URL to article
    • Related Articles Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient-Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa. J Eur Acad Dermatol Venereol. 2019 Apr 29;: Authors: Chernyshov PV, Zouboulis CC, Tomas-Aragones L, Jemec GB, Svensson A, Manolache L, Tzellos T, Sampogna F, Pustisek N, van der Zee HH, Marron SE, Spillekom-van Koulil S, Bewley A, Linder D, Abeni D, Szepietowski JC, Augustin M, Finlay AY Abstract This paper is organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on Quality of Life (QoL) and Patient-Oriented Outcomes and the EADV TF on acne, rosacea and hidradenitis suppurativa (ARHS). The purpose of this paper was to present current knowledge about QoL assessment in HS, including data on HS-specific health-related (HR) QoL instruments and HRQoL changes in clinical trials, and to make practical recommendations concerning the assessment of QoL in people with HS. HS results in significant quimp that is higher than in most other chronic skin diseases. HS impact in published studies was assessed predominantly (84% of studies) by the Dermatology Life Quality Index (DLQI). There is a lack of high-quality clinical trials in HS patients where HRQoL instruments have been used as outcome measures. One double-blind randomized placebo-controlled trial on infliximab with low number of participants reported significantly better HRQoL improvement in the treatment group than in the placebo group. Well-designed clinical studies in HS patients to compare different treatment methods, including surgical methods and assessing long-term effects, are needed. Because of lack of sufficient validation, the Task Forces are not at present able to recommend existing HS-specific HRQoL instruments for use in clinical studies. The EADV TFs recommend the dermatology-specific DLQI questionnaire for use in HS patients. The EADV TFs encourage the further development, validation and use of other HS-specific, dermatology-specific and generic instruments but such use should be based on the principles presented in the previous publications of the EADV TF on QoL and Patient-Oriented Outcomes. PMID: 31037773 [PubMed - as supplied by publisher] {url} = URL to article
    • Successful treatment of facial vascular skin diseases with a 577-nm pro-yellow laser. J Cosmet Dermatol. 2019 Apr 29;: Authors: Mohamed EM, Mohamed Tawfik K, Hassan Ahmad W Abstract BACKGROUND: Treatment of vascular skin diseases is one of the most important indications of the laser. AIMS: To evaluate the effectiveness of 577-nm pro-yellow laser in the treatment of some vascular skin diseases. PATIENTS/METHODS: Ninety-five patients with vascular skin diseases were included in this prospective monocentric study. They were classified into: port-wine stain birthmarks (n = 37), papulopustular rosacea (n = 20), facial telangiectasia (n = 16), and facial erythema (n = 22). All participants received a monthly session of 577-nm pro-yellow laser. Follow-up was done by comparing the photographs before and at every follow-up visit. RESULTS: At the final visit, there was a significant improvement (>50%) occurred in 24/37 (64.82%), 12/20 (60%), 10/16 (62.5%), and 19/22 (86.3%) cases and poor response occurred in 6/37 (16.2%), 2/20 (10%), 2/16 (12.5%), and 0/22 cases after a mean number of sessions 7.76 ± 2.28, 3.1 ± 1.8, 3.63 ± 1.12, and 1.8 ± 0.85 in port-wine stain, rosacea-, facial telangiectasia-, and facial erythema-treated groups, respectively. Transient irritation and erythema during the session were the only complications reported in the study. CONCLUSION: Facial port-wine stains, rosacea, telangiectasia, and erythema can be successfully treated with a single pass of 577-nm pro-yellow laser with a minimal side effect. Facial erythema showed the highest degree of success with the least number of sessions, while more sessions needed for the treatment of port-wine stain. PMID: 31033204 [PubMed - as supplied by publisher] {url} = URL to article
    • Naltrexone, a prescription drug, is "sold under the brand names ReVia and Vivitrol among others, is a medication primarily used to manage alcohol or opioid dependence." Wikipedia There is a thread at RF that some are taking this for rosacea in low dose tablets, which you may want to follow. If you discovered this here at the RRDi and find low dose naltrexone helps your rosacea, can you please post in this thread this is where you learned about it and post your results here? 
    • Image courtesy of Wikimedia Commons Demodetic Rosacea has a long history. For example, note the following quote in a paper written in 1886: "From these and other statements it is seen that in suggesting the thought that these minute forms of life are etiological factors in even some of the phases of acneform diseases, I shall be but little in accord with the highest authorities. In antagonism to these views, I may say that the results of my observations appear to indicate a close relationship of the parasites with the diseased condition." Demodex Folliculorum in Diseased Conditions of the Human Face Proceedings of the American Society of Microscopists, Vol. 8, 1886, page 123, Published by: Wiley-Blackwell According to Google Scholar a paper, Simon 1842, is cited by at least 38 articles that mention demodex foliculorum.  Simon G (1842), Ueber eine in den kranken und normalen haarsacken des menschen lebende milbe. Arch Anat, Physiol u Wissensch Med 11: 218–237. "D. folliculorum and D. brevis are typically found on humans. D. folliculorum was first described in 1842 by Simon; D. brevis was identified as separate in 1963 by Akbulatova. D. folliculorum is found in hair follicles, while D. brevis lives in sebaceous glands connected to hair follicles." Wikipedia For more information on demodectic rosacea 
    • Crotamiton is used mainly to treat scabies which is caused by the Sarcoptes scabiei mite and there are a few articles showing Crotamiton improves rosacea. For more information click here. 
    • Crotamiton is used mainly to treat scabies which is caused by the Sarcoptes scabiei mite and there are a few articles showing Crotamiton improves rosacea. If you are using crotamiton or know of any other articles like the ones below, please post in this thread. That is what volunteering is all about. Share your rosacea knowledge with other rosaceans.  "After clinical manifestations, the mites may be temporarily eradicated with topical insecticides, especially crotamiton cream, permethrin cream, and also with topical or systemic metronidazole. In severe cases, such as those with HIV infection, oral ivermectin may be recommended." [1] "When Demodex concentration is higher than 5/cm(2) we use topical crotamiton 10% or metronidazole." [2] "The skin lesions resolved after treatment including systemic metronidazole, topical metronidazole, crotamiton, or gamma benzene hexachloride." [3] "Patients with these skin conditions markedly improved with the use of topical crotamiton twice daily, regardless of results from a KOH test for the presence of Demodex mites. Crotamiton also possesses antipruritic properties, which may be helpful in cases associated with pruritis. Based on these findings, we recommend the use of topical crotamiton twice daily in patients with a chronic history of, or who present with, facial erythema, dryness, scaling, and roughness with or without papules/pustules." [4] "A random sample of 16 female patients suffering from papulopustular rosacea (PPR) as well as (16) normal female healthy subjects as control group were adopted in this study to assess of Demodex folliculorum pathogenesis. It was done through determination of mite density using a standard skin surface biopsy 10.5 cm2 from different designated 6 areas on the face, and scanning electron microscopic study (SEM) as well as total IgE estimation. A trial of treatment using Crotamiton 10% cream with special program was also attempted. All subjects ranged between 35-55 years old. All patients with rosacea and 15 of the control group i.e. 75.93% were found to harbour mites. The mean mite counts by site distribution were 28.6 & 6.9 on the cheeks, followed by 14.5 & 3.0 on the forehead and lastly 6.8 & 0.8 on the chin in PPR and control groups respectively. The total mean mite count in patients was 49.9 initially and 7.9 after treatment. In the control group it was 10.7 & 10.6 respectively. The mean total IgE was 169.4 & 168.4 and 96.3 & 98.4 in PPR and control groups respectively Light and scanning electron microscopy revealed that all mites were pointing in one direction. Some of them were containing bacteria inside their gut and on their skin. After treatment 3 cases (18.75%) were completely cured, 10 cases (62.5%) gave moderate response while 3 cases (18.75) have no response. In conclusion, this study supports the pathogenic role of D. folliculorum in rosacea." [5] End Notes [2] Indian J Dermatol. 2014 Jan-Feb; 59(1): 60–66.doi:  10.4103/0019-5154.123498PMCID: PMC3884930Human Demodex Mite: The Versatile Mite of Dermatological ImportanceParvaiz Anwar Rather and Iffat Hassan [2] Ann Dermatol Venereol. 2011 Nov;138 Suppl 3:S211-4 Treatment of rosacea. Parodi A, Drago F, Paolino S, Cozzani E, Gallo R [3] J Am Acad Dermatol. 2009 Mar;60(3):453-62 Demodicosis: A clinicopathological study. Hsu CK, Hsu MM, Lee JY [4] J Clin Aesthet Dermatol. 2009 January; 2(1): 20–25. Demodex Dermatitis, A Retrospective Analysis of Clinical Diagnosis and Successful Treatment with Topical Crotamiton Joseph B. Bikowski and James Q. Del Rosso [5] J Egypt Soc Parasitol. 1997 Apr;27(1):183-95.  A study on Demodex folliculorum in rosacea.Abd-El-Al AM, Bayoumy AM, Abou Salem EA.  
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