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  • Misdiagnosed Rosacea


    Articles, References and Anecdotal Reports

    There are articles on rosacea that mention misdiagnosed rosacea. While this isn't a massive problem, nevertheless, here is a list of different sources that mention the subject, including (if you scroll below) many anecdotal reports of misdiagnosis. If you want to add your experience with misdiagnosis please post your anecdotal report in this thread

    Articles and References

    "To the untrained eye, unusual skin presentations can cause confusion and alarm. They can also go misdiagnosed, often not getting the attention they require. This is because many skin conditions can seem similar in appearance to one another, says Shari Marchbein, board-certified dermatologist and clinical assistant professor of dermatology at New York University School of Medicine....Another common misdiagnosis is rosacea disguised as acne, says Estee Williams, a board-certified medical, cosmetic and surgical dermatologist and clinical professor in dermatology at Mount Sinai Medical Center in New York City." 
    4 Skin Conditions That Are Often Misdiagnosed, According to Dermatologists, BY ERIN NICOLE CELLETTI, Allure

    "Rosacea SKINsights sponsored by Galderma Laboratories [reveals] the lengths that women with rosacea would go to if they could get rid of their rosacea forever, and highlight the low awareness and complicated diagnosis path for this common condition. On average, women with rosacea waited at least seven months before receiving a correct diagnosis, and only half of respondents had ever heard of the condition upon the time of diagnosis. This reveals the high level of misunderstanding and confusion that surrounds rosacea..." Medical News Toda

    "Currently, rosacea is only diagnosed by clinical symptoms and can be confused with other dermatological diseases such as acne."
    New Treatment or Diagnosis for Rosacea with Existing Approved Drugs
    Tech ID: 19149 / UC Case 2007-047-0
    University of California, San Diego
    Technology Transfer Office

    "Despite its apparent high incidence, the nosology of rosacea is not well established, and the term “rosacea” has been applied to patients and research subjects with a diverse set of clinical findings that may or may not be an integral part of this disorder. In addition to the diversity of clinical manifestations, the etiology and pathogenesis of rosacea are unknown, and there are no histologic or serologic markers."
    Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea

    ''Some physicians may not be aware of or recognize rosacea and may treat patients with rosacea inappropriately as if they had adult acne.''
    Dr. Jonathan Wilkin NRS Medical Advisory Board

    "Rosacea is a common dermatologic disorder. It is frequently overlooked or misdiagnosed, particularly when mild in nature."
    Rosacea: A Review of a Common Disorder by Carolyn Knox, IJAPA

    "Patients with rosacea frequently present with coexisting skin conditions, such as seborrheic dermatitis, acne, perioral dermatitis, and melasma, which may complicate diagnosis and treatment."
    Heather Roebuck, Nurse Pract. 2011 Jan 11.

    "A committee member, Dr. Mark Dahl, a dermatologist at the Mayo Clinic in Scottsdale, Ariz., said, ''This is a syndrome with lots of different elements that is easy to diagnose when all the elements are present,'' but not as easy when only one or two of the characteristics appear."
    PERSONAL HEALTH; Sometimes Rosy Cheeks Are Just Rosy Cheeks
    By JANE E. BRODY, New York Times, March 16, 2004

    "Rosacea is a complex and often misdiagnosed condition." The Rosacea Forum Moderated by Drs. Bernstein and Geronemus

    "Whereas the classical subtypes of rosacea can be recognized quite well, the variants of rosacea may be overlooked or misdiagnosed." rosacea.dermis.net

    "Rosacea is often misdiagnosed as acne or discoid or systemic lupus erythematosus (SLE)." Christiane Northup, M.D.

    "Frequently misdiagnosed as adult acne, this chronic, progressive skin disorder affects millions." Recognizing and Managing Rosacea by Thalia Swinler, JSTOR

    "The last subtype, ocular rosacea, is common but often misdiagnosed." uspharmacist.com

    "The signs and symptoms of ocular rosacea in children may be frequently underdiagnosed or misdiagnosed..." NRS Rosacea Review, Summer 2008

    “It’s a condition that is often misdiagnosed and overdiagnosed. Sometimes a rosy cheek is just a rosy cheek.” Herbert Goodheart, M.D., a dermatologist in Poughkeepsie, N.Y., and author of “Acne for Dummies,” as quoted in the New York Times article

    "Dr. Jay points to the inherent dangers of misdiagnosis and inability to handle complications because of a limited understanding of cutaneous physiology."
    IPL: Wave of the future in rosacea therapy by John Nemec, Aug 1, 2006

    "...unusual manifestations of rosacea may be overlooked or misdiagnosed...."
    Rosacea: An Update
    Stanislaw A. Buechner
    Dermatology 2005;210:100-108 (DOI: 10.1159/000082564)

    "Rosacea is a skin condition as misunderstood as sensitive skin, and as frequently misdiagnosed." Dermilogica

    "Rosacea is a very common, but often misunderstood and misdiagnosed skin condition." skinlaboratory.com

    "Rosacea is a long lasting, non-scarring skin condition of the face that is often misdiagnosed as adult acne." Paul M. Friedman, MD

    "Rosacea is quite often misdiagnosed as any number of other skin disorders including acne." methodsofhealing.com

    "Often misdiagnosed as adult acne, allergy or eczema, Rosacea, if left untreated, tends to worsen over time...." Dana Anderson Skin Care

    "This present patient clearly had facial changes typical of acne rosacea, with erythema and telangiectasias of the cheeks, forehead, and nose. He had all the typical lid changes as well, including collarattes that are pathognomonic of staphylococcal blepharitis. Unfortunately, he had been misdiagnosed for several years…" Clinical Pearls by Janice A. Gault, p. 206

    "Due to the fact that lupus can cause a red rash across the nose and face, often in a butterfly pattern it can be confused with or misdiagnosed as rosacea. .." www.rosacea-treatment.net/

    "Dr. Callender also noted that rosacea is often misdiagnosed in patients of color, as clinicians may mistake the signs and symptoms of the condition for lupus – a systemic, autoimmune condition that commonly occurs as a “butterfly rash” involving the face."
    Treating acne and rosacea in people with skin of color - ihealthbulletin.com

    "...it's often overlooked in dark-skinned patients or misdiagnosed as lupus, which is marked by a red, butterfly-shaped rash in the center of the face,..." Shape May 2009

    "...the diagnosis of demodicosis is frequently masked by other skin diseases such as papulopustular or erythematotelangiectatic rosacea, seborrhoeic dermatitis, perioral dermatitis and contact dermatitis." Br J Dermatol. 2010 Feb 25.

    A Case of Precursor B-cell Lymphoblastic Lymphoma Misdiagnosed as Rosacea.
    Han EC, Kim DY, Chung JY, Chung HJ, Chung KY.
    Korean J Dermatol. 2008 Feb;46(2):264-267

    "It is when the first diagnosis and treatment don't work that dermatologists look deeper and often discover something called demodex." Microscopic menace may be cause of skin trouble, Jennifer Van Vrancken, Reporte, FOX 8 News: WVUE Live Stream

    "Busy doctors who cannot take a detailed history will frequently miss the diagnosis, complicated further by the fact that rosacea is a great mimic of other unrelated disorders that present with a “red face”. I have often seen classical cases of rosacea mistakenly diagnosed as acne vulgaris, lupus erythematosus, seborrheic dermatitis, contact dermatitis, and other inflammatory diseases." Albert Kligman, A Personal Critique on the State of Knowledge of Rosacea

    "Ocular rosacea is frequently misdiagnosed, particularly in the pediatric population." Eur J Ophthalmol. 2012 Jan 3:0. doi: 10.5301/ejo.5000103.

    A report, About some red faces, stated: "Diagnosis is based on different data: date and mode of appearance, characteristics of the erythema, functional signs, and associated systemic manifestations. A case of red face can have an infectious origin, caused by vascular, congenital, or acquired lesions, or be caused by photodermatosis, or be the main location of inflammatory dermatosis or collagenosis, but depending on the clinical context, many other diagnoses can be suggested."

    "Butterfly rash is a red flat facial rash involving the malar region bilaterally and the bridge of the nose. The presence of a butterfly rash is generally a sign of lupus erythematosus (LE), but it can also include a plethora of conditions. The case presented here is of a female with butterfly rash along with typical bright red discoloration of gingiva. The clinical, histopathological and biochemical investigations suggested the presence of rosacea."
    Contemp Clin Dent. 2012 Jul;3(3):356-8. doi: 10.4103/0976-237X.103637.
    Butterfly rash with periodontitis: A diagnostic dilemma.
    Aggarwal M, Mittal M, Dwivedi S, Vashisth P, Jaiswal D.

    "A 28-year-old female patient presented with extensive facial and ocular eruptions. She had a history of treatment with oral prednisolone due to the clinical diagnosis of lupus erythematosus (LE)....With the clinical diagnosis of severe oculofacial rosacea, she was successfully treated with oral doxycycline, steroid eye drops, and ocular lubricants. Histopathological features of skin biopsy were consistent with rosacea in the context of infection with Demodexfolliculorum.... Rosacea can be extremely severe and disfiguring, and it can be misdiagnosed as the pathognomonic butterfly rash of LE."
    J Ophthalmic Vis Res. 2017 Oct-Dec; 12(4): 429–433.doi:  10.4103/jovr.jovr_46_16
    PMCID: PMC5644412
    Severe Rosacea: A Case Report
    Ebrahim Shirzadeh, MD, Abbas Bagheri, MD, Mojtaba Fattahi Abdizadeh, PhD, and Mozhgan Rezaei Kanavi, MD

    Q: I was diagnosed with rosacea, but my skin isn’t responding to the rosacea treatments. In fact, it’s getting worse. Is it possible that I have both rosacea and acne?

    A: In a word, yes. For some patients, it is possible to have both rosacea and acne., Sue Chung , Patient Expert, Rosacea Misdiagnoses, Skin Health, Health Central

    Anecdotal Reports of Misdiagnosis

    The following is a partial list of anecdotal reports either of misdiagnosing rosacea for another skin disease or vice versa:

    1. Bob reports his rosacea was misdiagnosed for discoid lupus

    2. Elizabeth's initial diagnosis of rosacea turned out to be KP

    3. Andrea says her initial diagnosis of rosacea may have turned out to be pellegra

    4. Jason was misdiagnosed numerous times and was unfortunately given steroids which he believes aggravated the condition.

    5. Kari was initially diagnosed with rosacea and later found out it was eczema.

    6. maxigee2002 said after six months of being treated for rosacea a doctor discovered she was misdiagnosed and actually had Pityrosporum Folliculitis

    7. gdybe was misdiagnosed with Crohn's disease and after six months of steroids developed rosacea.

    8. Ladonna was misdiagnosed with rosacea and it turned out to be Graves Disease. 

    9. Susan reports that she developed "a rash above my eye (below the eyebrow - a little on the lid itself). First he said it was "orbital dermatitis" and gave me topical cortisone and anti-biotics. Not sure it helped much, it seemed to go away on its own schedule, although the steroid may have lessened the itchiness. I went back and he prescribed Metrogel and more 
    cortisone cream. He told me it was a form of rosacea."

    10. Tom says that 6 years before he was diagnosed with rosacea and treated and now says "This doctor does not think I have rosacea, instead 
    he thinks I have erythema." Tom says he thinks he might have KP. 

    11. DC says his physician misdiagnosed his dermatitis as rosacea. 

    12. NorthNova says he was misdiagnosed by dermatologists before he found out he had rosacea. 

    13. flareface reports that a dermatologist diagnosed her condition as "physiological flushing" and later she says a PA "misdiagnosed pretty much everything, gave me 3 different steroidal creams and sent me on my way." Later another derm diagnosed "contact allergy" on her eyes and prescribed a mild dose of cortisone cream for a couple days and it all cleared up. 

    14. redKen (see post #2) says his dermatologist misdiagnosed his rosacea for dermatitis. 

    15. nk104 says two dermatologists diagnosed rosacea. A third physician said it was not rosacea but neurodermitis. 

    16. Jonesy says his GB said he didn't have rosacea and later went to another physician who diagnosed urticaria. 

    17. RedFacedRedHead says her rosacea turned out to be KP.

    18. cliopatra25 says that for ten years she was misdiagnosed with acne when all the time she had rosacea. 

    19. vicky says "both my sisters was misdiagnosised collectively 10 times... and they have lupus...similar to my brother, he even had 2 positive ANA tests and thedoctor refused to treat him for lupus...... 

    20. Deb says, "I mentioned in another post that for years I was given things that were making the Rosacea worse, like retin-A and cortisone cream. I had mild rosacea then, so was misdiagnosed. For a while they thought it was Lupus since I also maintain a low-positive ANA. Their and my mistakes only made it worse, especially in the past few years." 

    21. Lisa M says, "I suffered from cystitis for years... and had to go on daily antibiotics for it for about 2 years. I also did saw a homeopath at
    the time and changed my lifestyle to no alcohol at all. I didn't know
    it at the time but I had rosacea (sadly totally misdiagnosed by
    several derms). 

    22. Mike says, "I also developed ocular rosacea a couple of
    years ago, after having facial rosacea for quite a few years. My first
    opthamologist misdiagnosed it, and treated me for months with steroids (mainly Tobradex) which ended up raising my IOP to a dangerous level. 

    23. Aurelia reports that "A teenage girl was given an "almost certain" diagnosis of ocular rosacea....The symptoms suffered by this girl did NOT match those of ocular rosacea and specialists later came up with a diagnosis of autoimmune Urticarial Vasculitis.

    24. Kerry reports that "I have found out today that I was yet again misdiagnosed and I don't have rosacea I have Lupus." 

    25. Sarah Smart says, "I am 12 weeks pregnant and my rosecea fulmins was horribly misdiagnosed by my derm (as shingles if you can imagine) and I spent 5 days in the hospital before they figured it out."Report.

    26. Kerry says, "I was misdiagnosed for 4 yrs by my gp as I have pretty severepsorisis on 60% of my body and scalp. They gave me a really strong steroid which has made my skin worse on my face.although it kept it under control. I found out 3 weeks ago i have rossacea and they
    stopped my steroids so my face has had a major eruption." 

    27. Ellen says, "my rosacea related blepharitis was misdiagnosed as seb derm." 

    28. sand7676 says, "I was misdiagnosed with acne I believe because of my skin tone. 

    29. Francois says that three derms diagnosed he had 'vascular dilation' and the last one said he had " 'Sebore' in Turkish. I looked at internet and I think it means 'Seborrhe'." 

    30. Kevin Forest says, "I've recently been diagnosed with rosacea after being misdiagnosed for ~2.5 years (errrrrr! derm aggerssion)."

    31. Joe says, "I've been misdiagnosed by numerous dermatologists who
    were in disbelieft that I would have rosacea at such a young age and
    assumed it was merely acne."

    32. Suzi LeBaron says, "I was misdiagnosed because it looked like
    rosacea -- including occular symptoms."

    33. Mike Lester says, "they called it seborrheic dermatitis, maybe rosacea. to be honest no one knew. many blood tests for lupus or something....Ive been going to doctors and doctors for my facial redness that ive had for over a year now. Well, they seem to have diagnosed me with ROSACEA!!!....I was checked for everything, lupus's, mastocytosis, carcinoids, tumors on the kidneys, brain tumors, and much, much more, some things some doctors have never even heard of. but it turns out i was misdiagnosed by the Mayo Clinic from the start, so we didnt need to go through months and months of stress, depression(which by the way i go to a psychologist now and am on PROZAC too).

    34. Stuart Clark says, "I too waited months for an appointment (on two separate occasions) and she completely misdiagnosed me." 

    35. Carol Voigt says, "I, too, was "misdiagnosed" for many years."

    36. Jeff says, "I got misdiagnosed by my previous dermatologist...So he gave me a steroid to apply twice a day, which of course, did not help. And by the time I had diagnosable rosacea..." 

    37. Eddie O'Neill says, "She said that I did NOT have bacterial conjunctivitis and had been misdiagnosed..."

    38. Chantal says, "in my early 20's (around 22-23), and was misdiagnosed for years (about 5) until the correct diagnosis of rosacea was made."

    39. Heather says, "My facial rosacea was misdiagnosed for MANY years (mainly an acne component with some redness)..."

    40. Jay Valof says, "2yrs ago i had septoplasty (deviated septum) nose surgery. soon after developed symptoms, was misdiagnosed as having asthma/allergy. 2 months ago derm. said in had rosacea..."

    41. jesseleigh says, " I just found out about a week ago I have rosacea, have been misdiagnosed with atopic dermatitis for ten years." 

    42. yoli says, "I was misdiagnosed for 2 years they thought I had dermatitis but in reality i don't itch but burn.... it took me 6 dermatologist in order to get diagnosed with Rosacea." 

    43. beecham says, "I was diagnosed in December 2007 with pustular rosacea by my new doctor, I was on oxytetracycline for about a year before with my previous doctor who had misdiagnosed me with perioral 
    dermatitis.... "

    44. LoriB says, "When I saw my general doctor while waiting for an appointment with a derm he misdiagnosed me as having acne vulgaris. He told me I don't have rosacea because my cheeks aren't red." 

    45. jodieginger says, "I was repeatedly misdiagnosed as having dermatitis and none of the derms seemed to care that I simultaneously had blepharitis simultaneously. "

    46. mineren says, "I have adult acne in addition to rosacea and
    was misdiagnosed a couple of times. "

    47. mythjedi says, "She stated that I had "contact dermatitis" and gave me doxycycline....but it wasn't long before transient, big, patchy red blotches began to form on my face and chest....I discovered that I was allergic to these pills, and I stopped taking them.... I have been
    off of the pills for six months...I went to a dermatologist and was diagnosed with rosacea..."

    48. Yvonne says, "My SD was misdiagnosed as rosacea." 

    49. Cassie Henderson says, "I was misdiagnosed by a blind derm and used hydrocotizone for three months. My rosacea went from a splotty red blotch on one cheek to an all over the face red hue very bumpy dry and ruddy looking. I then went to a derm who wasn't legally blind and started using metrogel and minocycline which helped for awhile."

    50. Keith on 07.15.09 at 12:43 pm says, "...I went to a highly accomplished and respected doctor in my area who diagnosed it as Rosacea so I guess thats what it is. Other Derms have said sundamage, Folliculitis, so it is still uncertain to me..." Scroll down to Comment # 91

    51. Lori said her acne was diagnosed as rosacea which later turned out to be also seborrhoeic dermatitis after she had taken Oracea for over a month. She was switched to Doxycycline at a higher dose and Finacea. See Comments #68, #84, #89, #93, #107, #114, #117, #123.

    52. raly says, ..."I've been "diagnosed" at different times as it being rosacea, folliculitis, sebderm or possibly just acne from both GPs and a dermatologist..." Scroll down to Post #9

    53. dan pacifik says, ".... After a second trip to the doctors, my doctor seemed to think it was rosacea so she prescribed me metro cream 0.75%....…I think! I pretty much used this for about 8 months....I went back to my doctor about this and she said it looked more like acne on my forehead....I am however skeptical over my doctors and derms diagnosis..." 

    54. kfoltz9 says, "I am a 25 year old female with what appears to be perioral dermatisis around my mouth. My family history only consists of Psoryasis and I have not had a personal experience with this. I am currently on Effexor XR. I use Aveda sensitive skin facial cleanser which does not contain any Petrolatum. I have not introduced any new cosmetic products into my regimen. The dermatologist I went to yesterday about this month-old rash (I have had one previous occurence, only less intense) did not even inspect the rash, asked me if I blushed easily or often (I do not, and told him that) and diagnosed Rosacea in about 3 seconds. 

    55. siliconmessiah says, "...I first went to the doctor on a "drop-in"-visit. One of them (a really shitty doctor actually) prescribed cortisone cream for my problems - I took it for a couple of weeks with no signs of getting better. I returned to a new doctor, a really good one I might add...she diagnosed me in one minute under the light of a lamp..." Scroll down to post #2

    56. brighteyes says, "It took me approximately 3 years (and 6 derms) to get an official diagnosis...." Scroll down to post #3

    57. Mistica says, "...So in my case, rosacea wasn't recognised immediately and even 10 and a half years on from the orginal diagnosis, the 'diagnosis' is continuing in some ways. It looks like rosacea ( no missing that!!) and it behaves like rosacea, ... but is it just Rosacea?..." Scroll down to post #8

    58. IJDVL reports, "Subsequently, the initial diagnosis of allergic conjunctivitis was revised by the ophthalmologists to ocular rosacea." *

    59. A 32-year-old woman had developed moderate swelling, erythema and papules of the central part of her face for 8 weeks. She started to apply various topical cosmetic products sold for acne that did not help. As one of her hobbies was outdoor biking she noticed that sun exposure aggravated her skin condition, also resulting in burning and stinging sensations. She consulted her general practitioner who prescribed prednicarbat cream for topical application on the affected regions. Whereas she observed a slight improvement of the skin condition during the first week, she later on suddenly developed a severe worsening with erythema, papules and many pustules. She presented to a dermatologist and was diagnosed with "steroid rosacea". She went off the steroid, started topical treatment with metronidazole 1% and oral treatment with metronidazole 500 mg twice daily for 2 weeks. After an initial worsening during the first 3 days the skin condition rapidly improved. She continued metronidazole 500 mg once daily for another 2 weeks and then stopped. The topical treatment was continued twice daily for altogether 4 weeks and then reduced to once daily for another 4 weeks. Besides, she applied sun screen whenever she was outside. She continued intermittent topical use of metronidazole 1%. She remained free of symptoms except of an intermittent slight centrofacial erythema. See case report #1 

    60. A 39-year-old woman was referred to a dermatology department because of worsening of her known rosacea. She had been suffering from rosacea for 3 years. After initial, short-term and intermittent oral therapy with tetracycline for periods of up to 3 weeks she had continued topical treatment with tretinoin without any problems for the last months. Suddenly, she developed an erythema of the face accompanied by strong burning that increased in the evening, decreased over night and was moderate at day time. She discontinued topical tretinoin therapy because she felt that the symptoms were caused by it. She presented to a dermatologist with a sharp erythema of the whole face with only solitary papules and pustules. Due to the patient's history and the clinical finding contact allergy was suspected. Patch testing revealed a sensitisation to cocamidopropyl betaine, a surfactant that is frequently added to shampoos and skin cleansing products. This substance could be identified in her skin cleanser. When she discontinued this product, the symptoms disappeared and the patient could continue her topical treatment.
    We recommend to precisely ask patients about all the topical drugs and cosmetics they use including skin cleansing products. Contact allergy can also occur in rosacea patients and may mislead patients and physicians. See Case Report #3

    61. A 56-year-old diabetic man presented erythematous papules and pustules on the neck and face who had developed since 3 months. He had been treated with topical corticosteroids for the same time period that resulted in progressive exacerbation. He additionally showed patches of hair loss in the beard area, erythema and scaling of the ears. Among various differential diagnoses the clinical picture reminded of stage II rosacea. Microscopial examination and culturing revealed Microsporum canis. He was diagnosed tinea incognito, a term that has been used to describe dermatophyte infections modified by corticosteroid treatment.
    This case report demonstrates that there is a number of other skin diseases that can mimic rosacea. (see Case Report #7)
    Gorani A, Schiera A, Oriani A: Case Report. Rosacea-like Tinea incognito. Mycoses 2002; 45: 135-137. 

    62. A Case of Precursor B-cell Lymphoblastic Lymphoma Misdiagnosed as Rosacea
    Han EC, Kim DY, Chung JY, Chung HJ, Chung KY.
    Korean J Dermatol. 2008 Feb;46(2):264-267

    63. Pete says, "...Had previously been misdiagnosed by my G.P. Had been treated with steroid creams for eczema...."

    64. shakti says, "...I had a horrible rash on my face which the Dr. (dermatologist) even took pictures of, but he said it was rosacea....Then a neurologist said I could have some sort of mild m.S..... I've recently had a "rosacea flare" swelling and redness around my eyes and upper cheeks, the tiredness has returned and so has pain in my bladder and gi tract...."

    65. belinda says, "After being misdiagnosed for 7 years, I had almost given up hope." published April 8, 2008

    66. mmee says, "...just wanted to say after many years of suffering with depression and social anxity because of a red face and not being able to get any information out of 3 dermatologists and about 5 GPs (they just said it was 'normal') . I've found out from a link on this website it must be Keratosis pilaris rubra faceii..." 

    67. Gem says, "A couple of months ago I developed a rash on my forehead and weas gicven a steroid cream for it that seemed to keep it under controlfor a while, then around 3 weeks ago it spread and looked angry, I went to the doctor who said it was acne the cream I was given just aggravated it, so I went back and was given another cream by a different doctor who still thought it was acne... this again aggravated it, so I started looking on the net for other ideas or medications that could help. I tried coconut oil and aloe vera topical and ingested, another trip to the GP I was given Tetracycline oral antibiotic but it was something like a 3 month course, ....I went to my doctor again today as my self treatment wasn't doing any good and I was told it looks like rosacea I've been given metronidazole gel and I've started the Tetracycline oral antibiotics again...." 

    68. ssaeed says, "...He diagnosed me initially with Seb Derm and prescribed Desonide cream for 3 weeks. I noticed my skin got a lot better and softer during this treatment although towards the end of the treatment I started getting small pus filled acne bumps on my nose and cheek, about the size of a pore. When I saw the doc after the 3 week Desonide treatment he told me I may have symptoms of Rosacea and started me off on a treatment of Metrogel once a day and Oracea once a day in the morning." 

    69. Ladonna says, "...my husband took me to the dermatologist and she said it was Rosacea and couldnt be anything but....So he took me to many doctors, and finally a wonderful doctor took a shot in the dark blood test and discovered my problem. Later more involved tests and scans confirmed it. I was Hyperthyroid...specifically Graves Disease..."

    70. DylanG says, "... I finally got an appointment with a dermatologist for my rosacea. After waiting about half a year, I go to the appointment. The dermatologist walks in, doesn't even look at my face and says "There's nothing I can do about redness. Some people just have red skin". Then, to top it off, he gave me cream for acne - something which I could care less about - that has the side effect of making your face red. I was out of his office in practically two minutes with about twenty tiny tubes of acne medication I had no need for. ..." Scroll to Post #22

    71. Donna says, "I got results back from labs and xray..i do NOT have sarcoidosis…but still not sure what i have …i have granulomas popping out on parts of my body and my face is still not clear. I am going to a conference of doctors on the 16th to get their opinions. I was originally diagnosed with Granulomateous rosacea so lets see what opinions i get." Post #146

    72. liangjuany says, "I saw another doctor today and was told what I had was not rosacea but pityriasis rosea instead." 

    73. huiness says, "another derms who told me I had acne, or folliculitis etc. When I finally decided to go back to Derm #2, he then diagnosed me with rosacea.....went to Derm #14809348. He agreed with the rosacea diagnosis but said that this was probably steroid induced...."

    74. mrsmoof says, "1st dermatologist thought I had dermititis.....Well, I went to a 2nd dermatologist and told her my story, symptoms.....within minutes she said it was Rosacea...." Scroll to Post #43 

    75. "My wife was diagosed by a local Dermatologist as having Rocacea. He only did a visual inspection without any actual skin testing. He was sure it was Rocacea and prescribed an expensive cream which she would have to use for who knows how many years. Luckily she had a severe reaction to the cream, and discontinued it. She visitited her home country of Russia and was treated by a specialist. He told her she didn’t have Rocacea but had Demodex. She had one treatment by the doctor and her face is still clear after 6 months. Always get a second opinion." J Noble on 01.12.10 at 7:11 am Post #215 

    76. spuggylegs says, "I think it took about 10 mins for a NHS dermatologist to tell me that I didnt have rosacea. She looked at my skin said there was no visible erythema or papules and pustules to suggest rosacea, and that I needed to stop "reading stuff on the internet". I had to actually ask for a blood test to rule out lupus etc!!!!! I asked my GP if he could send me for a second opinion but he refused. The problem is that there is a lot of inequality in the NHS...and as someone who lives in a deprived area, healthcare is usually not as good as those who live in more affluent areas. (but thats another story). Well I still carried on "reading stuff on the internet" : ) and decided the only way forward was to go private..even though i couldnt really afford it. So travelled from the north east to London, and got so stressed, as we got lost a few times, and London is not the friendliest of places. By the time I had got to see the derm I was having a major flush....so after reading my medical notes, asking about family members who may have rosacea,, symptons, and looking at my skin, he diagnosed rosacea. From what i can remember the consultation lasted about 30 mins." Scroll to Post #50

    77. Rachelle C says, "My doctor diagnosed me with rosacea, delusional paristosis. The medications for these did no good. Then another dermatolgist with an allergist diagnosed me with demodex (skin mite) allergy." Scroll to Post no. 77 on 05.04.10 at 1:00 AM

    78. Girrlock Holmes says, "…I was finally diagnosed hypothyroid, insulin resistant and PCOS, and my doctor also thinks my symptoms fit with fibromyalgia…I saw a dermatologist who said it was not Rosacea but offered no info on what it could be. Then I saw an allergist and he said the derm had no basis for saying it was not Rosacea; it looked like it to him. So you see I have no clear diagnosis. I am waiting for a different derm to see me but it will not be for another 2 months…"

    79. "Terri Flynn, a 63-year-old part-time receptionist from Texas....Two different evaluators told her she had "dry eye" and prescribed artificial tears and various eye medications, while one also suggested she have her bottom eyelids lifted to help retain the moisture in her eyes....She made an appointment with a dermatologist, who "took one look at me and said, 'Yes, it's rosacea." NRS Rosacea Review Spring 2010

    80. GNR reports, "...I was told I had Perioral dermatitis because there was an outbreak near my nose....Began to notice a swelling under my right eye and a red path beneath extending up the temple. It became hot and sensitive and flares when I workout with weights. Told "hmm don't know what that is, it's not rosacea (my fear was that it was) but try rozex cream to see if it goes." It didn't. Didn't change. Had a second opinion. Same as the first. "Don't know, looks like it might be fungul. Leave it until you see a dermatologist." Began to a sore eye, a few pains and watering. Went back to the second opinion to ge this checked was given a scrip for kenocomb ointment for fungus....out of desparation I went to another gp explained the whole story again. He checked the skin, told me it wasn't rosacea that it looked like a fungus infection try Nizoral 2%. Hmmm. Later that day I had an appointment with a new dermatologist who told me that I actually had seborrhec dermatitis...this sounded right as all the systems relate, rash on chest, dry skin in eyebrows, dandruff...funny I'd never connected these things and either had anyone else.
    He then checked the rash thing on the right side of my face and temple and told me it was rosacea. I asked about the pain in the eye, watery, and he said not connected. Gave me a print of what to expect with rosacea and out the door I went..."

    81. comicraven reports, "I had been misdiagnosed for a while - everything from shingles to testing for lupus - and was finally properly diagnosed about 6 months ago..."

    82. koki says, "OK according to dermatologist # 4 , again I dont have rosacea, I explained my symptoms and he said it sounds more like an allergic reaction and when he examined my face he said it was more like eczema/seborrheic dermatitis and gave me some diflucan. ....I am glad most derms say is not rosacea..."

    83. stb09 says, "In May 2004, I developed a pimple on my nose that left a red mark on it for, what must've been a solid YEAR after it cleared up. I was thorougly convinced this was a scar, and went to several dermatologists to find proper treatment. Such begins my ongoing battle (and subsequent HATRED) for all dermatologists.

    The first one I saw told me that it was a mole....
    I sought a second opinion. This one told me it was a scar, and could only be removed by a plasic surgeon. He took my $100, and gave me the number of a plastic surgeon.

    The plastic surgeon (who was once a dermatologist) was convinced it was a pimple still, and simply lanced it and dug around in it, ultimately making it worse....

    The fourth and final dermatologist perscribed me a prescription in January of 2005 for my back acne/oily skin. He agreed with ME that whatever was on my nose was inflammed and most likely a sebacous cyst. He injected it with cortisone, and that made a tremendous difference, and today there's not a mark to be found. This is the same dermatologist that dismissed my concerns of facial redness and never spoke a word about Rosacea in spite of my ruddy complexion that I was, at the time, unaware of....I was at a new branch of my college and went to the local dermatologist to seek treatment. He told me it was probably a scar and gave me the number of a laser surgeon FOUR hours away that "might" be able to help me.

    THIS is the first time a doctor has mentioned the word "Rosacea" to me. He explained that I had a ruddy complexion, and thus, the red spot on my nose was more noticable. He went on to state that people with my complexion "could be candidates for Roscea later in life." and encouraged me to stay out of the sun......I finally decided to see a dermatologist to rule Rosacea in or out so I could get on with my life one way or the other. I went back to the local dermatologist, who had told me that someone with my complexion might be a candidate for Rosacea later in life, and was told absolutely nothing new.

    He once again told me that, maybe I'd have it one day, and maybe not. I asked him if I should try avoiding "triggers" and he said that I shouldn't bother. Because it probably wouldn't help. I asked if there was any treatment, because I've since learned Rosacea is best treated early on. He said that any creams he could give me would most likely not do anything at all for me, and would be a waste of my money. The entire visit was quite ambiguous.

    I asked him what "Pre-rosacea" was, and what the difference was between that, and a normal ruddy complexion. He told me that, in his opinion, there wasn't one. As he considers anyone with a ruddy complexion at risk for developing Rosacea, and THAT he considers to be "pre-Rosacea."

    Before I left, I asked him for a definitive answer one way or the other, and he told me NO, I do not have Rosacea.....To the point of the original thread, I'd like to determine what it is I have. The doctor seems sure it's not Rosacea, but as evidenced by my ongoing battle with Dermatologists prior, I believe if I went to 10 Dermatologists I would receive 10 different opinions. Rosacea, ruddy complexion, acne, allergic rash, facial blushing, too much Niacin, high blood pressure, lupus...

    these people don't know anything, and with no insurance I'm not going to waste $100 a visit to find out precisely nothing.

    84. Ontarian says, "I was diagnosed with seborrheic dermatitis on my face about 5 years ago. The diagnosis was made by a dermatologist. Soon after, the dermatitis completely disappeared for a loooong time. Then, I suddenly got a red patch on my right cheek five years later, more precisely in February of 2006. It has slowly spread to my entire right cheek. It got worse in the summer. This whole time I thought I had seb. dermatitis. My family dr. said my face was dermatitic and prescribed hydrocortisone. It didn’t help. In August of 2006 I went to my dermatologist. This time, he said I had rosacea. I was shocked. I was not flushing like crazy (except maybe when I played soccer in +35 C degrees outside). My symptoms started as a small red patch on my right cheek, this could not be rosacea. I went to see another dermatologist (an old dude who thinks rosacea is a proper diagnosis only when your face is swollen like a balloon and when you are covered with pustules).
    So, now I have two doctors thinking I don’t have rosacea, and one doctor thinking I do." Posted: Tue Oct 17, 2006 1:34 pm (scroll down to find the post)

    85. Jen says, "Since I have stopped the med I was diagnosed with Perioral Dermititis and now as of yesteday the derm tells me I have acne.....The derm said I have almost all the face disorders (rosacea, acne, perioral dermititis, seb derm)....

    86. jhelli1 says, "I've been to four different doctors in the past and have gotten four different diagnosis. The last one was rosacea. Yesterday, I went to a fifth doctor and was told that I have..........eczema!

    87. fedup says, "....I went to this dermatologist maybe 2-3 times a year over about a 4 year period, every appointment he seemed to have absolutely no idea what was going on, or what he had prescribed/said the last time, he took a look at my scalp, says "its folliculitus" (the way he said it, every time, was as if it was a breakthrough and he figured out some giant mystery, even though he said the same thing last time....and sent me home with a prescription for Ceftin 500mg 2x a day for 2 weeks (insanely strong antibiotic, I know now..).....Made an appointment with a new dermatologist (roughly 2 years ago), after explaining the antibiotic fiasco, he told me my old doctor probably shouldnt be practicing medicine. He took about 10 seconds to diagnose me, looked at my scalp, and simply said "you have inflammatory rosacea."

    88. mutantfrog says, "...I always grumble to myself about rosacea...but if it turns out that I never had rosacea but instead have had an autoimmune disorder...well it's scary I'd rather take rosacea. I swear to god I'll never complain about 'rosacea' again..." Post #10 22nd July 2010, 07:40 PM

    89. quixotic_pessimist says, "Anyway, I had been seeing a dermatologist during this time period for acne that I have had for about 3 years, and he never mentioned anything about the red complexion of my nose. One time I voiced my concerns, and he pretty much dismissed them, saying that he didn't think my nose looked red. During my last meeting with him, I was a bit more belligerent (in that I brought up the grievances that I have with my red nose a few times). He then nonchalantly throws out that it is possible that I have Rosacea. How is it that I had been visiting this doctor for 3 years with the same red nose, but it is not until now that he suggests that I might have Rosacea? I don't get it."

    90. CHI_GUY says, "...First doc said, sebborhea/eczema. He gave me many different things, to list a few....Second doc, new one, diagnosed perioral derm. She gave me tetracycline. 500mg x2/day for the first month. She exclaimed that the previous doctor was treating the wrong thing, because I brought all my old meds in to show her...."

    91. Natasha says, "I have just been diagnosed with Rosacea....a week ago the doctor wrongly diagnosed excema..."

    92. hesperidianblue says, " I was going to 7 dermatologist till 2 of them agreed that is rosacea other wasn`t shore what is it often they thought it was atopic dermatitis."

    93. misdiagnosed says, "During this whole ordeal, I have seen a dermatologist (in OH) 2x. THe first time she tried to convince me it was “in my head” and reluctantly prescribed an antibiotic for adult acne. 8 weeks later, she seemed a little more open to the fact that it could be demodex and prescribed metrogel. Last week, I asked for metronidozale in a pill format because the lotion only does so much. She agreed to call it in. It is helping, but I have good and bad days, depending on the “hatching” cycle." #385 misdiagnosed on 10.08.10 at 12:45 AM

    94. Maureen says, "I have had this now for about I would say 2 years when I was told I had rosacea and lupus. Now a new dermatologist tells me no it's dermographism,..."

    95. francois can says, "I just cant believe. Today I went to see a derm. She looked at my face closely with a tool like a magnifier and said I misdiagnosed myself. She said rosacea has 4 components and someone has to have at least 3 of them to be diagnosed rosacea.....She said I have a
    condition associated with neurovascular dilaiton..."

    96. LarsMM says, "...First I went to a regular doctor and even though he ran a few tests he couldn't tell me wheat the problem was. He told me I shouldn't worry since the redness was at that time "barley noticeable". At the end of the third summer (2010) I went to another doctor and got the same response. After this visit I got somewhat frustrated since I was well aware that I had not been this red a few years earlier, as a result I started reading online and came across rosacea. I got an appointment with a dermatologist and she confirmed that I had stage one rosacea...."

    97. 444 says, "...my doctor has failed on many occasions to diagnose me properly probably due to my young age at the time and has disregarded any possiblilty of rosacea since the beggining....'

    98. claire says, "...I am 34 years old and I was wrongly diagnosed 7 years ago. I have gradually seen since then my skin get progressively worse, it is now in its advanced stages. ..." #41 claire on 05.16.09 at 8:16 PM

    99. Rachelle C says, "My doctor diagnosed me with rosacea, delusional paristosis. The medications for these did no good. Then another dermatolgist with an allergist diagnosed me with demodex (skin mite) allergy. Since I have very many allergies, this was a good bet. I treat itchy and red areas with tea tree oil and have managed to reielve my problem almost completely. The dermatologist also thinks a monthly treament with Kwellada-P would help further." #76 Rachelle C. on 05.04.10 at 1:00 AM

    100. findingaway says, "So I am no further forward...I still don't really know what it is I'm dealing with... Rosacea, SD, KP. All?" 

    101. Just an update and to show the importance of knowing what you have, I saw a Rosacea specialist with 20 years of treating and research under his belt, and made the appointment saying "Trying to treat Rosacea" as the reason. The second I came in he was confused and wondered where the Rosacea patient was. He looked at me and told me I absolutely do not have Rosacea, he's seen thousands of cases over decades and it's simply not it. And it's not caused by being choked, ever. It was thinned skin due to Steroid Creams, and thankfully, he caught that because the General Practitioner who 'diagnosed' me with Rosacea prescribed steroid cream. The most alarming was that the general practitioner gave me Metrogel which I understand is meant to help Pimples, and I have absolutely zero of those. AlenaCena post no 68

    102. I've been to dermatologists in three different countries starting when I was 16, and I'm now 41. When I first started going to them, they didn't know a lot about eczema and dermatitis and the treatment course was antibiotics and cortozone creams. (Not much has changed) Even then I knew foods and hormones were triggers or the cause of the skin eruptions. I've had dermatologists tell me it's not rosacea and dermatologists tell me it is. One things for certain out of the more than 30 dermatologists I've seen in my life time, no two have had the same things to say. However last time I was at one, she did look up patronizing and say, yes we now know hormones can affect eczema...as if her telling me that made a whit of difference to what I have already known. In the UK, where they have now said it is rosacea, I have had no other tests. The dermatologists I've seen refuse to accept other countries diagnosis of food allergies. They refuse to take into consideration what I'm saying, about my upper eye lid cracking (it's been cracking there my whole life, so much so I've a deep scar) and the bubbling around my eyes, and over my brows. In the end, I think a they've learnt mo about the what some skin problems are, they seem to have bunched the rest as rosacea. Which appears to me to be a blanket term, covering a huge amount of things. Melania post no 66

    More cases of misdiagnosed rosacea (or vice versa)

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    • Emily47 at RF (post no 54) reports, "I mixed Afrin and CeraVe (suggested my dermatologist) and it worked! Immediately less redness!" According to Vitacost.com, oxymetazoline hydrochloride, 0.05 percent, the active ingredient in Afrin nasal spray, works by constricting, or shrinking, the blood vessels in the nose, and thereby reducing nasal blood flow. - livestrong.com
    • Fluorouracil (5-FU), aka, Adrucil, Carac, Efudex, Efudix, others, used to treat cancer has the side effect or risk of inflammation of the skin. There are reports that this treatment exacerbates rosacea. Caveat emptor. Thread at RF about this
    • Hello Brady! Greetings from The Black Sea! You are right. The sad true just received in a message from Renee Marie Stephano(president and co-founder of the Medical Tourism Association) yesterday: "During this process, I learned a life lesson that I now know is the dirty little secret of healthcare: the system is rigged. The industries of health are rigged. They are designed for profit, not for people." You said that rosacea sufferers are mostly centered on their own rosacea issues and that is true in case over the years they have not succeeded to control/ manage their rosacea like in your case. The last dermatologist I have seen in Bucharest told me that she has no miracle solutions for me as an example(the last cream that was prescribed to me Anthelios Ultra SPF50+ from Roche Posay was tolarated by my face only six days ending in terrible pains in the skin of the face). Still fighting everyday here. Life is not a fairy tale cause life is real. Going to a Ozone Center for other medical problems and seeing on the website of the best dermatologist in Romania dr Ioan Nedelcu uses laser, IPL and Ozone as terapies to control Rosacea (http://drnedelcuioan.ro/servicii-medicale/dermatologie-consultatii-tratamente/cuperoza-rozacee) I asked the owner and doctor of the Ozone Center if I can make cosmetic injections with ozone. She told me will not be a good ideea and the best thing to do is to try ozonated olive oil (a brevet that belongs to Nikolai Tesla from 1904. Here is the product recommended http://www.rheumapraxis-altstetten.com/en/oxaktiv-cosmetic-eng) and I am in the day forth(till now is more than all right but on my face no cream passed the test of more than 12 consecutive days. I am praying here that this time to be the lucky one) and counting, hoping for a solution. I tried to search on our website ozone therapy and ozonated oils and there is no article and no information about it (I wish I was the one writting it). There is an article here https://www.amaskincare.com/how-to-get-rid-of-rosacea-top-treatments saying that: "#4 WAY OF HOW TO GET RID OF ROSACEA – THE MAGIC OF OZONE One natural remedy stands alone among the myriad of other natural therapies, both in its therapeutic effectiveness and the enormous amount of scientific study dedicated to its clinical use. Ozone. Ozone is a completely natural element readily found in nature and that can be generated in a pure form for medical use. It is a form of oxygen (O3) that has tremendous capacity to stimulate healthy physiological activity in every organ system of our bodies, all the way down to the level of individual cells. There is so much therapeutic value to its clinical use, that I will dedicate a series of articles about Ozone Therapy. For now, know this. Infused into natural oils such as olive oil and sunflower oil, topical use of these “ozonated” oils is safe, easy, and extremely effective to use as a rosacea treatment. In our experience, clinical protocols that combine the use of ozonated oil with laser treatments is the single most effective way of how to get rid of rosacea." From whom can we know for sure that ozonated olive oil and sunflower oil are good for Rosacea??? The guys from PureO3(http://shop.puro3.com) told me that ozonated jojoba and coconut oils are also good for Rosacea. Also I wish I could try and afford to buy the LaFlore Probiotic Concentrated Serum recommended by dr.  Whitney Bowe  here https://www.allure.com/gallery/probiotics-skin-care-products but the prices are beyond my current financial possibilities(https://laflore.com/shop-retail). Take care.  PS: I will have a look at your diet as in my case no salt, no sugar products, no dairy products, no cereals, nothing made and difference. So the only diet remained to try is a diet without food.   
    • Elucidating the role of Demodex folliculorum in the pathogenesis of rosacea: exciting first steps…. Br J Dermatol. 2018 Jul 19;: Authors: Forton FMN PMID: 30024649 [PubMed - as supplied by publisher] {url} = URL to article
    • How do you know if you are reading fake rosacea news?  Or what if you read about a certain rosacea treatment whether topical or oral? Can you trust the reviews from the web site? Who would you trust to substantiate a news item about rosacea? Maybe your physician? A social media site?  How about a non profit organization for rosacea patient advocacy? How do you produce a watchdog (a rosacea Snopes) who can substantiate a rosacea news item or weed out a fake reviewer and expose the bum is lying about a rosacea treatment? The RRDi is one of best sources of rosacea data to compare rosacea news items with fake or with what's really a trusted source on any news item about rosacea and is the only non profit organization for rosacea patient advocacy. The other non profit organizations for rosacea are not founded by rosacea sufferers and have a different rosacea agenda. Just follow the money how any non profit organization for rosacea spend the donations and you will see what the agenda is all about. Is the spending 60% of the donations on private contractors owned by the director of the non profit the main agenda? Is most of the spending of more than 75% of the donations on 'annual and mid-year meetings' for the professional members of the non profit the main agenda?  Follow the money.  Read an interesting tech article related to fake news at wired, SHADOW POLITICS: MEET THE DIGITAL SLEUTH EXPOSING FAKE NEWS by BY ISSIE LAPOWSKY, about how media scholar Jonathan Albright discovered through endless hours of research how the the world's biggest internet platforms were riddled with fake news. This inspired me to comment on all the data I have collected (basically just about everything at this web site has been collected by me, there may be a small percentage of posts adding some new information from RRDi members, and it would take me a number of hours to give you the math on this, which really isn't important at all at this point, you will simply have to trust me on this until proven otherwise) on rosacea trying to put them into logical categories in the forum and the affiliate store. I have tried unsuccessfully so far to attract some kindred spirits to help me in this endeavor but alas, what I have found is most rosacea sufferers are mostly centered on their own rosacea issues, whether it is rosacea or some other rosacea mimic, and simply will not volunteer to help make the RRDi's mission come true. It is very sad. 14 years ago when the RRDi was founded, there were quite a number of impassioned volunteers who assisted me in this endeavor but they are now mostly faded away. Where have all the volunteer rosaceans volunteer gone? Where is a passionate rosacea volunteer with a spirit like Jonathan Albright to be found? Alas, such volunteer rosaceans are slim to none.  The reason I am writing this post is that after reading how Jonathan Albright's passionate hours and hours of researching to discover how fake news was being spread through all the internet platforms, making a detailed map, which without a doubt took more hours to make, it has inspired me to explain that I have spent endless hours putting the RRDi together and basically this web site and all the rosacea data collected is the Crown Jewels. The RRDi MAC is definitely a close second (you try to bring together some noted rosacea professionals into a group). Third, the Internal Revenue Service approval as a 501 c 3 approved non profit organization (along with the non profit approval from the State of Hawaii) is the last crowning achievement.  I am now sixty eight years old. I have my rosacea controlled and have updated my regimen here. So I am seeing the hand writing on the wall, since who is going to take over the RRDi if I croak?  Basically, if someone doesn't have the kind of passion I have had for this mission and steps up the plate, the RRDi is going to fade away and all you have left is the NRS and the AARS. Is that what you really want to happen?  So think about what I am telling you and please comment in this thread what you think should be done about this? Just think if there is no RRDi, no real legal non profit organization for rosacea patient advocacy, and all you have left are the two non profit organizations mentioned above who are set up by NON ROSACEANS and whose donations are from primarily pharmaceutical corporations who have a vested interest in promoting skin products and who spend little (compared to how much money is donated) on rosacea research?  So if the RRDi fades out of existence and you do nothing about this, is that the way you want it to go?   What rosacea news is the NRS and AARS spreading?  Both non profits clearly state on their websites that pharmaceutical companies are sponsors. What is the agenda when posting information about rosacea? What is the agenda of spending the donations mainly on what?  Dr. Kligman mentions the 'indifference of the National Institutes of Health, which with an annual budget of nearly 30 billion dollars, has not seen fit to fund a single grant for the investigation of rosacea.' Dr. Kligman also says that most research done on rosacea is by the skin industry which is 'voluminous literature, mainly focused on treatments sponsored by commercial interests; perhaps not the most credible source of unbiased research.' ” A Personal Critique on the State of Knowledge of Rosacea, Albert M. Kligman, M.D., Ph.D.
      Department of Dermatology, University of Pennsylvania, Philadelphia, PA, U.S.A.
      publikation_kligman.pdf  Why not join the RRDi, volunteer, help find the cure and expose rosacea fake news?
    • If others don't volunteer and work together for rosacea patient advocacy then rosaceans deserve what they get with the NRS and the AARS which are the only non profits doing any rosacea research. And what kind of research do these organizations do? Who donated primarily to the these organizations? Pharmaceutical companies. And what kind of research do they engage in? You guessed it. Here is a quote from my book I wrote in 2007 on page 82: 

      "Dr. Kligman mentions the 'indifference of the National Institutes of Health, which with an annual budget of nearly 30 billion dollars, has not seen fit to fund a single grant for the investigation of rosacea.' Dr. Kligman also says that most research done on rosacea is by the skin industry which is 'voluminous literature, mainly focused on treatments sponsored by commercial interests; perhaps not the most credible source of unbiased research.' ” A Personal Critique on the State of Knowledge of Rosacea, Albert M. Kligman, M.D., Ph.D.
      Department of Dermatology, University of Pennsylvania, Philadelphia, PA, U.S.A.
    • In this study, significant cardiovascular disease risk factors such as a family history of premature cardiovascular disease, obesity, prediabetes and high C-reactive protein levels were found to be higher in rosacea patients than controls. Although the underlying mechanism is not clear, it is thought that chronic inflammation and disregulation of innate immune system increase risk of cardiovascular disease in rosacea patients. The American Journal of Cardiology
      Volume 121, Issue 8, Supplement, 15 April 2018, Page e106
      OP-264 - Investigation of Cardiovascular Risk Factors in Rosacea Patients
      Muhammed Karadeniz
    • Highlights of Skin Disease Education Foundations 42nd Annual Hawaii Dermatology Seminar. Semin Cutan Med Surg. 2018 Jun;37(4S):S75-S84 Authors: Baldwin HE, Stein Gold LF, Gordon KB, Green JB, Leonardi CL, Sengelmann RD Abstract
      Updates on managing some of the most common dermatologic conditions for which patients seek care illuminated presentations at the Skin Disease Education Foundation's 42nd Annual Hawaii Dermatology Seminar®. This educational supplement summarizes the highlights of clinical sessions presented during this CME/CE conference. Treatment of psoriasis has continued to advance, with three interleukin (IL)-17 antagonists approved by the US Food and Drug Administration (FDA) and a fourth in phase 3 trials. An authority on the use of biologics in psoriasis presents current data on the safety and efficacy of these therapies. Tumor necrosis factor (TNF) inhibitors also retain a place in the management of psoriasis, with records of long-term safety. A fourth TNF inhibitor awaits FDA approval for use in psoriasis, offering data on transmission during pregnancy and lactation. An expert on the use of this drug class presents the evidence. Topical therapies remain the cornerstone of care for many patients with psoriasis as well as those with rosacea. Our faculty update readers about new and investigational topical therapies for moderate or severe psoriasis, as well as for acne and rosacea. The current literature on monitoring patients receiving isotretinoin also is summarized. Aesthetic and cosmetic dermatology services form a sizable portion of some practices. Our faculty review data on safety of topical and procedural therapies for cellulite as well as safe injection of facial fillers.
      PMID: 30016379 [PubMed - in process] {url} = URL to article
    • In order to really understand and put rosacea research in perspective it is important to understand where rosacea is in terms of total disease on this planet. Google Answers says, "According to the World Health Organization, there are still no effective treatments available for around three quarters of the 30,000
      diseases known today worldwide." [1] “For two thirds of all known sicknesses—about 20,000—there is so far no way of treating the cause.” [2] So rosacea is somewhere between three quarters and two thirds of what is termed idiopathic diseases. [3] Since the cause of rosacea isn't known, and the number of theories on the cause of rosacea has grown exponentially over the years, rosacea is an idiopathic disease.  According to Michael Detmar, M.D., in 2003, only one paper was published for every 144,000 rosacea patients in the United States, compared to a 1-to-11 ratio for melanoma and 1 to 4,900 for psoriasis. [4] This indicates how rosacea research is compared to other idiopathic skin diseases that have a more devastating impact on sufferers. If you had to choose one of these three diseases as a consequence which one would you choose?  Comparing rosacea to melanoma or psoriasis does put rosacea into perspective when it comes to suffering.   So any papers published about rosacea is indeed something to be grateful for. With the increase of spending on pharmaceutical treatments for rosacea comes more research spending. The NRS and AARS, being sponsored by pharmaceutical companies, have engaged in most of the rosacea research.  Dr. Kligman mentions the 'indifference of the National Institutes of Health, which with an annual budget of nearly 30 billion dollars, has not seen fit to fund a single grant for the investigation of rosacea.' Dr. Kligman also says that most research done on rosacea is by the skin industry which is 'voluminous literature, mainly focused on treatments sponsored by commercial interests; perhaps not the most credible source of unbiased research.' ” A Personal Critique on the State of Knowledge of Rosacea, Albert M. Kligman, M.D., Ph.D.
      Department of Dermatology, University of Pennsylvania, Philadelphia, PA, U.S.A.
      publikation_kligman.pdf If rosaceans want to sponsor their own novel rosacea research, they would need to be united, have a volunteer spirit, and use the RRDi to sponsor their own research. Put that into perspective.  End Notes [1] how many diseases are there? [2] The German pharmaceutical publication Statistics ’97 [3] Idiopathic Disease, Wikipedia [4] Rosacea: turning all stones for source of pathology Rebecca Bryant, Dermatology Times, Jun 1, 2004
    • Related Articles Advanced oxidation protein products and serum total oxidant/antioxidant status levels in rosacea. Postepy Dermatol Alergol. 2018 Jun;35(3):304-308 Authors: Erdogan HK, Bulur I, Kocaturk E, Saracoglu ZN, Alatas O, Bilgin M Abstract
      Introduction: Rosacea is a chronic, inflammatory dermatosis which develops due to the effect of genetic and environmental factors.
      Aim: To evaluate the oxidative stress in rosacea patients by measuring serum total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI) and advanced oxidation protein products (AOPP) levels in our study.
      Material and methods: Our study included rosacea patients and healthy volunteers aged between 18 and 65 years. Total antioxidant status, TOS and AOPP levels were measured and OSI was calculated.
      Results: The study included 70 rosacea patients and 30 healthy volunteers as a control group. When TAS, TOS, OSI and AOPP levels were compared between rosacea and control groups, there was no difference for OSI levels; while TAS, TOS and AOPP levels were significantly higher in the rosacea group (p = 0.151, p = 0.013, p = 0.034, p = 0.017, respectively). In the rosacea group, there was no correlation between TAS, TOS, OSI and AOPP levels and disease duration. Besides there was no difference between family history, rosacea type, symptom frequency and ocular involvement and TAS, TOS, OSI and AOPP levels in the rosacea group.
      Conclusions: We observed that serum TAS, TOS and AOPP levels were significantly higher in rosacea patients, but there was no significant difference among the disease activity parameters. These results can support the role of oxidative stress in the pathogenesis of rosacea.
      PMID: 30008650 [PubMed] {url} = URL to article
    • image courtesy of Espiritu Salon and Spa There are now spa treatments using cryotherapy. Will this work for rosacea? Cryotherapy has been used to treat phenotype 5. Will it improve any other phenotype? Time will tell since without a doubt we will be receiving reports whether any other phenotype is improved with cryotherapy.  There is a history of using cryotherapy for rosacea going back to an article published in 1948:  "Despite the fact that cold may be an aetiological factor in rosacea (Haxthausen, 1930, Lortat- Jacob and Solente, 1930, Sequeira, Ingram, and Brain, 1947), cryotherapy is the most valuable ancillary method of treatment......In U.S.A., Bluefarb (I945) and Hume (I948) recommended that powdered sulphur should be mixed with the slush. Solente (I925) pointed out that its value in rosacea was due to the ultimate diminution, in calibre of the local blood-vessels in the dermis. This is the accepted mechanism of its action but Lortat-Jacob and Solente (I930) claim that there is an additional reflex action via the sympathetic. Some workers, such as Vieira (1947) use the snow only to destroy the small, easily visible, dilated, superficial vessels. This is the only purpose for which a snow stick may be better than slush.... ...Shortly after treatment the skin becomes bright red and remains unsightly for a few hours. This is accompanied by a mild feeling of burning (the actual application of the slush is more painful), which may be relieved by fuller's earth, talcum, or face powder. By next day all sign of the immediate efects of treatment should have gone but there may be some blistering especially after the first treatment when the sensitivity of the skin - is not known. There is less likelihood of blistering after subsequent applications. The total length of treatment is variable and must be judged separately for each patient; four to eight sessions are usual. The treatment nearly always leads gradually to much improvement. Each week the skin can be seen to be paler with fewer obvious dilated vessels and less thickening. Complete cure is less common. It is essential to remember that cryotherapy is only a part of the treatment." CRYOTHERAPY FOR ROSACEA
      By E. LIPMAN COHEN, M.A., M.B., B.CHIR.(Cantab.) London
      Postgraduate Medical Journal, December 1948 p 656-659
      image courtesy of Cryo.com.au The Cryo.com.au website uses LED with cryotherapy and states, "CRYO LED uses two wavelengths of light that are Food & Drug Administration (FDA) approved to promote collagen and elastin production, helping to reduce wrinkles and tighten skin. This process feeds cells with wavelengths of light that they convert to the fuel source ATP that promotes cell reproduction and renewal. An increase in local blood circulation helps to flush toxins from the dermal layers of the skin. CRYOTHERAPY AND CRYO LED not only improves your appearance but the experience will make you feel fantastic." So if you try cryotherapy for your rosacea, please post your results in this thread. There are a number of reviews you can read concerning cryotherapy at cryo.com.au. 
    • Take the $500 Microablation and Triphasic Combination Facial at Cornelia Day Spa in New York City. Aestheticians wave an electromagnetic wand over the skin to stimulate collagen, minimize lines, reduce acne and ease chronic irritation (like eczema or rosacea). They then use a triphasic resonator that relies on heat, vibration and therapeutic electrical force to contour and sculpt the face.  World's Most Expensive Spa Treatments
      By Lauren Sherman, Forbes  
    • Related Articles Drugs and Lactation Database (LactMed) Book. 2006 Authors: Abstract
      Limited information indicates that maternal use of brimonidine 0.2% ophthalmic drops do not adversely affect their nursing infants. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue. Topical brimonidine gel used to treat rosacea has not been studied during breastfeeding. It is unlikely that the topical gel would affect the breastfed infant, but the manufacturer states that it should not be used during nursing. Until more data are available, an alternative topical agent might be preferred

      PMID: 30000738 {url} = URL to article
    • Related Articles Relationship between Helicobacter pylori and Rosacea: review and discussion. BMC Infect Dis. 2018 Jul 11;18(1):318 Authors: Yang X Abstract
      BACKGROUND: Rosacea is an inflammatory disease affecting the central part of face characterized by persistent or recurrent episodes of erythema, papules, pustules and telangiectasias of unknown etiology. Helicobacter pylori (H. pylori) is a gram-negative bacillus, which is one of the main causes of chronic gastritis, gastric cancer and gastrointestinal ulcers. Recent evidences have suggested that H. pylori infection is closely related to the occurrence of diseases. In recent years, studies have found that Helicobacter pylori infection is associated with the occurrence of acne rosacea. So the treatment of Helicobacter pylori infection may be a therapeutic method of acne rosacea. But it continues to be controversial. In other studies, the treatment of Helicobacter pylori did not significantly reduce the severity of acne rosacea. To further explore the association between acne rosacea and Helicobacter pylori infection, a summarize method was used to study the relationship between acne rosacea and Helicobacter pylori, providing reference for clinical acne rosacea therapy.
      METHODS: Systematic searches were conducted on Wanfang Data, CQVIP, Springer, Public Health Management Corporation (PHMC), CNKI, and Pubmed, from January 1,2008 to Mar. 1, 2018, using Helicobacter pylori and rosacea to retrieve the literature. Depending on the inclusion and exclusion criteria, 27 articles considered or confirmed the correlation between H. pylori and rosacea.
      RESULTS: Epidemiological investigations and experiments have confirmed that H. pylori infection is associated with the development of rosacea. The effect of anti-H. pylori therapy is better than the routine therapy for rosacea. H. pylori can stimulate the immune system to produce a large number of inflammatory mediators, leading to the occurrence and aggravation of rosacea inflammation.
      CONCLUSIONS: It is confirmed that H. pylori infection is involved in the development of rosacea. It is suggested that rosacea patients should be tested for H. pylori infection, the H. pylori-positive rosacea patients should be treated with eradication of H. pylori, so as to enhance the therapeutic effect of rosacea. This study adds that H. pylori infection is involved in the development of rosacea. Epidemiological investigations and experiments have confirmed the rationality. The effect of anti-H. pylori therapy is better than the routine therapy for rosacea. H. pylori-positive rosacea patients should be treated with the therapeutic method of eradication of H. pylori.
      PMID: 29996790 [PubMed - in process] {url} = URL to article
    • AARS 2017 Form 990 Review 2017-Form-990.pdf Total Contributions from public support (99.33%) in the amount of $309,032.
      Total Expenses were $440,381.
      At the end of the 2017 the AARS has 'unrestricted net assets' totaling $374,176. The AARS spent most of its expenses on 'ANNUAL AND MID-YEAR MEETINGS' for its members in the amount of $261,451. The second highest expense was for 'MENTORSHIP AND CLINICAL RESEARCH GRANTS' in the amount of $109,840. Of these grants three were for ACNE and one was for "bioinformatics analysis of acne and rosacea transcriptomes" by Rivka C. Stone, MD, PhD. One quarter of the research grant money ($26,460) was spent on 'acne and rosacea' so half of that would be $13,730*. So technically of the total donations received that was spent on rosacea research was 4.4%. That means for every dollar donated to the AARS 4 cents was spent on rosacea research, 31 cents spent on acne, 84 cents spent on 'annual and mid-year meetings, and the AARS spent more money than was received drawing on their net assets to accomplish this. The AARS still has a lot of money left in their net assets at the end of the year to draw on for 2018 expenses.  You can view the published papers of the grant recipients on its web site to confirm that three grants were for acne and only one grant mentions rosacea.  The board of directors received no money and there are no private contractor expenses. So while the AARS did spend more money on acne research (and little for rosacea) than last year which more than doubled 2016's research grants, the same pattern of spending the vast majority on meetings for the AARS professional members seems to be what the priority is when spending the donations of this non profit.  *Of the four research grants, three were for acne research and only one was for 'acne and rosacea.' So half of $26,460 is $13,730 which is technically what was spent on 'rosacea' research. It only figures that acne would get primary attention since the name of the organization is 'Acne and Rosacea' and what comes first? Obviously by the way the AARS spends its money on research grants rosacea is considered second. Of course, we have no way of knowing how the total amount ($109,840) was distributed to the recipients of the grant money since the AARS isn't saying how much each one received, so all we can do is divide by four ($26,460).
    • I began using the Lutein/Zeazanthin treatment for about three months and recommend you try it. I really do think it helps rosacea. I take 40 mg/Lutein, this one. 
    • "They hope their findings will eventually lead to the development of a potent, broad-spectrum anti-inflammatory therapeutic." Natural Lipid Acts as Potent Anti-Inflammatory
      NIH Scientists See Therapeutic Potential Against Bacteria, Viruses
      July 6, 2018
      National Institutes of Health
    • This long-term study demonstrated sustained safety, tolerability, and efficacy of oxymetazoline for moderate-to-severe persistent erythema of rosacea. J Am Acad Dermatol. 2018 Jun;78(6):1156-1163. doi: 10.1016/j.jaad.2018.01.027. Epub 2018 Jan 31.
      Efficacy and safety of oxymetazoline cream 1.0% for treatment of persistent facial erythema associated with rosacea: Findings from the 52-week open label REVEAL trial.
      Draelos ZD, Gold MH, Weiss RA, Baumann L, Grekin SK, Robinson DM, Kempers SE, Alvandi N, Weng E, Berk DR, Ahluwalia G. David Pascoe has some comments about the above trial results at this post. 
    • "RHOFADE should be used with caution in patients with severe or unstable or uncontrolled cardiovascular disease, orthostatic hypotension, and/or uncontrolled hypertension/hypotension." [1] "As the 5-HT2B receptor is potentially involved in drug-induced valvulopathy, the benefit/risk ratio should be carefully considered, especially in patients with cardiovascular disease or other comorbidities." [2] "Alpha-adrenergic agonists as a class may impact blood pressure. Advise patients with cardiovascular disease, orthostatic hypotension, and/or uncontrolled hypertension or hypotension to seek medical care if their condition worsens. (5.1)
       Usewithcautioninpatientswithcerebralorcoronary insufficiency, Raynaud’s phenomenon, thromboangiitis obliterans, scleroderma, or Sjögren’s syndrome and advise patients to seek medical care if signs and symptoms of potentiation of vascular insufficiency develop. (5.2)
       Advisepatientstoseekimmediatemedicalcareifsignsand symptoms of acute narrow-angle glaucoma develop. (5.3)" [3] End Notes
      [1] Once-Daily Treatment Reduces Persistent Facial Erythema (Redness) Associated With Rosacea Through 12 Hours, Allergan, 01.19.2017 | Investors [2] Drugs in R&D, March 2018, Volume 18, Issue 1, pp 87–90 
      In Vitro Safety Pharmacology Profiling of Topical α-Adrenergic Agonist Treatments for Erythema of Rosacea
      David Piwnica, Atul Pathak, Gregor Schäfer. James R. Docherty [3] Allergan Prescribing Information for Rhofade
    • Posted this to in inquiry by mickwayne on July 2018 at RF posts no 5 and 7 which I thought would be interesting for any RRDi members who may not be reading posts at RF and might read it here:   Originally Posted by mickwayne  ...goes to "irosaceaa.org/register" URL instead of "irosacea.org" URL.
      I also have a question, Brady. Do we ever do any cold calling or events to raise money for rosacea, or specifically for the RRDi or the NRS?
      Maybe we could even post DONATE buttons on our articles about rosacea so that people could donate.  
      I would love to help with this as it would be a great way to essentially volunteer for what might help be close to a cure one day...or at least more improvement 😛 MY REPLY:  There are rosaceans who donate to the NRS, such as the owner of this forum, David Pascoe, who was instrumental in donating $16K to the NRS. Without a doubt rosaceans prefer the NRS. The NRS is founded and run by non rosacea sufferers. What does the NRS spend most of its donations on? I have been following for a long time. Since 1998 through 2016 the NRS has received in donations $13,898,646. The majority (60%) of the donations are spent on two private contractors (two corporations) that are owned by the founder and director of the NRS, Sam Huff. About 10% of the donations are spent on rosacea research which amounts to $1,403,031 (which is significant since the NRS spends more on rosacea research than any other organization). However, to put this in terms you can understand, for every dollar donated to the NRS 60 cents is spent on two private corporations owned by Sam Huff. Ten cents is spent on rosacea research. The remaining 30 cents is spent on everything else. Here is the data; you can do the math yourself if you prefer. 

      However, the RRDi was formed completely separately from the NRS and is founded and run by rosacea sufferers. The RRDi has tried to get corporate sponsors like the NRS has done but all the pharmaceutical companies, i.e., Galderma, Allergan, Bayer, Cutanea, Beiersdorf, colorscience, prefer to donate to the NRS. Rosaceans rarely donate to the RRDi. If you want to change this volunteer. Volunteering is not something most rosaceans want to do. They prefer how the NRS is spending the money. I have tried to gather together rosaceans into a non profit organization but the members don't post, they don't volunteer, nor do they donate. If you want to help, join the RRDi and volunteer. Sure could use the help. You can donate by clicking here. By the way, it is gracious on David Pascoe's part to let me post these words in his forum. Mucho Mahalo to David Pascoe. RF happens to be the most active rosacea forum. I have posted more posts in RF than in the RRDi because very few if any RRDi members post in the RRDi member forum. Weird, isn't it?
    • In inquiry on the status of Perrigo's generic ivermectin cream provided a response from Bradley Joseph, VP, Global Investor Relations and Corporate Communications, Perrigo Company, who wrote, "No change in the status of this product.  We will announce via press release the launch of this product.  Thanks." 
    • DemoDerm is the the cosmetic version of the Zhongzhou ointment rebranded as DEMODERM and is available in Germany with more European countries as The Netherlands, Austria and Slovenia will follow soon. Here is a translation of the ingredients from the website:  Ingredients:
      Aqua, Stearyl alcohol, Propylene glycol, Glycerol, Stearic acid, Zinc oxide, Sulfur, Isopropyl myristate, Petrolatum, Glyceryl stearate, Dimethicone, Menthol, Sorbitan stearate, Polysorbate 80, Wheat germ oil, Azone, Salicylic acid, Sodium lauryl sulfate , Active ingredients: zinc and sulfur DemoDerm is manufactured in China and tested in Germany. The cream contains no additives such as antibiotics or hormones.

      DemoDerm is available in pharmacies and can be ordered either with the PZN 10974861 or with the PPN 111097486112. Non-binding selling price: 44.95 €  For those who may want to order there are web sites to choose from:  Demoderm Official Website You can buy DemoDerm online at the general importer Agenki GmbH with attractive price scale from 36.95 € *. Please click the following link to order the cream: www.agenki.de Also on Amazon you can buy the cream. The price is € 46.95 * with free delivery. Please click the following link to buy DemoDerm on Amazon: www.amazon.de Here is a comparison of the Zhongzhou ingredient list with the DemoDerm ingredient list:  Zhongzhou DemoDerm Zinc oxide 7.1% Zinc oxide Sulfur Sublimate 7.1% Sulfur Mint (Herba menthae) 2% Menthol Boric acid 2%   Salicylic Acid 0.5% Salicylic acid Dimethiconum Composite Dimethicone Java Brucea     Azone   Glycerol   Glyceryl stearate   Isopropyl myristate   Petrolatum       Propylene glycol   Polysorbate 80   Sodium lauryl Sulfate   Sorbitan stearate   Stearyl alcohol   Stearic acid   Wheat germ oil The RRDi has no affiliate relationship with any of the links above and has graciously provided these links to help those in Europe to be able to order DemoDerm in the spirit of helping anyone find a way to control their rosacea. Please post in this thread if you have success in using DemoDerm. Mahalo. 
    • Related Articles Energy-Based Devices in Male Skin Rejuvenation. Dermatol Clin. 2018 Jan;36(1):21-28 Authors: Juhász M, Marmur E Abstract
      Men seek cosmetic procedures for vastly different reasons than women. Men often seek discrete cosmetic services with little downtime. Male skin structure generally differs from female skin structure. Dermatologists should consider subtle differences in the psyche of the male cosmetic patient.
      PMID: 29108542 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Epsolay, aka, VERED, S5G4T-1 and DER 45 EV, has reached Phase III clinical trial status according to Drug Development Technology. Epsolay is developed and promoted by Sol-Gel Technologies as "an innovative topical encapsulated benzoyl peroxide cream with a 5% concentration for the treatment of papulopustular rosacea."  Epsolay is designed for those who suffer from Phenotype 4.  Usually benzoyl peroxide exacerbates rosacea, but Epsolay is a "silica-based microencapsulation delivery system creates a silica barrier between benzoyl peroxide crystals and the skin, and as a result is expected to reduce irritation typically associated with topical application of benzoyl peroxide, thereby making the drug tolerable to rosacea-affected skin." [1] In a press release, June 18, 2018, Dr. Alon Seri-Levy, Chief Executive Officer of Sol-Gel, states, “Epsolay is aimed to address the need for more effective treatments for inflammatory papules and pustules of rosacea, a chronic condition for which patients often have low adherence to current drugs.”
      Sol-Gel Technologies Ltd., Israel  As more information is released it will be posted in this thread. If you are a member you can use the 'Notify me of replies' button near the bottom of this post and turn it on for any updates.  End Notes [1] Sol-Gel > Pipeline > VERED 
    • Hi Alexander,  Welcome to the RRDi. Practitioners are welcome as is evident from our list of MAC members. If members are interested in your service, they now are aware of it.  "Belief in such divine intervention is based on religious belief rather than empirical evidence that faith healing achieves an evidence-based outcome." Faith Healing, Wikipedia Do you suffer from rosacea and have a diagnosis of rosacea from a physician?  See rules no 4 and 5.  Admin 
    • Healing Erysipelas It’s well-known that since the beginning of time the most effective remedy for erysipelas has been faith healing by village women healers (we call them babka or elderly ladies). My personal experience fully proves the fact above as for fifty years of faith healing my own hands have cured dozens of erysipelas, and each case was a visual demonstration of quick and successful healing. I have always told my pupils that curing primary erysipelas is a healer skills assessment test. I have mostly healed villagers who perfectly know what to do in case of first attacks of erysipelas. Due to some reasons there are more cases of erysipelas in the villages than in the cities, and villagers know well that they should immediately ask a village woman healer (or babka) for help. Since I have been the principal woman healer in the village for over dozens of years, they have usually addressed me and I have never disappointed them. If timely treated, primary erysipelas is easily cured for one or two sessions of faith healing. The third session can be done as a confirming one. To mention, I have never seen any recurrence of erysipelas in patients who were treated with faith healing method. The situation is completely different in case of recurrent erysipelas. The easy and quick victory over the disease is not to be expected in that case. Pain relief, reducing redness and swelling occur even after the first session of faith healing. However, the signs above are not the recovery itself. The disease is likely to recur unless faith healing together with preparing healing water is continued for quite a prolonged period of time. In contrast to wide application of antibiotics, faith healing has neither contraindications nor side-effects. I have encountered four cases of erysipelas for this half a year. Two of them were primary ones, one of them was bullous and the other one was inveterate, recurring for over five years. There were no difficulties in healing the primary erysipelas while it took more than a month to cure the bullous one. I did faith healing once a week and later I did three sessions more, once a month each. Those sessions were a kind of preventive measure as the area which used to be affected with erysipelas was absolutely clean. As for the recurrent erysipelas, I had to spend more time on it, and even now it is still under my care. I occasionally do faith healing sessions and their results are quite good. City inhabitants start realizing the real danger of the disease only when it becomes serious and recurrent. Failing to follow doctor’s orders and switching to experiments with, to put it mildly, a wide range of incorrect home remedies including but not limited to red cloth or pounded brick can significantly aggravate the disease. Only then does the patient realize that erysipelas is a very serious disease. Improperly treated, it can result into patient’s disability, especially in case if he or she suffers from thrombophlebitis, diabetes, and many others. Erysipelas is extremely dangerous for newborns and infants. So, I would like pediatricians and children’s relatives to take this article seriously. In case of any skin problems, first, you should address a very good doctor to diagnose erysipelas. You cannot make an accurate diagnosis by yourself as primary manifestations of erysipelas are very similar to those of other skin diseases while methods of their treatment are different. After erysipelas has been diagnosed, you must follow all doctor’s orders. If you have done everything that way but the result of treatment is not satisfactory enough, which can happen very often, it’s up to you to choose whether or not to experiment with different kinds of home remedies. I wouldn’t criticize any methods of treating erysipelas. However, the most reliable one is to find a powerful woman healer or an intercessor who practices the method of Slavic village faith healing. The latter is, without doubt, the most effective in healing erysipelas. If you have not found a good village woman healer or an intercessor, I am ready to give you the contacts of my pupils working in Odessa, Kiev, Dnieper, Sumy, Poltava, Kherson, Simferopol and other cities who are highly likely to cope with this unpleasant disease. However, I would like to emphasize that healing erysipelas of any degree of complexity should be done only under the care of a highly experienced doctor. It is particularly the case when edema and lymphedema occur, and if erysipelas results from all kinds of disorders of blood vessels. Treating erysipelas requires both healer’s efforts and application of medicines and medical procedures. In case you did not manage to find a healer or an intercessor within your reach or due to some circumstances including your poor health you cannot travel at long distances to address a healer, you can still get the help you need. You can master the faith healing method after reading a book My Job is a Healer. There you can find a detailed description of this great method which is a real historical heritage of our Slavic nation. Using this method, you will be able not only to win the disease by yourself or, what is better, with the assistance of your nearest and dearest person but also you will feel God’s help in all His Majesty. I wish you good health and success in your fighting the disease!   By Alexander Novikov, the healer.   For more information, please visit: http://iscelenie-molitvoj.com/eng/mindexe.html If you have any further questions, feel free to contact Alexander Novikov e-mail: healerprayer@gmail.com
    • Related Articles Prescription to Over-the-Counter Switch of Metronidazole and Azelaic Acid for Treatment of Rosacea. JAMA Dermatol. 2018 Jul 03;: Authors: McGee JS, Wilkin JK PMID: 29971432 [PubMed - as supplied by publisher] {url} = URL to article
    • Effects of Initiation Time of Glycemic Control on Skin Collagen Recovery in Streptozotocin-Induced Diabetic Rats. Dermatology. 2018 Jul 04;:1-9 Authors: Suh Y, Moon J, Yoon JY, Kim SW, Choi YS Abstract
      BACKGROUND: Diabetes damages the collagen in the skin. No study has investigated the relationship between the treatment initiation time and the degree of collagen recovery. This study aimed to evaluate the effects of the initiation time of glycemic control on collagen recovery and to determine the basic molecules mediating the process.
      METHODS: Streptozotocin-induced diabetic rats were divided into five groups: normal controls (C), those with untreated diabetes (DM), and those with diabetes treated with daily insulin injections from 7 weeks (7W), 10 weeks (10W), and 13 weeks (13W) after diabetes induction. The levels of collagen and several molecules were compared among skin tissues collected at 14 weeks.
      RESULTS: The amounts of total collagen, collagen 1, and collagen 3 were significantly lower in DM than in C. Among the treated groups, recovery reaching normal levels was only observed in 7W and 10W. The earlier the treatment began, the greater was the collagen recovery. Similar to that of collagen, the expression of transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF), and insulin-like growth factor 1 receptor (IGF-1R) significantly decreased in DM compared with that in C. Higher recovery of TGF-β1 and VEGF was detected in groups with earlier treatment, whereas the IGF-1R level was identically elevated in all treated groups. The results suggest that these molecules affect collagen recovery at different time points during glycemic control.
      CONCLUSION: The initiation time of glycemic control is expected to have a considerable effect on collagen recovery in the diabetic skin through modulation of TGF-β1, VEGF, and IGF-1R.
      PMID: 29972827 [PubMed - as supplied by publisher] {url} = URL to article
    • STING crystal structure created by PDB protein workshop rendering PDB: 4EMU
      Wikipedia There is a theory that rosacea is a disorder of the innate immune system. In a recent article published In Nature, Targeting STING with covalent small-molecule inhibitors, [1] scientists at the Ecole Polytechnique Fédérale de Lausanne [EPFL] have discovered two small-molecule compound series that can effectively block a central pathway of the innate immune system. "STING plays an important role in innate immunity." [2] "To find out the compounds' mechanism of action, the researchers painstakingly mutated several of the amino acids that make up STING in order to find out which ones are targeted by the compounds. Doing so, the scientists identified a conserved transmembrane cysteine, which binds to the compounds irreversibly. As a consequence of this interaction, this particular cysteine residue can no longer undergo palmitoylation - a post-translational modification that attaches a fatty acid (palmitic acid) to STING." [3] Andrea Ablasser, Assistant Professor at EPFL, explains, "“Our work uncovered an unexpected mechanism to target STING and provided the first proof-of-concept that anti-STING therapies are efficacious in autoinflammatory disease. Beyond specific monogenic autoinflammatory syndromes, the innate immune system is implicated in even broader ‘inflammatory’ conditions, so we are excited to learn more about the role of STING in human diseases.” [4] The Nature article concludes, "In summary, our work uncovers a mechanism by which STING can be inhibited pharmacologically and demonstrates the potential of therapies that target STING for the treatment of autoinflammatory disease." [1] This may hold some hope for an 'Anti-STING Therapy for Rosacea."  End Notes [1] Nature, Letter, Published: 04 July 2018
      Targeting STING with covalent small-molecule inhibitors
      Simone M. Haag, Muhammet F. Gulen, Luc Reymond, Antoine Gibelin, Laurence Abrami, Alexiane Decout, Michael Heymann, F. Gisou van der Goot, Gerardo Turcatti, Rayk Behrendt & Andrea Ablasser  [2] Stimulator of interferon genes (STING), Wikipedia [3] New small molecules offer promising new way to treat autoinflammatory diseases, News Medical, Life Sciences, July 4, 2018 [4] New small molecules for the treatment of autoinflammatory diseases, EPFL News, July 4. 2018
    • "Rifaximin, sold under the trade name Xifaxan among others, is an antibiotic used to treat traveler's diarrhea, irritable bowel syndrome, and hepatic encephalopathy." Wikipedia  "Of the patients with SIBO, 28 were treated with rifaximin: 46% reported cleared or markedly improved rosacea, 25% reported moderately improved rosacea, and 11% reported mildly improved rosacea. All 4 patients with ocular rosacea and SIBO reported marked improvement. Rosacea was unchanged in 18% of patients.." [1]  For more information.  End Notes [1] Journal of the American Academy of Dermatology
      Volume 68, Issue 5, Pages 875–876, May 2013
      Rosacea and small intestinal bacterial overgrowth: Prevalence and response to rifaximin
      Leonard B. Weinstock, MD, Martin Steinhoff, MD, PhD
    • Abstract
      Rosacea affects many individuals and is commonly treated with long-term antibiotics, which are associated with the emergence of antibiotic-resistant organisms. Recently, subantimicrobial dose doxycycline 20 mg twice a day (SDD) has been used to treat rosacea because of its anti-inflammatory properties. Results of clinical studies support the benefits of SDD, its efficacy in rosacea and acne vulgaris, and even its potential use to prevent atherosclerosis. Cutis. 2005 Apr;75(4 Suppl):19-24.
      Subantimicrobial dose doxycycline: a unique treatment for rosacea.
      Berman B, Zell D.
    • "A 50-patient, open-label experience trial with SD doxycycline in the treatment of rosacea also provided evidence of the utility of the drug. The use of SD doxycycline can potentially avoid the adverse events of standard-dose, long-term therapy with tetracyclines for acne and thereby enhance patient compliance. In addition, widespread adoption of this dosage as part of a maintenance therapy for acne and rosacea will limit exposure of patients and their microflora to doxycycline and may slow the steadily increasing rate of resistance of P. acnes and other organisms to the tetracyclines." Subantimicrobial Dose Doxycycline for Acne and Rosacea
      Joseph B. Bikowski, MD
      Skinmed. 2003;2(4), Medscape
    • In an article, 100mg a day of Doxycycline is no better than Oracea, by David Pascoe, Rosacea Support, it points out, "If Oracea is too costly to be a part of your rosacea regime, you should consider 50mg a day of generic doxycycline. This is likely to be a much cheaper alternative but also offer the same benefits as oracea. [sic]" This point is valid. It may be possible that taking 50 mg/day of doxycycline is just as effective as Oracea. Another article by David Pascoe asks this question, "Is Oracea different to 50mg a day of Doxycycline?" Basically the only difference is that Oracea is 40 mg and has some timed release doxycycline and generic doxycycline doesn't have any time release properties.  Any further validation of this point will be placed in this thread. 
    • "Minocycline 100 mg is noninferior to doxycycline 40 mg in efficacy over a 16- week treatment period." Br J Dermatol. 2017 Jun;176(6):1465-1474. doi: 10.1111/bjd.15155. Epub 2017 May 8.
      DOMINO, doxycycline 40 mg vs. minocycline 100 mg in the treatment of rosacea: a randomized, single-blinded, noninferiority trial, comparing efficacy and safety.
      van der Linden MMD, van Ratingen AR, van Rappard DC, Nieuwenburg SA, Spuls PI.
    • Related Articles Rosacea-like demodicosis and papulopustular rosacea may be two phenotypes of the same disease, and pityriasis folliculorum may be their precursor. Response to the comment of Tatu. J Eur Acad Dermatol Venereol. 2018 Jul 01;: Authors: Forton F, De Maertelaer V Abstract
      We thank Tatu et al for their comment1 on our recent article2 in which they agree with the idea that rosacea-like demodicosis (RLD) and papulopustular rosacea (PPR) may be two phenotypes of the same disease. Tatu et al raise the question of the potential role of some of the numerous species of bacteria3 inadvertently ingested by Demodex that could potentially influence its behaviour.1 We did not explore this interesting hypothesis in our study but agree that this and other types of interactions, such as those of Staphylococcus epidermidis,4 are important areas for future study. This article is protected by copyright. All rights reserved.
      PMID: 29961950 [PubMed - as supplied by publisher] {url} = URL to article
    • The controversy of obtaining nutrients from supplements rather than from healthy food is widely discussed. The overall consensus is that eating natural, organic, healthy food to obtain nutrients is preferred over supplemental nutrition. However, even all the experts say there are exceptions.  For example, in an article published by the Harvard Health Letter, discussing this controversy says, "The evidence about the benefits of multivitamins is mixed." [1] The consensus is that eating a healthy diet is the best way to obtain nutrients. The counter argument is that if one is suffering from a disease, whether age related or not, is it possible that nutrient supplements may improve or at the very least assist in improving the disease? The overall consensus to this question is yes. For example, what if an individual is on a long trip and has no access to fruit with vitamin C? Yes, eating limes or lemons is preferred, but obviously taking Ascorbic Acid at the very least would help prevent scurvy from developing.  Consumer Lab answers the controversy with nutrients from supplements by stating, "It is generally best to get your vitamins (as well as minerals) naturally from foods or, in the case of vitamin D, controlled sun exposure.," but qualifies this with some examples of how nutrient supplements actually do help, i.e., "two B vitamins," then discusses the controversy of synthetic vs natural supplements concluding, "Sometimes synthetic forms of vitamins offer advantages over natural forms." The Mayo Clinic in an article under 'Nutrition and healthy eating' writes, "Supplements aren't for everyone, but older adults and others may benefit from specific supplements." [2] This underscores the point that since rosacea often develops in older individuals that possibly something in the diet is either contributing to the development of rosacea or something, i.e., a nutrient, is lacking in the diet?  The article continues that nutrients may be recommended in certain women and in individuals 50 years and older. [2] Time magazine wrote on this subject and concluded, "Most experts say that if you’re eating a healthy diet and don’t have an underlying health conditions that interferes with your body’s ability to absorb nutrients from your food, you generally shouldn’t need to take supplements. The same vitamins and minerals are often available in food." [3] Again, if you "don’t have an underlying health conditions" so if you have rosacea, is there a supplement that can improve your rosacea? The NY Times article on this subject had some insightful thoughts, such as, "Crops and animals will not grow properly if soil or feed is missing critical nutrients. Some nutrients are lost in shipment and storage and even more in processing, but generally not to the point that the food becomes nutritionally worthless. Far greater nutrient losses generally occur in kitchens than in food processing plants.....Considering the symptoms of marginal nutrient deficiencies - malaise, reduced appetite, sleepiness, insomnia, irritability and reduced attention span, among others - it's easy to see why so many people turn to supplements as a cure-all." [4] Scientific American has an article [5] discussing the difference between pill nutritional supplements vs nutrients in food stating, "Foods contain substances other than vitamins and minerals for good health. Fruits, vegetables and whole grains contain phytochemicals, or plant chemicals, that can help to fight the development and progression of many chronic diseases, including cancer." The article discusses the absorption value of pills vs food and states, "With only a few exceptions, the vitamins in pills are utilized and handled by the body just as efficiently, or more so, than the vitamin forms found in foods. Indeed, some of the vitamin forms (called vitamers) found in foods are less active and less easily converted into activated forms than the vitamers used in pills." [5] The Journal of Nutrition concluded, "Without enrichment and/or fortification and supplementation, many Americans did not achieve the recommended micronutrient intake levels set forth in the Dietary Reference Intake." [6] This is a strong indicator that supplemental nutrition is worthy of consideration. The article concludes, "Health professionals must be aware of the contribution that enrichment and/or fortification and dietary supplements make to the nutritional status of Americans." [6] Nutrition.gov has four Questions To Ask Before Taking Vitamin and Mineral Supplements.   Tanya Zuckerbrot, MS, RD, Fox News, points out, "Nutritional supplements can be helpful if: you don’t eat a balanced diet; you are a vegetarian or vegan; you are a woman who is pregnant or may become pregnant; or you are an adult over the age of 50. It is recommended that adults over the age of 50 take a supplement of B-12, either separately or in a multivitamin. Women who are pregnant should take iron supplements either separately or in a prenatal vitamin, and women who may become pregnant are advised to take 400 micrograms per day of folic acid." [7] The general consensus of health and nutritional experts agree with Ms Zuckerbrot's statement above. However, is the above the only times nutritional supplements are helpful?  Are there nutrients that rosacea sufferers are deficient in?  The answer to that question is the subject of another post.  End Notes [1] Should you get your nutrients from food or from supplements?, Harvard Health Letter, May 2015 [2] Supplements: Nutrition in a pill?, By Mayo Clinic Staff [3] Foods You Should Eat Instead of Taking Vitamins, By ALEXANDRA SIFFERLIN March 30, 2015, Time [4] FOR GOOD NUTRITION: BALANCED DIET VS. VITAMIN PILLS, By JANE E. BRODY, The New York Times, 1982 [5] Do vitamins in pills differ from those in food?, Scientific American, Christine Rosenbloom, Health [6] J Nutr. 2011 Oct;141(10):1847-54. doi: 10.3945/jn.111.142257. Epub 2011 Aug 24.
      Foods, fortificants, and supplements: Where do Americans get their nutrients?
      Fulgoni VL, Keast DR, Bailey RL, Dwyer J. [7] The Truth About Vitamin Supplements, Tanya Zuckerbrot, MS, RD, Fox News, FITNESS + WELL-BEING, 
    • Long-term effects of intense pulsed light treatment on the ocular surface in patients with rosacea-associated meibomian gland dysfunction. Cont Lens Anterior Eye. 2018 Jun 26;: Authors: Seo KY, Kang SM, Ha DY, Chin HS, Jung JW Abstract
      PURPOSE: We aimed to determine the long-term effects of intense pulsed light (IPL) treatment in rosacea-associated meibomian gland dysfunction (MGD).
      METHODS: We enrolled 17 rosacea subjects with moderate and severe MGD who underwent four IPL sessions at 3-week intervals and were followed up for 12 months. The subjects underwent clinical examinations at baseline (first IPL) and at 3 (second), 6 (third), 9 (fourth), and 12 weeks, as well as 6 and 12 months, after baseline. Ocular surface parameters, including the Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), staining score, and noninvasive Keratograph tear break-up time (NIKBUT), as well as meibomian gland parameters, including the lid margin vascularity and meibum expressibility and quality, were evaluated.
      RESULTS: All ocular surface and meibomian gland parameters for all subjects exhibited significant changes from baseline to the final examination (Friedman, P < 0.050 for all). In particular, improvements in the lower lid margin vascularity, meibum expressibility and quality, and ocular symptoms persisted up to the final examination (Wilcoxon, P < 0.050 for all). However, the improvements of TBUT, staining score, and NIKBUT after IPL were not maintained at 6 and 12 months after baseline.
      CONCLUSIONS: In rosacea-associated MGD, four IPL treatments at 3-week intervals can improve long-term lid parameters and ocular symptoms without adverse effects.
      PMID: 29958778 [PubMed - as supplied by publisher] {url} = URL to article
    • Rosacea-like demodicosis (but not primary demodicosis) and papulo pustular rosacea may be two phenotypes of the same disease-a microbioma,therapeutic and diagnostic tools perspective. J Eur Acad Dermatol Venereol. 2018 Jun 29;: Authors: Tatu AL, Clatici VG, Nwabudike LC Abstract
      The scope of their research appears to be limited to the effects of Demodex spp in rosacea and thus does not consider possible confounding factors such as the effects of Bacillus oleronius, which has been isolated from Demodex folliculorum and been identified as a trigger of inflammation in rosacea(2). Other endosymbionts described as related to Demodex are:I.Bacillus simplex, which was isolated from Demodex folliculorum in a patient with primary demodicosis(3) II. Bacillus pumilus positive culture and mass spectrometry were found in a patient with rosacea and D. Folliculorum(4)III.Bacillus cereus, instead of B. oleronius was identified in a patient with secondary demodicosis associated with steroid-induced rosacea-like facial dermatitis in one positive culture.(5) Would they care to comment on this? This article is protected by copyright. All rights reserved.
      PMID: 29959784 [PubMed - as supplied by publisher] {url} = URL to article
    • As with every treatment for rosacea there are risks and benefits, aka, the Risk-Benefit Ratio, taught to every medical student. You, the patient, have the right to know what the benefits of any treatment are, as well as the risks. When you agree to accept IPL/Laser/LED for your skin issues, you without a doubt sign a written agreement which mentions that you were informed of the risks. While the majority of reports of using any photo dynamic therapy [PDL], aka, broadband therapy, for rosacea are positive, since if it didn't work there wouldn't be doctors purchasing these expensive PDL equipment for their offices, most of these reports are from the doctors' patients which are posted on their websites and by the manufacturers of these devices. There are now a huge number of these devices that anyone can purchase ranging from under a hundred dollars to thousands of dollars. There are a minority of negative reports (tried to collect these in logical categories, i.e., IPL, LED, Laser, etc, mostly from RF which is as of this date more active than the RRDi forum). Of course, knowing how to operate these devices is a huge factor on the success of the treatment since you can obviously burn yourself or a technician can overcook you. While most of the reports in RF rave about PDL or broadband treatment, the facts are, (1) You have to go back for more treatment and usually this is expensive, (2) Repeated treatments may make your skin more sensitive, (3) Physicians who have purchased a certain broadband brand light device tend to bias toward the brand purchased, which is understandable, and mention its benefits for rosacea to their patients since they have an investment in the success of this device. (4) There are more positive than negative reports (you try to collect them as I have done and see what numbers you come up with; and while you are at it, try to get a number of rosaceans to come together and volunteer in a non profit organization that helps each other, and (5) Hair loss has been reported by some patients.
    • Related Articles Successful Treatment of Actinic Keratosis with Kanuka Honey. Case Rep Dermatol Med. 2018;2018:4628971 Authors: Mane S, Singer J, Corin A, Semprini A Abstract
      Actinic keratoses form as rough, scaly plaques on sun-exposed areas; they can be an important step in premalignant progression to squamous cell cancer of the skin. Currently, pharmacological treatments consist of topical immunomodulatory agents with poor side effect profiles. Use of honey has been common in both ancient and modern medicine, where it is now a key therapy in the management of wound healing. In vitro studies show the New Zealand native Kanuka honey to have immunomodulatory and antimitotic effects, with recent evidence suggesting efficacy of topical application in a variety of dermatological contexts, including rosacea and psoriasis. Here, we present a case report of a 66-year-old gentleman with an actinic keratosis on his hand, which had been present for years. Regular application of Kanuka honey over three months resulted in remission immediately following the treatment period with no signs of recurrence at nine months.
      PMID: 29955399 [PubMed] {url} = URL to article
    • Dear Madam, Thank you very much for taking the time to answer my questions. I am already a vistor of your web-site and your recommendations posted there(since a lady from Denmark named Tanja Eskildsen recommended to read your book). I will keep my eyes on your future career and web-site too. Thank you once again, All the best for your professional and personal life. Best regards from the other side of the Atlantic Ocean.
    • If you are taking Levothyroxine it has been reported to exacerbate rosacea.  Anecdotal Reports Celtigirl [post no 1] says, "I took levothyroxine for well over a year and it made my Rosacea 100 times worse." williamnation [post no 6] reports, "I have been taking levothyroxine 125 mcg/day and have the same problem." armabella [post no 1[ wrote, "After a year of taking the natural substitue, tests didn't look to good so she went back on the levothyroxine drug and this is when her Rosacea started." Eclara [post no 1] says, "I also recently switched from levothyroxine to Armour thyroid for my hypothyroidism, which I believe made a difference as well." CHILLYK reports, "I have an underactive thyroid, diagnosed about 4-5 yrs ago, now taking 150mcg Levothyroxine daily....In the last 2 weeks my cheeks have become redder and redder, my skin is burning and tingling....I am flushing a lot and my cheeks feel hot, I'm getting myself upset which is probably making things worse."
    • "Researchers from the University of Illinois at Chicago have identified a protein that is crucial for activating inflammation....Researchers led by Asrar Malik, Schweppe Family Distinguished Professor and head of pharmacology in the UIC College of Medicine, have now identified the channel, called TWIK2, and have studied its function in macrophages, a type of immune cell involved in fending off infections as well as clearing debris during inflammation. "Now that we have identified this crucial channel, it opens up the possibility of developing targeted new anti-inflammatory drugs to modify its function and help and reduce inflammation," said Malik. While some drugs currently exist that target potassium channels, drugs specific to the TWIK2 channel still need to be developed." [1] Key protein involved in triggering inflammation, University of Illinois at Chicago, Science Daily
    • Related Articles Successful treatment of erythematotelangiectatic rosacea with intense pulsed light: Report of 13 cases. J Dermatol. 2018 Jun 28;: Authors: Tsunoda K, Akasaka K, Akasaka T, Amano H Abstract
      Here, we describe the use of intense pulsed light (IPL) treatment for 13 cases of erythematotelangiectatic rosacea delivered in three sessions. For two-step irradiation, after the whole face had been irradiated using conventional IPL equipment covering a wide area, localized IPL spot irradiation was performed for visibly dilated capillaries. The therapeutic effect was evaluated by image analysis using Image J and scored by 10 dermatologists using two IPL instruments in combination. This therapeutic approach was found to be much more effective than irradiation using a single instrument. Our findings demonstrate that IPL irradiation using the present method can deliver a sufficient therapeutic effect even with a small number of treatment sessions. Although rosacea is difficult to treat, we believe that IPL can be therapeutically useful in such cases.
      PMID: 29952023 [PubMed - as supplied by publisher] {url} = URL to article
    • [Ophthalmic Rosacea: etiopathogenesis and modern treatment methods]. Vestn Oftalmol. 2018;134(3):121-128 Authors: Trufanov SV, Shakhbazyan NP Abstract
      Rosacea is a multifactorial chronic inflammatory disease with various clinical manifestations. Primarily it is seen as a dermatological condition, but it's not uncommon for it to develop ophthalmological implications affecting eyelids, cornea and conjunctiva. The article describes main aspects of its etiopathogenesis, variations in its clinical course and treatment approaches. There is currently no universal treatment strategy for the disease due to its varying clinical manifestation, particularly of its ophthalmological form, differing severity of the pathological process, lack of knowledge about its etiology and pathogenesis. Leading role in its pathological process belongs to disturbance of regulatory mechanisms of the vascular, immune and nervous systems. Additionally, higher levels of metalloproteinases and vascular endothelial growth factor (VEGF) can be observed. Possible influence of a range of micro-organisms also hasn't been excluded. Basic therapy involves both systemic and topical drugs. The first include tetracycline antibiotics. A new direction in Rosacea treatment that aims at structural and functional restoration of vascular endothelium, improvement of microcirculation and recovery of rheological properties of blood is angioprotector therapy, in particular with Calcium Dobesilate (Doxi-Hem). Aside from systemic drugs, the ophthalmological forms of Rosacea are treated topically with anti-inflammatory preparations, immunosuppressants and artificial tears that are chosen depending on the symptoms' severity. In cases with heavy corneal damage, various types of keratoplasty can be performed. Collaboration between ophthalmology and dermatology specialists is necessary in order to choose adequate strategy for Rosacea treatment.
      PMID: 29953092 [PubMed - in process] {url} = URL to article
    • Related Articles Diffuse Large B-cell Lymphoma Occurring with Rhinophyma: A Case Report. Cureus. 2018 Apr 25;10(4):e2536 Authors: Shatkin S, Shatkin M, Smith K, Beland LE, Oppenheimer AJ Abstract
      Rhinophyma is the final stage in the evolution of acne rosacea, a common vasoactive dermatosis. Individuals with rhinophyma present with a typical, disfiguring nasal appearance consisting of bulbous enlargement, erythema, and telangiectasia with a sebaceous, oily skin surface. This classic appearance permits a facile diagnosis but may also lead the physician to overlook a coexistent malignancy. We report the occurrence of a diffuse large B-cell lymphoma (DLBCL) arising synchronously with a marked rhinophyma. A wide local excision of the malignancy was performed, and the defect was reconstructed with forehead flaps. The rhinophyma was treated with a skin graft and cheek flaps. Following surgery, chemotherapy was used to manage the systemic disease. This case demonstrates the necessity for clinical scrutiny in the diagnosis and treatment of rhinophyma. It is imperative to entertain a high degree of suspicion when non-typical changes are observed within a rhinophymatous lesion or in adjacent areas of the nose.
      PMID: 29946504 [PubMed] {url} = URL to article
    • Dr. Robert Abel, Jr. explains why lutein is a safe supplement and how to best take it. Dr. Ray Sahelian talks about the benefits and side effects of the herbal supplement Lutein
    • "Lutein and zeaxanthin supplementation effectively whitens the skin and improves skin health attributes. There were no marked adverse effects." Advances in Nutrition, Volume 7, Issue 1, 1 January 2016, Pages 50A
      Skin-Whitening and Overall Skin Tone–Improving Effects of Oral Supplementation with Lutein and Zeaxanthin Isomers: A Randomized, Double-Blind, Placebo-Controlled Trial 
      Vijaya Juturu,  Alain Khaiat,  Jayant Deshpande
    • Related Articles Topical Ivermectin in the Treatment of Papulopustular Rosacea: A Systematic Review of Evidence and Clinical Guideline Recommendations. Dermatol Ther (Heidelb). 2018 Jun 25;: Authors: Ebbelaar CCF, Venema AW, Van Dijk MR Abstract
      INTRODUCTION: Rosacea is a chronic inflammatory skin disease with different phenotypes. There is accumulating evidence that the commensal Demodex mite is linked to papulopustular rosacea. Established treatment options, including topical metronidazole, azelaic acid, and tetracyclines, are thought to work through their anti-inflammatory effects. However, none of these therapies have been shown to be curative and are associated with frequent relapses. Therefore, new and improved treatment options are needed. Topical ivermectin 1.0% cream is a new option having both anti-inflammatory and acaricidal activity against Demodex mites which might pave the way to a more etiologic approach. Its use has now been widely adopted by clinical guidelines. The objective was to review the evidence and clinical guideline recommendations concerning ivermectin 1.0% cream in the treatment of papulopustular rosacea.
      METHODS: A systematic review of both medical literature and clinical guideline recommendations was conducted. Numbers needed to treat (NNT) were calculated for relevant dichotomous outcomes (e.g., relapse rate and achieving full lesion clearance) to compare ivermectin with other established treatment options for rosacea.
      RESULTS: The search identified three randomized trials, three extension studies, and two meta-analyses. Ivermectin has only been tested in moderate-to-severe papulopustular rosacea. Ivermectin is an effective treatment option for papulopustular rosacea and seems to be more effective than metronidazole (NNT = 10.5) at 12 weeks of treatment. Although ivermectin was numerically more effective than metronidazole at week 36 in preventing relapse (NNT = 17.5), relapse after discontinuation of treatment in both groups was common with 62.7% and 68.4% of patients relapsing. Based on limited generalizability of available evidence, clinical guidelines have yielded different treatment algorithms and, in some areas, conflicting recommendations.
      CONCLUSION: Topical ivermectin is an effective option in the treatment of papulopustular rosacea. Although ivermectin seems to be more effective than topical metronidazole, with both treatment options about two-thirds of patient relapsed within 36 weeks after discontinuation of treatment. More research is needed to establish the clinical benefit of ivermectin's acaricidal action in preventing relapse compared to other non-etiologic treatment approaches.
      PMID: 29943217 [PubMed - as supplied by publisher] {url} = URL to article
    • "Rosacea can be a challenging condition to treat. Tailoring therapies to the type of rosacea is an important part of management." Aust Prescr 2018;41:20-41 Feb 2018DOI: 10.18773/austprescr.2018.004
      An update on the treatment of rosacea
      Alexis Lara Rivero and Margot Whitfeld
    • "We used to think that the problem was primarily an immunological one in the skin with T-cells over-reacting and causing an inflammatory reaction to allergens - and we thought you would therefore get thinner skin as it all progressed. However, many now think we had that the wrong way round and it is because the skin barrier is not right that it all happens. Therapy to date has therefore been largely immunosuppressive, but barrier repair treatments have been showing great promise." Thinny Skinnies – Leaky skin: the cause of dermatitis, eczema and skin allergies?, by Micki Rose, Skin Matters
    • Low-level laser (light) therapy (LLLT) is a fast-growing technology used to treat a multitude of conditions that require stimulation of healing, relief of pain and inflammation, and restoration of function. Although the skin is the organ that is naturally exposed to light more than any other organ, it still responds well to red and near-infrared wavelengths. The photons are absorbed by mitochondrial chromophores in skin cells. Consequently electron transport, adenosine triphosphate (ATP) nitric oxide release, blood flow, reactive oxygen species increase and diverse signaling pathways get activated. Stem cells can be activated allowing increased tissue repair and healing. In dermatology, LLLT has beneficial effects on wrinkles, acne scars, hypertrophic scars, and healing of burns. LLLT can reduce UV damage both as a treatment and as a prophylaxis. In pigmentary disorders such as vitiligo, LLLT can increase pigmentation by stimulating melanocyte proliferation and reduce depigmentation by inhibiting autoimmunity. Inflammatory diseases such as psoriasis and acne can also benefit. The non-invasive nature and almost complete absence of side-effects encourages further testing in dermatology. Semin Cutan Med Surg. Author manuscript; available in PMC 2014 Aug 8.; Semin Cutan Med Surg. 2013 Mar; 32(1): 41–52.
      Low-level laser (light) therapy (LLLT) in skin: stimulating, healing, restoring
      Pinar Avci, MD, Asheesh Gupta, PhD, Magesh Sadasivam, MTech, Daniela Vecchio, PhD, Zeev Pam, MD,4 Nadav Pam, MD, and Michael R Hamblin, PhD
    • Anyone who has rosacea knows it’s hard to get rid of the red — topical therapies are only effective to a point. However, there is an option to erase the damage done and give you an even complexion: laser treatment for rosacea. Rosacea laser treatment uses heat from wavelengths of light to disintegrate the visible, tiny red blood vessels just underneath the skin. Is Rosacea Laser Treatment Right for You?, By Marie Suszynski, Medically Reviewed by Lindsey Marcellin, MD, MPH, Everyday Health
    • If you have rosacea, laser or light therapy may be a part of your treatment plan. It’s unlikely to be your only treatment, though. Different treatments for different signs of rosacea
      When dermatologists create a treatment plan for rosacea, the plan often consists of  medication, a rosacea friendly skin care plan, and tips to help you avoid flare-ups. Sometimes, a treatment plan also includes a procedure, such as laser therapy. Lasers and lights: How well do they treat rosacea?,  American Academy of Dermatology
    • While this was posted over a year ago, there are ten tips you may want to know about.  Top 10 treatment tips for rosacea, May 12, 2017,  londerma, The London Dermatologist