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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. Misdiagnosis is what falls under the medical umbrella called 'medical error.' You should be aware that rosacea may be a catch all diagnosis for a number of skin conditions that present with erythema and/or pimples. The list of skin conditions that need to be differentiated from rosacea is massive. It is no wonder that misdiagnosis occasionally happens. 

    Add Your Report
    If you want to add your experience with misdiagnosis please post your anecdotal report in this thread, since we are not adding to this page any more anecdotal reports. If you scroll below we have over 100 anecdotal reports of misdiagnosis. More are being added as we find more or if you add your report to this other thread

    Please take our poll on this subject

    Articles and References from Reputable Authorities 

    "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

    "Many people with skin of color who have rosacea may experience delayed diagnosis leading to inappropriate or inadequate treatment, greater morbidity, and uncontrolled, progressive disease with disfiguring manifestations, including phymatous rosacea."
    J Am Acad Dermatol. 2018 Sep 18;:
    Global Epidemiology and Clinical Spectrum of Rosacea, Highlighting Skin of Color: Review and Clinical Practice Experience.
    Alexis AF, Callender VD, Baldwin HE, Desai SR, Rendon MI, Ta ylor SC

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    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 GP 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

    103. I had a misdiagnosed case of demodex for many years. It was misdiagnosed as bacterial acne/hormonal acne and "allergic conjunctivitis". None of the treatment my 4 dermatologists prescribed ever worked. It turned into a really bad case of ocular rosacea. Early this year, I took the 2 week Oral Ivermectin + Oral Metronidazole treatment. It worked. ElaineA post no 2 

    More cases of misdiagnosed rosacea (or vice versa)

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    • The RRDi has been using Invision Community forum platform since 2004. When we started in 2004 it was recommended by Warren Stuart who was the assistant director of the RRDi to use what was then called Invision Power Services (later the name was changed to Invision Community). It is a powerful platform with many add-on features and a significant number of developers adding plugins and additional features to the platform. However, with the advent of mobile devices and social media platforms the trend has focused on mobile apps using iOS and Android devices found in the Apple App Store and Google Play Store. The popularity of using these apps over using a browser to view a website has increased the use of social media platforms such as Reddit, Facebook, Instagram, Twitter, etc. The developers and owners of the Invision Community platform have now announced beta versions of iOS and Android apps for their platform which has been embedded for years using only a web browser, so we have announced with this post here asking for volunteers to download the beta versions and help test these new apps. Please consider volunteering and using these beta versions of the apps.  Invision Community Clients There are some significant clients who use Invision Community as their platform which you can see below:  Medical Clients Who Use Invision Community Platform
    • Amelioration of Compound 48/80-Mediated Itch and LL-37-Induced Inflammation by a Single-Stranded Oligonucleotide. Front Immunol. 2020;11:559589 Authors: Dondalska A, Rönnberg E, Ma H, Pålsson SA, Magnusdottir E, Gao T, Adam L, Lerner EA, Nilsson G, Lagerström M, Spetz AL Abstract Numerous inflammatory skin disorders display a high prevalence of itch. The Mas-related G protein coupled receptor X2 (MRGPRX2) has been shown to modulate itch by inducing non-IgE-mediated mast cell degranulation and the release of endogenous inducers of pruritus. Various substances collectively known as basic secretagogues, which include inflammatory peptides and certain drugs, can trigger MRGPRX2 and thereby induce pseudo-allergic reactions characterized by histamine and protease release as well as inflammation. Here, we investigated the capacity of an immunomodulatory single-stranded oligonucleotide (ssON) to modulate IgE-independent mast cell degranulation and, more specifically, its ability to inhibit the basic secretagogues compound 48/80 (C48/80)-and LL-37 in vitro and in vivo. We examined the effect of ssON on MRGPRX2 activation in vitro by measuring degranulation in a human mast cell line (LAD2) and calcium influx in MRGPRX2-transfected HEK293 cells. To determine the effect of ssON on itch, we performed behavioral studies in established mouse models and collected skin biopsies for histological analysis. Additionally, with the use of a rosacea mouse model and RT-qPCR, we investigated the effect on ssON on LL-37-induced inflammation. We reveal that both mast cell degranulation and calcium influx in MRGPRX2 transfected HEK293 cells, induced by the antimicrobial peptide LL-37 and the basic secretagogue C48/80, are effectively inhibited by ssON in a dose-dependent manner. Further, ssON demonstrates a capability to inhibit LL-37 and C48/80 activation in vivo in two mouse models. We show that intradermal injection of ssON in mice is able to block itch induced via C48/80 in a dose-dependent manner. Histological staining revealed that ssON inhibits acute mast cell degranulation in murine skin treated with C48/80. Lastly, we show that ssON treatment ameliorates LL-37-induced inflammation in a rosacea mouse model. Since there is a need for new therapeutics targeting non-IgE-mediated activation of mast cells, ssON could be used as a prospective drug candidate to resolve itch and inflammation in certain dermatoses. PMID: 33101278 [PubMed - in process] {url} = URL to article
    • * Artificially Sweetened Drinks "Records for 104,760 participants were included....Artificially sweetened beverages were defined as those containing non-nutritive sweeteners. Sugary drinks consisted of all beverages containing 5% or more sugar....Researchers looked at first incident cases of cardiovascular disease during follow-up from 2009-2019, which were defined as stroke, transient ischemic attack, myocardial infarction, acute coronary syndrome and angioplasty. After excluding the first three years of follow-up to account for potential reverse causality bias, 1,379 participants had first incident cases of cardiovascular disease. Compared to non-consumers, both higher consumers of sugary drinks and of artificially sweetened beverages had higher risks of first incident cardiovascular disease, after taking into account a wide range of confounding factors..." Artificially sweetened drinks may not be heart healthier than sugary drinks, Medical Xpress, October 27, 2020, research letter in the Journal of the American College of Cardiology,  Sugar Any Better? "Drinking one or more sugary beverages a day was associated with a nearly 20% greater likelihood of women having a cardiovascular disease compared to women who rarely or never drank sugary beverages, according to new research published today in the Journal of the American Heart Association, an open access journal of the American Heart Association." California study finds drinking sugary drinks daily may be linked to higher risk of CVD in women, Medical Xpress, May 13, 2020, by American Heart Association Research on Sugar Beverages Triggering Rosacea Do you think it is possible for a non profit organization for rosacea get its members to each donate one dollar to investigate whether or not sugar beverages or artificially sweetened drinks are a rosacea trigger in a double blind, placebo controlled, peer reviewed clinical study? It would take approximately 10K members to do this if the members wanted this. What do you think? Have you noticed whether drinking a sugar beverage triggers your rosacea? *Image credit CCO public domain
    • 13 Variants of Rosacea The RRDi recognizes these thirteen variants of rosacea:  Demodectic Rosacea  Gastrointestinal Rosacea [GR], aka, Gut Rosacea Glandular Rosacea  Granulomatous Rosacea Halogen rosacea  Idiopathic facial aseptic granuloma (IFAG)  Neurogenic Rosacea  Pyoderma Faciale  Rosacea Conglobata  Rosacea Fulminans  Rosacea Lymphedema (Morbihan Disease) Rosacea Perioral Dermatitis [RPD] Steroid Rosacea [Facial corticosteroid addictive dermatitis] (FCAD) Etcetera Variant vs Subtype vs Phenotype
    • A new article on the pathophysiology of rosacea overlaps with demodectic rosacea and the phenotype classification. Below are the three highlights considered in the paper:  (1) New hypotheses to explain how Demodex mites may control host immunity, by analogy with what happens in tumor pathology: inducing tolerogenic dendritic cells through their Tn Ag, and diverting the body's defence reaction by exploiting the immunosuppressive properties of VEGF;  (2) Leading to consider rosacea not as a disease of the innate immunity, but as a chronicle infection by Demodex with T cell exhaustion; Highlighting of the ambiguities of the current definition of rosacea of the NRS, and the overlap with demodicoses, suggesting that all these dermatoses are different phenotypes of the same disease; (3) The suggestion, for the dermatologists, to learn to detect the demodicoses among the patients with persistent erythema, in the aim to treat at least these patients with topical acaricidal treatment. The article concludes, "The interactions among VEGF, Demodex, and the immune system need further exploration and the nosology of rosacea would then need to be adapted accordingly. The effectiveness of treating any patient with ETR first with an acaricidal cream needs to be assessed in prospective controlled clinical trials with long-term follow-up. Currently, learning to distinguish patients with pityriasis folliculorum from those with isolated ETR is crucial so that they can be managed appropriately with an acaricidal cream." [1] [1] Forton, F.M.N. The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea?. Dermatol Ther (Heidelb) (2020). https://doi.org/10.1007/s13555-020-00458-9 Image courtesy of Dermatology and Therapy
    • The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea? Dermatol Ther (Heidelb). 2020 Oct 23;: Authors: Forton FMN Abstract Rosacea is a common facial dermatosis but its definition and classification are still unclear, especially in terms of its links with demodicosis. Triggers of rosacea (ultraviolet light, heat, spicy foods, alcohol, stress, microbes) are currently considered to induce a cascading innate and then adaptive immune response that gets out of control. Recent histological and biochemical studies support the concept that this inflammatory response is a continuum, already present from the onset of the disease, even when no clinical signs of inflammation are visible. The Demodex mite is beginning to be accepted as one of the triggers of this inflammatory cascade, and its proliferation as a marker of rosacea; moreover, the papulopustules of rosacea can be effectively treated with topical acaricidal agents. Demodex proliferation appears to be a continuum process in rosacea, and may not be clinically visible at the onset of the disease. Molecular studies suggest that Demodex may induce tolerogenic dendritic cells and collaborate with vascular endothelial growth factor (VEGF) to induce T cell exhaustion and favor its own proliferation. These interactions among VEGF, Demodex, and immunity need to be explored further and the nosology of rosacea adapted accordingly. However, treating early rosacea, with only clinically visible vascular symptoms, with an acaricide may decrease early inflammation, limit potential flare-ups following laser treatment, and prevent the ultimate development of the papulopustules of rosacea. The effectiveness of this approach needs to be confirmed by prospective controlled clinical trials with long-term follow-up. Currently, the evidence suggests that patients with only vascular symptoms of rosacea should be carefully examined for the presence of follicular scales as signs of Demodex overgrowth or pityriasis folliculorum so that these patients, at least, can be treated early with an acaricidal cream. PMID: 33095403 [PubMed - as supplied by publisher] {url} = URL to article More in Demodectic Rosacea
    • "Fake news" in dermatology. Results from an observational, cross-sectional study. Int J Dermatol. 2020 Oct 23;: Authors: Iglesias-Puzas Á, Conde-Taboada A, Aranegui-Arteaga B, López-Bran E Abstract BACKGROUND: Social networks have become a means for disseminating information on health-related matters. OBJECTIVE: Describe the characteristics and analyze the accuracy of the dermatology content that is most often shared on the most popular social networks. MATERIALS AND METHODS: The content most often shared on social networks (Facebook, Pinterest, Twitter, and Reddit) between March 2019 and March 2020 was analyzed using the keywords: acne, alopecia/hair loss, psoriasis, eczema, melanoma, skin cancer, rash, and rosacea. The total number of interactions, skin disease, topic, and origin was collected from each of the records. The content was analyzed and was categorized as precise, confusing, or imprecise based on the scientific evidence available. RESULTS: A total of 385 websites were included. About 44.7% of the shared content was rated as imprecise, 20% as confusing, and 35.3% as precise. The records classified as imprecise obtained a higher mean number of interactions (P < 0.05). No differences were found in terms of the level of certainty and the dermatosis studied, whereas they did exist in relation to their topic and origin (P < 0.001). Of the contents classified as imprecise, the most frequent topic and origin were "alternative medicines" and "individual opinions, articles not affiliated with health institutions, nor peer reviewed," respectively. CONCLUSIONS: The majority of the contents often shared on social networks are below acceptable quality standards. Strategies are needed to discredit imprecise information and promote the dissemination of evidence-based dermatology information. PMID: 33095467 [PubMed - as supplied by publisher] {url} = URL to article This article is referenced in the post, What is the Butterfly Effect in Rosacea?
    • Volunteer Beta Testers Needed! Note: We have applied our community forum with Invision Community to list us under EDUCATION and we are still awaiting approval. As soon as we have been approved we will announce it and you should see the RRDi Member Forum listed along with the others.  We are pleased to announce that a new mobile app is available in beta version for Android (for Apple devices using iOS you need to scroll further down). You can find it on the Google Play store. It is the Invision COMMUNITIES app (not the Invision Community app which is for admins ONLY). Ditto, confusing, so, hopefully you won't download the wrong one. Here is a screen shot in the Google Play Store which is the second one called Invision COMMUNITIES:  We have listed our community, the RRDi, and you should be able to find it once we are listed in the beta version. Please let us know your experience with this new app on your mobile device?   The iOS version is still in beta testing. You can volunteer and be a beta tester if you follow the steps: 
    • The Pro-Differentiation Effect of Doxycycline on Human SZ95 Sebocytes. Dermatology. 2020 Oct 22;:1-5 Authors: Zouboulis CC, Ní Raghallaigh S, Schmitz G, Powell FC Abstract BACKGROUND: Despite their widespread clinical use in both acne vulgaris and rosacea, the effects of tetracyclines on sebocytes have not been investigated until now. Sebaceous glands are central to the pathogenesis of acne and may be important in the development of rosacea. OBJECTIVE: The aim of this study was to assess the effects of doxycycline on the immortalized SZ95 sebaceous gland cell line as a model for understanding possible effectiveness on the sebaceous glands in vivo. METHODS: The effects of doxycycline on SZ95 sebocyte numbers, viability, and lipid content as well as its effects on the mRNA levels of peroxisome proliferator-activated receptors α and γ, in comparison to the peroxisome proliferator-activated receptor γ agonist troglitazone, were investigated. RESULTS: Doxycycline reduced the cell number and increased the lipid content of SZ95 sebocytes in vitro after 2 days of treatment. These doxycycline effects may be explained by an upregulation of peroxisome proliferator-activated receptor γ mRNA levels at 12 and 24 h, whereas troglitazone already upregulated peroxisome proliferator-activated receptor γ levels after 6 h. Both compounds did not influence peroxisome proliferator-activated receptor α mRNA levels. CONCLUSION: These new findings illustrate a previously unknown effect of doxycycline on sebocytes, which may be relevant to their modulation of disorders of the pilosebaceous unit, such as acne vulgaris and rosacea. PMID: 33091909 [PubMed - as supplied by publisher] {url} = URL to article
    • Granulomatous Rosacea in Korean Patients: Diagnosis Based on Combining Clinical and Histological Findings. Dermatology. 2020 Oct 22;:1-5 Authors: Yang JH, Cho SI, Suh DH Abstract BACKGROUND: Granulomatous rosacea (GR) is a rare inflammatory skin disease, which is considered a variant of rosacea, apart from other types of rosacea. OBJECTIVE: This study aimed to summarize the characteristics of Korean patients diagnosed with GR by combining clinical and histological findings. METHODS: Fifteen cases, both clinically and histologically consistent with GR, were selected and were subsequently analyzed to describe clinical and histological characteristics. RESULTS: A total of 20 patients showed granulomatous infiltration in skin biopsies, but only 15 of them were clinically consistent with GR. Five patients who showed granulomatous inflammation were clinically consistent with erythematotelangiectatic or papulopustular rosacea. Among 15 patients, 13 (86.7%) were female and 2 (13.3%) were male. The most frequently involved area was the cheek, and none of the patients showed extrafacial lesions. There seems to be a possibility that treatment duration may be associated with the treatment response. CONCLUSIONS: This study confirms clinical characteristics of GR based on the diagnosis combining both clinical and histological findings. PMID: 33091912 [PubMed - as supplied by publisher] {url} = URL to article
    • As of this date there are at least 80 systemic comorbidities listed associated with rosacea. Can you find anywhere on the internet a list like this?  That is what the RRDi is about, 'everything rosacea.' We attempt to have on one website a comprehensive database of 'everything rosacea.' Can you find all the information on rosacea at the other non profit organizations for rosacea?  Why not browse the other non profit organizations for rosacea and see if they even come close to all the data we have categorized into logical categories for your investigative research into rosacea?  Do they have the data you are finding on the RRDi website about rosacea even comes close to what you have discovered here on this website?  For example, do they even mention non prescription treatments for rosacea such as over the counter topicals and allowing REVIEWS of these treatments?  Or why not go to your favorite rosacea social media platform like on Reddit, Facebook, Twitter or Instagram and see if you can logically figure out how to search for a subject you are investigating. Difficult task, isn't it? If you appreciate the data found on our website, why not volunteer and support the RRDi?  Could you at least donate one dollar so we can keep this website running?
    • Systemic Comorbidities in Korean Patients with Rosacea: Results from a Multi-Institutional Case-Control Study. J Clin Med. 2020 Oct 17;9(10): Authors: Woo YR, Kim HS, Lee SH, Ju HJ, Bae JM, Cho SH, Lee JD Abstract Recent evidence links rosacea to systemic disease, but there are not enough methodologic studies addressing this association in Asians. Our aim was to identify rosacea comorbidities in Koreans and establish a reference database. A multi-center, case-control study was performed where a total of 12,936 rosacea patients and 12,936 age- and sex-matched control subjects were identified from 2007 to 2018. Logistic regression was performed to find significant association between rosacea and Sjögren syndrome (odds ratio [OR] 2.05; 95% confidence interval, 1.40-3.00), systemic sclerosis (OR 6.56; 95% CI, 1.50-28.7), rheumatoid arthritis (OR 1.72; 95% CI, 1.50-1.98), ankylosing spondylitis (OR 2.32; 95% CI, 1.42-3.84), autoimmune thyroiditis (OR 1.96; 95% CI, 1.40-2.73), alopecia areata (OR 1.77; 95% CI, 1.27-2.45), vitiligo (OR 1.90; 95% CI, 1.30-2.77), lung cancer (OR 1.54; 95% CI, 1.06-2.21), hepatobiliary cancer (OR 1.38; 95% CI, 1.06-1.77), alcohol abuse (OR 1.59; 95% CI, 1.05-2.39), diabetes mellitus (OR 1.11; 95% 1.02-1.19), obesity (OR 1.72; 95% CI, 1.22-2.41), allergic rhinitis (OR 1.65; 95% CI, 1.54-1.76), allergic conjunctivitis (OR 1.57; 95% CI, 1.27-1.94), chronic rhinosinusitis (OR 1.28; 95% CI, 1.14-1.42), herpes infection (OR 1.69; 95% CI, 1.53-1.86), and human papillomavirus infection (OR 2.50; 95% CI, 2.06-3.02). Higher odds for Sjogren syndrome, systemic sclerosis, ankylosing spondylitis, thyroiditis, vitiligo, hepatobiliary cancer, and obesity was exclusive in female subjects with rosacea, whereas increased prevalence of alopecia areata and alcohol abuse was confined to men. Only those who were 50 years and older exhibited higher odds for vitiligo, lung cancer, and gastroesophageal reflux disease while individuals younger than 50 were exclusively associated with hepatobiliary cancer, allergic conjunctivitis, and irritable bowel syndrome. Our study suggests that Koreans with rosacea are more likely to experience systemic comorbidity. Clinicians should acknowledge these interrelations and employ comprehensive care with an individual-based approach. PMID: 33080929 [PubMed] {url} = URL to article
    • How intermittent fasting is a part of satvik diet and how it impacts the body homeostasis and kill the old cells and regenerate new cells. In Ayurveda it is stated to eat your last meal in the evening time and then give your internal system a full rest of long hours to keep your body healthy. When you do not consume anything after your evening meal and give your body intermittent fasting of more than 12 - 14 hours, your body automatically releases growth hormone and keeps your insulin in check and your body goes into fight or flight mode to function in a better manner and fighting diseases including rosacea. Yes I have been following intermittent fasting for quite a long time and it has a drastic impact on my rosacea. Keeping intermittent fasting reduces the flushing and gives your skin a boost because it kills off old and altered cells and regenerate new cells in our skin. Have a good amount of water and nothing else during fasting and keep healthy.
    • Related ArticlesA warning against associating doxycycline with isotretinoin. Arq Bras Oftalmol. 2020 08;83(4):350 Authors: Costa AXD, Benchimol GL, Reis TF PMID: 32756781 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Deep Learning for Diagnostic Binary Classification of Multiple-Lesion Skin Diseases. Front Med (Lausanne). 2020;7:574329 Authors: Thomsen K, Christensen AL, Iversen L, Lomholt HB, Winther O Abstract Background: Diagnosis of skin diseases is often challenging and computer-aided diagnostic tools are urgently needed to underpin decision making. Objective: To develop a convolutional neural network model to classify clinically relevant selected multiple-lesion skin diseases, this in accordance to the STARD guidelines. Methods: This was an image-based retrospective study using multi-task learning for binary classification. A VGG-16 model was trained on 16,543 non-standardized images. Image data was distributed in training set (80%), validation set (10%), and test set (10%). All images were collected from a clinical database of a Danish population attending one dermatological department. Included was patients categorized with ICD-10 codes related to acne, rosacea, psoriasis, eczema, and cutaneous t-cell lymphoma. Results: Acne was distinguished from rosacea with a sensitivity of 85.42% CI 72.24-93.93% and a specificity of 89.53% CI 83.97-93.68%, cutaneous t-cell lymphoma was distinguished from eczema with a sensitivity of 74.29% CI 67.82-80.05% and a specificity of 84.09% CI 80.83-86.99%, and psoriasis from eczema with a sensitivity of 81.79% CI 78.51-84.76% and a specificity of 73.57% CI 69.76-77.13%. All results were based on the test set. Conclusion: The performance rates reported were equal or superior to those reported for general practitioners with dermatological training, indicating that computer-aided diagnostic models based on convolutional neural network may potentially be employed for diagnosing multiple-lesion skin diseases. PMID: 33072786 [PubMed] {url} = URL to article
    • Cardiovascular Risk and Comorbidities in Patients with Rosacea: A Systematic Review and Meta-analysis. Acta Derm Venereol. 2020 Oct 19;: Authors: Tsai TY, Chiang YY, Huang YC Abstract The association between rosacea and cardiovascular disease remains controversial. A systematic review and meta-analysis of the literature, from inception to 15 February 2020, was performed to compare cardiovascular risk and comorbidities in individuals with and without rosacea. Twelve studies, involving 40,752 patients with rosacea, were included. Compared with controls, patients with rosacea had higher systolic blood pressure (standardized mean difference (SMD) 0.293, 95% confidence interval (CI) 0.054-0.532), diastolic blood pressure (SMD 0.309, 95% CI 0.003-0.615), total cholesterol (SMD 1.147, 95% CI 0.309-1.984), low-density lipoprotein (SMD 0.792, 95% CI 0.174-1.409), C-reactive protein (SMD 0.26, 95% CI 0.099-0.421), greater epicardial fat thickness (SMD 1.945, 95% CI 1.595-2.296), and higher incidence of hypertension (odds ratio (OR) 1.204, 95% CI 1.097-1.332) and insulin resistance (OR 2.338, 95% CI 1.187-4.605). This study reveals that patients with rosacea are predisposed to increased subclinical cardiovascular risk. PMID: 33073295 [PubMed - as supplied by publisher] {url} = URL to article
    • According to PRNewswire, New York, dated December 5, 2018, 'rosacea therapeutics demand to exceed $2 billion dollars.' This report includes an interesting factoid that "In the consolidated competitive landscape of rosacea therapeutics market, four leading companies account for over 75% share of the total market value, including Pfizer Inc., Teva Pharmaceutical Industries Ltd., Foamix Pharmaceuticals Ltd., and Bayer A." Rosacea Therapeutics Demand to Exceed US$ 2 Billion in 2019 - Persistence Market Research, PRNewswire, 12/5/2018
    • "Today, Aug. 21, 2019, a Delaware court issued an opinion finding three key patents covering Galderma’s Soolantra acne cream invalid and not infringed by Teva’s generic product....The FDA granted tentative approval to Teva’s generic product in March of this year; because of today’s decision, the FDA is now permitted to grant final approval. Today’s opinion is favorable for Teva, which may now launch its generic product at risk once it receives final approval from the FDA." (TEVA) Soolantra: Delaware Court Finds Galderma Patents Invalid; Teva May Launch Generic Version of Soolantra At Risk Pending FDA Approval, August 21, 2019, Reorg "On January 29, 2020, the Federal Circuit reversed and remanded an August 21, 2019 decision (Galderma v. Teva, 390 F.Supp.3d 582 (2019)) handed down by the United States District Court for the District of Delaware in the patent infringement dispute between Galderma Laboratories and generic manufacturer, Teva Pharmaceuticals, relating to Teva’s Abbreviated New Drug Application (“ANDA”) seeking approval to market a generic version of Galderma’s Soolantra® (1% ivermectin cream for topical use) for treating inflammatory lesions of rosacea." Galderma Prevails At The Federal Circuit, Forcing Case Back To The District Court To Consider Teva’s Additional Invalidity Theories, Wolf Track Life Sciences IP Blog, Posted by Gabe McCool on Feb 10, 2020 "The January 29, 2020, Federal Circuit decision in Galderma Laboratories, L.P. v. Teva Pharmaceuticals USA, Inc., is a non-precedential decision that was issued on the briefs (without oral argument), but is worth reviewing for its discussion of anticipation and inherency in the context of method of treatment claims. The decision shows that even in the context of anticipation, establishing inherency can be a high burden to carry." Necessity Is The Mother Of Single Reference Anticipation By Inherency, Courtenay C. Brinckerhoff, Foley & Lardner LLP
    • Related ArticlesPublication of national dermatology guidelines as a Research Letter in the BJD: can less ever be enough? Br J Dermatol. 2020 06;182(6):1319-1320 Authors: van Zuuren EJ, Arents BWM, Flohr C, Ingram JR PMID: 32476154 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Holistic care of patients with rosacea. J Cosmet Dermatol. 2020 Oct 14;: Authors: Searle T, Al-Niaimi F, Ali FR Abstract We thank the authors for their commentary on our article Rosacea and the Cardiovascular System.1 The authors discuss the risk of "excessive health examination". Whilst we do not advocate over investigation or over treatment of any patient, the association between cardiovascular disease and rosacea is evident2,3 and any dermatologist or clinician treating patients with rosacea should be aware of these associations as well as other extracutaneous associations of rosacea. PMID: 33051962 [PubMed - as supplied by publisher] {url} = URL to article
    • Acne in the first three decades of life: An update of a disorder with profound implications for all decades of life. Dis Mon. 2020 Oct 08;:101103 Authors: Greydanus DE, Azmeh R, Cabral MD, Dickson CA, Patel DR Abstract Acne vulgaris is a chronic, inflammatory, skin condition that involves the pilosebaceous follicles and is influenced by a variety of factors including genetics, androgen-stimulation of sebaceous glands with abnormal keratinization, colonization with Cutibacterium acnes (previously called Propionibacterium acnes), and pathological immune response to inflammation. Acne can occur at all ages and this discussion focuses on the first three decades of life. Conditions that are part of the differential diagnosis and/or are co-morbid with acne vulgaris are also considered. Acne in the first year of life includes neonatal acne (acne neonatorum) that presents in the first four weeks of life and infantile acne that usually presents between 3 and 6 months of the first year of life with a range of 3 to 16 months after birth. Acne rosacea is a chronic, inflammatory, skin condition that is distinct from acne vulgaris, typically presents in adults, and has four main types: erythemato-telangiectatic, papulopustular, phymatous and ocular. Treatment options for acne vulgaris include topical retinoids, topical benzoyl peroxide, antibiotics (topical, oral), oral contraceptive pills, isotretinoin, and others. Management must consider the increasing impact of antibiotic resistance in the 21st century. Psychological impact of acne can be quite severe and treatment of acne includes awareness of the potential emotional toll this disease may bring to the person with acne as well as assiduous attention to known side effects of various anti-acne medications (topical and systemic). Efforts should be directed at preventing acne-caused scars and depigmentation on the skin as well as emotional scars within the person suffering from acne. PMID: 33041056 [PubMed - as supplied by publisher] {url} = URL to article
    • Brazilian Society of Dermatology consensus on the use of oral isotretinoin in dermatology. An Bras Dermatol. 2020 Oct 03;: Authors: Bagatin E, Costa CS, Rocha MADD, Picosse FR, Kamamoto CSL, Pirmez R, Ianhez M, Miot HA Abstract BACKGROUND: Isotretinoin is a synthetic retinoid, derived from vitamin A, with multiple mechanisms of action and highly effective in the treatment of acne, despite common adverse events, manageable and dose-dependent. Dose-independent teratogenicity is the most serious. Therefore, off-label prescriptions require strict criteria. OBJECTIVE: To communicate the experience and recommendation of Brazilian dermatologists on oral use of the drug in dermatology. METHODS: Eight experts from five universities were appointed by the Brazilian Society of Dermatology to develop a consensus on indications for this drug. Through the adapted DELPHI methodology, relevant elements were listed and an extensive analysis of the literature was carried out. The consensus was defined with the approval of at least 70% of the experts. RESULTS: With 100% approval from the authors, there was no doubt about the efficacy of oral isotretinoin in the treatment of acne, including as an adjunct in the correction of scars. Common and manageable common adverse events are mucocutaneous in nature. Others, such as growth retardation, abnormal healing, depression, and inflammatory bowel disease have been thoroughly investigated, and there is no evidence of a causal association; they are rare, individual, and should not contraindicate the use of the drug. Regarding unapproved indications, it may represent an option in cases of refractory rosacea, severe seborrheic dermatitis, stabilization of field cancerization with advanced photoaging and, although incipient, frontal fibrosing alopecia. For keratinization disorders, acitretin performs better. In the opinion of the authors, indications for purely esthetic purposes or oil control are not recommended, particularly for women of childbearing age. CONCLUSIONS: Approved and non-approved indications, efficacy and adverse effects of oral isotretinoin in dermatology were presented and critically evaluated. PMID: 33036809 [PubMed - as supplied by publisher] {url} = URL to article
    • This is a note from the RRDi Treasurer about grant writing basics. Please read this page first! The RRDi received some education grants from Galderma which you can review here:  https://irosacea.org/articles/rrdi-education-grants/ Grant writing is a tedious and arduous task and we appreciate your volunteering to help us.  We went through all sorts of hoops with Galderma to get those grants. Now the process has changed and we are still trying to figure it out. What each company requires is different and you have to go through hoops to learn.  Basically, it would be prudent to try to learn how to apply for grants from pharmaceutical companies that make rosacea treatments. You can learn what prescription treatments for rosacea are here:  https://irosacea.org/forums/forum/21-prescription-treatments/ Some of the major pharmaceutical companies that make rosacea treatments are:  Galderma, Allergan, Alma, Almirall, Bayer, BioPharmX, Bristol Meyers, Candela, Chicet, Clinique, Cutanea, EPI Health, Foamix, GSK, Havione, Johnson & Johnson, Roche, Pfizer, Salix, Sanofi, Sol-Gel  Contacting these pharmaceutical companies and asking them what the hoops are to go through to obtain grants is what you should do. We have Medical Advisory Consultants who might answer some questions about rosacea if you need to know anything. The list is found here:  https://irosacea.org/mac/ Go through Apurva Tathe with your questions first since she has access to contacting the RRDi MAC members above in the list if you have medical rosacea research questions.   There are, of course, foundations that offer money for grants and each foundation has its hoops to go through, i.e., Bill and Melinda Gates Foundation https://www.gatesfoundation.org And there are many others. You can google 'how to apply for grants' which will give you more results.  When filling out forms use the following:  Address:  Rosacea Research & Development Institute  PO Box 858 Centre, AL 35960 EIN 20-1259275
    • Dermoscopy in Monitoring and Predicting Therapeutic Response in General Dermatology (Non-Tumoral Dermatoses): An Up-To-Date Overview. Dermatol Ther (Heidelb). 2020 Oct 08;: Authors: Errichetti E Abstract Besides the well-known use in supporting the non-invasive diagnosis of non-tumoral dermatoses (general dermatology), dermoscopy has been shown to be a promising tool also in predicting and monitoring therapeutic outcomes of such conditions, with the consequent improvement/optimization of their treatment. In the present paper, we sought to provide an up-to-date overview on the use of dermoscopy in highlighting response predictor factors and evaluating therapeutic results in the field of general dermatology according to the current literature data. Several dermatoses may somehow benefit from such applications, including inflammatory conditions (psoriasis, lichen planus, dermatitis, granulomatous conditions, erythro-telangiectatic rosacea, Zoon balanitis and vulvitis, cutaneous mastocytosis, morphea and extra-genital lichen sclerosus), pigmentary disorders (vitiligo and melasma) and infectious dermatoses (scabies, pediculosis, demodicosis and viral warts). PMID: 33030661 [PubMed - as supplied by publisher] {url} = URL to article • Full Text   Methods for Quantifying Demodex Mites  
    • [Manifestaciones clínicas y evolución a largo plazo de tres casos de rosácea ocular atendidos en un hospital de alta especialidad del sureste de México]. Biomedica. 2020 Sep 01;40(3):448-455 Authors: Xacur-García F, Díaz-Novelo R, Herrera-David L, Moreno-Arjona P, Méndez-Domínguez N Abstract La rosácea es una alteración cutánea crónica que se ha asociado con factores etiológicos inespecíficos y diversas manifestaciones sistémicas. La rosácea cutánea suele evolucionar a rosácea ocular del 6 al 72 % de los pacientes. Al no existir criterios específicos que la caractericen, la rosácea ocular implica un reto diagnóstico. Para fortalecer la sospecha diagnóstica temprana, se presentan tres casos de pacientes con evolución clínica distinta, pero que tuvieron en común el retraso diagnóstico, lo que se tradujo en manifestaciones graves y daño ocular extenso. PMID: 33030822 [PubMed - as supplied by publisher] {url} = URL to article
    • Thank you so much Dr. Tara for this podcast share.
    • Hello everyone, I know there are many new novice volunteers who want to help for the grant writing to get grants from pharmaceutical and other companies so that we can also research on the different aspects of rosacea through our medical advisory committee and run our organization. As you all know this is a non-profit organization and grant writing is what this non-profit organization does. So every new volunteer asks what should we do and how to start this? So I am writing this post to let you know how to do go through the grant writing process : 1. Select any pharmaceutical company or company which provide drug service for rosacea or other skin conditions and see if they provide grants or charitable donations. You need to go to their website and search for it. Google it. 2. Now see what is their criteria for funding. Is there any form to fill out or do we need to mail them? Read carefully and if you do not find anything proper just ask through snail mail what is the process? 3. And if you have gained enough information and understood everything then just go through the process carefully. 4. If you need any help in the middle of the process just ask us because you will need some information regarding some official documents detail or anything. You can inform us while going through the process and if you get the grant money, you will also get the share of it. I have shared as much information as I had in my mind, if I have left anything you can ask us. Thank you
    • I believe it can. I had rosacea for 20 years which only got worse over the years. I have been rosacea free since February (?) after beginning natural treatments involving gut, liver, detoxes, and demodex mite control. I started my natural treatments in December 2019 and continue to have clear skin. Every day I find more and more people with similar stories to mine. It's real, you just don't hear about it.  For more stories/info on healing naturally, a friend of mine has created a podcast of doctors and skin experts who all say the same thing: it can be healed.  https://journeytoglow.com/podcast/
    • Hi friends. I wanted to share a resource with you from a friend of mine. As a rosacea sufferer for 20 years, I recently healed my rosacea through changes in diet (no gluten, no dairy), a sulfur cream (ZZ), and multiple detoxes and cleanses for liver, spleen, heavy metals and viruses. It took a few months  to clear, but it's been 10 months now and I continue to be rosacea free. I recently found a fantastic resource full of testimonials from doctors and skin experts who have all treated their rosacea naturally and continue to be rosacea free. They are a collection of podcasts,  and there is some fantastic information for those who have already gone the pharma route with no success, or simply want holistic options. The website is https://journeytoglow.com/podcast/ .   Good luck and don't give up. Healing is possible, trust me. 
    • Rosacea in acne vulgaris patients: subtype distribution and triggers assessment--a cross-sectional study. J Cosmet Dermatol. 2020 Oct 06;: Authors: Chen H, Lai W, Zheng Y Abstract BACKGROUND: Recent studies have reported that the incidence of acne combined with rosacea is increasing. However, the clinical feature and inducing factor of this two diseases co-occurrence is remain unclear. This study aims to investigate the classification and severity of female patients combining with acne and rosacea. METHODS: Female Patients with facial acne combined with rosacea, 15-50 years old, were included from dermatology out-patient department from January 2019 to December 2019. The severity of acne was classified according to the Pillsbury grading system. Rosacea was diagnosed and classified according to the Standard issued by National Rosacea Society Expert Committee. Questionnaire was designed to collect the information of rosacea triggers from each patient. RESULTS: 563 vulgaris acne combined with rosacea patients (mean age 23.2±43), included 70.33% severe acne (n=396),15.81% moderate acne(n=89) and 13.85% mild acne(n=78), had finished the study. In severe acne group 72.47% combine with erythematotelangiectatic rosacea (ETR), 22.47% combined with papulopustular rosacea (PPR) and 5.05% combine with phymatous rosacea (PHR). In moderate acne group, 53.93% combine with ETR, 43.82% combined with papulopustular rosacea (PPR) and 2.24%combine with PHR. All patients in moderate acne subject group was combined with ETR (100%). Patients that did not use skin care produces presented 12.79 times higher rate to combine with ETR than that frequently using skin care products (P = 0.014). DISCUSSION/CONCLUSIONS: Erythema telangiectasia rosacea is the most common rosacea type in female acne patients. There is a need to be vigilant about the combination of sever /moderate acne and papulopustular rosacea. Rational daily use of skin care products can reduce the incidence of rosacea in acne patients. For acne patients without family history of rosacea, dermatologists should also not ignore the healthy education to avoid potential triggers of rosacea. PMID: 33025720 [PubMed - as supplied by publisher] {url} = URL to article
    • Rationale for Use of Combination Therapy in Rosacea. J Drugs Dermatol. 2020 Oct 01;19(10):929-934 Authors: Stein Gold L, Baldwin H, Harper JC Abstract BACKGROUND: Rosacea is a chronic skin condition characterized by primary and secondary manifestations affecting the centrofacial skin. The primary diagnostic phenotypes for rosacea are fixed centrofacial erythema with periodic intensification, and phymatous changes. Major phenotypes, including papules and pustules, flushing, telangiectasia, and ocular manifestations, may occur concomitantly or independently with the diagnostic features. The phenotypes of rosacea patients may evolve between subtypes and may require multiple treatments concurrently to be effectively managed. We report the proceedings of a roundtable discussion among 3 dermatologists experienced in the treatment of rosacea and present examples of rosacea treatment strategies that target multiple rosacea symptoms presenting in individual patients. METHODS: Three hypothetical cases describing patients representative of those commonly seen by practicing dermatologists were developed. A roundtable discussion was held to discuss overall and specific strategies for treating rosacea based on the cases. RESULTS/DISCUSSION: With few exceptions, the dermatologists recommended combination therapy targeting each manifestation of rosacea for each case. These recommendations are in agreement with the current American Acne and Rosacea Society treatment guidelines for rosacea and are supported by several studies demonstrating beneficial results from combining rosacea treatments. CONCLUSIONS: Rosacea is an evolving condition; care should take into account all clinical signs and symptoms of rosacea that are present in an individual patient, understanding that symptoms may change over time, and utilize combination therapy when applicable to target all rosacea symptoms. J Drugs Dermatol. 2020;19(10): 929-934. doi:10.36849/JDD.2020.5367. PMID: 33026776 [PubMed - as supplied by publisher] {url} = URL to article
    • "It was detected that number of Demodex affected from the glucose level and each increase in glucose level cause an increase on Demodex as 0.190 (P = .00, t = 4.746, B = 0.190, r = 0.57, Durbin-Watson = 1.801, confidence interval = 0.110 to 0.271 (for glucose))." J Cosmet Dermatol. 2020 Oct 05;: Association between Demodex folliculorum and Metabolic Syndrome. Toka Özer T, Akyürek Ö, Durmaz S Demodex Density Count - What are the Numbers? Sugar and Rosacea
    • You can make a difference while you shop Amazon Prime Day deals on October 13 & 14. Simply shop at smile.amazon.com/ch/20-1259275 or with AmazonSmile ON in the Amazon Shopping app and AmazonSmile donates to Rosacea Research And Development Institute. 
    • Association between Demodex folliculorum and Metabolic Syndrome. J Cosmet Dermatol. 2020 Oct 05;: Authors: Toka Özer T, Akyürek Ö, Durmaz S Abstract BACKGROUND: Demodex folliculorum mite infestation is associated with many diseases such as rosacea, pityriasis found with acne vulgaris, and blepharitis. AIM: In this research, the aim of this study was to investigate an association between patients who have metabolic syndrome and presence of Demodex folliculorum. PATIENTS/METHODS: This research was planned prospectively as a case-control study. Fifty cases who have metabolic syndrome and 50 control subjects in good health were included. Metabolic syndrome was diagnosed according to the NCEP Adult Treatment Panel III criteria. Standard superficial skin biopsy was performed for the presence of Demodex folliculorum mite infestation. RESULTS: It was detected that number of Demodex affected from the glucose level and each increase in glucose level cause an increase on Demodex as 0.190 (P = .00, t = 4.746, B = 0.190, r = 0.57, Durbin-Watson = 1.801, confidence interval = 0.110 to 0.271 (for glucose)). CONCLUSION: In this study, the presence of Demodex folliculorum was found to be higher in the cases who have metabolic syndrome compared to the healthy group. These results show that in cases with metabolic syndrome, high blood sugar levels make them more susceptible to infestation of Demodex folliculorum. PMID: 33017081 [PubMed - as supplied by publisher] {url} = URL to article More information on Demodectic Rosacea
    • Now available announced by Vyne Therapeutics. Ask your dermatologist. Post your experience in this thread. Find the reply button.  "The Company also announced that the annual list price of ZILXI will be $485 per 30-gram canister, in parity with the wholesale price of AMZEEQ® (minocycline) topical foam, 4%, the Company's topical minocycline indicated for the treatment of inflammatory lesions of non-nodular moderate to severe acne vulgaris in adults and pediatric patients 9 years of age and older."  PR Newswire Association LLC. All Rights Reserved. A Cision company
    • Diagnostic and Management Considerations for 'Maskne' in the Era of COVID-19. J Am Acad Dermatol. 2020 Oct 01;: Authors: Teo WL PMID: 33011321 [PubMed - as supplied by publisher] {url} = URL to article
    • Ocular rosacea. Curr Opin Ophthalmol. 2020 Nov;31(6):503-507 Authors: Redd TK, Seitzman GD Abstract PURPOSE OF REVIEW: To revisit ocular rosacea as an underappreciated condition which can cause permanent blindness if inadequately treated, and to review data supporting improved diagnostic and treatment strategies. RECENT FINDINGS: Ocular rosacea has an underrecognized prevalence in children and individuals with darker skin tone. Rosacea has several associations with other significant systemic diseases. Variations in local and systemic microbiome, including demodex infestation, may play a role in pathogenesis, severity, and in explaining the different phenotypes of rosacea. The National Rosacea Society Expert Committee established an updated classification system of rosacea in 2017. New treatment algorithms based on these clinical subtypes are suggested. SUMMARY: With continued advancements in the understanding of the epidemiology and pathogenesis of rosacea, randomized controlled trials specific for ocular rosacea remain lacking. There is overall consensus that rosacea and ocular rosacea require chronic maintenance treatment strategies involving combination topical and systemic therapies. PMID: 33009083 [PubMed - as supplied by publisher] {url} = URL to article
    • Azelaic acid stimulates catalase activation and promotes hair growth through upregulation of Gli1 and Gli2 mRNA and Shh protein. Avicenna J Phytomed. 2020 Sep-Oct;10(5):460-471 Authors: Amirfakhryan E, Davarnia B, Jeddi F, Najafzadeh N Abstract Objective: Although azelaic acid is effective for treatment of acne and rosacea, the biological activity of azelaic acid and the effect of its combination therapy with minoxidil were not elucidated with regard to hair growth. Materials and Methods: In this study, mouse vibrissae follicles were dissected on day 10 after depilation. Then, the bulb and bulge cells of the hair follicle were treated with minoxidil and azelaic acid for 10 days to evaluate Sonic hedgehog (Shh) protein expression. Moreover, bulge and bulb cells of the hair follicles were cultivated and the expression of Gli1, Gli2, and Axin2 mRNA levels was evaluated using real-time polymerase chain reaction (PCR) analysis. We further investigated the protective effects of azelaic acid against ultraviolet B (UVB) irradiation in cultured bulb and bulge cells by determining catalase activity. An irradiation dose of 20 mJ/cm2 UVB for 4 sec was chosen. Results: The results showed that catalase activity significantly (p<0.05) increased in the bulge cells after exposure to 2.5 mM and 25 mM azelaic acid. Meanwhile, treatment of the bulb cells with azelaic acid (2.5 and 25 mM) did not cause significant changes in catalase activity. We also found that azelaic acid (25 mM) alone upregulated Gli1 and Gli2 expression in the bulge cells and 100 µ minoxidil caused Gli1 and Axin2 overexpression in the bulb region of the hair follicle. Moreover, minoxidil (100 µM) alone and in combination with azelaic acid (25 mM) led to Shh protein overexpression in the hair follicles in vitro and in organ culture. Conclusion: Our results indicated a potential role for azelaic acid in the protection of bulge cells from UVB damage and its combination with minoxidil may activate hair growth through overexpression of Shh protein. PMID: 32995324 [PubMed] {url} = URL to article
    • Related Articles A new facial rash. Aust J Gen Pract. 2020 Jan-Feb;49(1-2):36-37 Authors: Sun C, Muir J PMID: 32008265 [PubMed - indexed for MEDLINE] {url} = URL to article Full Text of this article with photos, showing a differential diagnosis of rosacea with other skin conditions. 
    • Evaluation of the efficacy of subantimicrobial dose doxycycline in rosacea: a systematic review of clinical trials and meta-analysis. J Dtsch Dermatol Ges. 2020 Sep 28;: Authors: Husein-ElAhmed H, Steinhoff M Abstract BACKGROUND: Low-dose doxycycline (SDD) is an antimicrobial agent that appears to improve common inflammatory skin diseases. Few data are available regarding the overall effectiveness, appropriate length of treatment and optimal patient selection for rosacea. We therefore reviewed the efficacy of sub-antimicrobial doses of SDD in papulopustular rosacea (PPR) and aimed to determine the most suitable patients for this approach. METHODS: From July to September 2019, we carried out a comprehensive search of literature from five databases, using a combination of "rosacea" AND "doxycycline". RESULTS: Our search yielded 532 potentially relevant studies. Our meta-analysis showed no significant difference between SDD and a comparator (RR: 1.12, 95 % CI: 0.78-1.62, I2 =  86 %). Subgroup analysis of studies comparing doxycycline with placebo yielded a clear difference in favor of doxycycline (RR: 1.45, 95 % CI: 1.22-1.72, I2 =  31 %), while subgroup analysis of studies comparing active drugs revealed no difference between interventions (RR: 0.52, 95 % CI: 0.17-1.63, I2 =  90 %). CONCLUSIONS: There is strong evidence that SDD is more effective than placebo. However, other drugs such as minocycline or isotretinoin have shown outcomes at least similar to that of SDD. We suggest that the anti-inflammatory properties of SDD may be of more value for mild cases of rosacea than for moderate to severe cases, for which higher (antimicrobial) doses of doxycycline may be a more suitable choice. PMID: 32989925 [PubMed - as supplied by publisher] {url} = URL to article More info on low dose doxycycline
    • Related ArticlesBlemished noses in the art of three masters: Ghirlandaio, Rembrandt, and Warhol. Clin Dermatol. 2020 May - Jun;38(3):360-364 Authors: Mohammed TO, Hassan S, Hamideh N, Mahmoud A, Waugh MA, Plewig G, Parish LC, Hoenig LJ Abstract Blemished noses are portrayed in the paintings of such noted artists as Ghirlandaio, Rembrandt, and Andy Warhol. Sometimes, the deformity results from a skin disorder such as rhinophyma as in Ghirlandaio's An Old Man and his Grandson or a saddle nose deformity from congenital syphilis as in Rembrandt's Portrait of Gerard de Lairesse. Andy Warhol's Before and After portrays a large nose before and after cosmetic surgery. This contribution explores some of the lessons that can be learned, both artistically and medically, from these famous works of art. PMID: 32563351 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related ArticlesEvaluation of Botulinum Toxin A as an Optional Treatment for Atopic Dermatitis. J Clin Aesthet Dermatol. 2020 Jul;13(7):32-35 Authors: Khattab FM Abstract OBJECTIVE: Botulinum toxin (BTX) A has different biological activities, including anti-inflammatory and antipruritic behavior. Studies on humans and animals have shown that BTX is efficient in treating itch caused by histamine, lichen simplex chronicus, psoriasis, rosacea, allergic rhinitis, and scar avoidance. OBJECTIVE: This study sought to assess the impact of BTX-A in patients with atopic dermatitis using scores of SCORAD and to identify parameters linked to greater improvements. METHODS: This was a prospective, intrapatient, left-to-right, randomized, placebo-controlled study of BTX-A for the treatment of atopic dermatitis. The study included 26 patients with atopic dermatitis (12 males and 14 females) with an average age of 37.8 years. Responses to therapy were assessed using SCORAD, Dermatology Quality of Life Index (DLQI), and the worldwide clinical reaction score evaluation. RESULTS: Mean SCORAD values dropped from 50.5 to 11 points (p<0.001); meanwhile, 64.1 percent of patients reported an excellent response, including 78.9 percent of patients with severe AD. The DLQI score fell by 10.15 points (43.5%) in patients treated with BTX-A. A statistically significant reduction in SCORAD and DLQI scores occurred relative to in the placebo group (p<0.001). CONCLUSION: Based on the results of this study, BTX-A appears to be a safe and effective therapy for atopic dermatitis of all grades (mild, moderate, and severe). However, BTX-A appears to be best suited for patients with severe atopic dermatitis. PMID: 32983334 [PubMed] {url} = URL to article
    • Related Articles Rosacea and Associated Comorbidities: A Google Search Trends Analysis. J Clin Aesthet Dermatol. 2020 Jul;13(7):36-40 Authors: Marchitto MC, Chien AL Abstract BACKGROUND: There is recent evidence linking rosacea to systemic disease. OBJECTIVE: We sought to identify correlations in Google searches (Google LLC, Mountain View, California) for rosacea and comorbid conditions to assess whether the public is seeking information regarding these trends. METHODS: Google search data from January 1, 2004, to February 28, 2018, for rosacea and search terms representing common comorbid conditions were investigated. This analysis included searches occurring in the United States (US), Canada, the United Kingdom (UK), and Australia. Search volume index (SVI) data were plotted over time and Pearson correlation coefficients were calculated from search data to assess for correlations between search terms. RESULTS: The level of interest in rosacea was highest in the spring and lowest in the winter in the US, Canada, and UK. Seasonal search trends in Australia were the inverse of those in northern hemisphere nations. Significant correlations were found between depression and rosacea SVI in the US (R=0.481; p<0.001), dementia and rosacea SVI in the UK (R=0.774; p=0.011), and hypothyroidism and rosacea SVI (R=0.752; p<0.001) in the UK. Additionally, search trends for irritable bowel syndrome (R=0.399; p<0.001) and ulcerative colitis (R=0.514; p=0.032) correlated significantly with rosacea in Canada and the UK, respectively. In Australia, search trends for osteoporosis significantly correlated with rosacea (R=0.394; p<0.001). CONCLUSIONS: Our findings indicate growing interest among the general public regarding rosacea and comorbid diseases, which behooves clinicians to adopt a more comprehensive approach in managing rosacea patients. PMID: 32983335 [PubMed] {url} = URL to article See also Systemic Cormorbidities in Rosacea
    • Molecular functional analysis circulating RNA of patients presented as effective to ISO therapy image courtesy of PubMed Central.  "In conclusion, we found that isotretinoin could temporarily alter gene expression in acne patients, and the gene profiles among oral ISO-induced acne flare-up, effective, and ineffective patients were distinct. ISO therapeutic mechanisms were not only involved in regulating the inflammatory reaction but also in the process of DNA repair. Genes that regulated the inflammatory and defense response to microorganisms played a role in ISO treatment effects. GATA2, C4BPA, CCR5, DEFA3, ELANE, MMP9, and RPS4Y1 might be the susceptible genes implicated in ISO-induced acne aggravation. These findings revealed the genetic roles in the ISO treatment process and provided a basis for exploring precise personalized treatment plans for acne patients." Pharmgenomics Pers Med. 2020; 13: 385–395. Altered Gene Expression in Acne Vulgaris Patients Treated by Oral Isotretinoin: A Preliminary Study Yuchen Jiang, Haiyan Chen, Le Han, Xiaoyuan Xie, Yue Zheng, Wei Lai
    • "Overall, the current study demonstrates that topical minocycline gel is safe, efficacious and well tolerated in patients with papulopustular rosacea. The findings of this study support further evaluation of topical minocycline gel for the treatment of papulopustular rosacea." Br J Dermatol. 2020 Sep; 183(3): 471–479. With Photos A multicentre, randomized, double‐masked, parallel group, vehicle‐controlled phase IIb study to evaluate the safety and efficacy of 1% and 3% topical minocycline gel in patients with papulopustular rosacea G. Webster, Z.D. Draelos,  E. Graber,  M.S. Lee,  S. Dhawan,  M. Salman,  and G.N. Magrath
    • As I have introduced Satvik Diets and this diet contains seeds. So first I will introduce flaxseed and the reason is, I eat flaxseed and I will tell you the benefits of flaxseed for your skin.  I already have been using natural flaxseed gel for my curly hair but had never known the benefits of flaxseed for the skin especially the rosacea skin. I have been eating flaxseed for about more than two years when I found that it has anti-inflammatory properties. So I thought why not have it for my skin besides hair.   What is Flaxseed ? Flax commonly known as linseed is a food and fiber crop cultivated in the cooler regions of the world. There are two varieties of flaxseeds- brown and golden(1), the one I eat is brown flaxseeds because it is easily available to me.   Components of Flaxseeds 1. Polyunsaturated and saturated fatty acids : There is a mixture of fatty acids in flaxseed but polyunsaturated fatty acid (omega-3) is high in content than polysaturated fatty acids (omega-6) at the ration of 3:1. 2. Lignans : They are phytoestrogens means they are found in plants in rich amount but very weak in animals and flaxseed is the richest source of lignans. Plants contain good amount of lignans which I had described in my earlier post on my research on C.viminalis plant extract which has lignan compound in it. Lignans in flaxseed is in precursor form and converted to lignan by gut bacteria. 3. Fiber : it is a good dietary fiber source in flaxseed if you consume one tablespoon of flaxseed daily, it will give you all the benefits of flaxseed because your gut contains more immuntiy and when your gut is happy you are happy and flaxseed gives insoluble and soluble fiber to improve gut health and very friendly to bacteria and it balances the friendly bacteria of your gut to do their work to process lignan and fiber. 4.Protein,vitamins and minerals : Flaxseed contain some amount of amino acid, potassium (seven times higher than banana) and some lower amounts of other essential minerals.(2)   Benefits of Flaxseed for inflammatory skin There are so many benefits of consuming flaxseed but we will count the benefits of flaxseed for our inflammatory skin. So first we will see what does omega-3 do to our health, actually flaxseed is a richest source of ALA(omega-3) but we actually get the less benefits from it because before we get the benefits from it actually it must be converted into EPA and DHA by limited enzymes and that is the reason we get less amount of omega-3 from flaxseed. Omega-3 is the building blocks of skin and it maintains the skin barrier by locking in moisture and thus it keeps our skin smooth and hydrated. It has a very good effect on improving digestive health, blood pressure and reducing bad cholesterol basically keeping our heart safe and healthy. Lignans help reconstruct our broken blood vessels due to rosacea inflammation and renew our skin cells. Lignans have antioxidant properties, so it keeps our skin from oxidative damage such as free radicals and UV rays. This is a very important compound in flaxseed because we get less amount of benefits from omega-3 despite it is rich in flaxseed but we can count on lignans due to its antioxidant properties. Fiber we all know keep our gut healthy and happy and maintains the homeostasis of the gut. It has indirect effect on skin inflammation. if our gut is balanced,our gut immunity is balanced and as we all know there is a strong correlation between gut immunity and skin immunity because I have seen lots of time when my gut is upset and disbalanced, I can see redness on my face. So whenever I see this effect, I first cure my gut and redness on my face automatically lessens.   References 1. https://en.wikipedia.org/wiki/Flax 2. https://www.goldenvalleyflax.com/flax-facts/health-research-articles/nutritional-components-flax/
    • Thanks, correct spelling is Melazepam. We have that in our affiliate store so if anyone wants to check it out and purchase it the RRDi gets a small affiliate fee that helps us out a tiny bit. 
    • Also - if you are having issues with insurance, you can also order 20% AA from Australia under the AZClear brand: https://www.pharmacyonline.com.au/catalogsearch/result?q=azclear
    • It's a 20% AA cream: https://www.amazon.com/Ecological-Formulas-Melazepam-Cream/dp/B001WUEJ4U/ref=sxts_sxwds-bia-wc-drs1_0?cv_ct_cx=melazepam&dchild=1&keywords=melazepam&pd_rd_i=B001WUEJ4U&pd_rd_r=d8776536-23b0-4ca7-9db6-5662e9950a5a&pd_rd_w=ipVyQ&pd_rd_wg=qwcyw&pf_rd_p=99c7ce93-69a7-402a-ba4e-be326f866b88&pf_rd_r=KN04VE01K64ZWH604CTC&psc=1&qid=1601214129&sr=1-1-f6b8d51f-2c55-4dc3-89ad-0c3639671b2d
    • What is 'Malazapham' ?  
    • Thanks for the update! AA via the weird Malazapham (sp) from Amazon was one of my "false dawns." It's 20% and I jumped into using it twice a day. I lasted two weeks and it was clearing things but was super irritating to my skin. I had to stop. I will experiment with adding it in a few times a week. I'm thinking we need to have a multi-pronged approach to this. (1) Kill the yeast, (2) repair the damaged skin barrier, (3) remove the excess keratin/heal the bumps, (4) repopulate the skin microbiome. Tom's products should do the first three, albeit it very slowly.
    • Do you think that any rosacea non profit organization would do any research as this paper suggests, "that this opens a horizon for more research in the link between the skin and nervous system,"?  Most of the research on rosacea is profit motivated since the skin industry promotes and sponsors most of the clinical research papers on rosacea. In comparison to non profit rosacea research who would investigate this? Could a grassroots non profit organization for rosacea gather enough donations to investigate this subject?  What do you think?  For more information.  Are you aware that PD is also associated with lewy body dementia?
    • I was thinking about buying Tom's Lotion (used only the shampoo for about three months, not the lotion) but my dermatologist asked me if I have ever tried Azelaic Acid, which I have heard about since 2007 but never tried it. So I took her recommendation and have been using Azelaic Acid and you can review my updates on this in my rosacea blog. I have tried a long list of treatments mentioned in my blog to try to clear the folliculitis in my scalp and nothing cleared it. The Azelaic Acid has been the only thing so far that has taken away the itch and has definitely improved it. I will continue to use Tom's AquaVive shampoo to cleanse my scalp but will be using the Azelaic Acid for a couple more months, since usually it takes three months for any treatment for clearance. 
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