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  • Misdiagnosed Rosacea

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    Articles, References and Anecdotal Reports

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

    Articles and References

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    "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


    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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    • Comparative effectiveness of purpuragenic 595 nm pulsed dye laser versus sequential emission of 595 nm pulsed dye laser and 1,064 nm Nd:YAG laser: a double-blind randomized controlled study. Acta Dermatovenerol Alp Pannonica Adriat. 2019 Mar;28(1):1-5 Authors: Campos MA, Sousa AC, Varela P, Baptista A, Menezes N Abstract INTRODUCTION: Erythematotelangiectatic rosacea is a common condition in Caucasians. The most frequently used lasers to treat this condition are pulsed dye laser (PDL) and neodymium:yttrium-aluminum-garnet laser (Nd:YAG). This study compares the treatment efficacy of purpuragenic PDL with that of sequential emission of 595 nm PDL and 1,064 nm Nd:YAG (multiplexed PDL/Nd:YAG). METHODS: We performed a prospective, randomized, and controlled split-face study. Both cheeks were treated, with side randomization to receive treatment with PDL or multiplexed PDL/Nd:YAG. Efficacy was evaluated by spectrophotometric measurement, visual photograph evaluation, the Dermatology Quality of Life Index questionnaire, and a post-treatment questionnaire. RESULTS: Twenty-seven patients completed the study. Treatment was associated with a statistically significant improvement in quality of life (p < 0.001). PDL and multiplexed PDL/Nd:YAG modalities significantly reduced the erythema index (EI; p < 0.05). When comparing the degree of EI reduction, no differences were observed between the two treatment modalities. PDL was associated with a higher degree of pain and a higher percentage of purpura. Multiplexed PDL/Nd:YAG modality was associated with fewer side effects and greater global satisfaction, and 96.3% of the patients would recommend this treatment to a friend. CONCLUSIONS: Both laser modalities are efficacious in the treatment of erythematotelangiectatic rosacea. The multiplexed PDL/Nd:YAG modality was preferred by the patients. PMID: 30901061 [PubMed - in process] {url} = URL to article
    • Logo of the Human Microbiome Project, a program of the NIH Common Fund, National Institutes of Health, image courtesy of Wikimedia Commons This subject of microbiome-based therapeutic strategies for rosacea is one of my favorite subjects which I have done a great deal of research on. You may want to read the latest article I have written on this subject of the human microbiome. 
    • Related Articles Skin diseases are more common than we think: screening results of an unreferred population at the Munich Oktoberfest. J Eur Acad Dermatol Venereol. 2019 Mar 19;: Authors: Tizek L, Schielein MC, Seifert F, Biedermann T, Böhner A, Zink A Abstract BACKGROUND: Skin diseases are ranked as the fourth most common cause of human illness, resulting in an enormous non-fatal burden. Despite this, many affected people do not consult a physician. Accordingly, the actual skin disease burden might be even higher since reported prevalence rates are typically based on secondary data that exclude individuals who do not seek medical care. OBJECTIVE: The aim of the study was to investigate the prevalence of skin diseases in an unreferred population in a real-life setting. METHODS: A cross-sectional study of 9 days duration was performed in 2016 at the 'Bavarian Central Agricultural Festival', which is part of the Munich Oktoberfest. As part of a public health check-up, screening examinations were performed randomly on participating visitors. All participants were 18 years or older and provided written informed consent. RESULTS: A total of 2701 individuals (53.5% women, 46.2% men; mean age 51.9 ± 15.3 years) participated in the study. At least one skin abnormality was observed in 1662 of the participants (64.5%). The most common diagnoses were actinic keratosis (26.6%), rosacea (25.5%) and eczema (11.7%). Skin diseases increased with age and were more frequent in men (72.3%) than in women (58.0%). Clinical examinations showed that nearly two-thirds of the affected participants were unaware of their abnormal skin findings. CONCLUSION: Skin diseases might be more common than previously estimated based on the secondary data of some sub-populations. Further information and awareness campaigns are needed to improve people's knowledge and reduce the global burden associated with skin diseases. PMID: 30891839 [PubMed - as supplied by publisher] {url} = URL to article
    • Fractionated Carbon Dioxide Laser Resurfacing as an Ideal Treatment Option for Severe Rhinophyma: A Case Report and Discussion. J Clin Aesthet Dermatol. 2019 Jan;12(1):24-27 Authors: Comeau V, Goodman M, Kober MM, Buckley C Abstract Rhinophyma is a progressive, disfiguring condition that affects the nose and is caused by the hypertrophy of sebaceous glands and connective tissue. Although its exact pathogenesis remains unclear, it is generally thought to be a subtype of the chronic, inflammatory condition rosacea. To date, oral and topical treatments have been largely ineffective at treating rhinophyma. Laser resurfacing is an emerging treatment modality that offers hope for patients with severe rhinophyma. We present a case of rhinophyma treated via fractionated carbon dioxide laser resurfacing with impressive results, excellent tolerability, and minimal downtime. PMID: 30881573 [PubMed] {url} = URL to article
    • Effective Treatment of Morbihan's Disease with Long-term Isotretinoin: A Report of Three Cases. J Clin Aesthet Dermatol. 2019 Jan;12(1):32-34 Authors: Olvera-Cortés V, Pulido-Díaz N Abstract Morbihan's disease is characterized by the presence of chronic and persistent edema of the periorbital tissue, forehead, glabella, nose, and cheeks. In some cases, it is related to acne and rosacea, but its exact etiology remains unknown. A defined therapeutic approach has yet to be established for the treatment of Morbihan's disease. To date, the systemic and surgical options attempted have not been very successful and/or do not yield sustained results. Isotretinoin is a key systemic treatment used for the treatment of various skin conditions. However, there are few reports of isotretinoin being used to treat Morbihan's disease. Here, we present the details of three patients with Morbihan's disease who were successfully treated long-term with isotretinoin. PMID: 30881575 [PubMed] {url} = URL to article
    • They have now discovered that humans might be divided into three types of gut bacteria: Bacteroides, Prevotella and Ruminococcus, which may lead to personalizing medical treatment based upon which type gut microbes you predominantly have. "The three gut types can explain why the uptake of medicines and nutrients varies from person to person," [1] and may develop into a new ‘biological fingerprint’ on the same level as blood types and tissue types, akin to the 'blood type' diet and treatments. That is why probiotic treatment for rosacea is as valid, if not much better, as antibiotic treatment.  Bacteroides Bacteroides is a genus of Gram-negative, obligate anaerobic bacteria. Bacteroides species are non endospore-forming bacilli, and may be either motile or nonmotile, depending on the species. The DNA base composition is 40–48% GC. Unusual in bacterial organisms, Bacteroides membranes contain sphingolipids. They also contain meso-diaminopimelic acid in their peptidoglycan layer. Bacteroides species are normally mutualistic, making up the most substantial portion of the mammalian gastrointestinal microbiota, where they play a fundamental role in processing of complex molecules to simpler ones in the host intestine. As many as 1010–1011 cells per gram of human feces have been reported. They can use simple sugars when available; however, the main sources of energy for Bacteroides species in the gut are complex host-derived and plant glycans.[8] Studies indicate that long-term diet is strongly associated with the gut microbiome composition—those who eat plenty of protein and animal fats have predominantly Bacteroides bacteria, while for those who consume more carbohydrates the Prevotella species dominate.[2] Prevotella Prevotella is a genus of Gram-negative bacteria. Prevotella spp. are members of the oral, vaginal, and gut microbiota and are often recovered from anaerobic infections of the respiratory tract. These infections include aspiration pneumonia, lung abscess, pulmonary empyema, and chronic otitis media and sinusitis. They have been isolated from abscesses and burns in the vicinity of the mouth, bites, paronychia, urinary tract infection, brain abscesses, osteomyelitis, and bacteremia associated with upper respiratory tract infections. Prevotella spp. predominate in periodontal disease and periodontal abscesses. Research of human microbiota show that human gut is mainly inhabited by two phyla of bacteria – Firmicutes and Bacteroidetes, the latter mostly dominated by Bacteroides and Prevotella genera. Prevotella and Bacteroides are thought to have had a common ancestor. Formally, the two genera were differentiated in 1990. [3] Ruminococcus Ruminococcus is a genus of bacteria in the class Clostridia. They are anaerobic, Gram-positive gut microbes. One or more species in this genus are found in significant numbers in the intestines of humans. The type species is R. flavefaciens. As usual, bacteria taxonomy is in flux, with Clostridia being paraphyletic, and some erroneous members of Ruminococcus being reassigned to a new genus Blautia on the basis of 16S rRNA gene sequences. [4] End Notes [1] What’s in your gut? Microbiota categories might help simplify personalized medicineBy Katherine Harmon | April 20, 2011Scientific American [2] Bacteroides, Wikipedia [3] Prevotella, Wikipedia [4] Ruminococcus, Wikipedia
    • Caroline Jones, Rosacea Tips and Support Group, Facebook, reports, "I've been using egg white morning and night and my rosecea has completely gone after using for a month. I've suffered for over three years of red nose and cheeks with spots etc....Saw a programme about how they are looking at egg whites in medicine. It is full of collagen and helps get rid of wrinkles. So I tried it as anti wrinkle treatment.. Side effect was my rosecea started to get better....I just separate the white from the yolk and just smooth it as is over my skin. Leave for 10 mins ( your face will look like your young again whilst it tightens 😂) then just rinse with cold water. Pat dry. no whipping involved." If you try this treatment, please post in this thread your results.  
    • Dirk Bruere has a website where he has tried various formulas using DMSO with green tea, aspirin, alternating with a mixture of Copper Salicylate, Methyl Salicylate and Caffeine. He has tried other drugs/substances with DMSO which he lists that didn't work, and says he has totally cleared his rosacea for a good length of time. If you try this, please post your results in this thread. 
    • [Acne, rosacea, seborrheic dermatitis]. Rev Prat. 2018 Oct;68(8):e303-e309 Authors: Badaoui A, Mahé E Abstract PMID: 30869466 [PubMed - in process] {url} = URL to article
    • [Ocular and cutaneous rosacea in a child]. Arch Argent Pediatr. 2019 Apr 01;117(2):e170-e172 Authors: Di Matteo MC, Stefano PC, Cirio A, López B, Centeno M, Bocian M, Cervini AB Abstract Rosacea is a chronic skin disease characterized by erythema, telangiectasia, papules and pustules in the central facial region. It most often affects adults and is rare in children. Rosacea can also present ocular involvement. Symptoms can precede cutaneous findings, appear simultaneously or after them, with a higher risk of ocular complications in children. Because of low prevalence of rosacea in childhood, the diagnosis is frequently delayed. We report a 1-year-old boy with ocular and cutaneous rosacea who developed corneal opacities and visual impairment. Early diagnosis and treatment is considerable to avoid sequels. PMID: 30869500 [PubMed - in process] {url} = URL to article
    • violentred26 at Reddit (scroll down to find her post) reports, "All I did was buy a big thing of 99% pure aloe Vera gel from Whole Foods (their brand) and a bottle of Jarrow Formulas Curcumin 95. I then opened one capsule of curcumin and dumped it into like two tablespoons of aloe (approximate, I didn’t measure). Then I spread the mixture all over my face and left on for 15 minutes. Oh, I also keep the aloe refrigerated so it’s nice and cold when I put it on. I did this mask once per day starting last Saturday through Tuesday, and I **** you not, it completely killed the rosacea flare up."
    • Mastic Gum Tears - image Wikimedia Commons What is Mastic Gum? costcogoldmember at Reddit reports, "Took Mastic Gum for four weeks and HCL supplement (still to this day). This was the best my skin has ever looked in four years and it cleared up within a couple weeks. It's now March 2019 and I have clear skin." If you try this, please post in this thread your results.  Jarrow Mastic Gum.   Amazing Formulas     Betaine HCL.       Nutricost Betaine HCL                                        Mastic Gum
    • Related Articles New indications for topical ivermectin 1% cream: a case series study. Postepy Dermatol Alergol. 2019 Feb;36(1):58-62 Authors: Barańska-Rybak W, Kowalska-Olędzka E Abstract Introduction: Topical ivermectin is an effective treatment for inflammatory papulopustular rosacea in adults. Positive therapeutic effects of ivermectin due to its potential anti-inflammatory properties could be achieved in the other facial dermatoses. Aim: To assess the efficacy of topical ivermectin 1% cream therapy in mild and moderate perioral dermatitis (PD), seborrheic dermatitis (SD) and acne vulgaris (AV). Material and methods: The study comprising 20 patients diagnosed with PD (8), SD (8) and AV (4) was conducted between November 2016 and July 2017. Two scales were applied to establish efficacy of the treatment: Investigator Global Assessment score (IGA) and Patient Global Assessment of Treatment (PGA). Results: All patients responded to the treatment with topical ivermectin very well with a gradual reduction in inflammatory skin lesions. Complete or almost complete clearance (IGA score 0-1) was achieved in 20 cases. Four patients with PD achieved IGA 0-1 after 4 weeks of treatment, 1 patient after 5 weeks, 2 patients after 6 weeks and 1 patient after 12 weeks. In the total group of 8 patients with SD, 4 presented IGA 0 after 4 weeks of therapy, while 4 patients demonstrated IGA 1 after 6 weeks. Patients with AV required 8 and 10 weeks to obtain IGA 1. Nineteen patients of the studied group reported "very good" or "excellent" response to the therapy, only one patient with AV assessed therapy with topical ivermectin as "good". The adverse events were transient and manifested as mild-moderate desquamation, stinging and burning in 2 patients with PD. Conclusions: Topical ivermectin was well tolerated and beneficial for treatment of mild and moderate PD, SD and AV. PMID: 30858780 [PubMed] {url} = URL to article
    • Wish I could help but don't really know. You may want to know about Jamie Kern Lima, IT Cosmetics, who a rosacea sufferer. Our affiliate store carries some of her line of products. 
    • Related Articles Treatment of granulomatous rosacea with chromophore gel-assisted phototherapy. Photodermatol Photoimmunol Photomed. 2019 Mar 10;: Authors: Liu RC, Makhija M, Wong XL, Sebaratnam DF Abstract Granulomatous rosacea is a variant of rosacea characterized by discrete erythematous papules most commonly affecting the central face. It is a rare condition reported primarily in middle-aged women, and tends to have a chronic course often recalcitrant to therapy. We report a case of granulomatous rosacea treated with chromophore gel-assisted phototherapy (CGAP). This article is protected by copyright. All rights reserved. PMID: 30854732 [PubMed - as supplied by publisher] {url} = URL to article
    • Rebound according to Medicine.net is "The production of increased negative symptoms when the effect of a drug has passed or the patient no longer responds to the drug. If a drug produces a rebound effect, the condition it was used to treat may come back even stronger when the drug is discontinued or loses effectiveness."  This can happen with any drug, but with rosacea the reports of rebound most often are with Mirvaso (Brimonidine) and to a lesser extent with Rhofade (Oxymetazoline Hydrochloride). The RRDi began collecting anecdotal reports of Mirvaso Rebound and stopped at 242.  Both of these drugs are vasoconstrictors. You should be aware of this side effect or risk associated with these two drugs. 
    • sorry i don't try this recently i found the list of some best concealers in 2019 can you tell me what's your opinion ?? https://thefashionupdates.com/best-concealers/
    • The Daily Mail reports of an ex-model, Rebecca Morrison, who was able to stop her antibiotic treatment she was using for her rosacea and successfully used Kalme Day Defence SPF 25. Rebecca is reported to say, "I've now been using Kalme for a year and have been more or less free from all the symptoms for the majority of that time. Since using product I've seen almost 100 per cent improvement in my skin. I still get a few pimples now and then when I'm especially stressed and get a little flush if I'm out in the sun but zero flaking skin, painful irritation or furious redness! It has truly changed my life!" Kalme Day Defence SPF 25 is sold in the United Kingdom and you can review the ingredients.  Mother whose rosacea left her skin a 'furious' mess during pregnancy reveals she improved her skin in just four weeks WITHOUT medication - and it was all thanks to a £19.95 cream, By Chloe Morgan for MailOnline, Daily Mail  
    • Keep us posted on your progress. Taking probiotics (there is a lot of discussion on what brand to buy, but I think the main thing is your taking some kind of probiotic) along with Efracea can only help your gut and skin. I personally take bunch of vitamins and minerals. If you are interested in this subject, read this article on this FAQ: Do Rosacea Sufferers have Nutritional Deficiencies?
    • Thanks for your reply and it really helps me a lot!  I am so glad to meet RRDi and it just gave me so many information and solutions to tackle my skin problems (and not only rosacea).  I read some articles about probiotics from the forum and I am now taking a probiotic capsule which claimed to have 4 million friendly bateria. Do you have any suggestions on the brand/ type of bacteria?  Also I am now taking so many supplements. Evening Primrose oil, vitamin B, zinc picolinate and probiotics. I hope they work for me when I stop my Efracea ... i will start my soolantra treatment on Tue and hope it works for me and without making my skin worse.    Thanks a a lot again! 
    • Hi Jesse, Thanks for joining the RRDi and posting. The Efracea (European version of Oracea) and Soolantra are the gold standard for rosacea treatment currently, the state of the art. It has been reported that using Soolantra it does get worse before it gets better, but some report no worsening of the skin, only improvement. The Efracea should improve your skin since you responded so well with doxycycline before. You may want to look into probiotic treatment since this is now a medically acceptable treatment for rosacea. After you skin improves, you may want to consider the long term effects of antibiotic treatment and opt out for probiotics. There are many who report successful treatment of the gut, which the RRDi recognizes as GUT Rosacea when rosacea responds to intestinal treatment. Not all rosacea is demodectic rosacea and the RRDi is the only non profit for rosacea that recognizes thirteen variants of rosacea. Since you have dry skin you may want to consider the new cosmetic ZZ cream which will be released in April 2019 and is designed for dry skin manufactured in China by the Zhongzhou Pharmaceutical Company, the company that manufactures the original famous ZZ Cream. The Cosmetic ZZ cream has already been released in Europe as Demoderm. You may respond well to it so it may be worth your effort to try it since you are so close to the source. You will know in thirty days whether the ZZ cream works for you. Since you live in Hong Kong you may find is easy to drop by Demodex Solutions, a sponsor of the RRDi, at this address:  Demodex Solutions limited 1450 Chun Shing Factory Estate 85-89 Kwai Fuk Road Kwai Chung NT Hong Kong Tel: (852) 81916262 Mobile: (852) 85267369688 Fax: (852) 67369688 Email: info@demodex.com Skype name: demodexsolutions
    • Increased Risk of Cardiovascular Diseases in Female Rosacea Patients: A Nested Case-control Study. Acta Derm Venereol. 2019 Mar 08;: Authors: Sinikumpu SP, Jokelainen J, Auvinen J, Puukka K, Kaikkonen K, Tasanen K, Huilaja L PMID: 30848290 [PubMed - as supplied by publisher] {url} = URL to article
    • Hello.  I am Jesse and I am from Hong Kong. I am suffering from rosacea for more then three years and I found that there are little support in Hong Kong and China.  Three years ago, one day, I found there are so many papales and pustules on my cheeks and it was flushing. In my first year of rosacea, I was misdiagnosed by three doctors and they just prescribed steroid for me. I didn’t use that as I know it’s not good for me. Until the fourth doctor, who is a dermatologist, he diagnosed me with a rosacea. He prescribed me doxycycline and azelaic acid. The azelaic acid made my skin burn and I stopped to use it after applied it once. The doxycycline works well and I took it for two weeks. It seems it has been cured and I was so happy with this. However after the doxy treatment and until now the papales and pustules still appeared on my face and they were extremely itchy. As there are no flushing on my face, I didn’t think that it’s the rebound of the rocasea. Until there few months, my face become flushing and there are hundreds of pustules on my face. I found that my rocasea comes back occasionally ( I still can’t find what exactly trigger it in my case). I am so annoyed because it makes me so embarrassed and don’t want to go out.  I kept reading on the rocasea forums and the studies. I just want to ask if my rosacea comes out occasionally (twice a month), is it still possible to be caused by the  Demodex mites ? I have recently purchased Soolantra but afraid to use it as so many people said it will get worse before it get better.  I am now taking the Efracea (40mg modified release doxycycline). Would this be useful to calm the inflammation caused in the Soolantra treatment?  So many people gave good comments on the ZZ cream but some said that it dries out the skin. I have got a very sensitive dry skin, should I try Soolantra first or ZZ cream?  I have attached some photos in this post. Thanks a lot! 
    • Characterization of the Blood Microbiota in Korean Females with Rosacea. Dermatology. 2019 Mar 07;:1-5 Authors: Yun Y, Kim HN, Chang Y, Lee Y, Ryu S, Shin H, Kim WS, Kim HL, Nam JH PMID: 30844814 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Spanish Consensus Document on the Treatment Algorithm for Rosacea. Actas Dermosifiliogr. 2019 Mar 02;: Authors: Salleras M, Alegre M, Alonso-Usero V, Boixeda P, Domínguez-Silva J, Fernández-Herrera J, García-Navarro X, Jiménez N, Llamas M, Nadal C, Del Pozo-Losada J, Querol I, Salgüero I, Schaller M, Soto de Delás J Abstract Recent scientific evidence and the incorporation of new drugs into the therapeutic arsenal against rosacea have made it necessary to review and update treatment criteria and strategies. To this end, a panel of 15 dermatologists, all experts in rosacea, was formed to share experiences and discuss treatment options, response criteria, and changes to treatment. Based on a critical review of the literature and a discussion of the routine practices of Spanish dermatologists, the panel proposed and debated different options, with consideration of the experience of professionals and the preferences of patients or equality criteria. Following validation of the proposals, the final recommendations were formulated and, together with the evidence from the main international guidelines and studies, used to produce this consensus document. The goal of this consensus document is to provide dermatologists with practical recommendations for the management of rosacea. PMID: 30837074 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Rare diseases that mimic Systemic Lupus Erythematosus (Lupus mimickers). Joint Bone Spine. 2019 Mar;86(2):165-171 Authors: Chasset F, Richez C, Martin T, Belot A, Korganow AS, Arnaud L Abstract Several conditions have clinical and laboratory features that can mimic those present in Systemic Lupus Erythematosus (SLE). Some of these "SLE mimickers" are very common, such as rosacea which can be mistaken for the butterfly rash, while others such as Kikuchi disease, type-1 interferonopathies, Castleman's disease, prolidase deficiency, angioimmunoblastic T-cell lymphoma, Evans' syndrome in the context of primary immune deficiencies and the autoimmune lymphoproliferative syndrome are exceptionally uncommon. A proper diagnosis of SLE must therefore be based upon a complete medical history as well as on the adequate constellation of clinical or laboratory findings. While there is no single test that determines whether a patient has lupus or not, the search for auto-antibodies towards nuclear antigens is a key step in the diagnosis strategy, keeping in mind that ANAs are not specific for SLE. In case of persistent doubt, patients should be referred to reference centers with experience in the management of the disease. PMID: 30837156 [PubMed - in process] {url} = URL to article
    • image courtesy of Wikipedia Over the years it has amazed me how the public has so little knowledge of the three basic food groups, i.e., protein, fat and carbohydrate. Yes, a significant number of the public can name the three basic food groups, but that is as far as it goes and where the confusion begins. The public receives a lot of nutrition recommendations by not only their teachers, physicians, and the government, but also the incredible amount of data on the internet which appears to further confuse everyone. For example, the USDA Center for Nutrition Policy and Promotion lists five food groups in the MyPlate program, while the National Institute of Health proposes the Dietary Approaches to Stop Hypertension (DASH) diet lists eight food groups, and Pass My Exams lists seven nutrition food groups. If you google this subject, you will get so many different recommendations on what constitutes the food groups and how many there should be.  Nutrition Facts Label However, in most countries in the world, there is now mandated a Nutrition Facts Label that is prominently displayed on food and drink products that can really clear up all this confusion. In the USA, the "label was mandated for most food products under the provisions of the 1990 Nutrition Labeling and Education Act (NLEA), per the recommendations of the U.S. Food and Drug Administration." [1] Technically, the Pass My Exams that lists the seven nutrition food groups is closer to what is required for proper nutrition [2], and is true to survive and live healthy one needs all seven food groups listed but technically, carbohydrate is not an essential nutrient since you can obtain glucose, which is an essential carbohydrate nutrient required to survive that can be obtained from protein or fat. [3] Nevertheless, most humans obtain glucose from consuming carbohydrate and you do need the other six food groups and the Nutrition Facts Label can help sort through the confusion. For example, in the image at the top of this post is an example of the Nutrition Facts Label on a package of macaroni and cheese. The three basic food groups are in bold letters, Fat, Carbohydrate and Protein. Depending on the food or drink item the label may also include other nutrients such as Vitamins or minerals. However, if you note, water is never mentioned as a nutrition since everyone usually knows that water is essential for human survival and to maintain a healthy status, even though most food and drink contains some water. In this example, macaroni and cheese contains mostly carbohydrate (31 gram), fat (12 grams) and protein (5 grams) making a total of 48 grams. If you look at the total serving in this example it is 228 grams. If you subtract the basic three food groups from the total serving size you have 180 grams. So how do you account for the 180 grams? The Nutrition Facts Label acknowledges some of the essential nutrients such as sodium which amounts to 470 mg (less than half a gram). The other essential nutrients listed such as Vitamin A, Vitamin C, Calcium and Iron only take up such a trace amount of milligrams that it is not even listed. Water takes up most of the 180 grams unaccounted for. The label gives you information at the bottom concerning 'daily values' that is supposed to be helpful but can also be very confusing to the average reader, which if you want to clear up this confusion, you will have to do some more research.  What is the most helpful information about the Nutrition Facts Label is that it lists the three basic food groups, protein, fat and carbohydrate. You can determine the amount or the percentage of each of these food groups. To determine the percentage is simple math. Take our example of macaroni and cheese which contains a total of 48 grams. To determine the percentage of carbohydrate contained in this food serving you simply divide 31 grams into 48 grams and the result is 64.5% which is the total percentage of carbohydrate in a 228 gram serving of this item. This is why the label is so helpful, you can determine what the primary amount or percentage of a food or drink in terms of the three basic food groups. This helps you know how to see what you are consuming each day in terms of these basic three food groups.  Food Groups, Body Mass and Rosacea For rosaceans who are concerned about diet triggers, particularly sugar and carbohydrate diet triggers, understanding that the human body is mostly made up of water, protein and fat and how little is comprised of carbohydrate (about 1%) [4], should clear up some of the confusion on how over consuming carbohydrate can be an issue for rosacea sufferers. Using the Nutrition Facts Label to gain proper data on what you are consuming will help you see how your high carbohydrate diet is a factor in triggering your rosacea. [5] You can then decide what you want to do about this using the information you just read.  End Notes  [1] Nutrition facts label, Wikipedia [2] The seven essential nutrients are the following:  Carbohydrate Protein Fat Fibre Vitamins Mineral Water Source: Why We Need Food, Pass My Exams [3] Carbohydrate Not Essential For Human Survival [4] Carbohydrate Body Mass Percentage [5] Sugar and Rosacea
    • Many rosaceans complain of dry skin issues and want to find the perfect moisturizer. Those with oily skin usually don't complain about this issue. However, if you are treating your rosacea with sulphur based treatments, finding a perfect moisturizer can really be hard to find. You may want to ask your dermatologist for sample to try either the original formula emollient cream or the low sulphur emollient. This may be what the doctor ordered for your dry skin issues.  AVAR-e® Emollient Cream Prescribing Information AVAR-e® LS Emollient Cream Prescribing Information
    • My dermatologist gave me some samples of Avar-e Green and I noticed that it does indeed help my rosacea and SD. You may want to ask your dermatologist for some samples to try out and see if it works for you. Please post in this thread your results. AVAR-e Green® Cream Prescribing Information
    • Related Articles Idiopathic Facial Aseptic Granuloma: Updated Review of Diagnostic and Therapeutic Difficulties. Actas Dermosifiliogr. 2019 Feb 25;: Authors: Hasbún Z C, Ogueta C I, Dossi C T, Wortsman X Abstract Idiopathic facial aseptic granuloma is a pediatric skin condition involving asymptomatic reddish nodules. The etiology and pathogenesis is still under discussion, although the literature tends to place this condition within the spectrum of childhood rosaceas. The clinical course is chronic but benign, and cases have been reported to resolve spontaneously in less than a year. Even though no well-defined treatment has emerged, a conservative approach that avoids aggressive therapies is preferred. PMID: 30819406 [PubMed - as supplied by publisher] {url} = URL to article
    • Atrophic acne scar: A process from altered metabolism of elastic fibers and collagen fibers based on TGF-β1 signaling. Br J Dermatol. 2019 Mar 01;: Authors: Moon J, Yoon JY, Yang JH, Kwon HH, Min S, Suh DH Abstract BACKGROUND: Atrophic acne scar, a persistent sequela from acne, is undesirably troubling many patients in cosmetic and psychosocial aspects. Although there have been some reports to emphasize the role of early inflammatory responses in atrophic acne scarring, evolving perspectives on the detailed pathogenic process are promptly needed. OBJECTIVES: Examining the histological, immunological and molecular changes in early acne lesions susceptible to atrophic scarring can provide new insights to understand the pathophysiology of atrophic acne scar. METHODS: We experimentally validated several early fundamental hallmarks accounting for the transition of early acne lesions to atrophic scars by comparing molecular profiles of skin and acne lesions between patients who were prone to scar (APS) and not (ANS). RESULTS: In APS, compared to ANS, devastating degradation of elastic fibers and collagen fibers occurred in the dermis, followed by their incomplete recovery. Abnormally excessive inflammation mediated by innate immunity with Th17/Th1 cells was observed. Epidermal proliferation was significantly diminished. TGF-β1 was drastically elevated in APS, suggesting that the aberrant TGF-β1 signaling is an underlying modulator of all these pathological processes. CONCLUSIONS: These results may provide a basis for understanding the pathogenesis of atrophic acne scarring. Reduction of excessive inflammation and TGF-β1 signaling in early acne lesions is expected to facilitate the protection of normal extracellular matrix metabolism and the prevention of atrophic scar formation ultimately. This article is protected by copyright. All rights reserved. PMID: 30822364 [PubMed - as supplied by publisher] {url} = URL to article
    • image courtesy of Wikimedia Commons “The body of a healthy lean man is composed of roughly 62 percent water, 16 percent fat, 16 percent protein, 6 percent minerals, and less than 1 percent carbohydrate, along with very small amounts of vitamins and other miscellaneous substances. Females usually carry more fat (about 22 percent in a healthy lean woman) and slightly less of the other components than do males of comparable weight.” Human Nutrition, Kenneth Carpenter A. Stewart Truswell Douglas W. Kent-Jones Jean Weininger, Encyclopedia Britannica So depending on the weight and sex, you can see that the majority of the human body is water (62%), and protein and fat make up about a 50/50 ratio comprising of about a third of the body mass, while carbohydrate only amounts to a tiny 1% of the body mass. Since there is so little carbohydrate making up your body mass, why is it that today's modern diet consists of more carbohydrate than protein and fat? Yet, for most humans living in the modern world, the diet consists of a majority of carbohydrate. In times past, say a couple of hundred years ago, humans ate more protein and fat, or at the very least equal amounts of all three food groups. The increase of carbohydrate in the human diet, particularly sugar, whether as high fructose corn syrup or sucrose (or any other sugar) has only happened in the last couple of hundred years, particularly in the last one hundred years. What has the increased sugar intake in human consumption along with other carbohydrate done to health? The increased knowledge data of over consumption of sugar/carbohydrate continues to show the detrimental effect to human health and you are without a doubt aware you should limit your sugar/carbohydrate intake to improve your health. You know you are consuming too much sugar/carbohydrate in your diet and this is triggering your rosacea. If you are not convinced, why not try reducing sugar/carbohydrate for thirty days and see if your rosacea improves? This will probably be the hardest fast you have ever done since sugar/carbohydrate is embedded into the typical modern industrial diet and it is so difficult to avoid sugar/carbohydrate, mainly because you are addicted to sugar. But a clear face is worth it, isn’t it?        
    • image courtesy of Wikimedia Commons You without a doubt have heard about body mass so let me ask you a question: Question What percentage of body mass is your protein, fat and carbohydrate? You think about this for a while and then after you have your answer ready click below for the facts.
    • Related Articles Global rosacea treatment guidelines and expert consensus points: The differences. J Cosmet Dermatol. 2019 Feb 26;: Authors: Juliandri J, Wang X, Liu Z, Zhang J, Xu Y, Yuan C Abstract BACKGROUND: Rosacea is a highly prevalent, chronic inflammatory disease. The treatment of rosacea remains a challenge to dermatologists. Therapies include skin care, medications, lasers, and various combinations of these modalities. The appropriate treatment depends on clinical types and patient's various clinical symptoms. PURPOSE: The purpose of this study was to review and compare current therapies for rosacea of all severities from four different guidelines. METHODOLOGY: We searched PubMed using the keywords "rosacea," "treatment" AND ["erythema rosacea" OR "papulopustular rosacea" OR "ocular rosacea" OR "phymatous rosacea"]. We selected randomized controlled trials, observational studies, controlled clinical trials, and clinical trials. We indentified further studies (including the guidelines) by hand-searching relevant publications and included those that met the inclusion criteria. RESULTS: The total number of records identified was 421. We limited our search to the specific abovementioned study types. Twenty-five of these studies met with our inclusion criteria. An additional five manuscripts were selected using the abovementioned method, and four guidelines were included in this review. CONCLUSION: Diagnosing and choosing the appropriate treatment options of rosacea according to guidelines is the basis of scientific criteria. More large-scale randomized controlled clinical trials on new treatment methods, new drugs, or new dosage forms provide a new guideline for future rosacea treatment. Although there are some differences in the treatment of rosacea, it is generally based on anti-demodex, anti-inflammatory, and anti-angiogenesis. PMID: 30809947 [PubMed - as supplied by publisher] {url} = URL to article
    • Cutera has announced "a significant leap forward in the Company’s current excel V laser platform' introducing the excel V+ with the following features:  Fully-integrated 532/+ 1064 nm wavelengths, with the addition of ‘Green Genesis’ a micro-pulsed 532 nm procedure 50% more power with the 532 nm wavelength Large spot sizes up to 16 mm for 2X faster treatments New ‘Dermastat’ tracing handpiece to quickly treat small vascular and pigmented lesions on the face and body Cutera Announces Global Commercial Launch Of the excel V+® the Next Generation Laser Platform, Global Newswire
    • Update  "In the assessment of facial dermal tolerability at Week 52, more than 95% of patients had either no signs or symptoms, or signs/symptoms that were classified “mild” (burning/stinging, flushing/blushing, dryness, itching, peeling and hyperpigmentation). The severity of key clinical manifestations of rosacea - erythema and telangiectasia - had both significantly improved when compared to Baseline of the preceding double-blind studies. Patient satisfaction with FMX103 treatment remained high when re-assessed at Week 52 which was consistent with scores obtained at Week 12 (end of double-blind studies)." Foamix Announces Positive Results from Phase 3 Open-Label Safety Study Evaluating FMX103 Topical Minocycline Foam for Treatment up to 1 Year Long Term Data on FMX103 Demonstrated a Generally Favorable Safety Profile; 81.6% of Patients Achieved Clear or Almost Clear Skin at 52 Weeks Global Newswire
    • Update “Sol-Gel anticipates that building a portfolio of generic product candidates with favorable commercial agreements can supplement its branded pipeline and potentially have a meaningful contribution to the Company’s operating income,” stated Alon Seri-Levy, Chief Executive Officer of Sol-Gel. “This strategy first came to fruition last January when Perrigo received tentative approval from the FDA for ivermectin cream, 1%, developed in collaboration with Sol-Gel.  Perrigo was second to file and, as of today, has the only reported tentative approval for ivermectin cream, 1%, and there is no public disclosure of a third filer to the FDA," added Dr. Seri-Levy." Sol-Gel Technologies Announces Sixth Agreement for a Generic Product Candidate with Perrigo, Globe Newswire
    • image courtesy of Royal Queen Seeds "A study recently showed the efficacy of hemp seed oil to control the symptoms of dermatitis. Hemp seed oil contains stearidonic acid, gamma-linoleic acid, and oleic acid, which help reduce skin inflammation in conditions such as eczema and rosacea. Its content of polyunsaturated fatty acids, such as omega-6 and omega-3, improves blood circulation and vascular functionality even in the thin capillaries of our face. Plus, hemp seed oil contains vitamins that are essential for the skin, synergising with the other compounds to produce a more pronounced effect." How Cannabis And Hemp Can Reduce Symptoms Of Rosacea, Cannabis Blog, Royal Queen Seeds
    • Related Articles Erythematotelangiectatic rosacea may be associated with a subclinical stage of demodicosis. A case control study. Br J Dermatol. 2019 Feb 22;: Authors: Forton F, De Maertelaer V Abstract BACKGROUND: Facial densities of Demodex mite have been observed to be greater in patients with demodicosis and papulopustular rosacea than in healthy control patients. In patients with erythematotelangiectatic rosacea (ETR), this density has been observed to be similar to or greater than that of healthy controls. Erythema and telangiectasia, characteristics of ETR, are often observed among patients with pityriasis folliculorum, a discreet demodicosis, suggesting a possible link between these conditions. OBJECTIVES: To compare the facial Demodex densities of patients with clinical ETR and patients with healthy skin, demodicosis, rosacea with papulopustules, and other dermatoses. METHODS: In this retrospective study, we recorded Demodex densities measured using two consecutive standardised skin biopsies (SSSB1 and SSSB2) in 23 patients with ETR, 20 healthy control patients, 590 patients with demodicosis, 254 with rosacea with papulopustules, and 180 with other facial dermatoses. RESULTS: Patients with ETR had higher Demodex densities than did the healthy controls (mean ±SEM, SSSB1: 15.7±6.3 vs. 1.8±1.1 Demodex(D)/cm² [p=0.042]; SSSB2: 38.0±13.7 vs. 5.1±2.1 D/cm² [p=0.026]) and patients with other dermatoses (SSSB1: 0.4±0.1D/cm² [p=0.004]; SSSB2: 1.3±0.3 D/cm² [p=0.004]), but lower than patients with demodicosis (SSSB1: 82.7±4.2D/cm² [p=0.008]; SSSB2: 172.2±7.7 D/cm² [p=0.001]) or rosacea with papulopustules (SSSB1: 86.6±7.3 D/cm² [p=0.027]; SSSB2: 197.0±12.1 D/cm² [p=0.002]). CONCLUSIONS: ETR may be associated with non-visible Demodex proliferation, possibly corresponding to a subclinical stage of demodicosis. Dermatologists should be aware of this potential association and look for subclinical demodicosis in patients with ETR, so that topical acaricidal treatment can be offered if Demodex density is high. This article is protected by copyright. All rights reserved. PMID: 30801673 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Unusual case of rosacea fulminans after topical metronidazole application. Int J Dermatol. 2019 Feb 22;: Authors: Prieto Herman Reinehr C, Kalil CLPV, Bakos RM PMID: 30801678 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Rosacea fulminans - coincidence of the disease with inflammatory bowel disease. J Eur Acad Dermatol Venereol. 2019 Feb 22;: Authors: Nowak M, Barańska-Rybak W, Mehrholz D, Nowicki J Abstract Rosacea fulminans is characterised by indurated erythematous plaques, papules, pustules, nodules, typically occurring on the face. Forehead, nasal bridge, cheeks and chin are most severely affected. Scarring is unfortunately very common and expected often in poorly managed patients. This article is protected by copyright. All rights reserved. PMID: 30801824 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Epidemiology and Dermatological Comorbidity of Seborrhoeic Dermatitis - Population-based Study in 161,000 Employees. Br J Dermatol. 2019 Feb 25;: Authors: Zander N, Sommer R, Schäfer I, Reinert R, Kirsten N, Zyriax BC, Maul JT, Augustin M Abstract BACKGROUND: Seborrhoeic dermatitis (SD) is a common but epidemiologically poorly researched chronic skin disease. OBJECTIVES: To characterise the prevalence and dermatological comorbidity of SD in Germany. METHODS: In the course of voluntary company skin checks, full body examinations were carried out in more than 500 companies by experienced dermatologists and documented electronically. RESULTS: 161,269 participants were included (55.5% male, mean age 43.2+10.9 years). SD was identified in 3.2% (men: 4.6%, women 1.4%). A significant difference was found between age groups (2.0% in < 35; 3.6% in 35-64; 4.4% ≥ 65 years). Most frequent concomitant skin conditions were: folliculitis (17.0%, 95% CI 15.9-18.1), onychomycosis (9.1%, 95% CI 8.3-10.0), tinea pedis (7.1%, 95% CI 6.3-7.8), rosacea (4.1%, 95% CI 3.6-4.7), acne (4.0%, 95% CI 3.4-4.5) and psoriasis (2.7%, 95% CI 2.3-3.2). Regression analysis revealed the following relative dermatological comorbidity when controlling for age and gender: folliculitis (OR 2.1, 95% CI 2.0-2.3), contact dermatitis (OR 1.8, 95% CI 1.1-2.8), intertriginous dermatitis (OR 1.8, 95% CI 1.4-2.2), rosacea (OR 1.6, 95% CI 1.4-1.8), acne (OR 1.4, 95% CI 1.2-1.7), pyoderma (OR 1.4, 95% CI 1.1-1.8), tinea corporis (OR 1.4, 95% CI 1.0-2.0), pityriasis versicolor (OR 1.3, 95% CI 1.0-1.7) and psoriasis (OR 1.2, 95% CI 1.0-1.4). CONCLUSIONS: SD is a common disease which is more prevalent in men and older people and has an increased rate of dermatological comorbidity. However, absolute differences in prevalence of comorbidities are mostly small and negligible. Nevertheless, the findings underline the necessity of integrated, complete dermatological diagnostics and therapy. This article is protected by copyright. All rights reserved. PMID: 30802934 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles A novel moisturizer with high sun protection factor improves cutaneous barrier function and the visible appearance of rosacea-prone skin. J Cosmet Dermatol. 2019 Feb 25;: Authors: Baldwin H, Santoro F, Lachmann N, Teissedre S Abstract BACKGROUND: Consensus guidelines advocate general skincare for rosacea patients. OBJECTIVES: Two independent studies were performed to assess whether a tinted daily SPF-30 facial moisturizer (DFM30) improves barrier function of dry skin and the efficacy and tolerability of DFM30 on rosacea-prone skin. METHODS: In study 1, electrical capacitance (EC) and transepidermal water loss (TEWL) were measured at baseline, 2, 4, 8, and 24 hours after a single application of DFM30 and on a control site in 21 healthy females with dry skin. Study 2 evaluated 33 females with mild to moderate rosacea and nontransient erythema. Efficacy and tolerability after once-daily DFM30 were assessed using a chromameter, image analysis of photographs, and trained rater and patient evaluations up to day 22. RESULTS: In study 1, EC showed statistically significant increases at 2, 4, and 8 hours, and TEWL showed statistically significant decreases 2, 4, 8, and 24 hours after DFM30 application to healthy females compared to baseline. In study 2, covering skin redness improved significantly after DFM30 application on day 1; 33.3% showed improved covering skin redness compared to baseline. Patients reported significantly less redness on day 8 than day 3. Feelings of dryness and tightness/tension were lower 30 minutes after first application. Feeling of dryness was lower than baseline after 3 days, 1 and 3 weeks. Image analysis suggested redness was significantly lower on day 22 compared to baseline. Chromameter readings showed significantly lower erythema on the cheek compared to baseline. All patients stated that DFM30 relieves and neutralizes visible redness who also indicated that they would purchase DFM30, and the product was well tolerated. CONCLUSIONS: These studies show that DFM30 is suitable as part of the skincare regimens advocated by ROSacea COnsensus (ROSCO) for rosacea patients. DFM30 is an effective moisturizer that improves cutaneous barrier function and the appearance of rosacea-prone skin. PMID: 30803131 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Stepwise Surgical Treatment of Gnathophyma. Dermatol Surg. 2019 01;45(1):158-160 Authors: Moiin A, Mahmood SH, Kurtovic A PMID: 29642112 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Natural Skin Care Products as Adjunctive to Prescription Therapy in Moderate to Severe Rosacea J Drugs Dermatol. 2019 Feb 01;18(2):141-146 Authors: Draelos ZD, Gunt H, Levy SB Abstract Background: Rosacea is characterized by irritation associated with erythema, telangiectasias and papules/pustules. Whole formula nature-based sensitive skin products are formulated to maintain skin barrier and appropriate hydration that can lead to soothing benefits. Objective: To evaluate the efficacy and tolerability of a regimen consisting of a cleanser containing natural oils, beeswax, and witch hazel and day and night creams containing natural oils, glycerin, and botanical anti-inflammatories (NR); and a synthetic dermatologist-recommended regimen of cetyl alcohol, sodium lauryl sulphate-containing cleanser, and glycerin, polyisobutene-containing lotion (CR) in subjects with rosacea. Methods: 80 female subjects with rosacea who received 6 weeks of 0.75% metronidazole gel, were randomized to receive NR or CR, twice daily, for 4 weeks in conjunction with the gel. Blinded investigator global assessment of rosacea, investigator-rated, and subject-rated overall skin appearance was assessed using a 5-point scale (0=none, 4=severe) at baseline, 2 weeks, and 4 weeks. Noninvasive skin assessments for skin hydration and skin barrier function were made by corneometry and TEWL, respectively. Results: NR resulted in improvement in investigator global assessment of rosacea measures at 4 weeks from baseline (erythema, 28%; telangiectasia, 26%; papules/pustules, 34%: P<0.001) and CR resulted in a 8 to 12% improvement. Differences between treatments were statistically significant. Overall skin appearance measured by the investigator was clinically and statistically improved from baseline by 32% and 12% with NR and CR, respectively. Overall skin appearance measured by subjects was improved by both NR and CR from baseline with no differences between treatments. Both regimens improved barrier function from baseline to week 4 (13%, NR; 14%, CR). NR decreased hydration by 21% from baseline at week 4 while CR increased hydration by 14% (P<0.001 from NR). No clinically significant tolerability issues were reported in either regimen at week 4. Conclusion: NR was effective, well tolerated, and superior to CR in the management of rosacea, concomitantly treated with metronidazole. National Clinical Trial Identifier: NCT03392558 J Drugs Dermatol. 2019;18(2):141-146. PMID: 30794364 [PubMed - as supplied by publisher] {url} = URL to article
    • If you have been treating your rosacea and the treatments are not responding to the standard treatments offered by your dermatologist, this is an old article, written in 2008, which doesn't even mention the gold standard of treatment for rosacea, but you may find it helpful if you haven't heard of any of these treatments. All these treatments are mentioned in the category:  Forum Home > Forums >  Public Forum >  Rosacea Topics >  Prescription Treatments  "As you’re already aware, standard FDA-approved therapies for rosacea include topical preparations: metronidazole, clindamycin, azelaic acid, sulfur, sodium sulfacetamide and oral medications: tetracycline, doxycycline and minocycline. As all dermatologists know, these therapies sometimes do not work, so an awareness of off-label uses of other medication groups and approaches is useful to avoid treatment failure, patient frustration and dermatologist exasperation. I will focus on four groups and approaches: retinoids, anti-parasitic agents, Helicobacter pylori treatment and second-generation macrolides." There are other options or alternatives  also reported using oral ivermectin and metronidazole, other prescriptions, secondary therapy, the ZZ Cream, demodex treatments,  probiotics (probiotic therapy), or a growing list of non prescription or over the counter treatments (our affiliate store). 
    • The gold standard for rosacea treatment is Oracea and Soolantra, both Rx(s) from Galderma (yes, Galderma has sponsored three RRDi education grants).  If your physician (hopefully a dermatologist) hasn't treated you with the gold standard, then, your physician simply isn't keeping up with the latest information on rosacea treatment. If these two treatments don't improve your rosacea, then you obviously have some other rosacea variant, rosacea mimic, or some other possible co-existing condition. Also, if your physician diagnoses you with a subtype of rosacea, your physician hasn't been keeping up with the new phenotype classification of rosacea, so you may want to find one who is keeping up with the latest information on rosacea. Once you are on the gold standard of treatment for rosacea you should improve within thirty days. Some may take longer, say sixty to ninety days, but usually you will know whether this treatment improves your rosacea within this time period. If not, you simply go back to your physician (hopefully a dermatologist) who will prescribe a different treatment if you don't respond to the gold standard. Not everyone will respond well to the gold standard, but it is worth trying since many do improve their rosacea with this treatment.  Because the gold standard is so expensive (Oracea and Soolantra are expensive, hence the gold designation), in many social media groups, i.e., Facebook, Twitter, Reddit, there are reports that many have been trying an inexpensive horse paste and rave about the success. There are other options or alternatives  also reported using oral ivermectin and metronidazole, other prescriptions, secondary therapy, the ZZ Cream, demodex treatments,  probiotics (probiotic therapy), or when rosacea doesn't respond to standard therapies. 
    • Related Articles Occupational allergic contact dermatitis to sulfite in a seafood section worker of a supermarket. Contact Dermatitis. 2019 Feb 18;: Authors: Raison-Peyron N, Roulet A, Dereure O Abstract A 56-year-old female patient was referred for itchy face dermatitis of a few months duration (fig 1). She had had allergic contact dermatitis to cheap jewellery and to an antifungal cream (Kétoderm) and was regularly using cosmetics for vascular rosacea. This article is protected by copyright. All rights reserved. PMID: 30779161 [PubMed - as supplied by publisher] {url} = URL to article
    • At the Hilton Waikoloa Resort on the Big Island of Hawaii, the Skin Disease Education Foundation is holding its 43rd annual seminar, February 17 - 22, 2019. Linda Stein Gold, MD, RRDi MAC Member spoke on how to manage rosacea patients.
    • A June 2018 article published at Bustle adds more confusion to rosaceans who read this and believe there are '9 unexpected causes of rosacea' when such a title is very misleading and so untrue. What the article is actually discussing is common rosacea triggers which are found on many rosacea trigger lists and there has never been a rosacea trigger connected with causing rosacea. Triggers are only causing a rosacea flare up or flush. While the article starts out clearly stating that the "causes of rosacea are infuriatingly elusive," and clearly states there are "numerous unexpected factors that could be triggering your rosacea," the title suggests otherwise. The 'causes' in the title of the article should have read, 'triggers.' Ms Dixon does refer to the NHS website article on the web, Causes of Rosacea, stating "The NHS offers an exhaustive (and exhausting) list of theories surrounding the origins of rosacea." The NHS article in the first paragraph states, "The exact cause of rosacea is unknown, although a number of potential factors have been suggested." 9 Unexpected Causes Of Rosacea, Because Changing These Everyday Things Could Have A Huge Impact, Emily Dxon, Bustle By EMILY DIXON
    • "The study found that people stigmatized by rosacea: are embarrassed by their skin condition (77 per cent); have difficulty establishing new relationships (53 per cent); avoid public contact or cancel social engagements (54 per cent); get depressed (70 per cent); lose confidence (69 per cent); and feel frustrated and angry (74 per cent). Rosacea also negatively affected their sex life, family life, work life, mood and psychological condition." Study confirms the emotional pain rosacea inflicts, says Windsor dermatologist, Brian Cross, CTV Windsor  
    • Interview on CTV Windsor
    • Thanks for you post. That is what the RRDi is all about, a huge database of rosacea information to educate rosaceans. The treatments that don't work need to be flagged by posting a user experience. A treatment that does works needs to be shared. The RRDi has the means to contact any member by email address to confirm that the user is an actual rosacea sufferer and if the poster doesn't respond to the inquiry then the user can be banned. This isn't being done in rosacea groups on Facebook, Twitter or other social media (the posts could be spam and very little is being done to prevent spam). The RRDi has safeguards in place to prevent spammers and trollers who prey on rosacea sufferers. 
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