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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

    Anecdotal Reports of Misdiagnosis

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

    "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 #68

    "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 #66

    full reports, "Just diagnosed with this infuriating condition after 2 years of be wrongly diagnosed and treated for both rosacea and acne. I am really clueless about this condition and need a explanation of it.. Anyone ever permanently got rid of this? My face is only affected, mainly my cheeks.," full types in the subject of this post Pityrosporum Folliculitus

    lexflorex reports, "I just want to share with you that I didn't have Rosacea. I was first diagnosed with it and prescribed a medication that didn't help me at all. So I want back to the doctor's office the 2nd time and a different doctor said I had Dematitis. I used this topical cream that they prescribed and within a few days my face cleared up. 2 weeks into it it is almost completely gone. My point is you may want to get a 2nd opinion."

    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..."

    Bob reports his rosacea was misdiagnosed for discoid lupus

    Gem says, "A couple of months ago I developed a rash on my forehead and was given a steroid cream for it that seemed to keep it under control for 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...."

    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."

    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..."

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

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

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

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

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

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

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

    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."

    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.

    DC says his physician misdiagnosed his dermatitis as rosacea.

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

    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.

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

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

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

    RedFacedRedHead says her rosacea turned out to be KP.

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

    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......

    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."

    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).

    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.

    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.

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

    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.

    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."

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

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

    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'."

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

    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."

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

    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).

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

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

    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..."

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

    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."

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

    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..."

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

    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."

    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...."

    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."

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

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

    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..."

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

    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."

    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

    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.

    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

    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..."

    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.

    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

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

    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

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

    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

    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

    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.

    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

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

    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...."

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

    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..."

    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

    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

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

    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..."

    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

    "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

    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!!!!!

    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

    "The diagnosis of lupus flare was made by the general practioner who prescribed corticosteroids....and the patient was hospitalized....The diagnosis of erysipelas of the face was made...This coincidence is a rare condition which may lead to erroneous diagnosis and inappropriate therapy."
    A red face in a lupus patient: thinking beyond lupus rash.
    Stubbe M, Smith V, Thevissen K, Mielants H, De Keyser F.
    Acta Clin Belg. 2010 Jan-Feb;65(1):44-7.

    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

    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…"

    "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

    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..."

    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..."

    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 Accutane 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."

    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)

    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)....

    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!"

    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."

    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

    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."

    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...."

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

    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."

    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

    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...."

    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....'

    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

    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

    findingaway says, "Dermatologist: 'Hmm' he says...'I think it's Seborrheic Dermatitits, but it could be rosacea, but I doubt it and you seriously wouldn't want that' "

    pier01980 says, "The problem is that In 4 months I've seen two dermatologist and this allergist who have diagnosed me three different things: Acne, rosacea and now Seborrhoeic dermatitis."

    Gigi says, "I have seen five different dermatologists, and each came up with a different diagnosis. (Dermatologist no. 4 and no. 5 I had seen within two weeks.)

    1. Dermatologist: Seborrhoeic Dermatitis
    2. Dermatologist: Acne Vulgaris
    3. Dermatologist: Rosacea
    4. Dermatologist: Rosacea and Acne Vulgaris
    5. Dermatologist: Rosacea and Seborrhoeic Dermatitis" Post #2

    mccinnis says, "I have been posting on here for the last 2 months about my recent diagnosis of sebderm. I have rosacea and have been tyring to figure out the difference between both as my sebderm does not seem to be typical and i wasnt convinced I had it and actually stopped using my noritate/lamisel mix as I think it was making my face red and dryer. I went to a new derm yesterday and was told I do not have sebderm but KPRF."

    OCbKA says, "I have been diagnosed with Rosacea by 3 different derms (one thought it was Perioral Dermotitis" Comment #24 May 22, 2011

    Della says, "I am so relieved that i finally have the right diagnosis. I have been going to different doctors for many years and they told me i had contact dermatitis, eczema etc. The stuff they would give me would help for just a little bit and it got to the point that i would have to apply steroid cream 2x a day just to keep it from becoming really gross. I got lucky and saw another dr and finally got rosacea." #44175 Della on August 15, 2010 at 1:20 PM

    jca says, "After wasting my time w/ one Derm who said I just have “dry irritated sensitive skin….I got a 2nd opinion. Within seconds of my new derm looking @me she siad..its rosacea." #44183 jca on August 15, 2010 at 7:09 PM

    CR says, "My rosacea showed up 2 summers ago. My eyes felt itchy and irritated. Took awhile for my dermatologist to diagnose it, in fact, I led the way with what I read on the net." #59407 CR on June 8, 2011 at 5:29 AM

    Marianne says, "I suffer from what I think is a mild case of rosacea (doctors think this is it but are confused themselves) with papules/ pustules and a bit of redness on my left cheek." #39001 Marianne on June 4, 2010 at 6:12 PM

    jill says, "...Dr. gave me script for presidone, said it was contact allergy and eye doctor gave me eye drops....went to ANOTHER dermy. said i had rosacea. gave me sulfur medicine." #34440 jill on March 25, 2010 at 9:28 AM

    Drew says, "The other clinic's diagnosis was rosacea. This one proposes Postular Acne..." by Drew on Thu Apr 23, 2009 8:02 am

    kam says, "...I went to see my GP and he said that I had rosacea...On my next visit to the GP, I was advised by another doctor that I simply had over sensitized skin from using facial scrub too often, too much hot water on my face, and more recently, persistent exposure to the sun....and I was advised to use.... Efcortelan ointment 0.5% which is a brand of hydrocortisone. I tried this for 3 months...I stopped using hydrocortisone...My skin condition never improved...." by kam on Tue Jun 17, 2008 10:36 pm

    ohdarnit!987 says, "t took doctors almost 20 years to put a name to my problem - then the dermatologist today took one look at me and listened to my issues and said 'classic textbook case'." by ohdarnit!987 on Wed Jun 01, 2011 9:32 pm

    kwb says, "I went to see a doctor about some redness in my cheeks a good many years ago, but he said no, it's probably an allergy. So, recently I began to notice some cleary defined red lines under my eyes, and a burning sensation accompanied by some redness around my nose, so, I decied to go to a new doctor, this time yes, shes said it's 'classic Rosace'"." by KWB on Fri Jun 10, 2011 4:59 am

    jodie says, "Just wanted to let the people who have helped me over the last week know that it turns out i dont have rosacea after all. Last night i was in a lot of pain with my face burning and eventually after a day in tears i went to the walk in centre and was seen by another doctor who could see my face when it was at its worst. He said that it in no way looked like rosacea at all and that i had photosensitivity, literally everytime i went outside i was getting sunburned even when it was cloudy." by jodie on Mon Jun 20, 2011 1:48 pm

    shahin 25 says, "It has been 2 months since I was dignosed with seb derm (I spent 2 months prior to denying there was anything wrong with me) in total i have had this gross foreign fungus on my face for 4 months. It seems to be getting worse. I had my second consult with my derm dr & he threw more steroids at me, but when I ask him about my seb derm he never gives me straight answers."

    bizi says, "I saw the new derm and she is very good. She is at least 70 years old. She right away said that I have acne and rosacea, which the other derm said it was all rosacea." Post #19 Nov 18 at 04:30 AM

    ziggR says, "Its weird, "Rosacea" took my derm awhile to say also. I got "its just KRPF, Its just the weather or it could just be hormones". It wasn't until they started IPL and PDL on my cheeks that the derm said it looks like Rosacea." post #10 12/11/11

    lulu says, "I was diagnosed about a year ago with Rosacea but prior to that I was diagnosed with a very rare skin condition called Pyoderma Faciale. It's a condition that bizzarely only affects females, of 20 -40 and from reading your post - the symptoms your describe are very similar to the symptoms I had when I had pyoderma faciale. I am not a doctor or a skin expert, and I am not suggesting for a minute that this is what you have, but it may nevertheless be worth mentioning to your doctor. My own GP, first diagnosed it as acne. It was only when I self referred myself to a dermatologist that pyoderma faciale was diagnosed." by lulu on Tue Dec 20, 2011 9:13 pm

    freeme3 says, "My dermatologist thinks that I have rosacea. I think that he is right....The first derm thought I just had sensitive skin and prescribed me locoid steroid cream. It helped for awhile but then it stopped working...." by freeme3 on Wed Dec 21, 2011 1:33 am

    Mister88 says, "At first I was diagnosed with eczema, then after trial and error and 10 different topical creams I was sent to a different derma sinc .my derma was out of ideas. The new doctor said I have rosacea and was given finacea."

    Blackhawk says, "'Im currently 30 year old male (symptoms started at 28 / 29), and have been to about 5-6 dermatologists in the Chicagoland area over the past year and a half.....Every dermatologist tells me something different. I've been told its different forms of dermatitis/rosacea....So my latest visit to the derm told me I had a combo or seb dermatitis / rosacea."

    bobbydazler1981 says, "I have been told by Doctors initially that i had eczema, then Seborrheic Dermatitis, now 2 days ago i was told i have Acute Dermatitis."

    adinet says, "I was originally told I had rosacea then told I didn't!" Post #42 - 1st December 2011 01:02 AM

    "I was diagnosed with Rosacea many years ago and lived with it for a long time believing my doctor even though he did nothing other than ask me a few questions and peek at my skin from 4 feet away. No blood tests, nothing like that. I was in and out of his office in less then three minutes." Scully555 Post #18 19th September 2009 • "After years of misdiagnosis from two or three "specialists" I finally did what a coworker suggested.... It turns out I was using a heavily medicated dandruff shampoo loaded with "tar"......When I stopped using the shampoo, my face cleared up 100% within a few weeks and never came back...." Scully555 Post #20

    shan says, "I was offically diagnosed with a Sulphite allergy and produce anti-histamine and an allergic response.....I was also told I had Roseacea. Let me make myself clear, this is not a mis-diagnosis, as I had originally been diagnosed with Roseacea by my GP." See post #47 March 20, 2012

    trojan10 says, "a few derm's said i have rosacea, another said i just have sensitive skin and not rosacea YET." post #1 March 28, 2012

    Boiling_Point says, "* One says that I have Seb Derm and that I should use a Ketaconazole 2% dandruff schampo on scalp and face. * One says that I definitely not have Seb derm, it is Rosacea that I have and she tells me there's not much to do for me than to accept my current state (using Metronidazole-cream)."

    cherylarose says, "...My personal experience was a misdiagnosis for over 7 years (and 4 dermatologists). Perhaps your quote above is general for the forum, or perhaps you directed the statement to me. I want to assure you that I don't intend to mislead anyone by my personal experience with rosacea; I do in fact have rosacea which was diagnosed by Dr. Soldo. Even after the diagnosis, for confirmation, I underwent a series of allergy tests complete with IgE, so eczema has already been ruled out...." Post #48 24th April 2012 01:44 AM
    "Most of the dermatologists treated the condition as adult acne and prescribed Retin-A. The tipping point came when I had perioral inflammation and the doctor prescribed Elidel and topical steroids (for eczema) and the rosacea (of course) became much worse. That drove me to seek out a new dermatologist. When I was diagnosed by Dr. Soldo, he told me that the Retin-A in particular exacerbates Rosacea which made sense because my skin had several dry patches and redness but the pustules still remained. Dr. Soldo prescribed Finacea which has done a marvelous job as an exfoliant. However, it doesn't prevent flare ups from my food triggers. I also cannot use salicylic acid as it causes inflammation of the pustules and redness." Post #52 4th May 2012

    MOLLOBHG posts in the subject, "4 different doctors, 4 different diagnoses." and then says, "I've recently been told I have rosacea...... I'm still hoping there's a chance this doctor's got it wrong (as well)..." on Sun May 06, 2012 4:40 am

    dee62 says, "I was just formally diagnosed with Rosacea on Monday. I have known that I have it for some time. 1 of my doctor's diagnosed it back in 2008, after I had shingles on my face. My most recent doctor had said it was ezcema."on Wed May 02, 2012 10:40 pm

    j88e says, "Initially, I was diagnosed with contact dermatitis because this developed shortly after I had a bad reaction to a topical benzoyl peroxide/clindamycin medication I had been prescribed for acne. When it wouldn't go away, my dermatologist clung to her initial diagnosis and prescribed stronger and stronger steroids. I was skeptical, so I went to another dermatologist who instantly diagnosed rosacea."

    Lorraine says, "I was diagnosed with seborrheic dermatitis initially, then when I started complaining of redness to my cheeks the derm diagnosed me with mild rosacea." #53893 Lorraine on April 6, 2011 at 11:18 AM

    John says, "ive been diagnosed with rosacea for a few months now but for the last 11 years i’ve had this pimply rash on my forehead that would come and go . the first derm i saw said it was a fungal infection caused by the propecia i was taking for hair loss) so he gave me antifungal cream, lotion , shampoo with sulfa face scrub pads and sulfa lotion to put on and zithromax to take. then i moved too far away to see him so i went to a different derm as the rash came back a few months after i stopped the antifungals and this guy said i was fine -everyone has pimples now and then. The third one said I had acne and gave me a prescription face wash that worked pretty good for a few months. Then I went to a 4th guy who said I had rosacea." #102973 john on June 5, 2012 at 12:21 PM

    Lpkm says, "All of the doctors I have seen or spoken to have no clue about SD and instantly diagnose Rosasea - this has happened to me 3 times and i have SD not rosacea." Post #4 June 9,2012 at 9:39 AM Luke then gives details of his experience with four different doctors at this post.

    Cdw1262 says, "I just had my appointment with my primary care doctor today. He looked at some pictures briefly but basically said it was just some sort of infection, happens all the time, and gave me a perscription for a topical cream. I said well what about rosacea, and he blew me off and said no way, that only happens to old men's noses who have been drinking their whole lives and not to worry about it. I still have a follow up with a dermatologist scheduled for a few months from now." Cdw1262 Post #7 June 13, 2012

    davem81 says, "My dermatologists wavered between treating me for 'acne vulgaris' and 'acne rosacea' for a long time." davem81 Post #14 June 18, 2012

    Opinwyd says, "I have been seen by many dermatologists and the diagnosis vary each time but nothing seems to be effective. Anything from Rosacea, which they then prescribed me with several rosacea type medicines like metronidazol cream or noritate and none of it helps. Another said it was a histamine release and said take zyrtec or benadryl, that didnt work." Opinwyd Post #6 June 24, 2012

    Joejon says, "After about 10 years (I'm now 25), 10+doctors, 3 dermatologists, $1000's of dollars, countless hours of trial and error with OTC and prescription products and medications for acne I have finally been diagnosed with possible rosacea. None of the previous doctors or derm's even hinted at rosacea and I really didn't know what it was until now." Joejon Post #1 June 28, 2012

    padie says, "One of my daughters came across your post and brought it to my attention. Her sister, my youngest daughter, suffered rosacea fulminans several years ago and I thought I would share some of her experience with you. She was incorrectly diagnosed with acne initially and the condition had time to get far worse than it might have with a proper diagnosis from the beginning. We switched doctors because we knew it was not simple acne. Both of her sisters had suffered acne and she never had, so we knew what acne was and what she had was certainly not. We were lucky to see the new doctor's physician's assistant who listened patiently to her story (how her face had been clear and then suddenly she was getting multiple cysts and green puss was coming out of some of them). He said he did not know what the condition was but would find out. He called the next day and we went back to the office to hear that she had this very rare condition: rosacea fulminans." Post #6 July 18, 2012 at 05:18 AM

    buratino29 says, "In one year two dermatologists failed to diagnose me with rosacea until I persuaded the third that it is rosacea. I basically had to diagnose myself and then prove it in front of audience." Post #130 3rd April 2013 06:28 PM

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  • Posts

    • "Praxis Biotechnology is developing a medication to reduce inflammation associated with rosacea without affecting the rest of the body." Albany biotech startup wins $50K at business competition, By Madison Iszler, Albany Times Union
    • I found this article in the Houston Chronicle interesting since I take a 81 mg enteric coated Aspirin every day:  "Q: This is a true story. In the 1950s, my grandmother was taking a "heart pill" her doctor had prescribed. The older doctor retired, and Granny went to see the new doctor to get her heart pill refilled. The young doctor told her: "Mrs. G., this is nothing but aspirin. There is nothing wrong with your heart." He refused to refill her heart pill. Three weeks later she died of a heart attack. That was in the 1950s, before any research had been done on the effects of aspirin and the heart. A: It took decades for the medical profession to recognize how useful aspirin could be in preventing heart attacks. A recent Swedish study discovered that people who discontinued low-dose aspirin were 37 percent more likely to have a hospitalization, heart attack or stroke (Circulation, online, Sept. 26, 2017). The investigators suggest that there may be rebound blood clotting when aspirin is stopped suddenly. Other research also has shown a link between aspirin discontinuation and serious cardiovascular events. If people need to stop aspirin prior to surgery or because of side effects, they should do so under careful medical supervision." Sudden discontinuation of aspirin could create serious issues
      By Joe Graedon and Teresa Graedon, Houston Chronicle
    • A PRACTICAL UNDERSTANDING OF ROSACEA
      PART 1:
      HEAT REGULATION AND THE
      WARM ROOM FLUSH PHENOMENON
      By Colin Dahl
      Chief Scientist, Australian Sciences
    • dazed1 has been posting a lot in RF and recently posted about a natural topical treatment using oils from plants that you can make yourself. Her post at RF explains the process in details. This isn't for the lazy and requires a lot of work. If any of you try this treatment yourself, please post here in this thread the results. 
    • Hi, thanks for including my post.   If you go back to the standard animal diet, you might notice that you wont have issues as well, systematic inflammation caused by animal protein and high glycemic index/insulin foods is not something that is happening very soon. So the rest period of 2 weeks, might give you few days extra before the problem start arise, sure it can happen at once but most of the time is slow process. I can go on and on, but i'm short on time so i will leave out some videos with the subject i'm talking about, and that is the harmful effects of animal protein.                
    • "Spend more than three minutes talking to any dermatologist ever, and they’ll inevitably start raving about three things: 1. Wearing sunscreen every single day until the moment you die, 2. How Accutane is an actual miracle drug, and 3. Why everyone should be slathering vitamin C on their face every single morning, like it’s the antidote to sadness. (And if your skin is an issue, then yeah—it kind of is the cure)." Why Every Single Derm Thinks You Should Be Using Vitamin C on Your Face, by CHLOE METZGER, marie claire

    • "The Vivace is effective for reducing wrinkles and rosacea/spider veins, eliminating acne scars and stretchmarks and skin tightening. While most see immediate results, Dr. Shah recommends that her patients undergo three treatments for optimal results."  Expert NYC Dermatologist Introduces Breakthrough RF Microneedling Treatment in Manhattan
      PRESS RELEASE PR Newswire, Markets Insider "We start with the most revolutionary, best-in-class Vivace Microneedling RF device, designed for an incomparable, comfortable patient experience. Only The Vivace boasts a robotic motor that brings discomfort to a virtual zero compared to any other device you will find in your physician’s office. We recommend a personally compounded numbing cream, the best available today, and our carefully developed recovery system to make sure no one knows you just had a treatment today. The results are immediate and also improve over time, giving you the best of both worlds." Vivace Experience
    • Facial erythema is a condition where the face turns red and this type of condition is prominently seen in fair individuals. This facial redness arises due to the dilation of the cutaneous blood vessels and increased blood flow up to the skin. Facial erythema many times goes undiagnosed among the dark-skinned individuals. There are many factors responsible for the facial erythema, including the primary skin diseases like rosacea and systemic illness, and perioral dermatitis. Facial erythema condition is characterized by itching, redness, burning skin, dry skin, visible blood vessels, flushing, and pain. This disease affects many people worldwide and is a very common facial skin disease, is chronic and predominantly found in females with fair skin. Facial Erythema Treatment Market to Develop Rapidly by 2027, Find Market Research  Request Sample Report 
    • "We may love the way a bit of blush can enliven the skin, but rosacea, blotchiness and general redness on the face is different. We want to be the ones to decide where a red flush belongs, thank you very much. So what can we do about unwanted redness?" 12 Ways to Keep Calm and Get Rid of Skin Redness, by HEATHER CICHOWSKI, The Fashion Spot some of the products in the above article can be found in our store which the RRDi receives a small affiliate fee. Thanks for shopping through us!
       

    • image courtesy of Mark's Daily Apple In the spirit of 'everything rosacea' I have included a report by Darcelle (post no 23) at RF that "eliminating animal products from your diet [will] help with the rosacea," hence, an animal diet triggers rosacea. This is ironic because Darcelle started the thread with the title, Rosacea AFTER Going Vegan, but she changes her view as you read through the thread.  Darcelle cites two references in post no 23, the first, Lindsay S Nixon, who interviews Mary Lou who reports that eating a plant based diet cleared her rosacea in just 30 days, and the other example about Silpa Reddy who reports her "rosacea has lessened with every month."   dazed1 and MissM both advocate a plant based diet in this thread (posts 71 thru 75). dazed1's post no 39 explains in more detail how to implement a plant based diet supplemented with certain nutrients and a list of foods prohibited (be sure to pay extra attention to the little smiley that is shaking its head NO "diet - absolutely" which indicates the foods on the list are prohibited. You should be aware that rosacea triggers are basically anything put on a list made up of anecdotal reports from rosacea sufferers who say 'this triggers rosacea."  There are no clinical papers with double blind, placebo controlled studies done that substantiates any trigger. Furthermore, there is no known proposed rosacea trigger that will produce a rosacea flareup in every rosacea sufferer. All rosacea triggers are simply proposed. A proposed trigger may or may not trigger your rosacea. All you can do is just see if a proposed trigger on the list triggers your rosacea.  More on trigger avoidance.  It is only fair to include this for those who may want to try a plant based diet and see if it clears rosacea. If you have something to report about this please reply to this post. So the proponents of this particular plant based diet (with certain foods prohibited for two weeks) say you should start improving in two weeks to a month. After your improvement the real test is to go back on the animal diet you previously had before to see if your rosacea returns. That should be enough evidence to convince someone that an animal diet triggers rosacea. Then to prove it works go back on the particular plant based diet that is mentioned in this post to see if your rosacea is improved again or controlled to prove beyond any doubt this type of diet works. If there are any takers for this diet please post your results here.   
    • "In a recent interview, Zoe D. Draelos, MD, Consulting Professor of Dermatology at Duke University School of Medicine, High Point, NC, and one of the senior investigators of ivermectin 1% cream, discussed how it works, and what it is expected to contribute in the management of patients with rosacea." Payer Perspectives in Dermatology - Rosacea
      Caroline Helwick, American Health & Drug Benefits
    • "Roanhorse, who works professionally as a federal programs director for the Education Department of the Jicarilla Apache Nation, designed the skin care line, Skindigenous, with natural ingredients, geared specifically toward Natives with sensitive skin. She also aims to help people learn about the dietary and environmental factors that can lead to skin conditions like rosacea and acne." Native communities look to DIY model to get online
      By Sami Edge | The New Mexican
    • "If you’re constantly battling acne, eczema, rosacea or any number of other skin disorders, the solution may be in your fridge — not your bathroom cabinet. According to many progressive dermatologists, probiotic-rich foods like yogurt, kefir and kombucha can be even more effective in treating stubborn skin conditions than store-bought or prescription skin creams." Should You Put Probiotics On Your Face?, by Liivi Hess, Alternative Daily Probiotics in the RRDi Store
    • Rosacea and alcohol intake. J Am Acad Dermatol. 2017 Nov 07;: Authors: Drago F, Ciccarese G, Herzum A, Rebora A, Parodi A PMID: 29126626 [PubMed - as supplied by publisher] {url} = URL to article
    • "This study indicates that retinaldehyde has beneficial effects on the vascular component of rosacea." Dermatology 1999;199(suppl 1):53–56 
      (DOI:10.1159/000051380)
      Retinaldehyde Alleviates Rosacea
      Vienne M.-P. · Ochando N. · Borrel M.-T. · Gall Y. · Lauze C. · Dupuy P. "Retinal is also known as retinaldehyde. It was originally called retinene, and renamed after it was discovered to be vitamin A aldehyde." Wikipedia
    • "“As an intermediary step between topical antibiotics and oral isotretinoin, we propose that topical tretinoin may be effective in the management and reduction of rosacea symptoms,” Emily Forward, MD, of the University of Sydney, said at the meeting. There has been recent discussion regarding the use of low-dose isotretinoin in the treatment of rosacea, but safety with long-term use is an issue, she noted." Topical tretinoin resolves inflammatory symptoms in rosacea, in small study
      Publish date: May 17, 2017
      By: Bianca Nogrady, Dermatology News
    • Related Articles Rhinophyma graft for repair of the phymatous nasal ala. J Am Acad Dermatol. 2017 04;76(4):e123 Authors: Malone CH, DeCrescenzo AJ, Subrt AP, Wagner RF PMID: 28325413 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles Rhinophyma graft for repair of the phymatous nasal ala. J Am Acad Dermatol. 2017 04;76(4):e123 Authors: Malone CH, DeCrescenzo AJ, Subrt AP, Wagner RF PMID: 28325413 [PubMed - indexed for MEDLINE] {url} = URL to article
    • "Dr. Edina Garaczi emphasizes that all rosaceous patients should be treated personally. It is not enough to focus only on skin symptoms, there is not a panacea that is equally well-liked for everyone, everyone has to individually find and deal with rosacea provocative factors." Dr. Garaczi Edina's dermatologist-allergist also draws attention to things that many of us can know about rosaceous skin, Vital Article in Hungarian. Use Google Translate. 
    • "Sugar and trans fats also cause inflammation, which can lead to acne and other skin problems. Inflammation is also the main cause of many chronic diseases....Foods such as bagels, oatmeal, pretzels, pasta, and cereal have been proven to accelerate the skin's aging process and cause acne, wrinkles and rosacea by converting refined carbs into sugar and then glucose, which damages collagen." Avoid These Foods If You Want To Keep Your Youthful Glow
      The damage of a poor diet is aging you from the inside out before you even start to feel the effects.
      Rose Reisman Health and Wellness Expert, Caterer, Restaurateur, and Author, HuffPost
    • "While the original classification system designated the most common groupings of primary and secondary features as subtypes, the committee noted that because rosacea appears to encompass a consistent inflammatory continuum, it now seems appropriate to focus on the individual characteristics, called phenotypes, that may result from this disease process. Observing the respective phenotypes in clinical practice will also encourage consideration of the full range of potential signs and symptoms that may occur in any individual patient, and assessment of severity and the selection of treatment may be more precisely tailored to each individual." NRS Introduces New Standard Classification and Pathophysiology of Rosacea
      By Brad Bennett , in PR PR Health on November 8, 2017, The Daily Telescope
    • "Retinoids (the umbrella term for all forms of the vitamin A derivative, including the popular OTC version retinol) are the Screech of the skin world: irritating. So women who have had reactions to other skin products—or who have tried a retinoid in the past and ended up tingly and flaky—think it's not for them.... ....Rosacea itself is considered inflammatory and treated with products labeled "anti-redness"—so why willfully add more flame to the fire? The facts: It's not a good idea to use a retinoid in the midst of an outbreak, we'll give you that. Otherwise, however, you shouldn't have any additional redness after the first two weeks of use. And, in fact, one study found that retinoids might even be a treatment for rosacea." 5 Myths About Retinoids You Should Stop Believing ASAP, BY KAYLEIGH DONAHUE HODES November 8, 2017, Women's Health
    • "Whether you have acne, rosacea, or allergy-prone skin, you may think there's not much you can use on your touchy complexion. But the truth is, you could be seriously limiting your skin care by swearing off certain products. Here's the truth behind some of the most common sensitive skin myths...." 3 Sensitive Skin Myths—Busted!, Women's Health
    • " “True sensitive skin is a genetic predisposition and can be thought of as a built-in case,” she says. It’s found in individuals with very fair skin, usually of Northern European ancestry. This kind of skin is more delicate in make-up, with lower amounts of pigment and blood vessels that are closer to the surface of the skin, making it prone to redness, she explains. Sensitive skin has a less effective protective outer layer on the skin’s surface—which is known as the epidermis—so irritants like allergens and microbes can more easily penetrate skin and reach more deeply, causing reactionary inflammation. Skin itches, scales, blisters, flushes, and breaks out under conditions that wouldn’t bother regular skin types........ ......Meanwhile, sensitized skin occurs due to environmental effects and is “a growing phenomenon,” says Hammerman. It happens due to a number of factors, including over-exfoliation, cosmetic treatments like chemical peels and laser devices, exposure to stress, chemicals, smoking, alcohol, and pollution. Fortunately, sensitized skin is a lot easier to calm than clinically sensitive skin." [bold added] If You Think You Have Sensitive Skin, You Probably Don't - Here’s how to tell if you really have it. BY GRACE GOLD, Women's Health, December 16, 2015
    • "The National Rosacea Society (NRS) announced today (11/8/17) that a new standard classification and pathophysiology of rosacea has been published in the Journal of the American Academy of Dermatology....While the original classification system designated the most common groupings of primary and secondary features as subtypes, the committee noted that because rosacea appears to encompass a consistent inflammatory continuum, it now seems appropriate to focus on the individual characteristics, called phenotypes, that may result from this disease process. Observing the respective phenotypes in clinical practice will also encourage consideration of the full range of potential signs and symptoms that may occur in any individual patient, and assessment of severity and the selection of treatment may be more precisely tailored to each individual....According to the new system, the presence of one of two phenotypes – persistent redness of the facial skin or, less commonly, phymatous changes where the facial skin thickens – is considered diagnostic of rosacea....The committee noted that, as with the original classification of rosacea, the updated standard system is considered provisional and may require modification as the causes and pathogenesis of rosacea become clearer, and its relevance and applicability are tested by investigators and clinicians." NRS Introduces New Standard Classification and Pathophysiology of Rosacea, Cision, PRWeb
    • "As celebrity aesthetician Angela Caglia tells us, alcohol dehydrates your skin and robs it of its vital nutrients, so excessive alcohol consumption (think: drinking like you're still in college), can contribute to skin's premature aging in the long term, and bloating, puffiness, enlarged pores, dullness, and rosacea the day after....Caglia recommends living (or drinking) by the general rule of thumb that the clearer the alcohol, the better it'll be for your skin. Red wine, dark whiskey, a piña colada — these are the things a killer hangover and a puffy face are made of. Straight-up, no frills shots? Surprisingly not so bad." Here's how different types of alcohol affect your skin — and the only one you should order,  
      Megan Decker, Refinery29, Insider Health
    • Related Articles Topical a-Agonist Therapy for Persistent Facial Erythema of Rosacea and the Addition of Oxmetazoline to the Treatment Armamentarium: Where Are We Now? J Clin Aesthet Dermatol. 2017 Jul;10(7):28-32 Authors: Del Rosso JQ Abstract
      The presence of vasoactivity in rosacea-affected skin led to the development of two topical α-adrenergic receptor agonists, brimonidine tartrate 0.5% gel and oxymetazoline hydrochloride 1% cream, both approved by the United States Food and Drug Administration for treatment of persistent facial erythema of rosacea. In this article, the author discusses challenges related to the treatment of persistent facial erythema of rosacea and the use of a-agonist therapy. The author also discusses cases of worsening of facial erythema after the application of brimonidine, as well as briefly reviews recently reported clinical data on oxymetazoline. Finally, the author attempts to differentiate some potential mechanistic differences between these two agents.
      PMID: 29104721 [PubMed] {url} = URL to article
    • Comorbidities in rosacea: A systematic review and update. J Am Acad Dermatol. 2017 Oct 26;: Authors: Haber R, El Gemayel M Abstract
      BACKGROUND: Rosacea is linked to abnormalities of cutaneous vasculature and dysregulation of the inflammatory response. Recent reports on rosacea have shown a significant association with cardiovascular, gastrointestinal, and psychiatric diseases, all of which may affect morbidity and mortality among these patients.
      OBJECTIVE: To review available data regarding comorbidities associated with rosacea, discuss their pathogenesis, and highlight the evaluation of affected patients.
      METHODS: We performed a complete and systematic literature review in PubMed/Medline, Embase, and the Cochrane Collaboration databases, searching for all articles on possible associated diseases that have been reported with rosacea, with no limits on publication date, participant age, sex, or nationality.
      RESULTS: A total of 29 studies were included in this systematic review, including 14 case-control, 8 cross-sectional, and 7 cohort studies. Statistically significant association with rosacea has been mostly demonstrated with depression (n = 117,848 patients), hypertension (n = 18,176), cardiovascular diseases (n = 9739), anxiety disorder (n = 9079), dyslipidemia (n = 7004), diabetes mellitus (n = 6306), migraine (n = 6136), rheumatoid arthritis (n = 4192), Helicobacter pylori infection (n = 1722), ulcerative colitis (n = 1424), and dementia (n = 1194).
      LIMITATIONS: Limitations included the accuracy of the published data, potential patient selection, and possible confounding factors. The true nature of the drawn correlations is uncertain, and causality cannot be established.
      CONCLUSIONS: Rosacea is associated with a number of systemic disorders. Recognition of these conditions is critical to providing appropriate screening and management of affected patients.
      PMID: 29107339 [PubMed - as supplied by publisher] {url} = URL to article
    • Rosacea comorbidities and future research: The 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2017 Nov 01;: Authors: Gallo RL, Granstein RD, Kang S, Mannis M, Steinhoff M, Tan J, Thiboutot D PMID: 29102687 [PubMed - as supplied by publisher] {url} = URL to article
    • Role of Topical Oxymetazoline for Management of Erythematotelangiectatic Rosacea. Ann Pharmacother. 2017 Nov 01;:1060028017740139 Authors: Hoover RM, Erramouspe J Abstract
      OBJECTIVE: To review and summarize topical oxymetazoline's pharmacology, pharmacokinetics, efficacy, safety, cost, and place in therapy for persistent redness associated with erythematotelangiectatic rosacea.
      DATA SOURCES: Literature searches of MEDLINE (1975 to September 2017), International Pharmaceutical Abstracts (1975 to September 2017), and Cochrane Database (publications through September 2017) using the terms rosacea, persistent redness, α -agonist, and oxymetazoline.
      STUDY SELECTION AND DATA EXTRACTION: Results were limited to studies of human subjects, English-language publications, and topical use of oxymetazoline. Relevant materials from government sources, industry, and reviews were also included.
      DATA SYNTHESIS: Data support the efficacy of oxymetazoline for persistent facial redness. Little study beyond clinical trials cited in the drug approval process has been conducted. Current data suggest that oxymetazoline is similar in safety and efficacy to brimonidine. Head-to-head comparisons of topical α-agonists for erythema caused by rosacea are needed.
      CONCLUSION: The topical α-agonist, oxymetazoline, is safe and effective for reducing persistent facial redness associated with erythematotelangiectatic subtype of rosacea. Health care practitioners selecting among treatments should consider not only the subtype of rosacea but also individual patient response, preference, and cost.
      PMID: 29094614 [PubMed - as supplied by publisher] {url} = URL to article
    • "If you live with a common skin condition like eczema, psoriasis, or rosacea, you've probably tried every treatment in the book—but there's a reason why many sufferers swear by aloe vera. "With powerful phytochemicals that help reduce inflammation, aloe vera has been found to be an effective anti-inflammatory agent," says Brandon. So the next time you experience a flare-up, add some aloe vera to your normal topical treatment and try these 16 foods that ease painful inflammation." 10 Healing Benefits of Aloe Vera for Breakouts, Burns, and More
      If you think aloe vera is just for bug bites and sunburns, think again.
      BY ZARAH A. KAVARANA, Reader's Digest
    • The NRS has now moved forward with classifying rosacea into phenotypes with this published paper:  Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee .
    • "The national survey on rosacea was conducted with over 500 patients suffering from rosacea and about 300 dermatologist, the main finding included the patients struggle emotionally and low self-esteem, don’t feel comfortable talking to their physician, and impact their social and psychological life. Economic productivity loss due to skin diseases is increasing at an alarming rate. According to American Academy of Dermatologists (AAD), skin diseases affect not just productivity but confidence levels of patients, creating passive impact on long term work stature." Research Details Developments in the Rosacea Treatment Market
      BY POOJA, MilTech
    • "While alcohol may have contributed to some of that headache, excess sugar is likely the real culprit and may be currently wreaking havoc on skin....After a night of bad habits, “the gut develops an imbalance of bad bacteria, and the body can wake up craving even more sugar.” Snyder suggests taking a probiotic supplement to rebalance blood sugars, “give you energy, and reduce mood swings.”....Skin, too, can see the effects of a heavy night of trick-or-treating. “Excess sugar can cause inflammation and even rosacea,” explains top New York City facialist Mzia Shiman who is responsible for the flawless glow of the Victoria’s Secret Angels. First, the pro recommends drinking “a ton of water” to start the de-puffing process, and, if possible, have an at-home LED light mask at the ready. “The red lights can help calm skin and soothe redness,” she says." Do You Have a Halloween Candy Hangover? Read This
      by JENNA RENNERT, Vogue More on Sugar and Rosacea
    • "A dermatologist in Washington, D.C., was surprised to discover that one of her patients was using a powerful steroid cream bought without a prescription to treat a rash." Imported Skin Creams Can Pose Unexpected Risks
      90.3 KAZU
      CSU Monterey Bay
      A Community Service of California State University Monterey Bay More on Steroid Induced Rosacea
    • "...I'm intensely critical of what I'll put on my own skin. (Rosacea plus derm horror stories will do that to you.)....As a disclaimer on the instructions warns pale people, the lifting compounds that stimulate blood flow to your face may leave you red, which is a slight understatement. Immediately after my face is angry. But trust the process.....There was still some residual redness, but if I can find something that solves that problem, rest assured you'll know about it." I Tried the Hanacure Face Mask: Instagram’s Famous 'Grandma' Treatment
      BY LINDSAY SCHALLON, Glamour
    • Related Articles Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2017 Oct 28;: Authors: Gallo RL, Granstein RD, Kang S, Mannis M, Steinhoff M, Tan J, Thiboutot D Abstract
      In 2002, the National Rosacea Society assembled an expert committee to develop the first standard classification of rosacea. This original classification was intended to be updated as scientific knowledge and clinical experience increased. Over the last 15 years, significant new insights into rosacea's pathogenesis and pathophysiology have emerged, and the disorder is now widely addressed in clinical practice. Growing knowledge of rosacea's pathophysiology has established that a consistent multivariate disease process underlies the various clinical manifestations of this disorder, and the clinical significance of each of these elements is increasing as more is understood. This review proposes an updated standard classification of rosacea that is based on phenotypes linked to our increased understanding of disease pathophysiology. This updated classification is intended to provide clearer parameters to conduct investigations, guide diagnosis, and improve treatment.
      PMID: 29089180 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Evidence-based update on rosacea comorbidities and their common physiologic pathways. J Am Acad Dermatol. 2017 Oct 28;: Authors: Holmes AD, Spoendlin J, Chien AL, Baldwin H, Chang ALS Abstract
      Rosacea is a common chronic inflammatory disease affecting the facial skin whose etiology and pathophysiology are the subject of much investigation. Risk factors include genetic and environmental elements that may predispose individuals to localized inflammation and abnormal neurovascular responses to stimuli. Recent studies have introduced an array of systemic rosacea comorbidities, such as inflammatory bowel disease and neurologic conditions, that can be challenging to synthesize. We critically review the current data behind reported rosacea comorbidities and identify and highlight underrecognized physiologic mediators shared among rosacea and associated comorbidities. This information may be helpful in addressing patient questions about potential systemic implications of rosacea and can serve as a candidate platform for future research to understand rosacea and improve treatments.
      PMID: 29089181 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Severe Rosacea: A Case Report. J Ophthalmic Vis Res. 2017 Oct-Dec;12(4):429-433 Authors: Shirzadeh E, Bagheri A, Abdizadeh MF, Kanavi MR Abstract
      PURPOSE: To describe a case of severe rosacea with ocular involvement.
      CASE REPORT: 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), which had resulted in transient improvement of the lesions, but was followed by exacerbation of the lesions. 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. After four years, a relapse of the oculofacial lesions occurred, for which retreatment with oral tetracycline, steroid eye drops, and ocular lubricants was administered.
      CONCLUSION: Rosacea can be extremely severe and disfiguring, and it can be misdiagnosed as the pathognomonic butterfly rash of LE. Demodex carriage in rosacea is consistent and may play a significant role in the severe forms.
      PMID: 29090055 [PubMed] {url} = URL to article
    • Real-World Efficacy of Azelaic Acid 15% Gel for the Reduction of Inflammatory Lesions of Rosacea. Skin Therapy Lett. 2017 11;22(6):5-7 Authors: Wirth PJ, Henderson Berg MH, Sadick N Abstract
      Approximately 16 million Americans have rosacea, an inflammatory cutaneous disorder with central facial erythema, papules, pustules, telangiectasia, flushing, and swelling being among the more commonly recognized features. Overexpression of cathelicidin peptide LL-37 has been implicated in the pathophysiology of rosacea. Azelaic acid has been found to inhibit the pathologic expression of cathelicidin, as well as the hyperactive protease activity that cleaves cathelicidin into LL-37. Given these findings, a small prospective, open-label, interventional trial was undertaken to assess the effects of azelaic acid 15% gel on inflammatory lesions of papulopustular rosacea in a real-world setting. Use of azelaic acid was associated with a significant reduction in inflammatory lesions, which persisted beyond the active treatment phase. Overall, azelaic acid 15% gel is an appropriate initial topical therapy for the treatment of moderate facial rosacea.
      PMID: 29091380 [PubMed - in process] {url} = URL to article
    • Rosacea. N Engl J Med. 2017 Nov 02;377(18):1754-1764 Authors: van Zuuren EJ PMID: 29091565 [PubMed - in process] {url} = URL to article
    • Lisa Ajax
      image courtesy of Wikipedia Lisa Ajax, a Swedish singer, and winner of Idol 2014, suffers from rosacea according to Nyheter24 which reports, "she is suffering from skin disease Rosacea.- The whole forehead was covered. I panicked, says Lisa."

    • snail image courtesy of Wikipedia.                                                                      bee image courtesy of Wikipedia David Pascoe, rosacea guru extraordinaire, who owns RF and RSG posted in his blog an article, Snail slime and bee glue – say what?, about a patent David discovered at Google applied by Muciderm S.A., (GONZÁLEZ Elmo MORENO) [patent submitted on October 17, 2017] which uses a device application consisting of snail slime and propolis in a  "composition... in the form of a lotion, soap, cream or gel, which is embedded in a gauze-type fabric in the form of a plaster that can be applied to lesions caused by the different types of rosacea." The formulation also consists of camomile extract (1-4%), and other natural extracts such as marigold extract, honey and vegetable oils.  The patent application says the following:  "Therefore, it is strikingly clear that the snail has an activity that sticks to conventional treatments, particularly on erythema and telangiectasia produced in the disease. The present invention is further directed to the development of an application / device from the developed product, which will be more efficient and effective than the current treatment, which is essentially palliative. This treatment can, at best, stop the development of rosacea and completely eliminate erythema and telangiectasia produced. The use of the product may also allow the flaking of dead and regeneration of new skin due to the properties of its components described above." Pharmaceutical composition for preventing, treating and curing rosacea, comprising snail slime, camomile and propolis 
      WO 2016054757 A1
    • "Other symptoms include itching and burning sensation and small red spots might appear, some filled with pus, hence the confusion with acne......Ingredients such as raspberry extract help to strengthen the capillary walls, oats are known to reduce inflammation and heal the skin and sunscreens containing zinc oxide and titanium dioxide protect against UV damage without causing irritation." What is rosacea and what can you do about it?, Leah Cassady, The Sentinel
    • "Dr Lohia believes in double-cleansing, first with a wipe and then with a scrub or a gentle face wash....Then, because I have rosacea, I use Dr. Jart+ Cicapair cream to soothe and moisturise my skin." Do dermats walk the talk?, Faye Remedios, The Hindu
    • Inhibition of Human Kallikrein 5 Protease by Triterpenoids from Natural Sources. Molecules. 2017 Oct 27;22(11): Authors: Matsubara Y, Matsumoto T, Koseki J, Kaneko A, Aiba S, Yamasaki K Abstract
      Stratum corneum tryptic enzyme kallikrein 5 (KLK5) is a serine protease that is involved in the cell renewal and maintenance of the skin barrier function. The excessive activation of KLK5 causes an exacerbation of dermatoses, such as rosacea and atopic dermatitis. Some triterpenoids are reported to suppress the serine proteases. We aimed to investigate whether bioactive triterpenoids modulate the KLK5 protease. Nineteen triterpenoids occurring in medicinal crude drugs were evaluated using an enzymatic assay to measure the anti-KLK5 activity. The KLK5-dependent cathelicidin peptide LL-37 production in human keratinocytes was examined using immunoprecipitation and Western blotting. Screening assays for evaluating the anti-KLK5 activity revealed that ursolic acid, oleanolic acid, saikosaponin b₁, tumulosic acid and pachymic acid suppressed the KLK5 protease activity, although critical molecular moieties contributing to anti-KLK5 activity were unclarified. Ursolic acid and tumulosic acid suppressed the proteolytic processing of LL-37 in keratinocytes at ≤10 μM; no cytotoxicity was observed. Both triterpenoids were detected in the plasma of rats administered orally with triterpenoid-rich crude drug Jumihaidokuto. Our study reveals that triterpenoids, such as ursolic acid and tumulosic acid, modulate the KLK5 protease activity and cathelicidin peptide production. Triterpenoids may affect the skin barrier function via the regulation of proteases.
      PMID: 29077044 [PubMed - in process] {url} = URL to article
    • "Specialist skincare brand Dermalex commissioned the survey, which was conducted by YouGov, to expose the hidden cost of skin problems like eczema, psoriasis, acne and rosacea on people's lives and their mental and emotional health. 57% of skin sufferers stated that taking control of their skin condition would help their confidence and wellbeing. Yet there's a big knowledge gap, with over one-third (38%) saying they did not understand what had caused their skin condition." A Long-term Sentence: Dermalex Skincare Survey Reveals Millions of British Adults Have Suffered With Eczema, Psoriasis, Rosacea or Acne for More Than Ten Years, The Dermalex skincare survey, Cision PRNewswire
    • Related Articles Development of Ocular Rosacea following Combined Ipilimumab and Nivolumab Treatment for Metastatic Malignant Skin Melanoma. Ocul Oncol Pathol. 2017 Sep;3(3):188-192 Authors: Brouwer NJ, Haanen JBAG, Jager MJ Abstract
      PURPOSE: To report a case of severe ocular rosacea following ipilimumab plus nivolumab treatment in a patient with metastatic malignant skin melanoma.
      METHODS: Case report and review of the literature.
      RESULTS: A 68-year-old male with newly diagnosed metastatic malignant cutaneous melanoma was treated with first-line ipilimumab plus nivolumab, which resulted in a partial response. Four months after initiation of treatment, the patient developed red eyelids and conjunctivae, with painful gritty eyes, limiting his capacity to read. Following a diagnosis of severe ocular rosacea and dry eyes, treatment including corticosteroids, antimicrobial agents, and eyelid hygiene was started, and within 3 months, the ocular complaints resolved.
      CONCLUSION: Treatment with checkpoint inhibitor immunotherapy for metastatic melanoma may trigger several ocular immune-related adverse events. This case describes severe ocular rosacea as an adverse event following ipilimumab plus nivolumab treatment.
      PMID: 29071268 [PubMed] {url} = URL to article
    • "I have battled hay fever since my freshman year of college, rosacea for the last decade and stress probably since birth. And though there is virtually no scientific research to confirm salt proponents’ claims I nonetheless headed to Breathe, which has three salt rooms in Manhattan and two in Westchester County, N.Y., for the most immersive experience I could find." Cleanse your body with a stay in a salt room, By MARISA MELTZER, The New York Times, thestar.com
    • "IPL, or Intense Pulse Light, is a combination of wavelengths of light that target skin discoloration. Half of the wavelengths of light produced by this laser treat red spots, red areas of the face due to rosacea and small red vessels on the face." Everything You Wanted to Know About Lasers and Radiofrequency for Facial Rejuvenation, News Tribune
    • "And with a plethora of new products, techniques and tricks around, the simple act of cleansing has never been more fraught with confusion." Are you cleaning your face properly? Dermatologist shares her top tips, the most common MISTAKES and if you should double-cleanse, By SOPHIE HASLETT FOR DAILY MAIL AUSTRALIA
    • "The resident microbiota is important in maintaining structural and functional integrity of the gut and in immune system regulation. It is an important driver of host immunity, helps protect against invading enteropathogens, and provides nutritional benefits to the host. Disruption of the microbiota (dysbiosis) may lead to severe health problems, both in the gastrointestinal tract and extra‐intestinal organ systems. The precise mechanisms by which the intestinal microbiota exerts its effects are only beginning to be unravelled but research is demonstrating close links between gut microflora and many factors involved in the pathogenesis of atopic dermatitis (AD). AD and indeed any other ‘skin disease’, may be seen as a possible manifestation of a more systemic problem involving gut dysbiosis and increased intestinal permeability, which may occur even in the absence of gastrointestinal signs." Vet Med Sci. 2016 May; 2(2): 95–105.
      Published online 2016 Feb 23. doi:  10.1002/vms3.24
      PMCID: PMC5645856
      Atopic dermatitis and the intestinal microbiota in humans and dogs
      J. Mark Craig, BVSc, MRCVS Cert SAD

    • Sirokomsky Nikolai Lyubomyrovich
      image courtesy of sirokomsky.com Dr. Syrokomsky Lybomyrovich, a dermatologist in the Ukraine, has been around for a number of years and there are many reports of patients going to him to receive treatment for rosacea (and other skin issues). One such report is DG who posts Syrokomskyy's Protocol at RF. gerryc reports at RF [post #29] that he took the trip for Dr. Syrokomsky's treatment and posts:  "I have been to see Dr Syrokomskyy in the Ukraine about 4-5 years ago and found it a positive experience. I had amazing results for about 2 years my skin was absolutely great. This from someone with rosacea for over 20 years since i was about 17. Was a classic flusher, permanent redness and some acne breakouts Dr Syrokomskyy protocol helped the lot. The regime is extremely painful at times and lasts for 4 months if i remember correctly. I only managed 3 months which i really regret and was not great with the maintenance regime for the first year after treatment. My skin now days is still a lot better than prior to Dr Syrokomskyy treatment plan. I have very little flushing but still have the permanent redness to contend with along with a few zits. I do not regret going to the Ukraine one bit i was inspired by DGs great Blog at the time and a few others who also went over. Any questions just ask." Jerckii has a thread at RF you might want to read. moomy (post no. 7) has posted a list of the herbal treatments.  As with every rosacea treatment, not everyone reports success (you can google and find them) but in the spirit of 'everything rosacea' the RRDi is posting this because some report success in being treated by Dr. Syrokomsky. You can visit his web site which is in Ukranian. If you need to translate the site follow the steps using Google Translate. 
         
    • "WiseGuyReports published new report, titled “Rosacea – Pipeline Review, H2...Pharmaceutical and Healthcare disease pipeline guide Rosacea – Pipeline Review, H2 2017, provides an overview of the Rosacea (Dermatology) pipeline landscape....Wise Guy Reports is part of the Wise Guy Research Consultants Pvt. Ltd. and offers premium progressive statistical surveying, market research reports, analysis & forecast data for industries and governments around the globe." Sample Report Rosacea – Pipeline Review, H2 2017- Understanding the Focus Areas of Leading Companies, medGadget  
    • "When you take Oracea, you have to drink a lot of water and decrease your exposure to the sun. Currently, there is no cure for rosacea BUT I haven't had an outbreak since I began treatment with Oracea this year; I have not had any issues." Rosacea: My Story, By Justin B. Terry-Smith, TheBody.com
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