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  • Misdiagnosed Rosacea

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    Articles, References and Anecdotal Reports

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

    Articles and References

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


    Anecdotal Reports of Misdiagnosis

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

    1. Bob reports his rosacea was misdiagnosed for discoid lupus

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    More cases of misdiagnosed rosacea (or vice versa)

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    • Abstract
      In dermatology probiotic microorganisms have primarily been used orally for the prophylaxis and treatment of atopic disorders. In contrast to the successes achieved for gastrointestinal disorders, positive effects for atopic dermatitis only have been found in a few studies. New insights could now fundamentally change the impact of probiotics on dermatology. Probiotics are - like microflora of the skin - non-pathogenic microbes, which do not induce inflammatory responses in the skin. Common pathways for probiotics, non-pathogenic microbes, and microflora are characterized, in order to facilitate their more effective therapeutic use. These microbes display a majority of their effects directly at the site of application and thereby induce natural defense mechanisms. However, promotion of immunological tolerance is just as important in producing positive effects. Tolerance of the resident flora on surface organs developed during evolution and the mechanisms of action are multifaceted. Therefore, the topical application of probiotics and non-pathogenic microbes for prophylaxis and therapy of overwhelming cutaneous pro-inflammatory immune reactions is very promising. Results of recent clinical trials already have demonstrated the efficacy of this new therapeutic concept. Hautarzt. 2009 Oct;60(10):795-801. doi: 10.1007/s00105-009-1755-8.
      Outside-in. Probiotic topical agents.
      Volz T, Biedermann T.
    • Abstract
      INTRODUCTION AND OBJECTIVE:
      Normal human skin can produce a range of antimicrobial chemicals that play an important part in eliminating potential cutaneous pathogens. Lactobacillus plantarum is a gram-positive bacteria that produces antimicrobial peptides, which when applied to the skin can act like an anti-inflammatory as well as enhance the antimicrobial properties of the skin. Clinical studies were conducted to determine the effect of lactobacillus extract on improvement of skin barrier and reduction of erythema from chemical irritant, skin microflora, and acne. Results show that lactobacillus extract was effective in reducing skin erythema, repairing skin barrier, and reducing skin microflora, thereby exhibiting an effective reduction in acne lesion size and erythema at 5%, but not at 1%.
      CONCLUSION:
      Based on the results of these studies, lactobacillus extract (5%) can be used to treat mild acne lesions. J Cosmet Sci. 2012 Nov-Dec;63(6):385-95.
      Physiological effect of a probiotic on skin.
      Muizzuddin N, Maher W, Sullivan M, Schnittger S, Mammone T.
    • Related Articles Mindfulness-Based Cognitive Hypnotherapy and Skin Disorders. Am J Clin Hypn. 2018 Jul;61(1):34-44 Authors: Shenefelt PD Abstract
      Mindfulness-based cognitive hypnotherapy integrates mindfulness, cognitive-behavioral therapy, and hypnotherapy to improve physical, emotional, mental, and/or spiritual aspects of skin disorders. Meditation, including mindfulness meditation, and hypnosis both utilize trance phenomena to help produce focalization and specific improvements in skin disorders through psycho-neuro-endocrine-immunologic mechanisms. Hypnosis, cognitive hypnotherapy, focused meditation, and mindfulness meditation are discussed with respect to improving various skin disorders including acne, acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythema nodosum, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, prurigo nodularis, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Their integration into mindfulness-based cognitive hypnotherapy is then discussed and illustrated with improvement in a patient with systemic lupus erythematosus.
      PMID: 29771216 [PubMed - in process] {url} = URL to article
    • Related Articles Assessment of rosacea symptom severity by genome-wide association study and expression analysis highlights immuno-inflammatory and skin pigmentation genes. Hum Mol Genet. 2018 May 16;: Authors: Aponte JL, Chiano MN, Yerges-Armstrong LM, Hinds DA, Tian C, Gupta A, Guo C, Fraser DJ, Freudenberg JM, Rajpal DK, Ehm MG, Waterworth DM Abstract
      Rosacea is a common, chronic skin disease of variable severity with limited treatment options. The cause of rosacea is unknown, but it is believed to be due to a combination of hereditary and environmental factors. Little is known about the genetics of the disease. We performed a genome-wide association study (GWAS) of rosacea symptom severity with data from 73,265 research participants of European ancestry from the 23andMe customer base. Seven loci had variants associated with rosacea at the genome-wide significance level (p≤5 × 10-8). Further analyses highlighted likely gene regions or effector genes including IRF4 (p=1.5 × 10-17), an HLA region flanked by PSMB9 and HLA-DMB (p=2.2 × 10-15), HERC2-OCA2 (p=4.2 × 10-12), SLC45A2 (p=1.7 × 10-10), IL13 (p=2.8 × 10-09), a region flanked by NRXN3 and DIO2 (p=4.1 × 10-9), and a region flanked by OVOL1and SNX32 (p=1.2 × 10-8). All associations with rosacea were novel except for the HLA locus. Two of these loci (HERC-OCA2, SLC45A2) and another precedented variant (rs1805007 in MC1R) with an association p value just below the significance threshold (p=1.3 × 10-7) have been previously associated with skin phenotypes and pigmentation, two of these loci are linked to immuno-inflammation phenotypes (IL13, PSMB9-HLA-DMA) and one has been associated with both categories (IRF4). Genes within three loci (PSMB9-HLA-DMA, HERC-OCA2, and NRX3-DIO2) were differentially expressed in a previously published clinical rosacea transcriptomics study that compared lesional to non-lesional samples. The identified loci provide specificity of inflammatory mechanisms in rosacea, and identify potential pathways for therapeutic intervention.
      PMID: 29771307 [PubMed - as supplied by publisher] {url} = URL to article
    • TEAE percentage rate is low with oxymetazoline treatment for rosacea. For more information. 
    • A new acronym, TEAE [Treatment-Emergent Adverse Events], has been published in the June issue of the Journal of the American Academy of Dermatology,  in an article entitled, "Sustained Use of Oxymetazoline Cream Efficacious for Rosacea," according to MPR, about a study on the long-term safety (1 year) and efficacy of oxymetazoline cream 1.0% in 440 patients with rosacea spear headed by Zoe Diana Draelos, MD, who volunteers on the RRDi MAC. The study concluded: "This long-term study demonstrated sustained safety, tolerability, and efficacy of oxymetazoline for moderate-to-severe persistent erythema of rosacea." "The rate of discontinuation mostly due to application-site TEAEs was 3.2%" So the TEAE is low with oxymetazoline treatment for rosacea. 
    • Treatment for rosacea depends on the severity, but often requires some detective work to figure out your triggers as well as a carefully selected skin-care plan, including prescription and over-the-counter products. Some people may benefit from antibiotics, medications that specifically target redness, or isotretinoin (Accutane). For others, just keeping an eye on their triggers can have a profound impact.
      But the piece that tends to get overlooked in all of this is the mental health toll of dealing with a new skin condition—especially one that really has no cure. Below, we spoke with 11 people who have rosacea about how they were diagnosed, how they deal with their symptoms, and what they want others to know about the condition. 11 People Describe What It's Really Like to Have Rosacea, Sarah Jacoby, SELF
    • "For instance, at 28, I had what I thought was stubborn acne for a few years. I went all out in the drugstore aisle with harsh, drying products that ended up doing more harm than good. So when I was finally diagnosed with rosacea this past December, I was actually relieved. I assumed that having an answer would make it easier to treat."  Sarah Jacoby, Senior Health News Editor at SELF, who stated the above quote in her article, 11 People Describe What It's Really Like to Have Rosacea.  SELF Masthead • Twitter • Muck Rack • Refinery29 • Linkedin
    • image courtesy of Wikipedia Salvia hispanica, commonly known as chia, is a species of flowering plant in the mint family, Lamiaceae, native to central and southern Mexico and Guatemala. Wikipedia Comparing Essential Oils with Metronidazole and Mercury Oxide in Killing Mites (with emphasis upon Salvia Hispanic) Abstract
      Demodex belong to the smallest mites: the average length of adults is 250 μm. Up to now, two Demodex species have been described, which are specific for humans: Demodex folliculorum and Demodex brevis. A medical condition caused by presence of Demodexis called demodicosis. Gao et al. in 2005 reported good effects of tea tree oil on Demodex sp. in the in vitro and in vivo settings. Aim of this study was to check survivability of Demodex mites in various substances. Tests were made with the use of the most common substances used in demodicosis treatment, i.e. metronidazole and mercury oxide. The effects of essential oils from tea tree, sea buckthorn, aloe, salvia, peppermint, camphor tree, fennel, eucalyptus, and lavender were tested as well. For controls, Demodex were placed in saline. The mean survival time of Demodex was 64 hours for metronidazole, and 46 hours – for 2.5% mercury oxide. Much better results were obtained with 50% tea tree oil (7 minutes), peppermint oil (11 minutes) and salvia oil (7 minutes).  Research Gate, December 2014
      Effect of Metronidazol, Mercury Oxide and Essentials Oils on the in vitro survivability of Demodex mites.
      Aleksandra Sedzikowska,Maciej Oseka, B. Grytner-Zięcina, Emilia Jaremko ---------------------------------------------------------------- Abstract
      Demodicosis is a medical condition caused by presence of Demodex mites. Mites may cause ocular demodicosis with symptoms such as burning and itching of eyelids. Currently, several drugs are available for the treatment of demodicosis. However, their use carries a risk of serious side effects. According to recent studies, substances contained in some plant-derived essential oils kill Demodex mites. Good efficacy of tea tree oil against Demodex sp. has been reported. However, some patients develop allergic reactions and ocular irritation in the course of tea tree oil treatment. Tests with essential oils showed that salvia and peppermint oils rapidly kill Demodex-in 7 and 11 minutes, respectively. Salvia is known as a valuable herb and is used to treat eye disease. Therefore, salvia essential oil could be an alternative treatment for demodicosis. J Bacteriol Parasitol, 2015, Volume 6. Issue 3.
      Impact of Salvia and Peppermint Oil on the In Vitro Survival of Demodex Mites (PDF)
      Aleksandra Sędzikowska, Maciej Osęka , Beata Roman3and Emilia Jaremko.
      Department of General Biology and Parasitology, Medical University of Warsaw, Poland. Ofta Ltd., ul. Mleczna 8, 03-667 Warsaw, Poland, Verco Sp. z o.o., Warsaw, Poland.
    • We learned about the Rositta Method in June 2012 at this thread at RF and it was a mystery how she treated rosacea patients for a long time. However, Conf posted [post no 109 11th May 2018 07:10 PM] an article published March 14, 2018 in Beauty Journaal (translated from Dutch) that describes her method of extracting demodex mite eggs and her complete treatment. You may watch this video below if you understand Dutch: 
    • Related Articles A case report of granulomatous rosacea of the face. Singapore Med J. 2018 Apr;59(4):228-229 Authors: Kok WL, Oon HH, Giam YC PMID: 29748691 [PubMed - in process] {url} = URL to article
    • What Dr. Kluk and I both thought interesting was your comment about rosacea. It’s very possible that you don’t have it, but as Dr Kluk told me: "Rosacea is very misunderstood as a condition, and it’s very common. If you google it, you’re going to get quite graphic photos of people with extreme redness, rough and broken skin, that sort of thing, but that is a very advanced kind of rosacea. There are much subtler, less pervasive forms of rosacea, and just because you have a less aggressive kind of rosacea now, it doesn’t mean it will become more like that at all. It’s possible to have rosacea without any textural changes to the skin." Dear Daniela: What Can I Do About My Red, Blotchy Skin?
      DANIELA MOROSINI, Refinery29
    • Here is a very interesting article about vitamins and supplements and Rosacea https://rosadyn.com/rosacea/suppliments-vitamin/vitamins-supplements-rosacea-triggers/ It seems that in some case not the vitamin is the problem but the quantity. From it I have learned how many mistakes I have made in my case treating my Rosacea over time. I have been treated by neurologyst with Ginko Biloba and by psychiatrist with Vinpocetine(Cavinton Forte). I have been diagnosed recently with Vertebro Basilar Circulatory Insufficiency and Cavinton Forte 3x10mg per day for 3 months were prescribed to me. In less than a week my face was melted, hard to touch and with pain and acid sensations. My God are pysicians so ignorant when it comes to Rosacea???
    • Dual-Frequency Ultrasound as a New Treatment Modality for Refractory Rosacea: A Retrospective Study. Dermatol Surg. 2018 May 09;: Authors: Park JY, Ahn MK, Cho EB, Park EJ, Kim KH Abstract
      BACKGROUND: Dual-frequency ultrasound (DFU) has emerged as a new treatment modality for improving inflammatory skin disorders. Although there have been few pilot studies, there are a limited number of studies that investigated efficacy of DFU on refractory rosacea.
      OBJECTIVE: This study investigated the effect of DFU on patients with refractory rosacea.
      MATERIALS AND METHODS: The authors retrospectively analyzed medical records of 42 patients with refractory rosacea (erythematotelangiectatic rosacea [ETR], n = 26; papulopustular rosacea [PPR], n = 14, mixed, n = 2). The patients were treated with DFU twice per week for the 1st week, and then once per week thereafter. Efficacy was assessed using erythema index (EI), transepithelial water loss (TEWL), and patient self-assessment (PSA).
      RESULTS: Treatment with DFU resulted in significant decrease in EI, TEWL, and PSA. No significant difference was noted between ETR and PPR.
      CONCLUSION: Application of DFU in patients with refractory rosacea resulted in improvement in persistent erythema, barrier dysfunction, and patient-reported symptoms. Dual-frequency ultrasound may be an additional treatment option for rosacea that is resistant to other treatments.
      PMID: 29746429 [PubMed - as supplied by publisher] {url} = URL to article
    • Thanks for sharing the article. In my case no Micellar water worked, not even the Bioderma Sensibio H2O Solution Micellaire. They were making my skin drier and drier. I would be willing to give a try to Biossance 100% Squalane Oil(I did not know such a thing exist and I am speaking about Squalane Oil not Squalane).
    • Treating any specific skin issue is always about trial, error, and adaptation: What worked well one month might be fully ineffectual the next. But through all my experimentation — the countless serums, creams, toners, and treatments I’ve tried — these are the six essentials that consistently keep my skin calm all season long. 6 Beauty Essentials That Keep My Rosacea-Ridden Skin Under Control, Kelsey Haywood, Brit + CO 
    • According to Dr. Fishman, anyone with rosacea or especially sensitive skin would experience noticeable, positive differences with fewer products, fewer chemicals, and a decrease in skin irritants. "That includes exposure to cold, wind, low humidity, and extreme heat as well as products," she said. While it can be a bummer if you love product, she said, rosacea sufferers were not meant to constantly experiment with several new skin care formulations. "If you find products and ingredients that work for your skin, stick with them!" How To Navigate Beauty Products With Rosacea, by Lindsay Kellner, mbglifestyle  
    • The investigators concluded that the results of this study imply that the use of CD-doxycycline may have an impact on the previously reported association between rosacea and GID. This may be due in part to a dose-dependent effect, but it might also be linked to the inherent characteristics of the SD (modified-release) formulation of doxycycline. Longitudinal studies are warranted in order to further define this association. Fewer Gastrointestinal Issues in Rosacea Treated With Subantimicrobial vs Conventional Doxycycline, by Sheila Jacobs, Dermatology Advisor
    • After my two weeks were up, my takeaway was pretty clear: Changing my diet helped clear up and prevent rosacea flare-ups, but it didn't eliminate them completely. I still had redness and new bumps pop up over the course of the two weeks, despite adhering to my "rosacea diet." To be fair, this type of diet probably produces best results over the long term, and I will continue to follow some of the recommendations because they were actually helpful. Can the "Rosacea Diet" Actually Clear Your Skin?, By Julia Malacoff, Shape
    • A new photo series is rejecting a culture of ‘perfect’ pictures and airbrushing by celebrating women with common skin conditions such as acne, rosacea and eczema. Sophie Harris-Taylor’s project Epidermis is inspired by her own experience of being a young woman with severe acne, which left her struggling with self-confidence and acceptance. In Epidermis, twelve women are shown barefaced in unretouched images, some of who had never left the house before without their make-up on. Harris-Taylor says she deliberately shot it in the style of a beauty editorial shoot: “I wanted it to be seen as a beauty shoot first and an exploration of skin second.” With Epidermis, she hopes to make our perception of beauty less homogenised. Here, Harris-Taylor speaks to i about her series.  This make-up free photo series is celebrating women with acne, rosacea and other skin condition, by Healther Saul, iNews  
    • The investigators concluded that the results of this study demonstrate the wide-ranging, negative impact of rosacea on self-perception: and emotional, social, overall well-being; rosacea-specific QoL. Effective treatments that address the underlying etiology of the disease and its troublesome symptoms — along with appropriate education — are necessary in order to achieve optimal aesthetic and psychosocial outcomes in individuals with rosacea. Rosacea Has Significant Effects on Emotional, Social Well-Being, by Sheila Jacobs, Dermatology Advisor
    • "Rosacea is characterized by a red face or neck with broken blood vessels, with or without acne, and can run in families,” says dermatologist Jeanine Downie, M.D., founder of Image Dermatology. “You see it in light-skinned patients more, but you can see it in all races," she says. The good news: There’s a lot you can do to calm this Santa situation down. The Best Rosacea Treatments, Ranked, By Grace Gold, Women's Health
    • Thanks D-Mac,  Welcome aboard the RRDi member forum. Keep posting and mucho mahalo for your donation. 
    • Related Articles Rhinophyma: A Treatment Review. Dermatol Surg. 2018 Feb;44(2):275-282 Authors: Fink C, Lackey J, Grande DJ Abstract
      BACKGROUND: Rhinophyma is the overgrowth of sebaceous glands in nasal tissue and its etiology unclear. Without treatment, rhinophyma can be progressive and cause concern both with respect to function and cosmesis.
      OBJECTIVE: The objective of this work is to describe treatment options for rhinophyma and their respective risks and benefits.
      MATERIALS AND METHODS: A PubMed search was performed to include the terms "rhinophyma" and "treatment."
      RESULTS: Numerous physically destructive modalities exist for treatment of rhinophyma, falling primarily into 3 categories: mechanical destruction, directed electrical energy/radiofrequency, and directed laser energy.
      CONCLUSION: There are multiple treatment modalities available to dermatologists for the treatment of rhinophyma. To the best of our knowledge, there are no randomized, prospective, control studies for any treatment, which makes it difficult to recommend a single treatment over another. Nonetheless, it is important to recognize that scarring and hypopigmentation most often occur on or near the nasal ala. Moreover, risks may increase if tissue destruction extends to the papillary dermis or pilosebaceous units are ablated.
      PMID: 29140869 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles Regional Dermabrasion of Nasal Surgical Scars and Rhinophyma Using Electrocautery Scratch Pads. Dermatol Surg. 2018 Feb;44(2):300-302 Authors: Chuang GS, Alfaresi F PMID: 29401164 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles Skin mites in mice (Mus musculus): high prevalence of Myobia sp. (Acari, Arachnida) in Robertsonian mice. Parasitol Res. 2018 May 04;: Authors: Sastre N, Calvete O, Martínez-Vargas J, Medarde N, Casellas J, Altet L, Sánchez A, Francino O, Ventura J Abstract
      Myobia sp. and Demodex sp. are two skin mites that infest mice, particularly immunodeficient or transgenic lab mice. In the present study, wild house mice from five localities from the Barcelona Roberstonian system were analysed in order to detect skin mites and compare their prevalence between standard (2n = 40) and Robertsonian mice (2n > 40). We found and identified skin mites through real-time qPCR by comparing sequences from the mitochondrial 16S rRNA and the nuclear 18S rRNA genes since no sequences are available so far using the mitochondrial gene. Fourteen positive samples were identified as Myobia musculi except for a deletion of 296 bp out to 465 bp sequenced, and one sample was identified as Demodex canis. Sampling one body site, the mite prevalence in standard and Robertsonian mice was 0 and 26%, respectively. The malfunction of the immune system elicits an overgrowth of skin mites and consequently leads to diseases such as canine demodicosis in dogs or rosacea in humans. In immunosuppressed mice, the probability of developing demodicosis is higher than in healthy mice. Since six murine toll-like receptors (TLRs) are located in four chromosomes affected by Robertsonian fusions, we cannot dismiss that differences in mite prevalence could be the consequence of the interruption of TLR function. Although ecological and/or morphological factors cannot be disregarded to explain differences in mite prevalence, the detection of translocation breakpoints in TLR genes or the analysis of TLR gene expression are needed to elucidate how Robertsonian fusions affect the immune system in mice.
      PMID: 29728826 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Which acne treatment has the best influence on health-related quality of life? Literature review by the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes. J Eur Acad Dermatol Venereol. 2018 May 05;: Authors: Chernyshov PV, Tomas-Aragones L, Manolache L, Svensson A, Marron SE, Evers AWM, Bettoli V, Jemec GB, Szepietowski JC Abstract
      According to results of a recent literature search performed by the European Academy of Dermatology and Venereology (EADV) Task Forces (TF) on Quality of Life and Patient Oriented Outcomes (QoL and PO) and Acne, Rosacea and Hidradenitis Suppurativa (ARHS) most of publications where health-related (HR) QoL of acne patients was studied were clinical trials. Members of the EADV TF on QoL and PO decided to detect which acne treatment has the best influence on HRQoL of acne patients. A new literature search was organized to find publications on acne treatment where the HRQoL of patients was assessed as an outcome measure. From 186 papers with HRQoL assessment 37 papers were included for further analysis. Our results revealed that oral isotretinoin had the best influence on HRQoL of acne patients. Several other treatment methods also showed good effects on the HRQoL of acne patients. Oral isotretinoin and norethindrone acetate/ethinyl estradiol, topical clindamycin phosphate/benzoyl peroxide and adapalene/benzoyl peroxide showed significantly better effect on HRQoL than placebo. There is limited number of the high-quality studies on acne treatment where HRQoL were assessed. Dermatology-specific and acne-specific instruments showed much better sensitivity to successful therapeutic intervention than generic HRQoL instruments. The most frequently used HRQoL instrument was the DLQI questionnaire. This article is protected by copyright. All rights reserved.
      PMID: 29729107 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles A report and follow up of a patient with disseminated superficial actinic porokeratosis (DSAP) undergoing novel systemic treatment with palifermin (a keratinocyte growth factor) during chemotherapy. Dermatol Online J. 2018 Feb 15;24(2): Authors: Howard M, Hall A Abstract
      Disseminated superficial actinic porokeratosis (DSAP) is an inherited dermatosis triggered by chronic ultraviolet light exposure. Cosmetic improvement has been noted with topical therapies or laser treatment. Lesions of DSAP are precancerous, having been reported to develop into squamous cell carcinomas (SCCs) or basal cell carcinomas (BCCs) occasionally. We describe a patient with longstanding DSAP who developed a primary CNS lymphoma. Palifermin (a keratinocyte growth factor analogue) was used as an adjuvant for his chemotherapy to minimize mucositis. Our patient noted marked clinical improvement of his DSAP following his chemotherapy for lymphoma. Follow-up has shown a sustained improvement of his DSAP with no development of any SCCs. Palifermin may be safe for use in individuals at high risk of developing SCCs and further research into keratinocyte growth factors and risk of development of SCC is warranted. Systemic chemotherapy appears to improve DSAP lesions.
      PMID: 29630163 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Keep up the good work Brady. I read a lot of your posts and appreciate the effort you put it.  Rosacea is tough, but  it helps me immensely to read the stories of others. I will be donating to the rrdi very soon.  I encourage other rosaceans to do the same. 
    • Related Articles Skin neurogenic inflammation. Semin Immunopathol. 2018 Apr 30;: Authors: Choi JE, Di Nardo A Abstract
      The epidermis closely interacts with nerve endings, and both epidermis and nerves produce substances for mutual sustenance. Neuropeptides, like substance P (SP) and calcitonin gene-related protein (CGRP), are produced by sensory nerves in the dermis; they induce mast cells to release vasoactive amines that facilitate infiltration of neutrophils and T cells. Some receptors are more important than others in the generation of itch. The Mas-related G protein-coupled receptors (Mrgpr) family as well as transient receptor potential ankyrin 1 (TRPA1) and protease activated receptor 2(Par2) have important roles in itch and inflammation. The activation of MrgprX1 degranulates mast cells to communicate with sensory nerve and cutaneous cells for developing neurogenic inflammation. Mrgprs and transient receptor potential vanilloid 4 (TRPV4) are crucial for the generation of skin diseases like rosacea, while SP, CGRP, somatostatin, β-endorphin, vasoactive intestinal peptide (VIP), and pituitary adenylate cyclase-activating polypeptide (PACAP) can modulate the immune system during psoriasis development. The increased level of SP, in atopic dermatitis, induces the release of interferon (IFN)-γ, interleukin (IL)-4, tumor necrosis factor (TNF)-α, and IL-10 from the peripheral blood mononuclear leukocytes. We are finally starting to understand the intricate connections between the skin neurons and resident skin cells and how their interaction can be key to controlling inflammation and from there the pathogenesis of diseases like atopic dermatitis, psoriasis, and rosacea.
      PMID: 29713744 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles [Time to limit the use of antibiotics in rosacea!] Lakartidningen. 2018 Apr 24;115: Authors: Mobacken H, Berg M, Angesjö E, Dunér K, Svensson M, Synnerstad I Abstract
      Rosacea is a chronic inflammatory disease with facial erythema and papulopustules. It is common in middle-aged/elderly persons and often affects self-perception and social well-being. It is generally classified into four subtypes. Improved understanding of pathophysiology has resulted in novel treatment approaches, but routine management in health care usually follows old trails. Most patients are managed in primary care. Greater attention to the reduced skin barrier, avoidance of exacerbating factors, better topicals and encouragement to topical maintenance treatment should reduce the use of oral tetracyclines. Low-dose isotretinoin is reserved for treatment-resistant patients, but relapses are frequent unlike its use in acne. In order to reduce antibiotic use, we propose that patients should be referred to a dermatologist for optimization of therapy including consideration of isotretinoin following tetracycline treatment of a maximum of 4-6 months.
      PMID: 29714807 [PubMed - in process] {url} = URL to article
    • Related Articles Oral Azithromycin: A Treatment Option for Papulopustular Rosacea. Actas Dermosifiliogr. 2018 Apr 25;: Authors: Blanes M PMID: 29705016 [PubMed - as supplied by publisher] {url} = URL to article
    • Frank Bures: The mystery of rosacea, a disease with no known cause or cure
      Frank A. Bures For the Winona Daily News
    • ‘A diet high in sugar and high-glycemic index (GI) carbohydrates such as white rice, pasta, bread, and sweets have now been shown to cause inflammation in the body that can make the skin age much quicker,’ Dr Williams said.  One study, from the Leiden University Medical Centre in the Netherlands, made the first direct link between the amount of sugar circulating in the blood, and how old a person looks.
      It found the higher the amount of sugar and high GI carbs a person ate, the older they looked. Here’s what’s happening. When blood sugar levels are constantly on the high-low cycle that comes from a high sugar and high carb diet, (eating too often between meals has the same effect), sugar molecules permanently bond to proteins, including the collagen in your skin.  This is a process known as glycation, and produces aptly named compounds called AGES, or Advanced Glycation End Products (AGES), that cross-link with proteins, Dr Williams said.
      ‘Consequently, tissues become stiff and inflexible, skin becomes tougher, saggier, and wrinkles form often prematurely,’ she added. ‘ Where once we as dermatologists dismissed the idea of diet and pimples, there is now good evidence of a link between unrefined sugars, sweets, milk chocolate, and unrefined carbohydrates with increased incidence of acne breakout,’ she said.
      When he puts patients with inflammatory skin conditions, such as acne, psoriasis, and eczema, on diets reducing their intake of refined sugars and dairy products, Dr Lowe explained, their conditions often get better. ‘Changing their diets can reduce the severity of their conditions,’ he said. Want great skin? Dermatologists reveal which foods they swear by for a healthy glow - and those that never pass their lips, By ANNA MAGEE FOR HEALTHISTA, Daily Mail Watch the Video  
    • Related Articles Regional Dermabrasion of Nasal Surgical Scars and Rhinophyma Using Electrocautery Scratch Pads. Dermatol Surg. 2018 02;44(2):303 Authors: Monheit G PMID: 29360653 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles Papulopustular Rosacea: Response to Treatment with Oral Azithromycin. Actas Dermosifiliogr. 2018 Apr 23;: Authors: Lova Navarro M, Sánchez-Pedreño Guillen P, Victoria Martínez AM, Martínez Menchón T, Corbalán Vélez R, Frías Iniesta J Abstract
      INTRODUCTION: Oral tetracyclines and topical antibiotics have been used to treat papulopustular rosacea (PPR) for years, but it is not uncommon to find patients who do not respond to this standard treatment. In such refractory cases, oral azithromycin has proven to be an effective option.
      MATERIAL AND METHOD: We conducted a prospective pilot study of 16 patients with PPR who were treated with oral azithromycin after a lack of response to oral doxycycline and metronidazole gel. At the first visit, the patients were assessed for baseline severity of PPR on a 4-point clinical scale and started on oral azithromycin. At the second visit, response to treatment in terms of improvement from baseline was evaluated on a 3-point scale. Patients were then scheduled for follow-up visits every 12 weeks to assess long-term effectiveness.
      RESULTS: All 16 patients experienced an improvement in their PPR following treatment with oral azithromycin. Eight weeks after completion of treatment, 14 patients (87.5%) showed complete or almost complete recovery (slight or no residual redness and complete clearance of papules and pustules). Only 2 patients experienced a new episode of inflammatory PPR lesions during follow-up.
      CONCLUSIONS: The findings of this pilot study suggest that oral azithromycin could be a very effective short-term and long-term treatment for RPP resistant to conventional treatment.
      PMID: 29699769 [PubMed - as supplied by publisher] {url} = URL to article
    • "A patient with severe papulopustular rosacea (PPR) and severe background erythema responded well to a treatment regimen consisting of a short course of antibiotics in combination with a corticosteroid, followed by monotherapy with isotretinoin. In patients with very severe, inflamed disease, it is necessary to achieve a rapid response with a fast-acting combinatorial treatment regimen to reduce the inflammation. Patients with severe PPR and an inflammatory component can respond rapidly when treated using a multimodal, tailored approach."  Martin Schaller, who volunteers on the RRDi MAC, and Lena Gonser wrote a paper with above information of treating a female patient with severe Phenoytype 2 and Phenotype 4 (click here for photos) with antibiotics, prednisolone, topical brimonidine, topical metronidazole, and isotretinoin.   Drugs R D. 2016 Sep; 16(3): 279–283.
      Published online 2016 Sep 13. doi:  10.1007/s40268-016-0141-0
      PMCID: PMC5045832
      PMID: 27623792
      A Tailored Approach to the Treatment of a Patient with a Severe Dynamic Manifestation of Rosacea: A Case Report
      Martin Schaller and Lena Gonser
    • Skin specialist Joanne Frances outlines tips and treatments for rosacea.  Tips and treatment options for rosacea, WPTV, West Palm Beach
    • "Artesunate (AS) is a medication used to treat malaria. The intravenous form is preferred to quinidine for severe malaria. Often it is used as part of combination therapy. It is not used for the prevention of malaria. Artesunate can be given by injection into a vein, injection into a muscle, or taken by mouth." Wikipedia
    • The therapeutic effect of artesunate on rosacea through the inhibition of the JAK/STAT signaling pathway. Mol Med Rep. 2018 Apr 16;: Authors: Li T, Zeng Q, Chen X, Wang G, Zhang H, Yu A, Wang H, Hu Y Abstract
      Acne rosacea is a type of chronic dermatosis with the characteristics of erubescence, angiotelectasis and pustule formation. However, current treatment methods are limited due to the side effects. Artesunate demonstrated a promising therapeutic efficacy with a high safety margin. HaCaT cells were treated with antibacterial peptide LL‑37 to simulate rosacea caused by Demodex folliculorum (D. folliculorum) infection. Cell Counting kit 8 and flow cytometry assays were performed to measure cellular proliferation, apoptosis, the stage of the cell cycle and reactive oxygen species generation in order to determine the level of cell damage. Then the damaged cells were treated with different concentrations of artesunate and doxycycline to determine the therapeutic effect of artesunate. Pro‑inflammatory cytokines tumor necrosis factor‑α (TNF‑α), interleukin (IL)‑6, IL‑8 and C‑C motif chemokine 2 (MCP‑1) were measured using an ELISA, while western blotting was used to detect the expression of Janus kinase 2 (JAK2) and signal transducer and transcription activator (STAT3). As a result, LL‑37 treated HaCaT cells decreased in cell viability, had an increased apoptotic rate and cell cycle arrest, indicating that cell damage caused by rosacea was simulated. In addition, upregulated concentrations of the pro‑inflammatory cytokines TNF‑α, IL‑6, IL‑8 and MCP‑1 were attenuated in the artesunate group in a dose‑dependent fashion, indicating the therapeutic effect of artesunate. Furthermore, higher concentrations of artesunate exhibited an improved effect compared with the doxycycline group. In addition, increased expression levels of JAK2 and STAT3 following treatment with LL‑37 suggested that rosacea caused by D. folliculorum infection may lead to inflammation through the JAK/STAT signaling pathway. In conclusion, the potential mechanism by which damage occurs in rosacea was revealed and a promising therapeutic method against rosacea was demonstrated.
      PMID: 29693177 [PubMed - as supplied by publisher] {url} = URL to article
    • Dr Saleem told Dermatology Advisor, "The clinician should be aware that not all centrofacial erythema and telangiectasis represent ETR, and multiple other skin conditions can present with similar findings. Similarly, not all patients with facial erythema and papules have PPR. A thorough history and physical examination is required to eliminate clinical mimickers and to establish an accurate diagnosis." Treating Rosacea: Unique Clinical Characteristics Inform Treatment, Linda Peckel, DermatologyAdvisor
    • “Rosacea symptoms can come and go,” Dr. Hall said. “Identifying and avoiding the triggers that cause flare ups is an important part of treatment. These triggers aggravate rosacea by increasing blood flow to the surface of your skin.” Seeing Red: How to Spot and Treat Rosacea, The Dominion Post.   
    • David Burke has been around for a while, and has a huge amount of data on what he calls 'plugs', 'morgellons', or other names, but actually has photos of demodex and does indeed discuss demodicosis in his post, Preventing Reinfestation, with some tips on eradication. David has a gallery of photos worth considering. 
    • The investigators concluded that twice-daily dosing of oxymetazoline cream did not offer any significant improvements in clinical efficacy compared with once-daily dosing. Based on the study findings, oxymetazoline 1.0% once daily provided the optimal dosing regimen with respect to efficacy, safety, and tolerability, and was thus selected for evaluation in phase 3 clinical studies. Once-Daily Topical Treatment Effective for Rosacea-Associated Facial Erythema, Sheila Jacobs, Dermatology Advisor Reference
      J Drugs Dermatol. 2018 Mar 1;17(3):308-316.
      Phase 2 Randomized, Dose-Ranging Study of Oxymetazoline Cream for Treatment of Persistent Facial Erythema Associated With Rosacea.
      DuBois J, Dover JS, Jones TM, Weiss RA, Berk DR, Ahluwalia G.
    • Grant Genereux, an engineer and geologist, who no longer suffers from eczema, has an interesting theory that Vitamin A toxicity is the culprit for eczema and a long list of autoimmune diseases and has written a free ebook, Poisoning for Profits.  His website has more information on this.  For example, note his long post on Connecting Eczema, Crohn’s and Alzheimer’s. You can also read another book Genereux wrote, Extinguishing the Fires of Hell, Ending Autoimmune Disease, which the author says is "somewhat more relevant to topics of eczema, and rosacea." 
    • Rosacea may be easily mistaken as other skin conditions because it can masquerade as acne, sensitive skin or even look like a sunburn(3). While rosacea might be difficult to diagnose, the good news is that it is treatable, and clearer skin is possible. Battling Rosacea: How to Recognize and Treat the Common Skin Condition that Causes Redness, Bumps and Breakouts,  Weekly Mailer, Burley, ID
    • Related Articles It Takes One To Know One: Exploring Patient Dialogue On Rosacea Web Based Platforms And Their Potential For Significant Harm. J Dermatolog Treat. 2018 Apr 20;:1-37 Authors: Riddoch LH Abstract
      BACKGROUND: Rosacea is a non-curable skin condition, leading patients to turn self-management options from web based platforms. Self-management can be dangerous possibly under-reported.
      AIM: To discover the extent of online material and determine the potential for harm influenced by rosacea internet sources.
      MATERIALS AND METHODS: Material analysed included search engines, apps, YouTube, forums and Facebook groups. As Facebook and forums were most active, they became the core focus. A passive 'fly on the wall' approach allowed observation of user posts and their content.
      RESULTS: Three broad categories of dialogue were identified: prescribed medications, non-prescribed remedies and, most commonly, posts aimed to elicit emotional support. From this, positive and negative influences were identified. Negative influences were divided into 4 domains: physical harm, financial harm, emotional harm, and detrimental influences on patient-doctor relationships.
      CONCLUSIONS: Rosacea patients may be susceptible to rely on peer-generated information. Forums can have detrimental outcomes, primarily due to lack of monitoring and the potential for misplaced trust between fellow sufferers, encouraging others to try potentially harmful alternative remedies. Lack of monitoring allows the spread of inaccurate information, which can result in harm. Medical practitioners should be aware of trending online dialogue and self-treatment remedies to facilitate patient safety.
      PMID: 29676186 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Dose, duration, and cost: Opportunities to improve use of long-term oral antibiotics for people with rosacea. J Dermatolog Treat. 2018 Apr 20;:1-21 Authors: Rill JS, Lev-Tov H, Liu G, Kirby JS Abstract
      BACKGROUND: Systemic antibiotics are often used to treat rosacea and tetracyclines are the most common antibiotic prescribed; however, there is ambiguity among clinical guideline suggestions. Importantly, there is an increasing call to all clinicians to curtail antibiotic use.
      OBJECTIVE: Investigate the utilization and cost of long-term oral antibiotic use for the treatment of rosacea, including ocular rosacea.
      METHODS: This was a retrospective cohort study of MarketScan® Commercial Claims and Encounters database, from January 1, 2005 through December 31, 2014. Claim data were used to determine the duration and costs of antibiotic treatment among adults with rosacea.
      RESULTS: The sample included 72,411 patients. The mean (standard deviation [SD]) duration of long-term antibiotic treatment was 87.68 (145.99) days and for patients with ocular rosacea was slightly longer, 108.34 (176.74) days [p<.0001]. The majority of antibiotic courses were shorter than three months (80.04%) for the entire sample and the subset with ocular rosacea (53.64% [p=.007]).
      LIMITATIONS: Patient adherence is uncertain and database lacks information on rosacea severity and clinical outcomes.
      CONCLUSIONS: The majority of oral antibiotic course durations follow guidelines. Costs of antibiotic therapy were lower for shorter courses and those utilizing generic medications; the cost-effectiveness of these modifications has not been investigated.
      PMID: 29676194 [PubMed - as supplied by publisher] {url} = URL to article
    • Aissela92 in post no 1 at RF has come up with a novel way to eradicate demodex mites, using micropore tape. You can read all about it yourself. If you decide to try this out, please purchase through the RRDi below so that our non profit may receive a small affiliate fee and then post your results in this topic (thread) since you heard about it here. We need reports to confirm Aissela92's findings. Mahalo. 
    • Eric F. Bernstein, M.D., from the Mainline Center for Laser Surgery in Ardmore, Pa., and colleagues investigated a pulsed-dye laser using a 15-mm diameter beam for treatment of rosacea (four monthly treatments) among 20 patients......"This study demonstrates that a newly designed pulsed-dye laser having a novel 15-mm diameter treatment beam improves the appearance of rosacea with a favorable safety profile," the authors write. Newly designed pulsed-dye laser found effective for rosacea, Medical Press
    • Rosacea is a common chronic inflammatory disorder showing a wide range of clinical features such as telangiectasia, erythema, papules, and pustules primarily involving the central part of face (forehead, cheeks and nose) although extra facial manifestation have been described. We describe a case of rosacea with predominant scalp involvement successfully treated with a 8‐week‐course of doxycycline 40 mg once a day and probiotic therapy twice a day (Bifidobacterium breve BR03, Lactobacillus salivarius LS01 1 × 109 UFC/dose). Dermatologic Therapy, Volume29, Issue 4, July/August 2016 Pages 249-251
      A case of Scalp Rosacea treated with low dose doxycycline and probiotic therapy and literature review on therapeutic options
      M. C. Fortuna  V. Garelli  G. Pranteda  F. Romaniello  M. Cardone  M. Carlesimo  A. Rossi
    • Can the tea tree oil (Australian native plant: Melaleuca alternifolia Cheel) be an alternative treatment for human demodicosis on skin? Parasitology. 2018 Apr 18;:1-11 Authors: Lam NSK, Long XX, Griffin RC, Chen MK, Doery JC Abstract
      Australian tea tree oil (TTO) and its extract terpinen-4-ol (T4O) are found to be effective in moderating demodex-related diseases. Their possible effects are lowering the mite counts, relieving the demodex-related symptoms and modulating the immune system especially the inflammatory response. This review summarizes the topical treatments of TTO and T4O in human demodicosis, their possible mechanism of actions, side-effects and potential resistance in treating this condition. Although current treatments other than TTO and T4O are relatively effective in controlling the demodex mite population and the related symptoms, more research on the efficacy and drug delivery technology is needed in order to assess its potential as an alternative treatment with minimal side-effect profile, low toxicity and low risk of demodex resistance.
      PMID: 29667560 [PubMed - as supplied by publisher] {url} = URL to article
    • About the product (found on Amazon) • We have no anecdotal reports that this works for rosacea. • Buyer Beware!
      Keep to the original all selects the superior soil park skin of Chinese herbal medicine, Chinese medicine cream sophora, common cnidium fruit, kochia scoparia, cortex dictamni, cortex phellodendri, honeylocust thorn, unicorn, lotus, radix stemonae, Indian buead, seven swords, iron Holly plants such as soil extract refined from natural herbal essence of the new generation of skin cream preparation for external use traditional Chinese medicine.
      Scope of application : applicable to skin sterilization and bacteriostasis.Such as staphylococcus aureus (rotting aureus), candida albicans (fungus).
      Suitable for: psoriasis, eczema and all kinds of skin diseases.Topical products, the first sales volume of the whole of China, the effect is 100%.
      suggestion recommended : acute or chronic dermatitis, eczema, tinea manus (Hong Kong foot, fungal), body tinea (sweat stain), psoriasis, peeling, blister, bad feet, the feet itch, pruritus vulvae, hemorrhoids, mosquito bites, acne, prickly heat, itchy skin.
    • Related Articles Clinical Pearls in Dermatology 2017. Dis Mon. 2017 Jul;63(7):165-175 Authors: Newman CC, Litin SC, Bundrick JB PMID: 28545631 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Anecdotal Testimonies of Using Emu Oil  Psoriasis, Eczema, Rosacea, skin disease is no match for Natural Emu Oil, Montreal Times 
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