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  • Misdiagnosed Rosacea

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    Articles, References and Anecdotal Reports

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

    Articles and References

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


    Anecdotal Reports of Misdiagnosis

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

    1. Bob reports his rosacea was misdiagnosed for discoid lupus

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    More cases of misdiagnosed rosacea (or vice versa)

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  • Posts

    • has anyone noticed something experiencing this unusual condition with them? First time I have seen something like this and the thing is erythema is extended to arms and the redness is not causing any pain and itchiness and the startling thing is I get intense erythema on my right cheek than my left cheek and  the erythema on my right hand is more than the left hand. So I was observing, has right face erythema anything to do with right hand erythema? Does it have any connection in common?
    • [Acne rosacea-a pedigree with ten cases]. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2019 Jul 10;36(7):747 Authors: Xia R, Cao L, Fang L, Xiong H, Yang L PMID: 31302927 [PubMed - in process] {url} = URL to article
    • Treatment of Rhinophyma With Surgical Excision and Amniotic Membrane. J Craniofac Surg. 2019 Jul;30(5):1563-1564 Authors: Yoo JJ, Thaller SR Abstract Rhinophyma is a phenotypic subtype of rosacea affecting the nose. It is characterized by phymatous changes, skin thickening/fibrosis, glandular hyperplasia, and chronic inflammation. Treatment of severe rhinophyma is predominantly surgical excision with closure by secondary intention. Amniotic membrane has been used to promote wound healing, fibrosis, and inflammation. In this case study, the authors present a 63-year-old male with longstanding rhinophyma treated with surgical excision with intraoperative placement of amniotic membrane. PMID: 31299768 [PubMed - in process] {url} = URL to article
    • Difference in Vasoconstrictors: Oxymetazoline vs Brimonidine. J Dermatolog Treat. 2019 Jul 11;:1-23 Authors: Okwundu N, Cline A, Feldman SR Abstract OBJECTIVE: Topical oxymetazoline and brimonidine are the only medications approved for treating persistent facial erythema of rosacea. This review aims to investigate the efficacy, safety, pharmacodynamics, and pharmacokinetic properties of oxymetazoline and brimonidine. METHOD AND MATERIALS: Phase II and phase III clinical studies evaluating oxymetazoline and brimonidine were assessed to compare their efficacy and safety. RESULTS: In their respective phase III trials, both oxymetazoline and brimonidine met the primary efficacy outcome of having at least a 2-grade decrease from baseline on both the Clinician Erythema Assessment and the Subject Self-Assessment Scales compared to the vehicle control. Treatment related adverse events of oxymetazoline and brimonidine are most often mild and localized. CONCLUSION: Topical oxymetazoline and brimonidine are effective for the management of persistent facial erythema associated with rosacea with a few mild and localized adverse effects. Further long term research is imperative to further understand their long term effects. PMID: 31294643 [PubMed - as supplied by publisher] {url} = URL to article
    • Acne and rosacea: What's new for treatment? Dermatol Ther. 2019 Jul 11;:e13020 Authors: Dursun R, Daye M, Durmaz K Abstract Acne and rosacea are two well-known chronic skin diseases in dermatology. There are many known therapeutic options of both diseases, but new treatment agents and therapeutic advances come to the agenda day by day. We would like to summarize new treatment advances for acne and rosacea diseases. This article is protected by copyright. All rights reserved. PMID: 31294907 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Case of lupus miliaris disseminatus faciei associated with marked formation of cysts, successfully treated with intralesional injections of triamcinolone acetonide. J Dermatol. 2017 Jul;44(7):e164-e165 Authors: Shimizu A, Funasaka Y, Ueno T, Kanzaki A, Saeki H PMID: 28342206 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Noticed a couple of posts that nappy, [aka, diaper] (Australian English and British English), skin treatments are helpful in some cases. For example a post from Smacky at RF who reports, "I've been using Bepanthen for about a week now....So I tried Bepanthen, and within a few hours noticed the skin on my nose and cheeks had settled down a bit and looked better. I've been applying it every morning and night before bed, and every day this week I've woken up find my nose a little less red than the day before. I also haven't had a single new spot or lump. I woke up today and looked in the mirror and my nose is the same skin tone as my face. It's almost surreal. Its like looking at a different person who I'd forgotten about. I feel wonderful  Anyway I really hope this will help someone else." Ingredients in Bepanthen: Aqua, Lanolin, Paraffinum liquidum, Petrolatum, Panthenol, Prunus amygdalus dulcis oil, Cera alba, Cetyl alcohol, Stearyl alcohol, Ozokerite, Glyceryl oleate, Lanolin alcohol. Rubydo1 post no 2 states about this SD/Rosacea, "To be honest if it wasn’t for sudocrem I’d have a lot more spots." Sudocrem is a product made in Ireland which is available at Walmart. The ingredients for Sudocrem:  Zinc Oxide Ph. Eur., Benzyl Alcohol B.P., Benzyl Benzoate B.P., Benzyl Cinnamate, Lanolin, Purified Water, Liquid Paraffin, Paraffin wax, Beeswax, Micrcocrystalline wax, Sodium Benzoate, Linayl Acetate, Propylene Glycol, Citric Acid, Butylated Hydroxyanisole, Sorbitan Sesquioleate, Lavender fragrance  Ingredients for Dermocrem are similar:  A similar product that is also used to treat diaper rash is Rugby Zinc Oxide Ointment with the following ingredients:  Active ingredient Zinc oxide 20% Inactive ingredients mineral oil, petrolatum  
    • Gerd Plewig, MD, who volunteers on the RRDi MAC recently sent a message to all the RRDi members about his fourth edition of his classic book on acne and rosacea which we feature in our store. Below is his message:  On Mon, Jul 1, 2019 at 10:40 PM Plewig, Gerd Prof. Dr.med. wrote: Dear Members of the RRDi,   You may be interested that the  4th completely revised and augmented edition of Acne & Rosacea  is out. It is printed by Springer Milan, Italy, an can be ordered in print version, or electronically. The major chapter on rosacea has been  updated in text and  clinical illustrations. Also a new chapter on Demodex folliculorum mites with scanning electron microscopy images  is added. Finally a new chapter on the history of acne and rosacea is provided. Best wishes,   Gerd Plewig   Prof. Dr. Dr. h.c. mult. Gerd Plewig, FRCP Department of Dermatology University of Munich Frauenlobstrasse 9-11 80337 Munich Germany
    • Related Articles Nicotinic acid suppresses sebaceous lipogenesis of human sebocytes via activating hydroxycarboxylic acid receptor 2 (HCA2 ). J Cell Mol Med. 2019 Jul 05;: Authors: Markovics A, Tóth KF, Sós KE, Magi J, Gyöngyösi A, Benyó Z, Zouboulis CC, Bíró T, Oláh A Abstract Nicotinic acid (NA) activates hydroxycarboxylic acid receptor 2 (HCA2 ), and it is widely used in treating dyslipidaemias. Since its side effects include skin dryness, whereas its deficiency can be accompanied by dyssebacia, characterized by sebaceous gland enlargement, we asked if HCA2 is expressed on human sebocytes, and if NA influences sebocyte functions. By using human immortalized SZ95 sebocytes, we found that non-cytotoxic (≤100 μmol/L; MTT-assay) concentrations of NA had no effect on the homeostatic sebaceous lipogenesis (SLG; Nile Red), but normalized excessive, acne-mimicking SLG induced by several lipogenic agents (arachidonic acid, anandamide, linoleic acid + testosterone; Nile Red; 48-hr treatments). Moreover, it exerted significant anti-proliferative actions (CyQUANT-assay), and increased [Ca2+ ]IC (Fluo-4 AM-based Ca2+ -measurement). Although NA did not prevent the lipopolysaccharide-induced pro-inflammatory response (up-regulation [Q-PCR] and release [ELISA] of several pro-inflammatory cytokines) of the sebocytes, collectively, these data support the concept that NA may be effective in suppressing sebum production in vivo. While exploring the mechanism of the sebostatic actions, we found that sebocytes express HCA2 (Q-PCR, immunofluorescent labelling), siRNA-mediated silencing of which prevented the NA-induced Ca2+ -signal and the lipostatic action. Collectively, our data introduce NA, and HCA2 activators in general, as novel, potent and most likely safe sebostatic agents, with possible anti-acne potential. PMID: 31273921 [PubMed - as supplied by publisher] {url} = URL to article
    • Permethrin 5% Cream has also been found to improve demodectic rosacea. 
    • Queta at RF has posted her regimen for demodectic rosacea:  "Mix .5 TBL melted coconut oil (I put it in a the micro for a few seconds because it hardens at room temp) and 5-6 drop tea tree oil. Apply to face and leave on for 40 minutes each evening. I put some on my eyebrows and a little above my eyes but use extreme caution because tea tree oil will really burn your eyes if you get some in them. After waiting 40 minutes, wash off your face and do your usual nightly skin routine. For awhile after I was done washing my face I would use coconut oil as a moisturizer because I read that mites don't like it."
    • In the UK you can get a Rx from a doctor online at this website.  For example, you can get a Rx for Soolantra
    • It was announced by Galderma on its website on May 16, 2019, "Nestlé today announced that it has entered into exclusive negotiations with a consortium led by EQT and a wholly owned subsidiary of the Abu Dhabi Investment Authority (ADIA) for the sale of Nestlé Skin Health for a value of CHF 10.2 billion. The proposed transaction will be subject to employee consultations and approval of regulatory authorities and is expected to close in the second half of 2019."  
    • New evidence but still unmet medical needs in rosacea treatment. Br J Dermatol. 2019 Jul;181(1):11-12 Authors: Le Cleach L, Cribier B PMID: 31259410 [PubMed - in process] {url} = URL to article
    • The results of this study demonstrated that a single, high-density MFU-V treatment may be effective for treating erythematotelangiectatic rosacea. J Drugs Dermatol. 2019 Jun 01;18(6):522 Safety and Effectiveness of Microfocused Ultrasound for Treating Erythematotelangiectatic Rosacea Schlessinger J, Lupin M, McDaniel D, George R
    • Related Articles A comment on Helicobacter pylori and rosacea. G Ital Dermatol Venereol. 2019 Aug;154(4):507-508 Authors: Sacco M PMID: 31251009 [PubMed - in process] {url} = URL to article
    • Related Articles What Is PFE? It May Just Be Time You Found Out.... J Drugs Dermatol. 2019 Jun 01;18(6):503 Authors: Del Rosso JQ Abstract With all the literature and research we have on acne and rosacea, there are still many unanswered questions. Over time, as we uncover more information on both preexisting and newly recognized pathophysiologic pathways, modes of drug action, alternative therapies, caveats related to basic skin care, and the potential roles for physical modalities, we often find that specific information that we thought was fact, is later altered, expanded, or corrected. What is interesting, and sometimes perplexing to me personally, is how difficult it is for the clinical dermatology community at large to incorporate well-published concepts into everyday clinical practice. PMID: 31251541 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles The Use of Oral Antibiotics in the Management of Rosacea J Drugs Dermatol. 2019 Jun 01;18(6):506 Authors: Nagler AR, Del Rosso J Abstract Rosacea is common inflammatory facial dermatosis. Rosacea has variable manifestations including facial flushing, central facial erythema, telangiectasias, and papulopustular lesions. Treatment of rosacea is challenging given the varied manifestations and incompletely understood etiology, but the treatment of papulopustular presentations often relies on oral antibiotics. Tetracyclines, specifically doxycycline, are the most commonly prescribed antibiotics for rosacea. Other antibiotics that can be used include macrolides, commonly azithromycin, and rarely, metronidazole. This paper will review the evidence for the use of antibiotics in the treatment of rosacea. J Drugs Dermatol. 2019;18(6):506-513. PMID: 31251542 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Safety and Effectiveness of Microfocused Ultrasound for Treating Erythematotelangiectatic Rosacea J Drugs Dermatol. 2019 Jun 01;18(6):522 Authors: Schlessinger J, Lupin M, McDaniel D, George R Abstract Background: Anecdotal reports indicate the use of microfocused ultrasound with visualization (MFU-V) improves facial redness. Objective: The purpose of this pilot study was to assess the safety and effectiveness of MFU-V for improving the signs and symptoms of erythematotelangiectatic rosacea. Methods & Materials: Healthy adults with a clinical diagnosis of erythematotelangiectatic rosacea were enrolled (N=91). Eligible subjects had baseline Clinician Erythema Assessment (CEA) scores ≥3 and Patient Self-Assessment (PSA) of erythema scores ≥2. Subjects were randomized to receive one or two low-density MFU-V treatments or one or two high-density MFU-V treatments. Subjects were evaluated at 90, 180, and 365 days after treatment. The primary effectiveness endpoint was treatment success, defined as a 1-point change in CEA scores at 90 days post-treatment. Results: Across groups, 75 to 91.3% of subjects achieved treatment success at 90 days post-treatment. Notable adverse events include bruising (44%), tenderness/soreness (43%), and redness (35%). Treatment results were sustained, lasting up to 1 year. Subject satisfaction was high based on self-assessment questionnaires. Conclusion: The results of this study demonstrated that a single, high-density MFU-V treatment may be effective for treating erythematotelangiectatic rosacea. Based on these results, a large, randomized controlled study of single, high-density MFU-V treatment for erythematotelangiectatic rosacea is warranted. J Drugs Dermatol. 2019;18(6):522-531. PMID: 31251544 [PubMed - as supplied by publisher] {url} = URL to article
    • It really saddens us that Joanne Whitehead, Ph.D., has resigned from the board of directors of the RRDi. She was instrumental in obtaining and working with two educational grants we received from Galderma in 2015 and 2016. Her expertise will be missed and her volunteer spirit. The RRDi greatly appreciates all the volunteer work Dr. Whitehead performed for the RRDi. 
    • darren1 has shared his experience not only with YouTube but also with RF in this thread and you watch one of his videos below: 
    • Related Articles Contact allergy from fragrances and formaldehyde contributing to papulopustular rosacea. Contact Dermatitis. 2019 Jun 25;: Authors: Darrigade AS, Dendooven E, Aerts O Abstract Allergic contact dermatitis caused by fragrances and formaldehyde is common (1,2), but pustular dermatitis as a manifestation of contact allergy is rare (3). We report a case of therapy-resistant rosacea for which (occupational) contact allergy to fragrances, and to a lesser extent formaldehyde, was identified as an aggravating factor. This article is protected by copyright. All rights reserved. PMID: 31237351 [PubMed - as supplied by publisher] {url} = URL to article
    • Galderma has applied for a brimonidine foam patent which according to the patent is claimed to have the "advantage of remaining on the surface of the skin and of delivering a smaller amount so as to prevent undesirable effects (rebound effect) and too obtain a foam that is suitable for treating rosacea." US20190099369A1.pdf
    • And thats exactly the problem with Brevis. We have no way to check the levels of this parasite in rosacea. This study was able to check them by extracting eyelashes and found large numbers of brevis at the root. But what type of test is used to count them in the skin.  Surface tests will only count folliculorum levels and Soolantra won't have much of a problem killing them. But i have my doubts that it is able to kill brevis. 
    • Thanks Rory. Looking forward to your results. Did you see this paper about demodex brevis:  Demodex Brevis Higher Count Than Demodex Folliculorum in Cylindrical Dandruff Patients
    • Well, I think oral ivermectin should be more common as a rosacea treatment. Rosacea skin has a damaged barrier and topicals can be extremely difficult for many to tolerate. Also, topical treatments can be very slow to take effect as seen in a Galderma study of Soolantra where 30% of trial participants took up to a year to achieve clear/almost clear results. Then there is demodex brevis. A much smaller cousin of demodex folliculorum, which lives deeper in the pores. Little is known about brevis and, unlike folliculorum, it doesn't appear to exit pores at night to mate. If this is indeed the case then how do we kill it with a topical which may not penetrate the skin deep enough to reach it.  I think the horse paste is more of a hit in the States than in Europe. Its down to the crazy prescrition medication prices Americans pay, whereas in Europe Soolatra is many times cheaper. Ivermectin, as far as i know, is not water soluble. So any topical gel version of Soolantra will need one of those irritataing oil soluble excipients to disolve it. The horse paste looks like a gel but i have seen comments from people saying that it feels and looks like vaseline after applying it.  Anyway, I'll give it a couple of months and I'll post my results on the page you mentioned.
    • Actually I ran this by my dermatologist who was well aware that Rosaceans were using horse paste topically since he read about it in a journal. There are some dermatologists who are up to date with what is going on and then there are others who are in the dark. He told me that when prescribing Soolantra to his rosacea patients that about one in four patients were successful using it. He gave me a Rx for Soolantra and I tried it and I think now it was the inactive ingredients in Soolantra that irritated my skin. Galderma (or another pharmaceutical company) will probably eventually make an ivermectin gel with a very simple inactive ingredient list to compete with the horse paste that everyone is raving about. Galderma knows what is going on with rosaceans and obviously saw a slight dip in Soolantra sales due to thousands using horse paste. They know that a significant number of rosacea patients are not able to tolerate the inactive ingredients in Soolantra. 
    • Rory, thanks for clearing this up that you are taking the horse paste orally. We do have a thread dedicated to taking ivermectin orally. While many may think that taking oral ivermectin isn't a good idea, the fact is that oral ivermectin has been given to millions of people worldwide and there are long term studies on oral ivermectin in children. However, the RRDi recommends you check with your physician when embarking on this form of treatment as a precaution. It would be better you post in the oral ivermectin thread since this thread is about using horse paste topically. Thanks. 
    • The RRDi is pleased to announce that Apurva Tathe has been appointed to serve on the RRDi Board of Directors. She has a masters of science in biotechnology and is an excellent addition to the board. 
    • Related Articles Topical probiotics: the unknowns behind their rising popularity. Dermatol Online J. 2019 May 15;25(5): Authors: Lee GR, Maarouf M, Hendricks AJ, Lee DE, Shi VY Abstract OBJECTIVE: Topical probiotics have been used for skin care and treatment since the early 20th century. Over the past decade, there has been a dramatic surge of commercially-available topical probiotic products. We conducted a systematic search of clinical data relating to the use of topical probiotics and identified relevant clinical and regulatory gaps. METHODS: PubMed and Google Scholar searches were conducted for trials and reviews of probiotics. FDA definitions of cosmetics, drugs, and regulation of topical probiotics were reviewed. RESULTS: Topical probiotics have shown efficacy in a number of limited trials, particularly those involving the treatment of acne, atopic dermatitis, and rosacea. However, there is a paucity of literature on the safety profiles, mechanistic action, and therapeutic potential of topical probiotic products. Several regulatory gaps exist, including approval and classification of topical probiotic products by the FDA; currently there are no topical probiotic products the FDA has approved as drugs. CONCLUSION: With increasing popularity among the general public, but insufficient clinical data to demonstrate large-scale effectiveness and a thorough understanding of side effects, there is a need for further mechanistic and clinical investigation, as well as improved regulation and standardization of topical probiotic products. PMID: 31220895 [PubMed - in process] {url} = URL to article
    • Yes I'm ingesting it. I took a 250 lb dose. No, i dont weigh 250 lb. I just like the idea if a large dose. Each syringe has enough for a 1250 lb horse, so thats 5 doses per syringe. 
    • Ok I guess you are ingesting it orally? and if you are ingesting it orally, it has residual effects means it is stored in body fat and then progressively released to work and taking too often will cause build up. So you have mentioned that you have already taken your first dose so wait for one week and see the results and then follow the next dose and the recommended dose is 200 mcg(micrograms) per kilogram body weight but slight point difference will be ok but ask and consult your physician before you take any treatment.
    • What I mean is, you are using the Bimectin topically, correct? 
    • No, its the oral, apple flavoured horse paste with the syringe. You have a picture of it at the top of this page. The ingredients are not listed on the box. 
    • The Bimectin is topical, correct? Does it list the inactive ingredients?
    • Item 109 – UE 4 Dermatoses faciales : acné, rosacée, dermatite séborrhéique. Ann Dermatol Venereol. 2018 Mar;145 Suppl 1:S7-S16 Authors: CEDEF PMID: 29429583 [PubMed - indexed for MEDLINE] {url} = URL to article
    • I ordered Bimectin Brady. It arrived 2 days ago. Not easy to get cause its not available in some european countries. I took a dose yesterday on an empty stomach with plenty of water. Not exactly sure when i should take the next dose, maybe in a few days or next week. So, all i can do now is wait and see what happens.
    • [PATHOGENETIC FEATURES AND METHODS FOR TREATMENT OF VARIOUS FORMS OF ROSACEA]. Georgian Med News. 2019 Apr;(289):116-120 Authors: Tsiskarishvili T, Katsitadze A, Tsiskarishvili NV, Tsiskarishvili NI, Chitanava L Abstract The aim of the work was to study the features of the pathogenesis of various clinical forms of rosacea (the presence of mite Demodex folliculorum, the determination of VEGF, IL-2 IL-6, IL-8) and, based on the obtained results, to ensure adequate methods of therapy. Mite identification was performed by microscopy. The concentration of cytokines in patients with various clinical forms of rosacea (papulopustular form 15 patients, steroid form - 15, erythematous telangiectic form - 10, Ophthalmo Rosacea - 3, rhinophyma - 3) was determined by enzyme immunoassay using appropriate monoclonal antibodies and expressed in samples. Based on the results we obtained in the local treatment of patients with papulopustular rosacea (with a high population density of demodicosis ticks and an increased concentration of IL-8 in the blood), 1% ivermectin cream was applied externally to the skin of the face 1 time per day every day for the entire course of treatment (3-4 months). In patients with erythematous-teloangiectatic form (with a high cytokine VEGF, IL-8), a combined phased use of 1% pimecrolimus cream 14 days and 0.5% bromonidine tartrate gel was administered once a day - 14 days (with a single course of 1 month). In patients with a steroid form of rosacea with a high concentration of cytokines (IL-2, IL-6, IL-8), 1% pimecrolimus was administered 2 times a day - 1 month, 1% ivermectin 1 time a day - 14 days. During therapy, patients with advanced treatment were divided into 2 groups. Patients of group 1, who received externally 1% ivermectin 1 time per day as the main therapy, in the evening for 16 weeks. Group 2 applied 1% ivermectin and 1% pimercolimus cream for 16 weeks. In group 2 patients showed a significant improvement in a shorter time (4 weeks compared to 8 weeks in 1 group of patients). Taking into account the torpid flow and the difficulty of rosacea therapy, the pathogenetic approach when choosing new external preparations, opens promising directions for further deeper study of the pathophysiological mechanisms underlying the individual clinical forms of dermatosis. At the same time, the efficacy and safety of using ivermectin, pimecrolimus, and brimonidine tartrate in the treatment of various forms of this dermatosis suggests their widespread use in practical dermatology. PMID: 31215891 [PubMed - in process] {url} = URL to article
    • We have some instructions provided by IPS on how to use our forum. For example, watch this video on how to change your display name:  Editing your profile Sending/Receiving messages General Posting Control Previewing post content Managing followed content How to Use CLUBS Two Factor Authentication Viewing Attachments Reputation & Reactions Custom Profile Fields User Ranks Post color highlighting Profile Completion Other Profile Settings
    • "The mechanism of action (MOA) of Soolantra® (ivermectin) Cream, 1% in treating rosacea lesions is unknown." However, we are concentrating on an investigation into the 'basis for the vehicle' statement by Galderma regarding Soolantra.  In the Soolantra News post if you scroll down to Cetaphil Base, Galderma, on its Mechanism of Action page, posts : "Soolantra Cream combats inflammatory lesions of rosacea with a formulation designed for tolerability, utilizing Cetaphil® Moisturizing Cream as the basis for the vehicle." However, now this page is no longer available, but we have a screen shot of the Way Back Machine on August 21, 2018 which shows you the statement below:  Soolantra mechanism of action (MOA) (Way Back Machine url)  Actually after a careful search, Galderma has moved the statement that Cetaphil is the 'basis for the vehicle' statement to this page:  https://www.soolantra.com/hcp/about-soolantra-cream SOOLANTRA (ivermectin) cream, 1% is a white to pale yellow hydrophilic cream. Each gram of SOOLANTRA cream contains 10 mg of ivermectin. It is intended for topical use. While the claim by Galderma that utilizing Cetaphil is 'basis for the vehicle' we have investigated and notice the differences with the inactive ingredients in Soolantra with the ingredients in Cetaphil below.  SOOLANTRA cream contains the following inactive ingredients: carbomer copolymer type B, cetyl alcohol, citric acid monohydrate, dimethicone, edetate disodium, glycerin, isopropyl palmitate, methylparaben, oleyl alcohol, phenoxyethanol, polyoxyl 20 cetostearyl ether, propylene glycol, propylparaben, purified water, sodium hydroxide, sorbitan monostearate, and stearyl alcohol. Source Cetaphil Moisturizing Cream Ingredients: Water, Glycerin, Petrolatum, Dicaprylyl Ether, Dimethicone, Glyceryl Stearate, Cetyl Alcohol, Prunus Amygdalus Dulcis (Sweet Almond) Oil, PEG-30 Stearate, Tocopheryl Acetate, Acrylates/C10-30 Alkyl Acrylate Crosspolymer, Dimethiconol, Benzyl Alcohol, Phenoxyethanol, Glyceryl Acrylate/Acrylic Acid Copolymer, Propylene Glycol, Disodium EDTA, Sodium Hydroxide Source Compare Soolantra inactive ingredients to Cetaphil Moisturizing Cream Ingredients Google Sheet
    • What is interesting is that Galderma claims Soolantra's base is Cetaphil. However, we did an investigation and compared Cetaphil's ingredients with the list shown in Soolantra and discovered there is a difference. For more information:  Soolantra mechanism of action (MOA)  SOOLANTRA (ivermectin) cream, 1% is a white to pale yellow hydrophilic cream. Each gram of SOOLANTRA cream contains 10 mg of ivermectin. It is intended for topical use. SOOLANTRA cream contains the following inactive ingredients: carbomer copolymer type B, cetyl alcohol, citric acid monohydrate, dimethicone, edetate disodium, glycerin, isopropyl palmitate, methylparaben, oleyl alcohol, phenoxyethanol, polyoxyl 20 cetostearyl ether, propylene glycol, propylparaben, purified water, sodium hydroxide, sorbitan monostearate, and stearyl alcohol. Source Cetaphil Moisturizing Cream Ingredients: Water, Glycerin, Petrolatum, Dicaprylyl Ether, Dimethicone, Glyceryl Stearate, Cetyl Alcohol, Prunus Amygdalus Dulcis (Sweet Almond) Oil, PEG-30 Stearate, Tocopheryl Acetate, Acrylates/C10-30 Alkyl Acrylate Crosspolymer, Dimethiconol, Benzyl Alcohol, Phenoxyethanol, Glyceryl Acrylate/Acrylic Acid Copolymer, Propylene Glycol, Disodium EDTA, Sodium Hydroxide Source Compare Soolantra inactive ingredients to Cetaphil Moisturizing Cream Ingredients Google Sheet
    • With regard to flushing, it would be good to read this post. There are a number of drugs used to avoid flushing. There are also a number of other non prescription treatments to avoid flushing which are found here. 
    • There are so many alcohols in Soolantra's inactive ingredients which cause dryness and flakiness of skin which in turn cause itching and irritation and redness. Parabens and propylene glycol are also there which tend to penetrate the skin to help allow other ingredients to enter and this may be the reason your skin reacted and couldn't handle because everyone's skin reacts differently to chemicals.
    • Yes admin I had learned about the difference when I got rosacea sometimes It was sudden intense redness and bump and sometimes it was episodic redness so I researched about it because it happens with me with the onset of autumn. When the autumn starts I get sudden intense flare with redness and bumps and then the redness and bumps last longer and take time to go and during full autumn and winter after that flare-up, I get short episodic flushing very frequently which looks like it is blushing. but it is all unexpected and unanticipated about its timing.  
    • Apurva,  You may be interested in reading this post, Liver, Yogurt, Sour Cream, Cheese, Eggplant, and Spinach, in the research articles section of our website to get an understanding between the difference of a rosacea flareup trigger vs a flushing trigger. 
    • "In 2016, the definition of sensitive skin (SS) was established by a special interest group from the International Forum for the Study of Itch. SS is defined as a syndrome defined by the appearance of unpleasant sensations (stinging, burning, pain, pruritus, and tingling sensations) in response to stimuli that would not normally cause such sensations.....To our knowledge, only 2 transcriptomic studies have been performed for SS. ...As previously done with rosacea, these two studies provide very interesting data allowing, orientating and suggesting further research. Transcriptomic studies on larger populations are needed but these studies give key data to focus on some pathogenic mechanisms." Front Med (Lausanne). 2019; 6: 115. Sensitive Skin: Lessons From Transcriptomic Studies Adeline Bataille, Christelle Le Gall-Ianotto, Emmanuelle Genin, and Laurent Misery What if a non profit organization for rosacea gathered together 10,000 members, and each member donated one dollar and everyone agreed that a study on transcriptomic research be conducted? Could that be done? It is all up to you whether you think this would be worth investigating. 
    • An article published in the Daily Mail, Nerve injection that can stop the nightmare of hot flushes, by Robert Dobson, states, "An injection in the neck might ease the symptoms of hot flushes....known as a stellate ganglion nerve block."  Many rosaceans are more concerned with avoiding flushing than with anything else. What exactly is stellate ganglion nerve block? The Cleveland Clinic answers, "A stellate ganglion block is used to diagnose or treat circulation problems or nerve injuries..." Cedars-Sinai states, "A stellate ganglion block (sympathetic block) is an injection of local anesthetic into the front of the neck." Rehabilitation & Orthopaedic Institute, University of Maryland states, "A stellate ganglion block is an injection of local anesthetic (numbing medicine) to block the sympathetic nerves located on either side of the voice box in the neck." One paper on this subject states, "Due to a high risk of side effects, for example, pneumothorax and vascular puncture, an image-guided approach is strongly suggested, even with the "safer" C6 approach." [1]  "The inputs from sympathetic ganglia have been known to be involved in the pathophysiology of various conditions like complex regional pain syndrome (CRPS)" [2] Stellate ganglion block (SGB) "Stellate ganglion, also known as the cervicothoracic ganglion,....SGB is the oldest and most common sympathetic block that is applied today....There is a broad range of case studies that report the effectiveness of SGB in many different conditions. The outcomes may look promising, but expanding the indications of SGB needs more randomized, controlled studies." [2] End Notes [1] Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Stellate Ganglion Blocks Emanuele Piraccini; Ke-Vin Chang. [2] J Pain Res. 2017; 10: 2815–2826. Ganglion blocks as a treatment of pain: current perspectives Osman Hakan Gunduz and Ozge Kenis-Coskun  
    • This article is found here. 
    • Rory,  You will probably have better results using the horse paste over Soolantra, mainly because the horse paste is stronger ivermectin 1.87% over Soolantra's 1% and also because the inactive ingredients in the horse paste are simpler than Soolantra's list of inactive ingredients. So what brand of horse paste did you order? Also please be sure to post your results of taking oral ivermectin in the oral ivermectin post here. Just look at this comparison of horse paste inactive ingredients over Soolantra's inactive ingredients to see the difference:  Eqvalan inactive ingredients: Hydrogenated Castor Oil, Titanium Dioxide (E171) 2.0% w/w., Hyprolose, Propylene Glycol Agri-Mectin inactive ingredients:  Corn Oil, Polysorbate 80, Apple Flavor, and Aerosil.  Soolantra's inactive ingredients: carbomer copolymer type B, cetyl alcohol, citric acid monohydrate, dimethicone, edetate disodium, glycerin, isopropyl palmitate, methylparaben, oleyl alcohol, phenoxyethanol, polyoxyl 20 cetostearyl ether, propylene glycol, propylparaben, purified water, sodium hydroxide, sorbitan monostearate, and stearyl alcohol. This simple comparison explains why more positive results are with horse paste because of its simple inactive ingredient list compared to the huge number of inactive ingredients in Soolantra which may explain why some like you and me may have a side effect of dryness or whatever. Probably the other horse paste brands have few inactive ingredients just as the two we did find above. The most popular horse paste, Durvet Paste doesn't list the inactive ingredients but it probably is a list of only three "Proprietary Components".  Just about everyone reports it takes 12 weeks for clearance, but so do the positive reports using Soolantra, 12 weeks.     
    • I've tried Soolantra a couple of times. Lasted at best about 2 months but my face couldn't handle it. No idea why maybe its the propylene glycol in it. Im going to try the oral route and see what happens. I've ordered the paste.  One thing i noticed each time I used Soolantra was that my face was in good condition for a while after i stopped using it. So i do think demodex has some part to play for me. 
    • In the past, the general consensus has been that more women have rosacea than men, particularly in certain variants of rosacea. We will use this post to collect papers on this subject. If you find any papers on this subject, please post in this thread.  Severity Scores  One report concluded, "Self-assessment severity scores were significantly higher in men (3.6 ± 1.3) than women (3.2 ± 1.0; P = .04).The authors conclude that rosacea is more severe in men and younger patients." [1] End Notes Dermatol Clin. 2018 Apr;36(2):97-102. doi: 10.1016/j.det.2017.11.004. Epub 2017 Dec 16. Measurement of Disease Severity in a Population of Rosacea Patients. Alinia H, Tuchayi SM, James SM, Cardwell LA, Nanda S, Bahrami N, Awosika O, Richardson I, Huang KE, Feldman SR.
    • Rory,  Soolantra is 1% ivermectin and the active ingredient. 
    • Haven't heard of this lutein stuff Brady. Havent really been around much lately. So youre still using zz, using some topical peroxide, low carb diet and lutein. Hell of a life, eh.  Topical ivermectin may be the best option but some of us cant tolerate it. Im not sure any derm would be able to answer that question. Probably better to ask a vet.
    • I have been taking the lutein/zeaxanthin which seems to dry up my skin some. Wrote a post about oral ivermectin. I would run this by my dermatologist before ingesting it. Topical ivermectin seems the best route. 
    • Related Articles Minocycline-Induced Hyperpigmentation. J Am Osteopath Assoc. 2018 Jul 01;118(7):492 Authors: Skorin L, Norberg S PMID: 29946676 [PubMed - indexed for MEDLINE] {url} = URL to article
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