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  1. So going to the gym or exercising to increase muscle mass may improve your rosacea. Just about any physician will tell you that exercise and eating healthy will improve not only health but also your rosacea.
  2. Admin

    Low Dose Naltrexone

    Dr. Chris Steele talks about LDN.
  3. Admin

    Low Dose Naltrexone

    Flugs at RF has started a thread indicating that low dose Naltrexone helps with phenotype 1 (of course Flugs calls it subtype 1). If you read the entire thread Flugs also takes propranolol (10 mg 3 times daily ), uses IPL (post no 29), however, in post no 49 Flugs writes, "I’ve also dropped all the meds I have tried in the past, none of which seemed to help much anyway... at least not enough for me to want to do something to my heart in order to help my face. So all I’m taking now is LDN and a tablesppon of apple cider vinegar every day." Flugs reports at post no 80, "On the down side though - I have to confess that i have had a few (pretty minor) flushes in the past two or three weeks. Almost always for no apparent reasons. It may still be post IPL recovery, last one was a month ago.. but IPL recoveries used to be waaaayyy worse, so if this is all I get I'm fine with that. I confess I have also been dabbling with (very mild) mandelic acid of late - I think I was overdoing it - Ive dialled back." So Flugs is still trying some other treatments along with LDN. In post 99 he mentions his 12th IPL treatment. At post no 112 Flugs writes, "I am still prone to flushing a little when I get too warm - and also (oddly) when I am trying, and failing, not to fall asleep, such as late at night in front of the tv (that’s always made me flush.. does that happen with anyone else!?) when I say “flushing a little” I mean that my cheeks get red and feel warm, but I can take it down pretty much instantly by cooling them (fan, water spray etc) in some way. Even if I were to leave them be they would go down themselves within a few mins... compare that to the sometimes 12 hour long painful flushes I got when the rosacea arrived two years ago." Judworth who suffers from Neuropathic Rosacea (has lots of posts) reports in the same thread Flug started mentioned above about his experience taking LDN, "Since taking LDN I am cautiously happy to report that I haven't had any facial nerve pain, I still get the warm room flush, but my face is less reactive in general, even after a spell on the computer (which always gave me an element of activity even if it wasn't a full-blown flush)." At post no 117 Judworth writes, "LDN has been a god-send for me, not only calming the skin, stopping my facial nerve pain and halting the burning sensation in my mouth caused by lichen planus, I feel it is somehow re-booting my faulty immune system!" The low dose Naltrexone is usually starting out at 1 mg and gradually increasing to 4.5 mg. Flugs insists that taking more than this won't work (go through his thread which has many other users reporting success with what they call LDN). You may want to show your doctor this pdf: Low-dose Naltrexone (LDN) Fact Sheet 2014 LDN Research Trust LDNNow
  4. That has been my question for a number of years when I noticed no activity here at the RRDi, even though having over 1200 members, hardly anyone posts. I have thought during this time obviously rosaceans prefer social media over the forum style posting that has been around for twenty years, which doesn't have the user experience they are accustomed to using social media platforms. I have been browsing and posting a little at Facebook, Reddit, and Twitter and found that the level of education about rosacea is paltry and mostly these groups of rosaceans are into horse paste. They feel very comfortable showing horrible photos of their rosacea which I find really ironic since I heard so many complaints about joining the RRDi and filling out contact information (so we dropped the requirement and only require an email address). The lack of knowledge about rosacea in these social media groups and the spam posts allowed for all sorts of treatment for rosacea, not to mention the advertising, to me is a sad choice rosaceans have made instead of joining together in to a non profit organization for patient advocacy. At least I know where the rosaceans have gone. Very sad.
  5. image courtesy of IMDB Canadian Egyptian actress Christine Solomon has rosacea. She is reported as stating, "I purchased acne products off the shelf, and that turned out to be a big mistake! My cheeks became inflamed because of the ingredients in those products, and my condition worsened. That’s when I consulted a dermatologist for the first time, and he diagnosed me with rosacea at the age of 14 years old." Ms Solomon is the 2018 spokesperson for the Acne and Rosacea Society of Canada’s Rosacea Awareness Campaign. Canadian Egyptian Actress On Rosacea, Acne and Rosacea Society of Canada
  6. Admin

    Horse Paste for Rosacea?

    Tom Busby, SD poster extraordinare at RF, mentioned in a post on this subject at RF, "an alternative source of ivermectin, on eBay" which is ivermectin powder. I asked Tom whether this would be a good idea since it seems a lot safer to use the horse paste than have to concoct a paste with grain alcohol and his comment is, "horse paste is fairly expensive for a really tiny amount of product.... I have to assume that someone who has some experience formulating hot emulsions (oil in water) could make a non-greasy cream with this ivermectin powder." I would prefer the horse paste for a trial run before purchasing a chemistry set to make this. Most rosaceans are not into a laboratory approach to treatment preferring a pill or a topical than experimenting with such treatments in a lab coat. But, of course, this is the internet, and guess what? Horse paste for rosacea. Watch Mr. Wizard concoct a new rosacea treatment on YouTube. Maybe we will hear reports of this. If you haven't heard of the new TXA treatment, it also requires concocting a rosacea treatment yourself by purchasing powder from Amazon or your local chemical store.
  7. "Rosacea appears to be the first human skin disease to be treated with a veterinary medication....Doctors and researchers have growing concerns about the widespread use of this homegrown treatment." [1] You can read about all this in a Reddit group r/rosacea or in the Facebook Group Rosacea (English) and this is spreading in other groups. Therefore, the rosaceans who are trying this over-the-counter treatment for horses on their rosacea while reporting success will be the first guinea pigs in this group who have valiantly gone where no rosaceans have gone before and will eventually in the future report back any of the side effects and long term results or risks associated with using a veterinary medication for horses on their rosacea. It would be ironic that using a horse paste for rosacea that costs a few dollars is just as valid as using Soolantra which has cost millions of dollars for Galderma to go through the hoops to get FDA approval. End Notes [1] People are turning to medication made for horses to treat rosacea, and dermatologists are concerned, J.K. Trotter, Insider Br J Dermatol. 2018 Dec 30. doi: 10.1111/bjd.17540. Misuse of veterinary wormers in self-medication of rosacea and scabies. Hellen R, Ní Raghallaigh S.
  8. Evidence for a genetic component to rosacea has been hypothesized, with a retrospective study showing that rosacea patients have a greater than fourfold increased odds of having a family member with rosacea (Abram et al., 2010; Steinhoff et al., 2013), but the genes leading to this association are not known....A genome-wide association study was conducted in 22,952 individuals whose genomes showed >97% European ancestry. Because of the sample size needed for this study, cases and controls were identified by an online questionnaire in which participants responded to a survey item on whether a healthcare professional had ever diagnosed them with rosacea. Participants who answered “yes” were defined as “cases” (n=2,618), and those who answered “no” (n=20,334) were defined as “controls”.... Together, these data strongly suggest a role for antigen presentation by class II HLA in the etiology of rosacea. The data presented from this large discovery and replication group provide evidence for a genetic component of rosacea. J Invest Dermatol. 2015 Jun; 135(6): 1548–1555. Assessment of the Genetic Basis of Rosacea by Genome-Wide Association Study Anne Lynn S Chang, Inbar Raber, Jin Xu, Rui Li, Robert Spitale, Julia Chen, Amy K Kiefer, Chao Tian, Nicholas K Eriksson, David A Hinds, and Joyce Y Tung
  9. Note: This article is updated as we receive new data on theories relating to the cause of rosacea. We categorize all the rosacea theories in our forum. Innate Immune System Disorder “These findings confirm the role of cathelicidin in skin inflammatory responses and suggest an explanation for the pathogenesis of rosacea by demonstrating that an exacerbated innate immune response can reproduce elements of this disease.” [3] If you will notice in the above statement that the findings suggest an explanation for the pathogenesis of rosacea. Gallo, et.al, never said they found the cause of rosacea. The media came to the conclusion that now all the mystery of rosacea is over and we have the cause nailed down. All we have to do is wait for the treatment. While the research of Gallo, et.al, at UCSD is remarkable and insightful, the jury is still out on what causes rosacea. And while the jury is still out, there is more news worth mentioning that may be related to cathelicidin, peptides or antigenic proteins. The cathelicidin theory on the cause of rosacea is rooted in the immune system disorder theory, which is probably the most popular one as of this date. More on cathelicidin. "Our current hypothesis is that a genetic predisposition, together with trigger factors, leads to the clinical occurrence of transient flushing, which may be because of overstimulation of the sensory and/or autonomic nervous system in the skin and induction of innate immune responses. The concrete relationship between the skin nervous system and the innate immune system is still unclear." [22]. So the nervous system is also being considered important to the innate immune system disorder. "This research demonstrates early and late stage components of innate immunity in specimens of rosacea ratifying the existence of an altered innate immunity in its pathogenesis." [28] Demodectic Rosacea According to The Irish Times, Irish Scientists blame bacteria as the cause of rosacea according to a different study. This study is the result of researcher Dr Kevin Kavanagh, a senior lecturer in biology at NUI Maynooth. According to The Irish Times, “Working with the Mater hospital, the researchers previously identified a Bacillus bacterium inside Demodex mites. The bacteria release two proteins that trigger an inflammation in patients with facial rosacea.” [4] At least one type of bacteria is associated with demodex mites and rosacea and now others are implicated. This bacteria is Bacillus oleronius according to an NRS press release [5] which quotes Dr. Kavanagh as saying, “This indicates that the Bacillus bacteria found in the Demodex mite produce an antigen that could be responsible for the tissue inflammation associated with papulopustular rosacea.” A study released in September 2007 by Dr. Frank Powell, et.al, also concluded, “Antigenic proteins related to a bacterium (B. oleronius), isolated from a D. folliculorum mite, have the potential to stimulate an inflammatory response in patients with papulopustular rosacea.” [6] Another study released in January 2010 also said, “The strong correlation provides a better understanding of comorbidity between Demodex mites and their symbiotic B oleronius in facial rosacea and blepharitis.” [7] Now, another bacteria, Bartonella quintana, may be implicated with the mites according to a report by David Pascoe. [17] A number of other bacteria has now been added to list connected to demodex. The consensus has grown that demodectic rosacea is a variant of rosacea. [20] IBS Another theory on the cause of rosacea is that irritable bowel syndrome is related to rosacea. “Rosacea may be a symptom of an unhealthy gastrointestinal system and healing the entire gastrointestinal system may be the basis for eliminating rosacea. Many people with rosacea also have been diagnosed with Irritable Bowel Syndrome (IBS), Crohn’s Disease or some for of Colitis.” [12] This theory falls under Other Theories > IBS and Rosacea. Bacteria Theory The IBS theory also is related to bacteria in the gut and that using antibiotics clears rosacea. An article in the St. Louis Dispatch [13] says that one doctor has been prescribing Xifaxan, an antibiotic for gastric problems and reports clearing of rosacea. Previous to this report a study done in Italy published that eradicating the bacteria in the gut had improved rosacea. [14] This theory falls under Rosacea Theories > Bacteria Theory. SIBO Another theory that has come up is that SIBO is related to rosacea. The previously mentioned rosacea online guru had this to say about SIBO and rosacea: “This sort of abstract just make me shake my head. If you read quickly you will think that this abstract suggests that Small Intestinal Bacterial Overgrowth (SIBO) causes rosacea. What this abstract is saying that is that rosacea sufferers seem to have a higher incidence of SIBO than non rosacea sufferers.” [15] “The link between SIBO and the papules and pustules of rosacea is still a mystery.” [16] For more information on rosacea and SIBO click here. This theory falls under Other Theories > SIBO and Rosacea. H pylori Speaking of bacteria, particularly gram negative bacteria, there is a continuing controversy as to whether H pylori is a factor in rosacea ( read an article on this subject). This theory falls under Various Environmental Stimuli > Microorganisms > Helicobacter Pylori. Associated Diseases (Systemic comorbidities) Rosacea is associated with a number of other diseases, referred to as 'systemic comorbidities' and this list keeps growing. This complicates the theories on the cause of rosacea increasing the call for further research. However, in one study it was stated, "In this large study of patients with rosacea, atopic dermatitis, and psoriasis, we did not detect an increased 1-year risk of cardiovascular disease after adjusting for confounders." [18] Therefore, papers stating an association of rosacea with other diseases should all be taken with a grain of salt due to 'confounders' since another paper states, "Limitations included the accuracy of the published data, potential patient selection, and possible confounding factors. The true nature of the drawn correlations is uncertain, and causality cannot be established." [26] "In statistics, a confounder (also confounding variable, confounding factor or lurking variable) is a variable that influences both the dependent variable and independent variable causing a spurious association." Wikipedia Inflammation One study in Finland looked at levels of C-reactive protein (CRP), commonly used in clinical studies as a strong marker for inflammation. The researchers found that individuals with slightly elevated blood levels of CRP were 1.7 times more likely to have rosacea than normal individuals. The study concluded, "low grade inflammation is present in several skin diseases," including rosacea. [27] Trigeminal sensory malfunction theory In 2017 another proposed theory on the cause of rosacea is the Trigeminal sensory malfunction theory which we await further discussion and development to see if this becomes popular or not. This theory involves inflammation as the previous paragraph mentions. Bradykinin Theory For more information. Low Gastric Acid Theory There is evidence you should consider that low gastric acid is a factor in rosacea. Conclusion The jury is still out on what causes rosacea. "The pathophysiology of rosacea is still poorly understood."[22] "Demodex folliculorum, the small intestinal bacterial overgrowth (SIBO) and Helicobacter pylori are the most investigated, studied but also debated regarding their contribution in the pathogenesis of rosacea." [24] "Vasculature, chronic inflammatory responses, environmental triggers, food and chemicals ingested and microorganisms either alone or in combination are responsible for rosacea....In conclusion, we can say that there are multiple factors responsible for the disease." [23] The headlines may one day report another ’cause’ of rosacea or highlight the ones discussed above. Whatever happens, keep an open mind, since we still don’t know what causes rosacea. We may be surprised one day to actually read a headline that truthfully explains the cause of rosacea or clearly distinguishes rosacea from the plethora of mimics. For more information on the cause of rosacea and other theories on this subject click here. End Notes [1] Scientists unmask the cause of rosacea August 06, 2007 by Alison Williams, Staff Writer, Los Angeles Times Scientists determine cause of rosacea, UPI [2] UCSD Researchers Discover Cause of Rosacea UCSD News Center [3] Increased serine protease activity and cathelicidin promotes skin inflammation in rosacea Kenshi Yamasaki, Anna Di Nardo, Antonella Bardan, Masamoto Murakami, Takaaki Ohtake, Alvin Coda, Robert A Dorschner, Chrystelle Bonnart, Pascal Descargues, Alain Hovnanian, Vera B Morhenn & Richard L Gallo Nature Medicine 13, 975 – 980 (2007) Published online: 5 August 2007 | doi:10.1038/nm1616 [4] Study finds cause of rosacea Claire O’Connell The Irish Times – Tuesday, July 14, 2009 [5] New Study Shows Role for Bacteria in Development of Rosacea Symptoms NRS Press Release, May 3, 2004, Suzanne Corr / Barbara Palombo [6] Mite-related bacterial antigens stimulate inflammatory cells in rosacea. Lacey N, Delaney S, Kavanagh K, Powell FC. Department of Biology, National University of Ireland, Maynooth, Co. Kildare, Ireland Br J Dermatol. 2007 Sep;157(3):474-81 [7] Correlation between Ocular Demodex Infestation and Serum Immunoreactivity to Bacillus Proteins in Patients with Facial Rosacea, Li J, O’Reilly N, Sheha H, Katz R, Raju VK, Kavanagh K, Tseng SC. Ophthalmology. 2010 Jan 14, [8] page 110 quote Beating Rosacea Vascular, Ocular & Acne Forms Geoffrey Nase, Ph.D. Nase Publications 2001 [9] "I have always pushed the line that demodex mites have thus far only been proven to be innocent bystanders in rosacea symptoms." Ocular Demodex, Tea Tree Oil as a treatment, David Pascoe, March 28, 2007, Rosacea Support Another source of the above statement (April 14, 2007). [10] The Role of Demodex Mites in the Pathogenesis of Rosacea and Blepharitis and Their Control Kosta Y. Mumcuoglu, Ph.D., Oleg E. Akilov, M.D., Ph.D. Journal of the Rosacea Research & Development Institure, Vol.1, No.1 [11] For a partial list of Demodex in rosacea and acne click here. [12] Dr. David Dahlman, a Chiropractic Physician with a degree in Nutrition [13] New way to treat skin disorder By Cynthia Billhartz Gregorian, St. Louis Post Dispatch, 04/29/2010 [14] Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication. Parodi A, Paolino S, Greco A, Drago F, Mansi C, Rebora A, Parodi A, Savarino V. Department of Internal Medicine, Gastroenterology Unit, University of Genoa, Genoa, Italy. Clin Gastroenterol Hepatol. 2008 Jul;6(7):759-64 [15] SIBO eradication clears rosacea: are you serious ? May 7th, 2008, by David Pascoe [16] Gut Bacteria and Xifaxan get some press coverage, April 30th, 2010, by David Pascoe [17] Another Demodex Bacteria Isolated: Bartonella quintana, David Pascoe, Rosacea Support Group [18] Dermatol Ther (Heidelb). 2016 Sep 22. Cardiovascular Disease Outcomes Associated with Three Major Inflammatory Dermatologic Diseases: A Propensity-Matched Case Control Study. Marshall VD, Moustafa F, Hawkins SD, Balkrishnan R, Feldman SR In another study it was noted, "In the multivariate logistic regression analysis, epicardial fat thickness was independently related to presence of rosacea (P<0.001, OR=13.31)." Thickness of carotid intima and epicardial fat in rosacea: a cross-sectional study. An Bras Dermatol. 2017 Nov-Dec;92(6):820-825 Belli AA, Altun I, Altun I [19] "The HLA-DRA locus is associated with rosacea as well as with other inflammation-associated disorders, such as inflammatory bowel diseases including ulcerative colitis, Crohn’s disease, and celiac disease....Moreover, Spoendlin et al. found that an increased risk of rosacea was observed particularly during the period of increased gastrointestinal tract inflammation. Thus, the overlap in the genetic relevance of HLA-DRA between rosacea and inflammatory bowel diseases might imply a potential link between these disorders...Patients with rosacea have a higher risk of cardiovascular comorbidities including hypertension, dyslipidemia, and coronary artery disease than that seen in controls. Rosacea severity was also found to be dependent on the presence of cardiovascular comorbidities....In addition, the association between cardiovascular diseases and rosacea might also be explained by enhanced expression of the cathelicidin, which has been observed both in the course of atherosclerosis and rosacea. The GWAS by Chang et al. [20] also revealed that patients with rosacea shared a genetic locus with type 1 diabetes mellitus; this association was further confirmed by a population-based study as well....Patients with rosacea have a significantly increased risk of neurologic disorders such as migraine, depression, complex regional pain syndrome, and glioma...Recently, an increased interest has been shown in the potential associations between neurodegenerative diseases and rosacea....For example,...Parkinson’s disease...dementia, especially Alzheimer disease..." Int J Mol Sci. 2016 Sep; 17(9): 1562.Published online 2016 Sep 15. doi: 10.3390/ijms17091562, PMCID: PMC5037831Rosacea: Molecular Mechanisms and Management of a Chronic Cutaneous Inflammatory ConditionYu Ri Woo, Ji Hong Lim, Dae Ho Cho, and Hyun Jeong Park, Chris Jackson, Academic Editor Study Finds Association Between Rosacea & Migraine NRS Posted: 01/03/2017 [20] In the past, a couple of noted rosacea online gurus have dismissed the role of demodex in rosacea. One such rosacea guru said, “Rosacea experts all agree that this mite plays no real role in the development of progression of rosacea (except for the odd pustule).” [8] The other rosacea guru says, “I have always pushed the line that demodex mites have thus far only been proven to be innocent bystanders in rosacea symptoms.” [9] However, the NRS continues to sponsor research into demodex and the RRDi released a paper by Dr. Kosta Y. Mumcuoglu and Dr. Oleg E. Akilov on demodex’s role in rosacea. [10] In fact, there is probably not many other types of research with as many papers on the subject of demodex except for a scarce few. The number of these articles on demodex list keeps growing. [11] Currently the demodex mite theory has gained popularitiy in the minds of the public and the medical authorities. This theory falls under Various Environmental Stimuli > Microorganisms > Demodex Mites. However, it should be noted that not all rosacea cases are demodectic. Hence, Demodectic Rosacea is a rosacea variant. [21] There may be a relationship between rosacea and chronic rhinosinusitis (CRS) as the following quote concludes: "Patients with rosacea and CRS manifested severe erythematotelangiectatic rosacea. There was enough evidence to suggest an association between rosacea and CRS. Clinical and radiological assessments of the paranasal sinuses are recommended." Med Princ Pract 2014;23:511-516 (DOI:10.1159/000364905) Rosacea and Chronic Rhinosinusitis: A Case-Controlled Study Al-Balbeesi A.O. Department of Dermatology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia [22] J Investig Dermatol Symp Proc. Author manuscript; available in PMC 2013 Jul 8. Published in final edited form as: J Investig Dermatol Symp Proc. 2011 Dec; 15(1): 2–11. doi: 10.1038/jidsymp.2011.7 PMCID: PMC3704130 NIHMSID: NIHMS479650 Clinical, Cellular, and Molecular Aspects in the Pathophysiology of Rosacea Martin Steinhoff, Jörg Buddenkotte, Jerome Aubert, Mathias Sulk, Pawel Novak, Verena D. Schwab, Christian Mess, Ferda Cevikbas, Michel Rivier, Isabelle Carlavan, Sophie Déret, Carine Rosignoli, Dieter Metze, Thomas A. Luger, and Johannes J. Voegel Rosacea Research in Perspective of Idiopathic Diseases [23] Int J Med Sci. 2015; 12(5): 387–396. Published online 2015 May 5. doi: 10.7150/ijms.10608 PMCID: PMC4441063 Major Pathophysiological Correlations of Rosacea: A Complete Clinical Appraisal Ravi Chandra Vemuri, Rohit Gundamaraju, Shamala Devi Sekaran, and Rishya Manikam [24] Clinical, Cosmetic and Investigational Dermatology, Dove Press Volume 10, Aug 10, 2017 Rosacea and Helicobacter pylori: links and risks Lazaridou E, Korfitis C, Kemanetzi C, Sotiriou E, Apalla Z, Vakirlis E, Fotiadou C, Lallas A, Ioannides D [25] J Am Acad Dermatol. 2017; doi:10.1016/j.jaad.2017.08.032. Obesity and risk for incident rosacea in US women Suyun Li, PhD, Eunyoung Cho, ScD, Aaron M. Drucker, MD, ScM, Abrar A. Qureshi, MD, MPH, Wen-Qing Li, PhD Obesity parameters may predict incident rosacea risk in women, Healio Dermatology Excess Weight May Raise Rosacea Risk, By Maureen Salamon, HealthDay Reporter, WebMD [26] J Am Acad Dermatol. 2017 Oct 26;: Comorbidities in rosacea: A systematic review and update. Haber R, El Gemayel M For an example of the odd results in a study, one clinical paper concluded, "In summary, based on a large, well-established cohort, we provide evidence in US women that past smoking is associated with an increased risk of rosacea, while current smoking is associated with a decreased risk of rosacea." [27] Acta Derm Venereol. 2017 Sep 13. doi: 10.2340/00015555-2795. The Association Between Low Grade Systemic Inflammation and Skin Diseases: A Cross-sectional Survey in the Northern Finland Birth Cohort 1966. Sinikumpu SP, Huilaja L, Auvinen J, Jokelainen J, Puukka K, Ruokonen A, Timonen M, Tasanen K. [28] Arch Dermatol Res. 2018 Mar;310(2):139-146. doi: 10.1007/s00403-018-1806-z. Epub 2018 Jan 12. Inate immunity in rosacea. Langerhans cells, plasmacytoid dentritic cells, Toll-like receptors and inducible oxide nitric synthase (iNOS) expression in skin specimens: case-control study. Moura AKA, Guedes F, Rivitti-Machado MC, Sotto MN. [29] J Am Acad Dermatol. 2015 Oct;73(4):604-8. doi: 10.1016/j.jaad.2015.07.009. Epub 2015 Aug 6.Rosacea is associated with chronic systemic diseases in a skin severity-dependent manner: results of a case-control study.Rainer BM, Fischer AH, Luz Felipe da Silva D, Kang S, Chien AL. [30] Dermatol Clin. 2018 Apr;36(2):115-122. doi: 10.1016/j.det.2017.11.006. Epub 2017 Nov 29. Rosacea Comorbidities. Vera N1, Patel NU2, Seminario-Vidal L3. [31] J Am Acad Dermatol. 2018 Apr;78(4):786-792.e8. doi: 10.1016/j.jaad.2017.09.016. Epub 2017 Oct 26. Comorbidities in rosacea: A systematic review and update. Haber R1, El Gemayel M2. The American Journal of Cardiology Volume 121, Issue 8, Supplement, 15 April 2018, Page e106 OP-264 - Investigation of Cardiovascular Risk Factors in Rosacea Patients Muhammed Karadeniz J Dermatol. 2018 Nov 22;: Risk of psychiatric disorders in rosacea: A nationwide, population-based, cohort study in Taiwan. Hung CT, Chiang CP, Chung CH, Tsao CH, Chien WC, Wang WM [32] Study Finds Possible Link Between Kidney Disease and Rosacea, NRS [33] Int J Dermatol. 2018 Dec 21;: Systemic comorbidities associated with rosacea: a multicentric retrospective observational study. Aksoy B, Ekiz Ö, Unal E, Ozaydin Yavuz G, Gonul M, Kulcu Cakmak S, Polat M, Bilgic Ö, Baykal Selcuk L, Unal I, Karadag AS, Kilic A, Balta I, Kutlu Ö, Uzuncakmak TK, Gunduz K [34] Clin Exp Dermatol. 2019 Jan 31;: The mental health burden in acne vulgaris and rosacea: an analysis of the US National Inpatient Sample. Singam V, Rastogi S, Patel KR, Lee HH, Silverberg JI
  10. Rosacea is associated with a number of other diseases, referred to as ‘systemic comorbidities’, which one study reports, “Clinicians must be aware of the potential for systemic comorbidities in rosacea patients, which becomes more likely as disease duration and severity increase.” [1] The following is a growing list: Autoimmune conditions [2] Allergies (airborne, food, etc.) Anxiety Disorder [3] Alzheimer's Disease Cancer Chronic rhinosinusitis (CRS) [4] CKD Cardiovascular diseases [3] Depression/anxiety disorders [3] Dementia Diabetes [3] Dyslipidemia [3] Female hormone imbalance [5] [10] Gastroesophageal Reflux Disease (GERD) and other GI disorders [1] Glioma Hair loss Helicobacter pylori infection [3] Hepatobiliary system disorders [1] Hyperlipidemia [3] Hypertension [6] Inflammatory bowel disease (IBD) HLA-DRA Locus [7] Kidney Disease [8] Low-grade inflammation Mental Health Disorders [9] Metabolic diseases [1] MetS Migraine [31] Multiple sclerosis Obesity [25] Parkinson's disease Psychiatric diseases [3] Respiratory diseases [1] Rheumatoid Arthritis [3] SIBO Ulcerative Colitis [3] Urogenital diseases [10] The above list keeps growing. This complicates the theories on the cause of rosacea increasing the call for further research. However, in one study it was stated, "In this large study of patients with rosacea, atopic dermatitis, and psoriasis, we did not detect an increased 1-year risk of cardiovascular disease after adjusting for confounders." [18] Therefore, papers stating an association of rosacea with other diseases should all be taken with a grain of salt due to 'confounders' since another paper states, "Limitations included the accuracy of the published data, potential patient selection, and possible confounding factors. The true nature of the drawn correlations is uncertain, and causality cannot be established." [26] "In statistics, a confounder (also confounding variable, confounding factor or lurking variable) is a variable that influences both the dependent variable and independent variable causing a spurious association." Wikipedia End Notes [1] Int J Dermatol. 2018 Dec 21;: Systemic comorbidities associated with rosacea: a multicentric retrospective observational study. Aksoy B, Ekiz Ö, Unal E, Ozaydin Yavuz G, Gonul M, Kulcu Cakmak S, Polat M, Bilgic Ö, Baykal Selcuk L, Unal I, Karadag AS, Kilic A, Balta I, Kutlu Ö, Uzuncakmak TK, Gunduz K [2] Dermatol Clin. 2018 Apr;36(2):115-122. doi: 10.1016/j.det.2017.11.006. Epub 2017 Nov 29. Rosacea Comorbidities. Vera N1, Patel NU2, Seminario-Vidal L3. [3] J Am Acad Dermatol. 2018 Apr;78(4):786-792.e8. doi: 10.1016/j.jaad.2017.09.016. Epub 2017 Oct 26. Comorbidities in rosacea: A systematic review and update. Haber R1, El Gemayel M2. [4] There may be a relationship between rosacea and chronic rhinosinusitis (CRS) as the following quote concludes: "Patients with rosacea and CRS manifested severe erythematotelangiectatic rosacea. There was enough evidence to suggest an association between rosacea and CRS. Clinical and radiological assessments of the paranasal sinuses are recommended." Med Princ Pract 2014;23:511-516 (DOI:10.1159/000364905) Rosacea and Chronic Rhinosinusitis: A Case-Controlled Study Al-Balbeesi A.O. Department of Dermatology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia [5] "There is no research regarding hormones and their effect on rosacea," Dr. Bergfeld said. "However, it has been widely observed that rosacea is often aggravated at menopause and sometimes during mid-cycle." Women May Need Added Therapy, Rosacea Review, NRS [6] Cardiovascular Diseases and Rosacea [7] "The HLA-DRA locus is associated with rosacea as well as with other inflammation-associated disorders, such as inflammatory bowel diseases including ulcerative colitis, Crohn’s disease, and celiac disease....Moreover, Spoendlin et al. found that an increased risk of rosacea was observed particularly during the period of increased gastrointestinal tract inflammation. Thus, the overlap in the genetic relevance of HLA-DRA between rosacea and inflammatory bowel diseases might imply a potential link between these disorders...Patients with rosacea have a higher risk of cardiovascular comorbidities including hypertension, dyslipidemia, and coronary artery disease than that seen in controls. Rosacea severity was also found to be dependent on the presence of cardiovascular comorbidities....In addition, the association between cardiovascular diseases and rosacea might also be explained by enhanced expression of the cathelicidin, which has been observed both in the course of atherosclerosis and rosacea. The GWAS by Chang et al. [20] also revealed that patients with rosacea shared a genetic locus with type 1 diabetes mellitus; this association was further confirmed by a population-based study as well....Patients with rosacea have a significantly increased risk of neurologic disorders such as migraine, depression, complex regional pain syndrome, and glioma...Recently, an increased interest has been shown in the potential associations between neurodegenerative diseases and rosacea....For example,...Parkinson’s disease...dementia, especially Alzheimer disease..." Int J Mol Sci. 2016 Sep; 17(9): 1562. Published online 2016 Sep 15. doi: 10.3390/ijms17091562, PMCID: PMC5037831 Rosacea: Molecular Mechanisms and Management of a Chronic Cutaneous Inflammatory Condition Yu Ri Woo, Ji Hong Lim, Dae Ho Cho, and Hyun Jeong Park, Chris Jackson, Academic Editor [8] Study Finds Possible Link Between Kidney Disease and Rosacea, NRS [9] Clin Exp Dermatol. 2019 Jan 31;: The mental health burden in acne vulgaris and rosacea: an analysis of the US National Inpatient Sample. Singam V, Rastogi S, Patel KR, Lee HH, Silverberg JI [10] J Am Acad Dermatol. 2015 Aug 6; Rosacea is associated with chronic systemic diseases in a skin severity-dependent manner: Results of a case-control study. Rainer BM, Fischer AH, Luz Felipe da Silva D, Kang S, Chien AL
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    Ungex Videos

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  12. The above report was done with 'questionnaires' and was not done with placebo controlled double blind studies. Again, the above study on diet and rosacea is simply anecdotal reports. Another point to question is, does the tea consumed by the respondents to the 'questionnaire' have sugar?
  13. "We found that high-frequency intake of fatty food and tea presented a positive correlation with rosacea, while high-frequency dairy product intake showed significant negative correlation with rosacea. Sweet food, coffee and spicy food appeared to be independent of any subset of rosacea in our study. However, high-frequency dairy product intake showed a borderline beneficial effect on rosacea severity. We further analyzed the correlation between diet and the subtype of rosacea. We found that high-frequency fatty intake was associated with erythematotelangiectatic rosacea (ETR) and phymatous rosacea, while high-frequency tea intake was only associated with ETR. In addition, high-frequency dairy product intake showed negative correlations with ETR and papulopustular rosacea. Rosacea is associated with some dietary factors, and our study is valuable in establishing dietary guidelines to prevent and improve rosacea." J Dermatol. 2019 Jan 18. doi: 10.1111/1346-8138.14771. Relationship between rosacea and dietary factors: A multicenter retrospective case-control survey. Yuan X, Huang X, Wang B, Huang YX, Zhang YY, Tang Y, Yang JY, Chen Q, Jian D, Xie HF, Shi W, Li J.
  14. A post by johny at RF recommends a trial diet using the principles of the 'carnivore diet' and states, " if you have decades long skin problems, you probably have issues with plant material. The best evidence is to trial the diet and see for yourself, if you give it an honest effort and don't like it no harm done." A thirty to ninety day trial diet cannot do any permanent damage no matter what proof you come up with, you can always go back to the way you were eating before the trial, and as johny points out, 'no harm done.' There is a huge number of links in a google search on 'carnivore diet' and after reading several articles on this subject, I liked the one by Dave Asprey, Carnivore Diet Results: Why It Works for Some People But Didn’t for Me, who tried eating the carnivore diet for three months, and did notice some improvement which is noted in his article (no mention of rosacea, his improvements included "felt great for the first month") and then explains why modifying the carnivore diet with some tweaks to improve it. Sugar and Carbohydrate are rosacea triggers and any diet that reduces these two items will improve rosacea. Maybe the carnivore diet is something you can at least try and report in this thread your results.
  15. Medical News Today has an article by Christian Nordqvist on rosacea [1] that is fairly comprehensive and takes about five minutes to read but isn't keeping up with the phenotype classification of rosacea, refers to 14 million Americans having rosacea (current estimates are 16 million Americans or 415 million worldwide), doesn't get into the many theories on the cause of rosacea, instead discusses five 'factors' that are thought to contribute to rosacea. The article should be updated and I give it a grade C for reporting and keeping up with rosacea. End Notes What is rosacea? Last updated Fri 15 December 2017 By Christian Nordqvist, Reviewed by Cynthia Cobb, APRN, Medical News Today
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    Steroid Rosacea

    Steroid Rosacea image credit: Corinna Kennedy own work 2017 https://upload.wikimedia.org/wikipedia/commons/d/d9/Steroid_Rosacea.jpg
  17. Admin

    Steroid Rosacea

    FCAD (Facial corticosteroid addictive dermatitis) or Steroid Rosacea is recognized as a Rosacea Variant Steroids are sometimes used for rosacea and other skin conditions for treatment, usually in severe cases, for a limited time or short term therapy. Steroids are not recommended for long term treatment of rosacea. If your doctor recommends a steroid treatment for your skin problem it should be explained to you what the benefits and risks or side effects associated with this treatment are. Usually the insert that comes from the product explains what these risks and side effects might be. Obviously, sometimes short term steroid treatment has been helpful to some who have had rosacea or other skin condition, or we wouldn't even hear of anyone being prescribed steroids. While some rosaceans have mixed the two, steroids and rosacea, it is not a good idea. And if you want some good advice, never mix the two. Do not use topical steroids on rosacea, period! Why is this such a problem that it is listed as a variant? Because rosaceans continue to use steroids or allow their physicians to treat them with steroids. An informed rosacean can decide whether the benefit of using steroids for rosacea is worth the risks, and your physician should explain the benefit/risk ratio to you. You have the choice to either accept the treatment or decline it. Dermatologists have been using topical corticosteroids since the 1950s treating intractable dermatoses. However, a report in 1988 says, "Disadvantages of corticosteroid activity include the possibility of adrenal suppression, epidermal and dermal thinning, and local effects such as purpura, striae, and steroid-induced rosacea and perioral dermatitis." [1] It has been given the name: Facial corticosteroid addictive dermatitis (FCAD). [2] Steroid rosacea photos by DermNet NZ Another report called it "steroid dermatitis." [25] "...Corticosteroids were first introduced for topical use in dermatology in 1951. Since then uncontrolled use (abuse) has caused many different reactions, often with manifestations resembling those of rosacea..." [3] "...Dermocorticosteroids can be indicated in numerous inflammatory skin diseases (psoriasis, eczema ...). They are formally contraindicated in case of skin infections, diaper rash, acne and rosacea..." [4] "Never, never, never, ever prescribe steroids for rosacea." [5] Ironically, uninformed physicians sometimes prescribe steroids for rosacea or rosaceans may use over the counter non-prescription steroid topicals for rosacea and initially the rosacea may improve but after continuous use the rosacea gets worse. Hence the term, steroid-induced rosacea has developed due to uninformed rosaceans using long term topical steroids to treat rosacea or other skin conditions. This indicates that it is up to rosaceans to be informed and ask their physicians if they are keeping up with current treatment for rosacea. Reports still show that physicians prescribe steroids for acne rosacea, for example: "The first patient was treated with oral steroids, as well as doxycycline, to control his acne rosacea." (1998) [6] Here is a classic example of physicians treating rosacea with prednisolone, a steroid, in 1990: "Metronidazole was investigated in the basic dermatologic agent Elacutan W to improve the topical therapy of rosacea. The suitability of that basic dermatologic agent was verified for metronidazole, prednisolone and dexamethasone by stability tests (UV-spectroscopy, pH) and by in-vitro-liberation-measurements (membrane method). The drugs are stable for a period of 100 days." [7] And here is what these physicians should have read about prednisone in 1989: "A patient with malignant lymphoma repeatedly developed transient rosacea-like dermatitis several days after each interruption of continuous oral prednisone intake. We thought that the eruption was provoked by withdrawal of orally administered steroid, and thus we diagnosed the patient as having steroid-withdrawal rosacea-like dermatitis, one manifestation of steroid-withdrawal syndrome." [8] What is difficult to understand is that two variants of rosacea, Rosacea Fulminans, and Perioral Dermatitits are treated with Accutane and steroids. One report says that Corticosteroids and isotretinoin are regarded as the two main therapeutic agents for treating RF. [9] Periorol Dermatitis, a variant of rosacea, is sometimes the result of steroid use so rosaceans wonder what should they do if the physician prescribes steroids with all this conflicting data? Demodicosis may develop after the use of steroids according to the following two reports: "...the highest density of mites was found on the cheeks. A statistically significant increase in mites was found in all subgroups of rosacea, being most marked in those with steroid-induced rosacea...CONCLUSION: Increased mites may play a part in the pathogenesis of rosacea by provoking inflammatory or allergic reactions, by mechanical blockage of follicles, or by acting as vectors for microorganisms." [10] "...Demodex folliculorum were also more frequently detected in patients who had previously been treated with topical corticosteroids (even in 91.9%), what was often followed by epitheloid granulomas..." [11] However, one report in 2002 says the following: "...Recently, steroid components have been synthesized that aim to have adequate anti-inflammatory effects and minimal adverse effects. The newest topical corticosteroids used for the treatment of different dermatoses and allergic reactions of the respiratory tract (in particular asthma) are budesonide, mometasone furoate, prednicarbate, the di-esters 17,21-hydrocortisone aceponate and hydrocortisone-17-butyrate-21-propionate, methylprednisolone aceponate, alclometasone dipropionate, and carbothioates such as fluticasone propionate..." [12] As these new synthesized steroids are used, no doubt we will hear reports later of the long term effects for treating rosacea with these drugs. You as a rosacean have the right to ask questions about what treatment your doctor recommends. "...54% developed the steroid rosacea while being treated with the lowest-strength (class 7) topical corticosteroids. Even over-the-counter hydrocortisone preparations induced steroid rosacea in susceptible children. Susceptibility may be genetic as 20% of children had a first-degree relative with rosacea." [13] "...Initially, the mass was thought to be rhinophyma, but biopsy of the mass revealed noncaseating granulomata consistent with sarcoidosis. The mass resolved following several steroid injections..." [14] Apparently topical fluorinated steroid therapy resulted in an onset of smooth, shiny, erythematous papules on the face according to one report. [15] 1% hydrocortisone was applied to six patients. Three developed a rosacea-like eruption for the first time and one also had perioral dermatitis. [16] With Primary care physicians (PCPs), "When asked to rank the potency of 4 surveyed TCs [Topical Corticosteroids], 51.2% respondents were able to identify hydrocortisone acetate 1% cream as a low potent topical steroid." And with PCPs, "33.9% incorrectly responded that TCs can be used in all skin rashes, and 37.8% in acne vulgaris." [27] Treatment for FCAD 0.03% tacrolimus and 595-nm pulsed dye laser [17] 1% pimecrolimus cream [18] FK506 (tacrolimus) may control the increase in IL-1alpha with glucocorticoid in KCs, suggesting FK506 to suppress harmful effects of glucocorticoids such as steroid rosacea. [19] Combination therapy of tetracyline and tacrolimus [20] However, one report of using Tacrolimus resulted in a "proliferation of Demodex due to local immunosuppression." [21] Caveat emptor! Another report concluded "Topical tacrolimus is becoming an important cause of RD [rosacea-like dermatitis] along with topical steroids." [24] A combination of oral antibiotics and topical tacrolimus is the treatment of choice for steroid-induced rosacea. [22] Treating Steroid Induced Rosacea, Linda Sy, MD [23] Calendula cream for steroid induced rosacea by May2012 Episofit A [26] Probiotics Anecdotal Reports Henry Two Reports in one. M's report of what to do for steroid rosacea TrixP was diagnosed with dermatitis and treated with a steroid and developed steroid induced rosacea. reddy says, "My doctor gave me Daktakort cream which I have been using for the past 3 years but she told me if I kept using the cream it would make my skin very thin, only recently the cream has stopped working and when I use it now it makes my face even worse." Fallout2077 writes, "...however I stupidly continued to use this same steroid cream on and off for 3 years and then every single day for the next year. Whilst it did suppress the flakes and dryness, it made my face gradually become very sensitive, red and spotty and so i thought i had developed rosacea...." frank88 reports, "...I decided to cease the 1% cream on the 27th April about 20 days ago and my entire face has become very red, blotchy and inflammed with little pimples, all moreso in both the applications sites where I lightly applied the cream...." End Notes [1] Clinical pharmacology and pharmacokinetic properties of topically applied corticosteroids. A review. Goa KL., Drugs. 1988;36 Suppl 5:51-61. [2] Facial corticosteroid addictive dermatitis in Guiyang City, China. Lu H, Xiao T, Lu B, Dong D, Yu D, Wei H, Chen HD. Clin Exp Dermatol. 2010 Aug;35(6):618-21. Epub 2009 Dec 8. [3] Steroid dermatitis resembling rosacea: aetiopathogenesis and treatment. Ljubojeviae S, Basta-Juzbasiae A, Lipozenèiae J. J Eur Acad Dermatol Venereol. 2002 Mar;16(2):121-6. [4] Local corticosteroid therapy in dermatology Chosidow O, Lebrun-Vignes B, Bourgault-Villada I. Presse Med. 1999 Nov 27;28(37):2050-6. [5] "Dr.Kligman (Dermatology-University of Philadelphia) & Dr. Plewig (Dermatologische Klinik Und Poliklinik der Universitat Munchen, Germany) state in their 1973 book, entitled Acne & Rosacea, First edition. Likewise, their second edition in 1993 harshly criticizes dermatologists that prescribe steroids for rosacea." Topical Steroids International Rosacea Foundation [6] Mooren's ulcer. Seino JY, Anderson SF. Optom Vis Sci. 1998 Nov;75(11):783-90. [7] Stability of metronidazole, prednisolone and dexamethasone in urea-containing Elacutan W dermatologic agent Heyde R, Dorsch S, Heidenreich S, Illig G. Dermatol Monatsschr. 1990;176(7):407-15. [8] Steroid-withdrawal rosacea-like dermatitis. Tomita Y, Tagami H. J Dermatol. 1989 Aug;16(4):335-7. [9] Rosacea fulminans in pregnancy. Lewis VJ, Holme SA, Wright A, Anstey AV. Br J Dermatol. 2004 Oct;151(4):917-9. [10] The Demodex mite population in rosacea. Bonnar E, Eustace P, Powell FC. J Am Acad Dermatol. 1993 Mar;28(3):443-8. [11] The possible role of skin surface lipid in rosacea with epitheloid granulomas. Basta-Juzbasi&#263; A, Marinovi&#263; T, Dobri&#263; I, Bolanca-Bumber S, Sencar J. Acta Med Croatica. 1992;46(2):119-23. [12] New and established topical corticosteroids in dermatology: clinical pharmacology and therapeutic use. Brazzini B, Pimpinelli N. Am J Clin Dermatol. 2002;3(1):47-58. [13] Steroid rosacea in prepubertal children. Weston WL, Morelli JG. Arch Pediatr Adolesc Med. 2000 Jan;154(1):62-4. [14] Sarcoidosis of the external nose mimicking rhinophyma. Case report and review of the literature. Goldenberg JD, Kotler HS, Shamsai R, Gruber B. Ann Otol Rhinol Laryngol. 1998 Jun;107(6):514-8. [15] Recent onset of smooth, shiny, erythematous papules on the face. Steroid rosacea secondary to topical fluorinated steroid therapy. Martin DL, Turner ML, Williams CM. Arch Dermatol. 1989 Jun;125(6):828, 831. [16] Complications of topical hydrocortisone. Guin JD., J Am Acad Dermatol. 1981 Apr;4(4):417-22. [17] Eur J Dermatol. 2016 Jun 1;26(3):312-4. doi: 10.1684/ejd.2016.2757. Recalcitrant steroid-induced rosacea successfully treated with 0.03% tacrolimus and 595-nm pulsed dye laser. Seok J, Choi SY, Li K, Kim BJ, Kim MN, Hong CK. [18] The use of 1% pimecrolimus cream for the treatment of steroid-induced rosacea. Chu CY., Br J Dermatol. 2005 Feb;152(2):396-9. [19] FK506 (tacrolimus) inhibition of intracellular production and enhancement of interleukin 1alpha through glucocorticoid application to chemically treated human keratinocytes. Horiuchi Y, Bae SJ, Katayama I., Skin Pharmacol Physiol. 2005 Sep-Oct;18(5):241-6. Rosacea: where are we now? Bikowski JB, Goldman MP. J Drugs Dermatol. 2004 May-Jun;3(3):251-61. [20] Combination therapy of tetracycline and tacrolimus resulting in rapid resolution of steroid-induced periocular rosacea. Pabby A, An KP, Laws RA., Cutis. 2003 Aug;72(2):141-2. [21] Induction of rosaceiform dermatitis during treatment of facial inflammatory dermatoses with tacrolimus ointment. Antille C, Saurat JH, L&uuml;bbe J. Arch Dermatol. 2004 Apr;140(4):457-60. [22] Steroid-induced rosacea: a clinical study of 200 patients. Bhat YJ, Manzoor S, Qayoom S. Indian J Dermatol. 2011 Jan;56(1):30-2. [23] Rosacea Support Treating Steroid Induced Rosacea December 4th, 2007, by David Pascoe [24] Tacrolimus-Induced Rosacea-Like Dermatitis: A Clinical Analysis of 16 Cases Associated with Tacrolimus Ointment Application. Teraki Y, Hitomi K, Sato Y, Izaki S. Dermatology. 2012 May 22. [25] ISRN Dermatol. 2013 Apr 21;2013:491376. doi: 10.1155/2013/491376. Print 2013. Steroid dermatitis resembling rosacea: a clinical evaluation of 75 patients. Hameed AF. [26] Georgian Med News. 2013 Oct;(223):31-5. Improvement of rosacea treatment based on the morphological and functional features of the skin. [Article in Russian] Tsiskarishvili NV, Katsitadze A, Tsiskarishvili Ts. Source: Tbilisi State Medical University, Department of Dermatology, Georgia. [27] Saudi Med J. 2017 Jun; 38(6): 662–665. doi: 10.15537/smj.2017.6.17586 PMCID: PMC5541192 Topical corticosteroids knowledge, attitudes, and practices of primary care physicians Sarah F. Alsukait, MBBS, Najd A. Alshamlan, MBBS, Zeina Z. Alhalees, MBBS, Sami N. Alsuwaidan, MD, and Abdulmajeed M. Alajlan, MD Other Sources Steroid-induced rosacea. Litt JZ. Case Western Reserve University School of Medicine, Cleveland, Ohio. Topical tacrolimus Protopic. Lazarous MC, Kerdel FA. Department of Dermatology and Cutaneous Medicine, University of Miami School of Medicine, Miami, FL 33136, USA. Potential future dermatological indications for tacrolimus ointment. Ruzicka T, Assmann T, Lebwohl M. Department of Dermatology, University of Dusseldorf, Moorenstr 5, 40225 Dusseldorf, Germsny Tacrolimus clinical studies for atopic dermatitis and other conditions. Bergman J, Rico MJ. Division of Pediatric and Adolescent Dermatology, Children's Hospital, San Diego, CA, USA. - 2001 Tacrolimus ointment for the treatment of steroid-induced rosacea: a preliminary report. Goldman D. - 2001 Rosacea in association with the progesterone-releasing intrauterine contraceptive device. Choudry K, Humphreys F, Menage J. Rosacea induced by beclomethasone dipropionate nasal spray. Egan CA, Rallis TM, Meadows KP, Krueger GG. Department of Dermatology, University of Utah School of Medicine, Salt Lake City 84132, USA. Practical aspects of local steroid treatment Gehring W, Gloor M. - 1989 Possible side effects of topical steroids. Morman MR. - 1981 Steroid rosacea in children. Franco HL, Weston WL. - 1979 Differential diagnosis of facial skin swellings (author's transl) Hornstein OP. - 1979 Perioral dermatitis (rosacea-like dermatitis)--adverse effects of externally applied steroid preparations Urabe H. - 1978 The treatment of steroid-induced rosacea and perioral dermatitis. Sneddon IB. - 1976 Perioral dermatitis and rosacea-like dermatitis: clinical features and treatment. Urabe H, Koda H. 1976 Steroid rosacea. Leyden JJ, Thew M, Kligman AM. Rosacea with steroid atrophy. Abell E, Borrie PF - 1969
  18. Dr. Eric Berg explains why MSM and Grapefruit Seed Extract Oil are beneficial for rosacea.
  19. Admin

    Stephanie Lange Has Rosacea

    Beauty blogger Stephanie Lange has a YouTube channel with a lot of followers has rosacea. She posted on Facebook, "I had a bad flare up of rosacea so I thought instead of hiding - what better way to test out the new @deciem The Ordinary Coverage Foundation!" She has a video, How to Cover Redness / Rosecea / Acne / Inflammation with Makeup you can watch below:
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    Casey Holmes Has Rosacea

    Beauty blogger Casey Holmes has rosacea according to Devon Abelman, allure, in an article, Casey Holmes Shares the Inside Scoop on Her Smashbox Spotlight Palettes, where Casey is quoted as saying, "Since I have a lot of texture and pretty big pores because I have rosacea, I wanted a formula that was very smooth...." Casey has a lot of followers in her YouTube channel and she has a Vlog.
  21. Admin

    Cosmetics for Rosacea 101

    Cæcilie Johansen, MD, who has rosacea explains in details makeup and medicine for rosacea. Zoe Draelos, MD, volunteers for the RRDi MAC, is also the editor of Cosmetic Dermatology and has advice on cosmetics for rosacea. Dr. Sherry Shieh has some advice on what should be in your cosmetic medicine cabinet. Jamie Kern Lima, the co-founder and CEO of IT Cosmetics has rosacea. Beauty bloggers Casey Holmes and Stephanie Lange both have rosacea. There are a number of cosmetic posts for rosacea for your consideration that may prove helpful to you, not to mention our affiliate store has a whole cosmetic category (our non profit organization for rosacea receives a small fee if you purchase a cosmetic for your rosacea which keeps our web site going). We have a informative article about cosmetics and rosacea. Green is the color concealer of choice for rosacea.
  22. TXA crystals are available at Amazon below:
  23. There is a new cheap treatment using tranexamic acid solution (Transamin inj/sol 500 mg/5 mL) infused wet dressing for erythematotelangiectatic rosacea. The results of an unblinded study of 20 patients resulted with "All patients were improved in the end of the therapy....The improvement lasted more than four months." [1] Another clinical paper on TXA says, "Finally, TXA repressed the angiogenesis by reducing the number of CD31+ cell and downregulating the expression levels of VEGF in rosacea. In conclusion, our finding defines a treatment mechanism by which TXA ameliorates rosacea symptoms by regulating the immune response and angiogenesis." [2] Microneedling with tranexamic acid solution was an effective treatment for women with erythematotelangiectatic rosacea, according to late-breaking research presented at the American Academy of Dermatology Annual Meeting. [3] "Topical tranexamic acid could improve the epidermal permeability barrier function and clinical signs of rosacea, likely resulting from inhibition of PAR-2 activation and consequent calcium influx. Thus, tranexamic acid could serve as an adjuvant therapy for rosacea." [4] "Taken together, we report that TA solution soaking is an easy, safe and non-costly approach to improve skin rosacea rapidly, although further randomized controlled trials should be conducted." [5] "Also, recent studies demonstrated that tranexamic acid inhibits epidermal PAR-2 expression which is elevated in rosacea patients (Zhong et al., 2015). Taken together, these results suggest that combination treatment of minocycline, propranolol, and tranexamic acid may be a possible strategy for treatment of rosacea, especially that involving severe flushing, refractory erythema, and sen- sitive skin." [6] We have started a list of TXA over the counter products available through our Amazon Affiliate program if you scroll down to the second comment in this post. A thread at RF discusses this subject. Any new information will be posted in this thread. If you have something to add please reply to this thread. In this thread, jrlhamcat2 [post no 47] reports, "I've soaked one side of my face about 6 times over around 10 days now. My skin has been getting less red and the flushing has been less frequent and less intense, but on both sides of my face, not just the one I've been treating" and [post no 60] reports later, "so far it seems like this is a good treatment for reducing subtype one symptoms." DERMO PHARMA DNA CREAM TRANEXAMIC ACID + COLLAGEN, by Dermapharma (Switzerland) [7] End Notes [1] J Cosmet Dermatol. 2018 Aug 11;: The new therapeutic choice of tranexamic acid solution in treatment of erythematotelangiectatic rosacea. Bageorgou F, Vasalou V, Tzanetakou V, Kontochristopoulos G [2] Int Immunopharmacol. 2018 Dec 19;67:326-334 Tranexamic acid ameliorates rosacea symptoms through regulating immune response and angiogenesis. Li Y, Xie H, Deng Z, Wang B, Tang Y, Zhao Z, Yuan X, Zuo Z, Xu S, Zhang Y, Li J [3] Microneedling with tranexamic acid solution By Admin, March 8, 2017 in Rosacea in the News, RRDi Forum [4] DERMATOLOGICA SINICA 33 (2015) 112e117 Topical tranexamic acid improves the permeability barrier in rosacea Shaomin Zhong, Nan Sun, Huixian Liu, Yueqing Niu, Can Chen, Yan Wu [5] Letters to the Editor, 40 (1), Pages 70-71, (2012) The Journal of Dermatology, Japanese Dermatological Association Tranexamic acid solution soaking is an excellent approach for rosacea patients: A preliminary observation in six patients Myoung Shin KIM, Sung Eun CHANG, Sik HAW, Hana BAK, Youn Jin KIM, Mi Woo LEE [6] Dermatologic Therapy, 30(3), e12439. doi:10.1111/dth.12439. August 2016 Combination treatment of propranolol, minocycline, and tranexamic acid for effective control of rosacea Kwon, H. J., Suh, J. H., Ko, E. J., & Kim, B. J. [7] See fourth post in this thread
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