Guide

Steve Bannon, White House Chief Strategist, is the subject of an article by Harry Shukman, The Tab, about his facial skin condition. "He's got blushing on the nose, which is generally the result of what is called rosacea. That's a pretty common disorder, maybe a third of the population has it. It can cause redness, and we don't really know why. We think it's because of proliferation of oil glands, sebaceous glands. It's a very common disorder. A dermatologist explains what’s wrong with Steve Bannon’s haggard face, Harry Skukman, The Tab image courtesy of Wikipedia Famous Rosaceans

The research answers the following questions: What are the key drugs marketed for Rosacea and their clinical attributes? How are they positioned in the Global Rosacea market? What are the unit prices and annual treatment cost for Rosacea therapies in different countries? What are the drug pricing trends and how are they expected to change in the future? How are the drug pricing and reimbursement landscape different by countries? What are the unmet needs in the global Rosacea drugs market? What would be the ideal pricing strategy for a new pipeline therapy for Rosacea? Rosacea Drugs Price Analysis and Strategies 2012-2016 & Forecasts to 2021 - Research and Markets, PR Newswire

"Before my treatment, I assumed that laser procedures were going to be part of my beauty regimen way down the line, not when I'm in my early 20s. But according to Graceanne Svendsen, the aesthetician who performed my procedure, lasers are becoming increasingly popular with women in their 20s, particularly those who deal with skin conditions such as rosacea or general unevenness." I Tried Laser Treatment To Help With My Rosacea & I Was Amazed With The Results — PHOTOS, By JESSICA THOMAS, Bustle

"A recent study in the British Journal of Dermatology makes a case for treating and managing rosacea based on the clinical presentation, or phenotype....The international ROSCO panel was able to reach a consensus on initial, combination, and maintenance therapy using a phenotype-based approach for treating skin features of rosacea. Ophthalmologists on the panel also agreed on an approach to managing ocular rosacea. Results suggest that physicians should select a combination of treatments for rosacea based on presenting features, overall disease activity, and the severity of the features." Global Consensus on Rosacea Treatments by Phenotype, by Jennifer Newton, Clinical Trials and Research, Medical News Bulletin

“This nationwide cohort study provided evidence of an association between rosacea and incident IBD,” the researchers concluded. “The link between long-term antibiotic use and development of IBD needs further investigation.” – by Bruce Thiel. Healio Dermatology Rosacea may be tied to increased risk for inflammatory bowel disease Wu C-Y, et al. J Am Acad Dermatol. 2017;doi:10.1016/j.jaad.2016.11.065.

A recent study says sugar weakens MIF (Macrophage migration inhibitory factor)

"Macrophage migration inhibitory factor (MIF or MMIF), also known as glycosylation-inhibiting factor (GIF), L-dopachrome isomerase, or phenylpyruvate tautomerase is a protein that in humans is encoded by the MIF gene. MIF is an important regulator of innate immunity." Wikipedia "The study says blood sugar glucose and the neurological condition has close connections. Glucose weakens the key enzyme called MIF, or macrophage migration inhibitory factor that resists the spread of the disease...Regarding the most vulnerable people, the study says higher risk prevails for people who are obese and diabetic as they have high levels of blood sugar, or hyperglycemia. This leads to the accumulation of abnormal proteins in the brain.....In the next level of research, they study team will examine whether similar changes are happening in the blood as well, added Van den Elsen." Here's Why Using More Sugar May Cause Alzheimer's Disease, By Kalyan Kumar, Tech Times With the current theory that rosacea may be an immune system disorder, can you see the connection between Sugar and Rosacea?

"And if the machine shows rosacea what would you recommend for that? I heard there is a new cream on the market that works well." Kristin Auble "Yes, it’s called Rhofade and it just received FDA approval. So that’s exciting. We also have a laser called the Vbeam that helps with vascular issue such as rosacea. So I would recommend a combo of the cream and laser treatment." Dr. David Shafer, New York City Tech Alert: 3D Imaging May Be The Secret to Perfect Skin, by Kristin Auble, W Magazine

Dermata Therapeutics, a San Diego development-stage biotech advancing new treatments for rosacea, eczema, and related dermatological diseases, said it has secured $5 million in additional funding from private investors and entered into a $5 million credit facility with Silicon Valley Bank. Dermata has developed DMT210 which is for rosacea. Dermata Secures $10M in Combined Financing for Skin Treatments, by Bruce V Bigelow, Xconomy, San Diego

The Dermatologist Forms Collaboration with The National Rosacea Society, PRWeb, Benzinga

"A recent study in the British Journal of Dermatology makes a case for treating and managing rosacea based on the clinical presentation, or phenotype." Global Consensus on Rosacea Treatments by Phenotype, by Jennifer Newton, Medical News Bulletin

You've probably heard of common skin conditions like psoriasis and eczema, but do you also know about rosacea? If not, you've got to listen up. "Rosacea is abnormal blood vessel growth in all layers of the skin, caused by internal problems and inflammation within the body and skin," says Julia T. Hunter, MD, a dermatologist and founder of Wholistic Dermatology. This abnormal blood vessel growth is the result of low thyroid, fungal overgrowth internally, gut inflammation, and chronic sun overexposure, she says. 10 Things You Need to Know About Rosacea—Whether You Have It or Not, by AUBREY ALMANZA, Reader's Digest

"Topical oxymetazoline applied to the face once daily for 29 days was effective, safe, and well tolerated in the treatment of moderate to severe persistent facial erythema of rosacea." J Drugs Dermatol. 2018 Mar 1;17(3):290-298. Pivotal Trial of the Efficacy and Safety of Oxymetazoline Cream 1.0% for the Treatment of Persistent Facial Erythema Associated With Rosacea: Findings from the Second REVEAL Trial. Baumann L, Goldberg DJ, Stein Gold L, Tanghetti EA, Lain E, Kaufman J, Weng E, Berk DR, Ahluwalia G. "Oxymetazoline applied to the face once daily for 29 days was effective, safe, and well tolerated in patients with moderate to severe persistent facial erythema of rosacea." J Drugs Dermatol. 2018 Jan 1;17(1):97-105. Pivotal Trial of the Efficacy and Safety of Oxymetazoline Cream 1.0% for the Treatment of Persistent Facial Erythema Associated With Rosacea: Findings from the First REVEAL Trial. Kircik LH, DuBois J, Draelos ZD, Werschler P, Grande K, Cook-Bolden FE, Weng E, Berk DR, Ahluwalia G. "The topical use of oxymetazoline 0.05% solution in the management of rosacea has been primarily limited to data from case series involving fewer than 10 patients and demonstrating sustained improvements in both erythema and flushing. Alhough oxymetazoline is not recognized in national guidelines, an international consensus statement recognizes the possible therapeutic role of oxymetazoline in the management of rosacea, despite the limited evidence." Hosp Pharm. 2013 Jul-Aug; 48(7): 558–559. Published online 2013 Jul 9. doi: 10.1310/hpj4807-558 PMCID: PMC3839519 Oxymetazoline (Topical): Rosacea Joyce A. Generali, RPh, MS, FASHP, (Editor) and Dennis J. Cada, PharmD, FASHP, FASCP

I haven't used the Soolantra since February 13, 2017 so for more than 72 hours my skin has been healing and I don't have the burning feeling I had, so I thought I would take three more photos to show my skin condition after using Soolantra for 105 days, just three days later.

Maria, Actually I am cheap, since it costs me around $40/jar for the ZZ cream which I actually prefer. But since I have insurance in my old age now, I would prefer to pay a nominal fee for a sulphur treatment if it works reasonably well. I was using the sulphur butter due to a post made by Joanne Whitehead, PhD, (Assistant Director of the RRDi) since it was cheap and it works sort of ok, but I don't like the oily part of the formula since my skin is already oily. The ZZ cream is so different and it dries up my skin which is wonderful, and it feels cool when you put it on due to the menthol in it. I just love it and have one jar left as an emergency jar. So if the Americans can make a cheaper sulphur topical I am willing to give it a try and apparently there are a number of them. My insurance wouldn't approve the one my dermatologist prescribed yesterday (not sure of the exact Rx that was denied) and it takes days to do the documents to get it approved and my doctor doesn't like having his staff write up these letters (such are the woes of the American Medical System), so I heard he can write a Rx for a generic sulphur drug that my insurance will accept. Time will tell what Rx I get. As to the demodex population, I think I nuked all those little buggers with the ivermectin. My face is healing nicely each day now and I plan on doing nothing but washing with water for the next few days and then I will take photos of my face to show you the difference. I read a post in RF from Toen (post #684) how he only uses Soolantra occasionally which seems like a good idea to me, like if I get a pustule, since I noticed the Soolantra seems to work rather nicely on them and reduces them quickly, within a couple of days. I think I just over did the Soolantra. You would think that someone would mention this, that Soolantra is powerful, that more is not good sometimes. I can still get more tubes of Soolantra if I want. But I think the one I have which is half gone will last me months.

Maria, You are so kind. My face has been burning where I have been applying the Soolantra everynight, even when I wash it off in the am, the burning continues. I explained all this the dermatologist who said to stop using it. I really did give it a go. There must be something in the Soolantra that irritates my skin. It has been over 24 hours since I applied the Soolantra and my face has already started to calm down and cool off. The burning has almost completely gone. I am going to let my skin rest for a few days to recover from this and then apply the sulphur generic prescription my dermatologist prescribed since I have experienced good results from the sublimed sulphur in the ZZ cream. However, the ZZ cream costs more than my generic prescription since I have insurance. I am now convinced that Soolantra just isn't for me. My dermatologist says one out of four of his rosacea patients gets excellent results with Soolantra. I may in the future use a dab of Soolantra on a zit to see what happens, but no more night applications for me.

Went to the dermatologist today and he advised me to stop Soolantra since I am not a candidate for this treatment. After 105 days, I was hoping Soolantra would work for me, but alas, as you can see below, my rosacea seems to inflamed too much from using Soolantra. My dermatologist prescribed a generic sulphur based cream for me to try since I have responded well in the past to similar treatment using the ZZ cream. I have to pick up the prescription and will start another review later. Here are my photos for today:

Combined therapy was superior in decreasing the D. folliculorum count in all groups and in reducing the mite count to the normal level in rosacea and in anterior blepharitis. On the other hand, the two regimens were comparable in reducing the mite count to the normal level in acne and peri-oral dermatitis lesions. [1] "By RCM, a reduction in the density of Demodex mites in facial skin of patients with rosacea under therapy, correlating to clinical improvement, can be quantified and monitored noninvasively." [2] "Demodex proliferation also appears to be a continuum process in rosacea, and high Demodex density is beginning to be accepted as an important trigger of the inflammatory cascade and as a marker of rosacea: moreover, papulopustules of rosacea can be treated using acaricides...Multiple molecules have been reported to reduce the number or density of Demodex mites and improve or cure symptoms of demodicosis and rosacea in case studies." [3] In one paper decreasing the demodex count didn't make any difference in the success of the treatment. "This is the first study in the literature investigating the change in demodex density in rosacea patients treated with pro-yellow laser therapy. In this study, it was shown that pro-yellow laser treatment is effective in reducing the density of demodex." This same report states, "There was no significant correlation between the decrease in the density of the demodex mite and the success of the treatment (p = 0.46)." [4] Et Cetera Demodex Density Count - What are the Numbers? Methods for Quantifying Demodex Mites Increased Blood Glucose Level Shows Increase in Demodex Density Count Reply to this Topic There is a reply to this topic button somewhere on the device you are reading this post. End Notes [1] International Journal of Infectious Diseases Volume 17, Issue 5, May 2013, Pages e343–e347 Evaluation of the efficacy of oral ivermectin in comparison with ivermectin–metronidazole combined therapy in the treatment of ocular and skin lesions of Demodex folliculorum Doaa Abdel-Badie Salema, Atef El-shazlya, Nairmen Nabiha, Youssef El-Bayoumyb, Sameh Salehc [2] Br J Dermatol. 2015 Jul;173(1):69-75. doi: 10.1111/bjd.13783. Epub 2015 May 29. Reflectance confocal microscopy for monitoring the density of Demodex mites in patients with rosacea before and after treatment EC Sattler, VS Hoffmann, T Ruzicka, TV Braunmühl, C Berking [3] Dermatology and Therapy volume 10, pages1229–1253(2020) The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea? Fabienne M. N. Forton [4] The effect of 577-nm pro-yellow laser on demodex density in patients with rosacea

"There are many effective treatments for rosacea. Some common topical medications include metronidazole, azalaic acid, ivermectin, or sulfur-based products. Oral antibiotics are commonly used, such as doxycycline, especially when papules and pustules are present. Redness and broken blood vessels are much more difficult to treat with medications. A topical medication that was originally designed to treat glaucoma can be used, providing temporary relief by blanching the superficial blood vessels. This medication, called Mirvaso, is very effective for some people but, unfortunately, not all patients are responsive." Reviewing Rosacea, By Darrel Arthurs, ARNP, DCNP , Dermatology Education & Practice from NADNP, Healthcare POV, Advance Web

There are a number of papers indicating niacinamide (Nicotinamide) improves rosacea. You may want to ask your dermatologist about niacinamide. You can purchase niacinamide over the counter (non prescription). Wikipedia points out that "nicotinamide has the benefit of not causing skin flushing." Niacinamide eases rosacea inflammation June 01, 2010 By Lisa Samalonis, Dermatology Times Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea. Cutis. 2005 Aug;76(2):135-41 Authors: Draelos ZD, Ertel K, Berge C A review of nicotinamide: treatment of skin diseases and potential side effects. J Cosmet Dermatol. 2014 Dec;13(4):324-8 Authors: Rolfe HM

There are papers indicating that Niacinamide improves rosacea. For example, Helen M. Torok, M.D. reports in an article in Dermatology Times, "Niacinamide can be an effective treatment for the inflammation related to rosacea" Several non prescription topicals containing Niacinamide are Acnessential, InstaNatural Niacinamide Serum, Paula's Choice RESIST 10% Niacinamide Booster, The Posh Company B3 Nicinamide Serum, and Luminositie Niacinamide B3 Cream.

Ivermectin is supposed to kill mites. I am simply not having the success that many have reported happens to them using Soolantra. I was hoping the fourth month would really be more of an improvement but so far I am not impressed. I am seeing the dermatologist on Feb 15 and get a professional evaluation on my progress. I can tell you that using the ZZ cream works way better for me than Soolantra. I guess I am one of those who responds better to sulphur treatment than Ivermectin.

Trump’s longtime doctor, Harold N. Bornstein, revealed in a New York Times story Wednesday that Trump takes the antibiotic tetracycline to stave off rosacea, which causes redness and bumps on the skin, and Propecia to keep his hair voluminous. Beauty companies selling non-prescription remedies think the president should reconsider his hair-loss and rosacea solutions. “We know there’s a better way than pill popping for rosacea,” exclaimed Alexandra Calvo, founder of the rosacea-fighting brand NuRevealOrganics. “Trump needs to watch his diet and cut out rosacea food triggers such as avocados, chocolate, yogurt and cheese. Living a lavish lifestyle also may not be the best for rosacea since spa days in the sweltering sauna, and long days on the beach under intense sun both cause rosacea flare-ups.” Salvo additionally recommended a skin-care regimen that includes NuRevealOrganics’ Bella Rosa Oil Cleanser and Rosehip Healing Night Face Cream. Beauty Companies Offer Trump Rosacea, Hair-Loss Advice – and Products The president's personal prescription drug plan includes medications for baldness and redness. By Rachel Brown, Fashion / Fashion Scoops, WWD

Drug Therapies for Rosacea Drug Dosage Form FDA Indication for Rosacea Adverse Event topical metronidazole (Metrogel, Metrocream, Metrolotion, Noritate, Rosadan) gel, cream, or lotion Varies by product - Metrogel : inflammatory lesions of rosacea. Metrocream, Metrolotion, Rosadan: inflammatory papules and pustules of rosacea. Noritate: inflammatory lesions and erythema of rosacea Pruritus, stinging, irritation, dryness oral doxycycline (Oracea) oral capsule only inflammatory lesions (papules and pustules) of rosacea nasopharyngitis, sinusitis, diarrhea, hypertension azelaic acid (Finacea) gel inflammatory papules and pustules of mild to moderate rosacea Stinging, irritation, burning brimonidine (Mirvaso) gel persistent (non-transient) erythema of rosacea Pruritus, burning, irritation, dryness, erythema ivermectin (Soolantra) cream inflammatory lesions of rosacea Burning, skin irritation oxymetazoline (Rhofade) cream persistent facial erythema associated with rosacea Irritation, burning, worsening inflammatory lesions of rosacea Treatment Options for Rosacea, Mel Seabright, PharmD, MBA, Pharmacy Times

They found rosacea patients were 46% more likely than controls to have celiac disease; 45% more likely to have Crohn’s disease; 19% more prone to ulcerative colitis; and had a 34% higher rate of irritable bowel syndrome. The co-occurrence of Helicobacter pylori infection and small intestinal bacterial overgrowth was significantly higher among patients with rosacea at baseline, but the risk of developing incident Helicobacter pylori infection or small intestinal bacterial overgrowth during follow-up was insignificant, the study’s lead author Alexander Egeberg, M.D., Ph.D., department of dermatology and allergy, Herlev and Gentofte Hospital, Hellerup, Denmark, tells Dermatology Times. Rosacea and gastro disorders possibly related, Large study supports likelihood of yet-to-be-defined link, By Lisette Hilton, Dermatology Times