Guide

"The Regenlite Transform Laser is now available in Colorado at Aria Integrative Health." Beautiful skin with Aria Integrative Health POSTED 11:27 AM, DECEMBER 13, 2016, BY TRAVIS DOOLEY HARRISON, KDVR • A TRIBUNE BROADCASTING STATION

"Keratosis pilaris is a condition that mimics rosacea, but should not be treated like rosacea, Dr. Rao notes. "It is commonly mistaken for rosacea," Dr. Rao says. "Anti-keraloytic agents like lactic acid and alpha-hydroxy acids can be used as well as moisturizer (to treat keratosis pilaris)."" Various conditions respond to energy-based therapies, by Louise Gagnon, Dermatology Times. Dermatology Canadian Association of Aesthetic Medicine 2016

"If you have any skin conditions — eczema, rosacea, seborrheic dermatitis, or anything else that can be literally hacked off your face — you’ll want to stay away from the straight razor. "With those conditions, you don’t want a close shave," says Dr. Shari Lipner, dermatologist at Weill Cornell Medicine and New York-Presbyterian. "If you need a close shave for work, get an electric razor or a two-bladed razor that doesn’t cut so close." If your skin is just naturally dry, pick up a daily moisturizer. The more hydrated your skin, the less likely it is to get irritated." Do You Have the Skin for a Straight-Razor Shave?, By Max Plenke, Men's Journal, Shaving Note: I use the Gillette Fusion Razor and found that electric razors were more rough on my face causing redness. So you will have to figure out what is best for you.

“Injecting small quantities of neuromodulators superficially into the skin has been a life-changing treatment for some of my patients,” says Dr. Gilbert. Those who have seen benefits from the treatment notice a reduction in flushing for three to four months after a single treatment — a timespan with which no single use of a topical can compete." There's A New Way To Treat Rosacea — & It Might Surprise You, ERIKA STALDER, Refinery29 DECEMBER 13, 2016, 11:30 AM

She had seen various doctors over the past two years. Most of them had told her she had eczema and prescribed steroid-based creams that did help, but not for long. When she stopped applying them, the flushing returned with a vengeance. There was nothing wrong with the creams - it was the diagnosis that was incorrect. Once, a doctor told her she had acne. The topical medication that was given to her made her redness and sensitivity worse. This is the classic history of a person who is suffering from rosacea, which is often mistaken for other skin diseases. A rosacea patient may be misdiagnosed and wrongly treated for years. Don't be red-faced over rosacea, Lynn Teo, Strait Times, Singapore For more info on misdiagnosed rosacea

"Alcoholic drinks have a high sugar content, and we know that sugar leads to inflammation in the skin," explains Chiu. "Overtime that can cause breakouts, and even start to break down healthy collagen." Point being: Regular hangovers are no good for your body or your skin. So if you need a little added incentive to pass on that last glass of eggnog, remember that doing so will not only help you feel better the next morning, but look better, too. 5 Ways to Fight a Skin Hangover, By Melanie Rud Chadwick | Dec 12, 2016, Shape One too many glasses of bubbly can leave your skin looking less than stellar the next morning. Here, how to treat your complexion when you need to counteract the effects of a late night out.

Under Pharmacology, the (.5%) ketamine (and 1% amitriptyline) (mixing in a 1 to 1 ratio) compounds with either a base gel such as Lipoderm or cream such as pluronic lecithin organogel. The article notes that the Lipoderm administers the ketamine quicker and with better absorption. Is Topical Ketamine Ready For Prime Time? A literature review reveals limited evidence of efficacy, but larger studies are needed. By Joseph Rabi, MD

"In conclusion, this randomized, placebo-controlled trial examining topical 2% amitriptyline, 1% ketamine, and a combination of both in the treatment of neuro- pathic pain revealed no differences between groups. Optimization of doses may be required, because another study has revealed that higher concentrations of these agents combined do produce significant analgesia." Anesthesiology 2005; 103:140 – 6 © 2005 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc. Topical 2% Amitriptyline and 1% Ketamine in Neuropathic Pain SyndromesA Randomized, Double-blind, Placebo-controlled Trial Mary E. Lynch, M.D., F.R.C.P.C., Alexander J. Clark, M.D., F.R.C.P.C., Jana Sawynok, Ph.D.,‡ Michael J. L. Sullivan, Ph.D.

"The common misperception is that patients with rosacea or sensitive skin cannot use a retinol or retinoic acid,” explains Suneel Chilukuri, M.D., a board certified dermatologist and fellowship-trained Mohs Micrographic, cosmetic, and laser surgeon, who is also the founder of Refresh Dermatology in Houston, Texas. "Retinoids actually improve skin texture, tone, and quality, and over time, decrease many of the symptoms of rosacea,” he told me." These 4 Products Were My Intro to Retinols 101, Victoria Moorhouse, xoVain Amazon carries three of the four products mentioned in the article: Here is a less expensive alternative:

"The global market for rosacea therapeutics is expected to grow steadily during the forecast period 2016-2024, owing to rising awareness among people. Increasing smartphone ownership and penetration of internet has enabled quick and effective dissemination of information through which many people have become aware of this ailment. As rosacea can be effectively managed through over-the-counter gels, many pharma companies have launched their products in the market." Rosacea Therapeutics Market : Positive Long-Term Growth Outlook Up To 2024, medGaget

"Rosacea is difficult to live with, and even though it is not dangerous, it can take a toll on your self-esteem. If you are suffering from this skin disease, don’t be afraid to take action." 10 Ways to Treat Rosacea During Winter Months, by Linsha Qi, Her

“Rosacea is a type of acne that tends to cause persistent redness over a lengthy period of time, hence the term ‘acne rosacea’. Some people simply use the term to refer to facial redness, but dermatologists do not,” explains Dr Adam Friedmann, consultant dermatologist at The Harley Street Dermatology Clinic Treating skin redness, Irish World

Every year for some time now I have been reviewing the NRS Form 990 which was recently posted on its web site (the NRS filed an extension). It is similar to the other reviews I have given in the past (2013 or 2014). Very few are interested in how the NRS spends it money nor care at all. As far as I know I am the lone watchdog on the NRS. However, since the NRS was the chief reason the RRDi was formed because we thought donated funds could be better spent than how the NRS spends its donated funds giving rosacea sufferers an alternative, you may see why I continue to monitor and review the NRS spending and post my review. The nutshell version for 2015 is that the NRS received $520,532 in revenue and spent $659,106 in expenses. You may wonder how they can do that but the simple reason is that the NRS has assets which they can draw upon when the NRS spends more than it receives in donations. The NRS spent $75,010 on research grants. So that amounts to 14.41% of its donations. To put this in perspective, every dollar donated in to the NRS in 2015, about 14 cents was spent on research grants. 95% ($494,219) of the donations were spent on two private contractors, Glendale Communications Group, Inc. and Park Mailing and Fulfillment, Inc. that are owned by Sam Huff, President of the NRS. It was also reported that Sam received $114,117 in salary while his secretary, Mary Erhard, received $39,364. Here is a breakdown of the Form 990: Form 990 Part 1 Revenue Line 8 Contributions and grants $462,608 Line 9 Program service revenue $ 57,674 Line 10 Investment Income $ 250 Total Revenue $520,532 Expenses Line 13 Grants and similar amounts paid $ 75,000 Line 17 Other expenses $584,096 Total expenses $659,106 Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors Section A (1) Samuel B Huff, President Reported compensation from related organizations $114,117 (2) Mary F. Erhard, Secretary Reported compensation from related organizations $ 39,364 Schedule R Part V Transactions with Related Organizations Note 1 m Performance of services or membership or fundraising solicitations for related organization(s) n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) o Sharing of paid employees with related organization(s) Note 2 (1) Glendale Communications Group, Inc (c) $447,912 (2) Park Mailing and Fulfillment, Inc. (c) $ 46,307 Total Transactions $494,219 2015 NRS Form 990 For a spreadsheet of all the years reviewed click here.

PainFree-IBU Fast Gel • Ketamine 10%.......NMDA Blocker, Analgesic • Gabapentin 4%..............Nerve Blocker • Ibuprofen 10%...............Anti inflammatory • Diclofenac 4%................Anti inflammatory • Amitriptyline 1%.............Nerve Blocker • Cyclobenzaprine 2%..... Muscle Relaxant • Apply 0.5-1.0ml 3-4 x daily • Use 1-4 drops on the affected area either alone or after the PLO gels. Response is in 1-2 minutes. The Lost Art of Compounding June 18, 2010, Tom Schnorr, RPh, CCN Apothecary Shop Pharmacy

Amitriptyline A double-blind, placebo-controlled trial of a topical treatment for chemotherapy-induced peripheral neuropathy: NCCTG trial N06CA. A pilot study examining topical amitriptyline, ketamine, and a combination of both in the treatment of neuropathic pain. Combination gel of 1% amitriptyline and 0.5% ketamine to treat refractory erythromelalgia pain: a new treatment option? Effective use of topical amitriptyline hydrochloride 2.5% and ketamine hydrochloride 0.5% for analgesia in refractory proctodynia. Evaluation of the effect of locally administered amitriptyline gel as adjunct to local anesthetics in irreversible pulpitis pain. Peripheral antinociceptive actions of desipramine and fluoxetine in an inflammatory and neuropathic pain test in the rat. Topical amitriptyline and ketamine in neuropathic pain syndromes: an open-label study. Topical amitriptyline and ketamine in neuropathic pain syndromes: an open-label study. Topical amitriptyline combined with ketamine for the treatment of erythromelalgia: a retrospective study of 36 patients at MayClinic. Topical amitriptyline combined with topical ketamine for the management of recalcitrant localized pruritus: a retrospective pilot study. Topical amitriptyline in healthy volunteers. Topical amitriptyline, ketamine, and lidocaine in neuropathic pain caused by radiation skin reaction: a pilot study. Topical amitriptyline-ketamine for the treatment of brachioradial pruritus. Topical amitriptyline-ketamine for treatment of rectal, genital, and perineal pain and discomfort. Use of transdermal amitriptyline gel in a patient with chronic pain and depression. Ketamine A double-blind, placebo-controlled trial of a topical treatment for chemotherapy-induced peripheral neuropathy: NCCTG trial N06CA. A pilot study examining topical amitriptyline, ketamine, and a combination of both in the treatment of neuropathic pain. Effective use of topical amitriptyline hydrochloride 2.5% and ketamine hydrochloride 0.5% for analgesia in refractory proctodynia. Ketamine as an analgesic: parenteral, oral, rectal, subcutaneous, transdermal and intranasal administration. Ketamine mouthwash for mucositis pain. Ketamine: an introduction for the pain and palliative medicine physician. Mechanisms and treatment of neuropathic pain. Recent advances in postoperative pain management. Reduction of allodynia in patients with complex regional pain syndrome: A double-blind placebo-controlled trial of topical ketamine. Topical amitriptyline and ketamine in neuropathic pain syndromes: an open-label study. Topical amitriptyline and ketamine in neuropathic pain syndromes: an open-label study. Topical amitriptyline combined with ketamine for the treatment of erythromelalgia: a retrospective study of 36 patients at MayClinic. Topical amitriptyline-ketamine for the treatment of brachioradial pruritus. Topical amitriptyline-ketamine for the treatment of brachioradial pruritus. Topical amitriptyline-ketamine for treatment of rectal, genital, and perineal pain and discomfort. Topical ketamine and morphine for post-tonsillectomy pain. Topical ketamine cream in the treatment of painful diabetic neuropathy: a randomized, placebo-controlled, double-blind initial study. Topical ketamine gel: possible role in treating neuropathic pain. Topical ketamine in the treatment of mucositis pain. Topical ketamine treatment of postherpetic neuralgia. Topical ketamine treatment of postherpetic neuralgia. Transdermal ketamine as an adjuvant for postoperative analgesia after abdominal gynecological surgery using lidocaine epidural blockade. Transdermal Lidocaine and Ketamine for Neuropathic Pain: A Study of Effectiveness and Tolerability.

Neuropathy & Neuralgia Therapies Local Anesthetics, Gabapentin, Ketamine, Amitiptyline ❧ Bind to Na+, K+ and Ca2+ channels in damaged nerves to suppress abnormal spontaneous activity ❧ Disrupt G protein coupling to produce anti- inflammatory effects ❧ Typical usage has been shown to be safe and without serious adverse effects ❧ Consider surface area Flores et al Rev Bras Anestesiol 2012;62(2):244-52, Shipton Anesthesiol Res Pract 2012:546409, Drugdex Evaluations [Internet]. Cited April 2012 Compounded Specialty Prescriptions in Women’s Primary Care Natalie Gustafson, PharmD Director of Pharmacy at Lloyd Center Compounding Pharmacy & Pacific Compounds Pharmacy July 20, 2014

"At this point, twice daily applications of topical 2% amitriptyline compounded with 0.5% ketamine in an organogel were added to the patient’s treatment regimen. The gel was initially applied only to the skin surrounding the affected area, but as the erosions healed the gel was applied to the area of herpetic infection." Amitriptyline/Ketamine as Therapy for Neuropathic Pruritus and Pain Secondary to Herpes Zoster JDD, February 2015 | Volume 14 | Issue 2 | Original Article | 115 | Copyright © 2015 John R. Griffin MD and Mark D.P. Davis MD Topical gel combo decreases severe pruritus, pain in shingles-related case Dermatology Times, March 16, 2015 By Bill Gillette "In conclusion, this randomized, placebo-controlled trial examining topical 2% amitriptyline, 1% ketamine, and a combination of both in the treatment of neuro- pathic pain revealed no differences between groups. Optimization of doses may be required, because another study has revealed that higher concentrations of these agents combined do produce significant analgesia." Anesthesiology 2005; 103:140 – 6 © 2005 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc. Topical 2% Amitriptyline and 1% Ketamine in Neuropathic Pain SyndromesA Randomized, Double-blind, Placebo-controlled Trial Mary E. Lynch, M.D., F.R.C.P.C., Alexander J. Clark, M.D., F.R.C.P.C., Jana Sawynok, Ph.D.,‡ Michael J. L. Sullivan, Ph.D. "This pilot study demonstrated a lack of effect for all treatments in the 2 day double blind placebo controlled trial, followed by analgesia in an open label trial in a subgroup of subjects who chose to use the combination cream for 7 days. Blood analysis revealed no significant systemic absorption of either agent after 7 days of treatment, and creams were well tolerated. A larger scale randomized trial over a longer interval is warranted to examine further effects observed in the open label trial." Clin J Pain. 2003 Sep-Oct;19(5):323-8. A pilot study examining topical amitriptyline, ketamine, and a combination of both in the treatment of neuropathic pain. Lynch ME, Clark AJ, Sawynok J. "This study demonstrates that topical 2% amitriptyline/1% ketamine, given over 6-12 months, is associated with long-term perceived analgesic effectiveness in treatment of neuropathic pain. Antidepressants and ketamine both produce multiple pharmacologic effects that may contribute to peripheral analgesia; such actions include block of peripheral N-methyl-D-aspartate receptors, local anesthetic properties, and interactions with adenosine systems." J Pain. 2005 Oct;6(10):644-9. Topical amitriptyline and ketamine in neuropathic pain syndromes: an open-label study. Lynch ME1, Clark AJ, Sawynok J, Sullivan MJ.

Dry Eye: Awareness, Diagnosis, and Management Why prevalence increases after menopause JOSEPH MUSSOLINE, MD Dry-Eye-Awareness-Diagnosis-Management.pdf "The results of this study suggest that, in patients with moderate to severe symptoms, combination therapy of intense pulse light (IPL) and meibomian gland expression (MGX) could be a safe and useful approach for improving signs of dry eye disease (DED) due to meibomian gland dysfunction (MGD)." Intense pulsed light improves signs and symptoms of dry eye disease due to meibomian gland dysfunction: A randomized controlled study Reply to this Topic There is a reply to this topic button somewhere on the device you are reading this post.

"Pharmaceutical companies are working to bring the combination to market, but it’s not yet available commercially, so Mayo Clinic dermatologists have their pharmacists compound it in two strengths – 2% amitriptyline and either 0.5% or 5% ketamine – using Lipoderm cream as the base, according to Dr. Davis. Patients apply the mixture three times daily. Why it works isn’t clear; the drugs have different and perhaps synergistic effects on skin pain.....Of more than 1,000 Mayo Clinic patients who have tried the combination, "I’d say less than 1% has told me that they’ve ever had a side effect," he said. "I’ve had just two or three patients tell me they’ve gotten nightmares," a known effect of ketamine. "This is a product that has great promise," he noted." Dermatology News Creams and patches can replace narcotics for skin pain Publish date: December 4, 2013 M. Alexander Otto Frontline Medical News

"Topically formulated neuroleptic agents, including doxepin, glycopyrrolate, amitriptyline, capsaicin, and ketamine, were occasionally effective (3 of 7)." Neurogenic Rosacea

A similar compounding numbing cream that contains ketamine 5%, amitriptyline 2%, clonidine 0.2%, gabapentin 5% in a base of lipoderm has been reported by Elanor Linsel for dysautonomia. "The dysasthesia can be very disturbing for many patients and improved with amytriptyline or gabapentin." Rosacea: Choosing Among the Topical and Systemic Therapeutic Options As the field of therapies available for rosacea has expanded, clinicians must weigh the topical and oral treatment options on a case-by-case basis By Mark Bechtel, MD and Ann Bechtel, BSN, Practical Dermatology

"The pathogenesis of IFAG is still unclear but it is likely to be associated with granulomatous rosacea in childhood....supports the hypothesis that IFAG may belong to the spectrum of rosacea." [1] Images of IFAG End Notes [1] Case Rep Dermatol. 2016 May-Aug;8(2):197-201 Idiopathic Facial Aseptic Granuloma in a 13-Year-Old Boy Dramatically Improved with Oral Doxycycline and Topical Metronidazole: Evidence for a Link with Childhood Rosacea. Orion C, Sfecci A, Tisseau L, Darrieux L, Safa G Reply to this TopicThere is a reply to this topic button somewhere on the device you are reading this post. If you never heard about this topic and you learned about it here first, wouldn't it be a gracious act on your part to show your appreciation for this topic by registering with just your email address and show your appreciation with a post? And if registering is too much to ask, could you post your appreciation for this topic by finding the START NEW TOPIC button in our guest forum where you don't have to register? We know how many have viewed this topic because our forum software shows the number of views. However, most rosaceans don't engage or show their appreciation for our website and the RRDi would simply ask that you show your appreciation, please, simply by a post.

"Conclusions: A majority of patients with erythromelalgia (75%) reported improvement in pain with topical application of a compounded amitriptyline-ketamine formulation. The medication was well tolerated." Neurology, Mayo Clinic Topical amitriptyline combined with ketamine for the treatment of erythromelalgia: A retrospective study of 36 patients at mayo clinic Timothy J. Poterucha, Sinead L. Murphy, Mark D P Davis, Paola Sandroni, Richard H. Rho, Roger A. Warndahl, William T. Weiss JDD, March 2013 | Volume 12 | Issue 3 | Original Article | 308 | Copyright © 2013

Found one other anecdotal report, Despotic_Monarch, who reports, "The only thing out of 25 or so drugs/medications that worked is a cream base that contains... Ampitriptyline 1.0%/ Ketamine 0.5% cream in a 1 to 1 ratio. In just one week I went from being a tomato to a piece of paper and finally my skin can heal. If you are suffering from Rosacea this might be an amazing/safe treatment for you! Please see your derm."

"Rosacea is a type of acne that tends to cause persistent redness over a lengthy period of time, hence the term 'acne rosacea'. Some people simply use the term to refer to facial redness, but dermatologists do not." Dr Adam Friedmann, consultant dermatologist at The Harley Street Dermatology Clinic Treating skin redness by Exposé