Prevalence of rosacea in the general population of Germany and Russia - The RISE study.

In a recent study from our department 7/54 adult atopic dermatitis patients treated with systemic immunosuppressants were referred by ophthalmologists because of severe ocular involvement keratoconjunctivitis with or without keratoconus associated with milder skin symptoms (2). We report the case of a woman affected by atopic dermatitis and asthma in childhood who developed at 63 years of age conjunctivitis associated with blepharitis without causative contact allergen identification at skin testing. She received multiple topical and systemic treatments including cyclosporine 2mg/kg/day stopped after 4 days because of digestive adverse effects.

Azathioprine-induced rosacea.
J Eur Acad Dermatol Venereol. 2016 Dec 20;
Richard M, Seneschal J, Taïeb A

ResearchGate
 

Young woman with the typical butterfly rash found in lupus

Image courtesy of Wikimedia Commons

Rosacea and Lupus can co-exist. There are a number of anecdotal reports in this in this thread. 

Lupus should be differentiated from rosacea in a differential diagnosis. 

In Lima’s YouTube and QVC demonstrations, the pitch works like this: She appears before the camera looking impeccable, without a blemish or a hair out of place. Then she takes a face wipe and rubs it on her right cheek (always the right cheek). “Hello, rosacea!” Lima says genially as she uncovers a patch of skin as red and bright as a burn.

The Beauty Queen of QVC Jamie Kern Lima sells confidence for $39.95, brush included.
By LINDA WELLS, TheCut, Cover Story, NYMag

"SHE was once a news anchor and thought that would be her lifelong career path. But things took a different turn for Jamie Kern Lima, co-founder and CEO of IT Cosmetics when she developed hereditary rosacea in her 20s."

Covered, on many fronts,  BY MEERA MURUGESAN, NEW STRAITS TIMES PRESS

Dr Sandra Lee - known around the world as Dr Pimple Popper - is an expert in dermatology, and spoke to Express.co.uk about the do’s and don’ts for rosacea sufferers.

Rosacea: Dermatologist Dr Sandra Lee explains how YOU can minimise symptoms, Dr. Sandra Lee, Express.co.uk

Most who receive treatment get to a stable state with fairly minor symptoms, but in a few it is more severe and progressive needing ongoing aggressive treatment. So if you have some of the telltale symptoms that may be rosacea, get it checked out early.

Rosacea can worsen with alcohol use, exercise, Andrew Smith, MD, The Daily Times, Maryville, TN

CONCLUSION: This study suggests that the AIF and BF supplements provide significant clinical benefits in the reduction of facial erythema and hyperpigmentation.  

Plast Reconstr Surg Glob Open. 2016 Sep; 4(9 Suppl): 25-26. Published online 2016 Sep 16. doi: 10.1097/01.GOX.0000511256.60478.59 PMCID: PMC5147057https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5147057/
Abstract: The Efficacy of Two Melon-Derived Superoxide Dismutase/Wheat Gliadin Oral Formulae in the Treatment of Facial Skin Hyperpigmentation and Erythema
Cory S. Goldberg, BSc, MD, MASc and Joshua T. Gauci, MSc

We need more research on this.

Ketamine 0.5% and Amitriptyline 1% Topical Compounding Formula (Announcement in Rosacea in the News)

If you have tried this topical treatment please post your results in this thread. 

Truth Vitality Lux renew is FDA-cleared for the treatment of facial wrinkles and acne. It is a handheld at-home device combining ultrasound technology with red and blue LED light therapy. Lux Renew safely delivers anti-aging treatments to help firm and smooth skin.

The Soolantra seems to be improving my skin after 45 days. Still some redness showing but it is definitely improving. Hope this keeps working. 

"Anecdotal results of reduced erythema and acne with the use of OnabotulinumtoxinA (Botox®, Allergan, Irvine, CA, USA) for cosmetic purposes led Dayan et al to experiment further in 13 patients with rosacea. Over the course of 2 years, patients received intralesional microdroplet injections (0.05 mL) of onabotulinumtoxinA in a dilution of 7 mL of saline solution per 100 units. The results indicated significant reduction in erythema and flushing of the affected area 2–4 weeks after treatment. Their predecessors reported similar results after a 26-year-old male was injected with 10 units of onabotulinumtoxinA at 1 cm intervals into one cheek."

Clin Cosmet Investig Dermatol. 2015; 8: 159–177.
Published online 2015 Apr 7. doi:  10.2147/CCID.S58940
PMCID: PMC4396587
Update on the management of rosacea
Allison P Weinkle, Vladyslava Doktor, and Jason Emer

We need more studies on this.

"Finally, a formulation of low molecular weight hyaluronic acid sodium salt 0.2% cream (Bionect® Cream, Innocutis Holdings, Charleston, SC, USA) applied twice daily for 8 weeks showed a statistically significant reduction in papules, erythema, burning, stinging, and dryness in a small study. Along with excellent tolerability, a reduction in papules, erythema, burning/stinging, and dryness was clearly apparent by week 4 and remained by the final visit at week 8. Notably, erythema was reduced by the greatest amount, with an approximate 50% improvement by week 2. This study demonstrates the importance of skin barrier maintenance and repair in the pathogenesis of rosacea. With a hydrophilic structure, low molecular weight hyaluronic acid penetrates the stratum corneum where it interacts with fibrin and collagen to support remodeling of the extracellular matrix. This mechanism, along with induction of the antimicrobial peptide β-defensin 2 release from keratinocytes, ultimately accelerates re-epithelialization and reduces pain and edema."

Clin Cosmet Investig Dermatol. 2015; 8: 159–177.
Published online 2015 Apr 7. doi:  10.2147/CCID.S58940
PMCID: PMC4396587
Update on the management of rosacea
Allison P Weinkle, Vladyslava Doktor, and Jason Emer

We need more studies on this. 

Quassia amara image courtesy of Wikimedia Commons

"In another single-center, open-label study, a group of 30 patients with rosacea of variable severity were treated with 4% Quassia amara extract topical gel for 6 weeks. Reportedly, Q. amara possesses antiparasitic and anti-inflammatory properties that have the capability to decrease the inflammatory response with few complications. Efficacy comparable with that of first-line topical treatments like azelaic acid and metronidazole was observed after Q. amara treatment, with superb tolerability."

Clin Cosmet Investig Dermatol. 2015; 8: 159–177.
Published online 2015 Apr 7. doi:  10.2147/CCID.S58940
PMCID: PMC4396587
Update on the management of rosacea
Allison P Weinkle, Vladyslava Doktor, and Jason Emer

We need more studies about this. 

"Long story short, a dermatologist diagnosed with rosacea. Which doesn’t have a cure. Oh yeah and is treated “simply” with 2 doses of an antibiotic daily, and 2 applications of a medicated cream daily. Sigh....But I was desperate to start looking like myself again. So I looked into this “It.” Turns out it is sold in Ulta, and, after viewing their videos, my God, their products really do fight the good fight against rosacea, meaning it covers up the damn redness. (Sorry for doubting you, Ma)."

Me, Rosacea, And It Cosmetics
April 29, 2016 by lifesucksinastraplessbra 

Anecdotal reports of rosacea clearance on a vacation 

anon24 reports that going to the beach improved his rosacea.

CrabbyCathy » Wed Oct 20, 2010 1:53 am (sixth post in the thread) posts, "My skin has calmed down nicely--partly, I think, because I am on vacation! No joke."

________________
Mister88 (also nat007 post #8, Acne Rosacea Support post #9, maroon5 post #10):

post no 1: "I clearly nailed down my triggers;-) and sun is Ok! not sure why my face cleared up but I think it's one of these, dr said don't use rosula( sulfar wash) while on vacation.. maybe the sulfar causes more harm?  I also introduced accilophodus+ hcl digestive supplements. Or it could be that the sun helped?" 

post no 8: "I heard so many stories from rosacea friends dreading their holidays as their skin is in a bad state, and I have had the same situation plenty of times, and almost always they go with dread and find their rosacea is way less bad during the vacation! It must be the emotional factor, being relaxed, and warmer temperatures might play a role too!"

post no 9: "I tend to agree, when I go on vacation my symptoms don't seem to be as bad."

post no 10: "Also tend to agree my skin is generally clearer on holiday - although I'm very careful with my face and would never risk getting burnt."
------------------------------------------

People's Pharmacy Comments confirms similar results for Tracy, Dave, Lynn and her husband:

Tracy: "I’ve just returned from the seaside and all my rosacea has cleared . I was only there for 2 days"

Dave: "That being said, in January I went on a weeklong trip to the Virgin Islands. During that week I snorkeled several times, probably for 2 hours total. I was convinced beforehand that the saltwater would irritate my skin (anything irritates my skin). I couldn’t have been more wrong, my skin looked better than it had for 3 months using all types of medicine from the dermo."

Lynn and husband: "Both my husband and I also have Rosacea. We too have noticed when we return from a trips from Florida or Hawaii, the Rosacea has cleared up."

--------------------------------------

Nick [nfaieta] (and BVokey see post #2) writes, "Why did my skin clear up on vacation? Why is it that my skin pretty much cleared up when I spent a week in Florida recently. When I got home it went right back to being red and irritated. Is it just because I got some sun and it looked more tan? My face did not get irritated by the sun, it actually felt way better."

BVokey posts: "The exact same thing happened to me while in Hawaii recently and also happens whenever I am staying in a warm climate. I was there for two weeks and my Rosacea cleared up almost completely however slowly returned once I got back home to the cold weather and back to the grind."

RaymondS post #8: "No stress....come back to normal life and things get worse, my skin looked amazing in Thailand. Very humid / was in the water a lot. But it's hot here in summer and I swim and my skin is not amazing? Thinking stress less"

----------------------------------

tifer (post no 1) reports, "there’s only 1 thing that COMPLETELY eliminates my seb derm (AND dandruff): going on vacation. and whats mind blowing is the fact that my scalp goes back to normal 100% within 3-5 days. it’s unbelievable. 

‎Lee-Ann Findlater‎, Rosacea Tips and Support Group, posts, "i thought the sun is meant to make rosacea worse. I've came on holiday thinking the worst as its all new to me. and its a actually cleared it up a good bit?? its definitely rosacea."

Seb91 [post no 6] reports, "I went to Central America last year travelling for 4 months. I went to visit my girlfriends family in Canada on the way and my skin was so bad whilst I was there that I said to her "I don't think I am going to last 2 weeks in Central America," I was dreading it. I got to C, America and after 3 days my skin started to improve. I was in the sea surfing, my skin started to burn less, sensitivity went down, even had a few drinks that I hadn't had for years without a flare up. Whether its a combination of stress, humidity, surf, sea, sun, I don't know, but it showed me that it CAN get better. It might not always seem the case, much like the period that I am going through now, I need to remind myself, last year I went to C, America in 30C heat and it was manageable."

Seb91 [post no 34] didn't mention the South Pacific or a beach but did say this: "I went to Mexico for 4 months with my girlfriend 2 years ago, a trip I was absolutely dreading because my skin was in a bad place, and I ended up being absolutely fine and having the best time, without much pain, sensitivity, and redness. Not sure why? Maybe it was because I was doing something I love (surfing), humidity, the air quality, I really don't know. But seeing my skin on that trip said to me that this isn't the result of lasers, this is a result of an environmental change."

BVokey [post no 1] reports, "Honorable mention: going to the beach and swimming in the ocean, warm/hot showers, hot tubs, etc all actually reduce my redness for a short time. I think it's related to my entire body getting water. The biggest healer of the above is swimming in the cool ocean saltwater - it drastically reduces my redness to an almost pale pink. Being out in the sun as much as possible as long as I am wearing sunblock,,,"

"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