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"There has been a definite change in the lifestyle due to the current Covid-19 pandemic. People are compulsorily using face masks to avoid the spread of Covid-19 infection. This change in behavior has brought out a surge of rosacea like lesions on the covered area of face. Partly, it can be explained by change in innate immunity due to excessive sweating and change in microenvironment of skin." Unusual Spurts of Rosacea Like Dermatoses, Posing a Diagnostic Dilemma During Covid-19 Pandemic: A Cross-Sectional, Observational Study From a Tertiary Care Centre

"In conclusion, our findings identified and verified metformin as a novel therapeutic candidate for rosacea, and it alleviates the pathological symptoms, possibly by suppressing inflammatory responses, angiogenesis in rosacea." Pharmacol Res. 2021 Nov 8;105971. doi: 10.1016/j.phrs.2021.105971. Online ahead of print. Exploring metformin as a candidate drug for rosacea through network pharmacology and experimental validation Yangfan Li, Li Yang, Yaling Wang, Zhili Deng , San Xu, Hongfu Xie , Yiya Zhang, Ji Li "Metformin, sold under the brand name Glucophage among others, is the first-line medication for the treatment of type 2 diabetes, particularly in people who are overweight." Wikipedia

It still amazes me that rosaceans feel absolutely comfortable posting at social media sites like Facebook or Reddit and for some reason that doesn't seem logical to me can't even post a reply to this thread that doesn't require registration and can totally hide behind a cryptic display name of their own choosing so that no one knows who they are. Could someone out of the graciousness of their heart explain this to me? What are your thoughts on why the current state of rosacea sufferers are not posting here at the RRDi? It would be helpful to understand this. If you know nothing about the RRDi click here. After you learn about the RRDi please join the conversation here by finding the reply to this topic button found on your device in this discussion thread about the RRDi. Or find the QuOTE button and post. Or you might find the join the conversation and post your thought. Usually there are at least two or more ways to post in this thread located somewhere on your device.

"The majority of patients who had acne vulgaris (79.7%), vitiligo (79.3%), hair disorders (76.9%), or rosacea (71.5%) reported a small to no effects on their QoL." Quality of life assessment among patients suffering from different dermatological diseases

"Using SF-36, rosacea patients were affected mentally the most as they reported the worst mental component scores, and the scores were significantly worse than that of melasma patients (rosacea vs. melisma = 46.5 vs. 52.7, p = 0.007)." Impacts of skin disorders associated with facial discoloration on quality of life: Novel insights explaining discordance between life quality scores and willingness to pay

"After 52 weeks of once-daily treatment, subantibiotic dose doxycycline significantly reduced the relapse rate and inflammatory lesion counts in subjects with moderate-to-severe inflammatory rosacea." Long-Term Inflammatory Rosacea Management with Subantibiotic Dose Oral Doxycycline 40 mg Modified-release Capsules Once Daily

It is of interest to note that an anti-depressant, fluvoxamine, brand name Luvox, which is a selective serotonin reuptake inhibitor (SSRI) most often used to treat obsessive compulsive disorder (OCD) and depression is being considered to treat Covid 19. A CNN article states the following about this drug treating cytokines: " 'Fluvoxamine may reduce the production of inflammatory molecules called cytokines, that can be triggered by SARS-CoV-2 infection,' Reiersen said in a statement. The drug may also reduce blood platelets, which may affect the clotting effects of coronavirus infection." Cheap, generic anti-depressant may reduce severe Covid-19 disease, study finds. Maggie Fox, CNN

"Skin, the largest organ in the human body, is exposed to air pollutants, including diesel exhaust fumes, ultraviolet rays, food, xenobiotics, drugs, and cosmetics, which promote the production of ROS. ROS exacerbate skin aging and inflammation, but also function as regulators of homeostasis in the human body, including epidermal keratinocyte proliferation. Although ROS have been implicated in various skin diseases, the underlying mechanisms have not yet been elucidated." [1] "The regulation of free radical and ROS has been implicated in the development of various skin diseases; however, the underlying mechanisms have not yet been elucidated in detail, and proper usage of antioxidant drugs is still unknown now. In addition, there lacks studies concerning physiological roles of free radicals and ROS in skin homeostasis, and the information about duration of the generation, action and ratio of free radicals and ROS is still unclear in skin diseases.' [1] What Are Reactive Oxygen Species, Free Radicals, and Oxidative Stress in Skin Diseases?

"Research has documented that stress has wide-ranging physiologic and clinical impacts on skin disease [1]. This has led to an interest in mind body therapies (MBTs) as potential adjunct therapies in the treatment of skin disease... ...MBTs may be considered as adjunct therapy in the treatment of several dermatologic conditions, including atopic dermatitis, psoriasis, self-induced skin conditions, and others. Other indications include during dermatologic procedures. Further research is needed to confirm beneficial effects, to determine patient selection, and to delineate mechanisms of action. However, many of these therapies are low risk and referral to experienced practitioners or multidisciplinary clinics should be considered." Stress and Skin: An Overview of Mind Body Therapies as a Treatment Strategy in Dermatology In addition to stress, Nocturnal Pruritus (NP) is mentioned in this post.

"There is a growing concern amongst patients about topical corticosteroid (TCS) side effects, with increasing discussion of topical steroid addiction (TSA) and topical steroid withdrawal (TSW) particularly on social media platforms...However, concepts such as topical steroid addiction (TSA) and topical steroid withdrawal (TSW) are controversial with majority of the dermatological community questioning this entity. Differences in opinion between dermatologists and patients who believe in TSA/TSW create challenges in treatment and a failure to acknowledge the patient’s concerns can result in a weakening of the patient-healthcare relationship (ongoing study)." Steroid Phobia: Is There a Basis? A Review of Topical Steroid Safety, Addiction and Withdrawal

"Recently, mast cells (MCs) have emerged as key players in the pathogenesis of rosacea through the release of pro-inflammatory cytokines, chemokines, proteases, and antimicrobial peptides leading to cutaneous vasodilation, angiogenesis, and tissue fibrosis. Several existing and emerging topical, oral, and injectable therapeutics have been associated with improvement of rosacea symptoms based on their ability to stabilize and downregulate activated MCs." [1] Cromolyn Sodium may be "a potential therapeutic in the treatment of erythematotelangiectatic rosacea." [1] "In recent years, a number of topical, oral, and injectable therapeutics have been shown to alleviate the symptoms of rosacea through stabilization and inhibition of MC signaling." [1] Other MC stabilizers include Brimonidine tartrate 0.33%, Artemether emulsion 1%, Hydroxychloroquine, Artemisinin, and Botulinum toxin. [1] Mast Cell Stabilizers in the Treatment of Rosacea: A Review of Existing and Emerging Therapies

Pruritis, severe itching of the skin, is occasionally described as a symptom in rosacea patients and is usually described in folliculitis or other skin conditions. One paper in discussing Nocturnal Pruritus (NP) had this to say about it: "Skin conditions such as atopic dermatitis, psoriasis, urticaria, and prurigo nodularis are well-described causes of NP." [1] Find the reply button on your device and comment on your thoughts on this subject. End Notes [1] Nocturnal pruritus and sleep disturbance associated with dermatologic disorders in adult patients

"Chronic visible skin diseases are a highly prevalent health problem. In Germany, around 10 million people are affected, most commonly by psoriasis, acne, rosacea and atopic dermatitis. In addition to medical consequences, patients have a substantial psychosocial burden. A study among dermatological outpatients in 13 European countries reported the presence of depression in 10.1%, anxiety in 17.2% and suicidal ideation in 12.7% of all patients. Patients with skin conditions also frequently report an impaired health‐related quality of life4 and feelings of stigmatisation." Effectiveness of a structured short intervention against stigmatisation in chronic visible skin diseases: Results of a controlled trial in future educators

Some articles report taking skin hydration tests to understand its relationship to rosacea. Here are two reports: Skin Hydration Sensor (SHS) Biodisplay

Tetracycline has been used to treat rosacea for a long time, particularly doxycycline. One of side effects is photosensitivity. The article below distinguishes between a phototoxic or a photo allergic reaction. "Tetracyclines (TCs) are a group of broad‐spectrum antibiotics discovered in the 1940s and exhibited activity against a range of microorganisms including gram‐positive and gram‐negative bacteria (e.g., chlamydiae, mycoplasmas, rickettsiae), and protozoa; they are largely prescribed in dermatology and infectious diseases, both for the anti‐bacterial and anti‐inflammatory actions. TCs are considered generally well tolerated, although some adverse events may occur during treatment, one of them is photosensitivity. From the photobiological point of view, the photosensitivity reactions are a consequence of the absorption of light energy by a photosensitizing substance (e.g., a drug) and of the subsequent photochemical reactions determining changes in living tissues. They are usually divided in phototoxic or photoallergic, depending on the different mechanism involved. TCs have been reported as phototoxic, but not photoallergic drugs." Tetracyclines and photosensitive skin reactions: A narrative review

While the following conclusion is a valid point of this article on the skin microbiome, it totally focuses on bacteria. "Further research on the skin microbiome in inflammatory skin diseases is needed, particularly concerning the impact of antibiotics on the microbiome and the beneficial effects of topical probiotics in improving skin health and the individualized treatment of skin diseases." Features of the Skin Microbiota in Common Inflammatory Skin Diseases A similar approach focusing again on bacteria states the following: "This is a compelling area for future research, and to achieve this objective microbiota research should focus on a much more integrative model that takes into account the target microbiota but also other supposedly unrelated microbiotas." Human Microbiota Network: Unveiling Potential Crosstalk between the Different Microbiota Ecosystems and Their Role in Health and Disease

'In conclusion, dermatologic patients had generally positive attitudes towards COVID-19 vaccination, and their preferences were affected by age.' Attitudes of Dermatologic Patients Towards COVID-19 Vaccines: a Questionnaire-Based Survey "COVID-19 knows no borders. During an international medical crisis, the global perspectives and insights from those in our field are invaluable. For instance, the regional differences observed in regard dermatologic manifestations of COVID-19, such as pernio-like lesions, could provide insight into various pathogenic mechanisms of COVID-19. Furthermore, it seems that a hybrid of teledermatology and in-person visits may be most ideal to reduce contact and potential transmission while also ensuring timely diagnosis and treatment of urgent skin disorders. Although responses to the pandemic varied depending on government leadership, culture, and resources, the lessons learned and experiences of dermatologists during this time can serve as a guidepost to help our field address new challenges as cases continue to escalate in parts of the world." How Coronavirus Disease 2019 Changed Dermatology Practice in 1 Year Around the WorldPerspectives from 11 Countries

Burning and Stinging is included in diagnostic symptoms of rosacea. Usually signs in rosacea are those that can be observed, while symptoms are those described by the patient. Burning and stinging are invisible symptoms. [1] This post is devoted to clarifying these two symptoms since they may be important to you to learn more. First, burning and stinging may possibly be included in differentiating sensitive skin from rosacea. Some authorities believe sensitive skin should be differentiated, while others feel that sensitive skin is included in diagnosing rosacea. Treatment for sensitive skin is therefore the logical choice. [2] "Available therapies for rosacea have the potential to treat beyond signs, and improve burning and stinging symptoms in parallel. Further investigation is needed to better understand these benefits and to optimize the management of rosacea." [3] If you have something to add to this post, find the reply to topic button on your device. End Notes [1] Whether burning and stinging are included as part of non-visible disabilities remains to be seen. If enough rosaceans got together in a non profit organization for rosacea and demanded such a determination depends on a rosacea patient advocacy organization. What are your thoughts? "Hidden Disabilities or Non-visible Disabilities (NVD), can hinder a person's efforts to go to school, work, socialize, and more." Invisible Disability, Wikipedia [2] Sensitive Skin vs Rosacea [3] PubMed RSS Feed - -The Importance of Assessing Burning and Stinging when Managing Rosacea: A Review

If you have been diagnosed with Phenotype 5, it usually responds to treatment quite well. We have a list of treatment options to consider listed in this post which requires you join the RRDi as an active member to view. Have you been diagnosed with Phenotype 5? What 2 prescription treatments have you used?

Green tea hasn't been on an rosacea trigger list. What is on most rosacea trigger lists is HOT BEVERAGES may cause a flush, whether it is green tea, black tea, white tea, coffee, hot water, etc. FOR MORE INFORMATION

If you are a RRDi inactive member, you need to login to your account. Then simply accept the new terms of registration and subscribe for a minimum of one month (discount for three, six, twelve, or hundred twenty month subscriptions). That reactivates your account. Once you are reactivated, under your display name it shows 'Active Member Subscribed.' This gives you 30 days of access to our website where guests are restricted (or longer if you chose a longer subscription plan). If you remember the email address you used to register your account but forgot the password, use the forgot password tool to reactivate your account: https://irosacea.org/lostpassword/ If you don't remember your login credentials, our volunteers can assist. Use the contact form and give us what you remember you used to register your account, i.e., your display name? We can then reset your password for you if we can figure out what EMAIL you used to register your account.

Just saw a new page on the NRS website designated, 'key staff' and you can see a screen shot below: If you will note in the above paragraph, Mr Huff is stated as 'president of the Glendale Communications Group, which provides infrastructure and personnel for for the NRS program services at no cost to its members.' If this is correct, why do the past 22 years of public Form 990s (1998 thru 2019) show that over $10 million of the donations to the NRS have been spent on private contractors that are owned by Mr. Huff, including Glendale Communications Group? For example, in 2019 the NRS spent $285,871 on 'private contractors' including Glendale Communications Group which happens to be 94% of the donations given to the NRS in 2019. If this is 'no cost to its members' then why report this expense on Form 990 for 2019? In the previous year, 2018, the NRS spent $432,408 on private contractors, one of which is Glendale Communications Group, which happens to be 93% of the total donations given to the NRS in 2018. For a complete list of these Form 990s click here. For a breakdown of how the NRS spends its donations click here.

The FDA has tweeted this:

The controversy of using ivermectin for Covid 19 continues. For example, watch this TV station news report on this. ----------------------------------- NEWS • 02 August 2021 • Nature Flawed ivermectin preprint highlights challenges of COVID drug studies The study’s withdrawal from a preprint platform deals a blow to the anti-parasite drug’s chances as a COVID treatment, researchers say. ======================== Rand Paul has a *very* wacky theory about ivermectin Analysis by Chris Cillizza, CNN Editor-at-large, Updated 8:46 PM ET, Tue August 31, 2021

Thanks for your insight into all this. Very few, as you have pointed out, are motivated to express any thought on this subject. The RRDi has social media accounts. Would you like to volunteer to moderate and manage one or more of them?