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A novel topical consisting of 15% Azelaic Acid and 1% Dihydro Avenanthramide D for rosacea is mentioned in a clinical paper posted in our member forum at this link. You will need to join the RRDi to view this post. Membership is free. We happen to have the MOST private rosacea forum on the internet, if you join using Sign in with Apple and use Apple's Hide My Email. Android users can still join as well as Windows users are welcome.

There is "a novel formulation cream containing 15% AzA (anti‐inflammatory/anti‐oxidant/anti‐microbial agent) combined with 1% dihydroavenanthramide D (anti‐inflammatory/anti‐itch)" that was evaluated using an instrumental "erythema‐directed digital photography (EDDP)." The study concluded "that this new non‐irritating product represents a valid therapeutic option for mild/moderate inflammatory rosacea." J Cosmet Dermatol. 2021 Apr; 20(Suppl 1): 28–31. A novel azelaic acid formulation for the topical treatment of inflammatory rosacea: A multicentre, prospective clinical trial Federica Dall’Oglio, MD, PhD, Aurora Tedeschi, MD, PhD, Francesco Lacarrubba, MD, Gabriella Fabbrocini, MD, PhD, Nevena Skroza, MD, PhD, Paolo Chiodini, MS, Giuseppe Micali, MD "It was found that the synthetic analog dihydroavenanthramide D (DHAvD) can interact with the neurokinin-1 receptor (NK1R) and inhibit mast cell degranulation." Experimental Dermatology 26(8) November 2016 Dihydroavenanthramide D inhibits mast cell degranulation and exhibits anti-inflammatory effects through the activation of neurokinin 1 receptor Tobias Lotts, Konstantin Agelopoulos, Ngoc Quan Phan, Karin Loser "Avenanthramides (anthranilic acid amides, formerly called "avenalumins") are a group of phenolic alkaloids found mainly in oats (Avena sativa), but also present in white cabbage butterfly eggs (Pieris brassicae and P. rapae), and in fungus-infected carnation (Dianthus caryophyllus). A number of studies demonstrate that these natural products have anti-inflammatory, antioxidant, anti-itch, anti-irritant, and antiatherogenic activities." Wikipedia Closeup of oat florets (small flowers) image courtesy of Wikimedia Commons

An article published at mgblifestyle, discusses 'cold and formaldehyde-containing foods' as well as 'a pretty fancy-sounding protein' (actually a couple of fancy sounding proteins) that 'sets off a chain reaction that ultimately results in the release of histamines and cathelicidins by your skin's immune system.' The two proteins discussed in the article are transient receptor potential vanilloid 4 (TRPV4) and transient receptor potential alkyrin 1 (TRPA1). New Research Shows How Certain Foods & Drinks Affect Rosacea, Alexandra Engler, mgblifestyle Grapefruit image courtesy of Wikimedia Commons

"Although ivermectin has been shown to inhibit the replication of severe acute respiratory syndrome coronavirus (SARS‐CoV)‐2 at supratherapeutic doses in vitro, no benefit has been seen in real‐world treatment of COVID‐19." Clin Exp Dermatol. 2021 Jun 26 : 10.1111/ced.14704. Ivermectin in dermatology: why it ‘mite’ be useless against COVID‐19 D. Roche, C. O’Connor, M. Murphy

Received the 2020 Form 990 from the AARS. Total revenue received $258,366. Who contributed most of the revenue? The 'skin industry.' GALDERMA LABORATORIES L.P. $87.5K LA ROCHE POSAY $15K ORTHO DERMATOLOGICS $35K SOL-GEL TECHNOLOGIES INC. $15K SUN PHARMACEUTICALS $36K ALMIRALL, LLC (FORMERLY AQUA PHARMA) $35K BOTANIX PHARMACEUTICALS $5K EPI HEALTH, LLC $5K Total donations from the skin industry is $233.5K. The AARS was refunded one of the grants given out last year in the amount of $10K and also received $10,150 in membership dues from dermatologists. See below: What did the AARS spend most of its donations on? Again, the largest amount was on 'Conferences, conventions, and meetings' in the amount of $167,836. Two other large expenses was $48K on 'management' and $12,280 on 'website expenses.' See below: Is this the way you think a non profit organization for rosacea should be run? If you are a dermatologist it seems appropriate to run this non profit the way it is run. However, if you are a rosacea sufferer, is this the rosacea non profit organization you want to support? Why should there be a rosacea non profit run by rosaceans? You can read the Form 990 below: AARS-2020Form990.pdf

Received the 2019 Form 990 from the AARS. Total revenue received $195,638 and here is the breakdown of the top contributors who donate at least $5K: ACLARIS THERAPEUTICS $10K CUTANEA LIFE SCIENCES (NOW OWNED BY BIOFRONTERA) $35K CASSIOPEA S.P.A. $10K FOAMIX PHARMACEUTICALS $10K GALDERMA LABORATORIES L.P. $50K RODAN AND FIELDS, LLC $35K THE PROACTIV COMPANY $35K Total from 'skin industry' $185K It would be safe to say that the vast majority of donations are from the 'skin industry.' In addition to this, $10,450.00 revenue came from membership dues (dermatologists). It would be prudent to note that there is little, if any, public support donations to the AARS. This organization operates more like a 501 6 c which is a business league. What did the AARS spend most of the 'donations' on? $234,961 on "Conferences, conventions, and meetings." You ask, how can the AARS spend more than it received in revenue? Answer: carry over assets. One expense worth noting is how the AARS spent $3,830.00 on its website. Here is a screen shot of all the expenses: The AARS did spend $40K on research grants in 2019 and you can review below who received the money: Your can read the form 990 yourself below: AARS-2019-Form990.pdf

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One paper discusses granulomatous rosacea (GR) and and cutaneous lupus erythematosus (CLE) with "the codiagnoses of GR and CLE later confirmed with clinicopathological correlation." Severe Granulomatous Rosacea with Cutaneous Lupus Erythematosus

We have made the MEMBER FORUM totally private now. If one registers with Sign in with Apple, hides behind a cryptic, mysterious DISPLAY NAME and hides their email address using Apple's Hide My Email service when registering, this makes the RRDi member forum the most private rosacea forum on the internet. Guests can only view a portion of our website. Registered Active members have full access to the Member Forum.

"Prior studies have revealed the adverse effects (AEs) of PPE on healthcare workers (HCWs); however, no review has focused on the AEs of PPE on HCWs in intensive care units (ICUs). This review aimed to identify the AEs of PPE on HCWs working in ICUs during the COVID-19 pandemic." SAGE Open Nurs. 2021 Jan-Dec; 7: 23779608211026164. Adverse Effects of Personal Protective Equipment Among Intensive Care Unit Healthcare Professionals During the COVID-19 Pandemic: A Scoping Review Takeshi Unoki, PhD, RN, Hideaki Sakuramoto, PhD, RN, Ryuhei Sato, PhD, RN,3 Akira Ouchi, PhD, RN, Tomoki Kuribara, MSN, RN, Tomomi Furumaya, MSN, RN, CCNS, Junko Tatsuno, PhD, RN, CCNS, Yuki Wakabayashi, MSN, RN, Asami Tado, PhD, RN, CCNS,8 Naoya Hashimoto, BSN, RN, Noriko Inagaki, MSN, RN, CCNS, Yoshiko Sasaki, PhD, RN,

"In conclusion, the proportion of rosacea patients who have anxiety or depression is large. However, the psychological distress experienced by these patients is usually neglected by clinicians. Our study revealed that younger age, more severe self-reported symptoms, and higher disease burden may indicate the possibility of anxiety or depression, especially when clinical signs and self-reported symptoms are inconsistent or if patients have apparently impaired quality of life. Psychological intervention should be taken into consideration when prescribing atreatment regimen." Front Psychiatry. 2021; 12: 659171. Prevalence and Risk Factors of Anxiety and Depression in Rosacea Patients: A Cross-Sectional Study in China Mengting Chen, Zhili Deng, Yingxue Huang, and Ji Li1

Thanks Elaine for putting all this in perspective. As with all treatments there are risks, but the risks associated with taking oral metronidazole are indeed very small. Appreciate your investigation and personal experience into this since you are quite knowledgeable in this area of expertise. We do have a post on oral ivermectin for rosacea and a post on Oral Ivermectin Compared with Ivermectin–Metronidazole Combined Therapy.

"Here, we review adverse effects and drug-drug interactions observed with oral administration of minocycline and contrast this with topical minocycline formulations recently approved or under development for effectively treating dermatological disorders with fewer adverse effects and less drug interaction." A Review of Systemic Minocycline Side Effects and Topical Minocycline as a Safer Alternative for Treating Acne and Rosacea

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Our website is now a subscription based members only website. We experimented with closing out 95% of our website to member only and set up a GUEST area which is shown below. However, we changed back to allowing guests and members to view 95% of the website for free since we rely totally on donations from members, sponsors, and our affiliate store to keep this website and non profit organization going. So whether you are in our guest area of the forum or our actual member forum the public has access to all our rosacea data for free. Guests May View the Following Home • Welcome • Blogs • Clubs • Site Index • Cause of Rosacea • Demodectic Rosacea • Misdiagnosed Rosacea • Phenotypes • Rosacea is a chronic inflammatory disease • Rosacea in the News • Announcements and News • RSS • Research Articles • MAC • Donate • Why Form Another Non Profit for Rosacea Sufferers? • Store • About • Amazon Associates • Board of Directors • Charter • Contact • Financial • Journal of the RRDi • Legal Disclaimer • Links • Member Information • Message from the Founder • Mission • Publications • Official Documents • Rules • Sponsors • Volunteers • Guidelines • Staff Directory • Recent Activity • Search • Leaderboard • Downloads • 5Min • Alabama • Amazon • Apple • ATP • Benefit Risk Ratio in Rosacea • Butterfly • Carbohydrate • Comorbidities • Conditions • Demodectic Rosacea Articles • Demodex Solutions • Donation Sample Letter • Final Appeal • Google Workspace • Grassroots • Guest Forum • Guidestar • GUT Rosacea • Hawaii • History of the RRDi • Horsepaste • How to Find Rosacea Topics on a Mobile Device Video • How To Videos • Invision Community • Isotretinoin • Ivermectin • MAC Alphabetical List • MAC Information • Mimics • Mirvaso • Mobile App • Most Private Rosacea Community • Newsletter • Non Profit • Nutrition • Oracea • Questions, Comments, Complaints, Suggestions • Rebound • Recalcitrant • Remission • Is this Rosacea? • Rosacea in the News • Rosaceans • RRF • RSS PubMed Feed • Social Media • Soolantra • Sponsors • Square • Stages of Rosacea • Steroids • Store Video • Submit Your Paper • Subtypes • Sugar • Survey • Tee Shirts • Theories • Topics • Triggers • Why • ZZ Cream • Members Have Access To Way More Rosacea Information

Teva Pharmaceuticals, a U.S. affiliate of Teva Pharmaceutical Industries Ltd.(NYSE and TASE: TEVA), announced on June 16, 2021 the U.S. launch of its generic version of once daily SOOLANTRA® (ivermectin) Cream, 1% for the treatment of inflammatory lesions of rosacea. Teva Announces the U.S. Launch of its Generic Version of SOOLANTRA® (ivermectin) Cream, 1% for Once Daily Treatment of Rosacea, Businesswire It may be possible that this new generic ivermectin cream has inactive ingredients that may be better tolerated than the 'Cetaphil' like inactive ingredients in Soolantra which are: Citric Acid Anhydrous Benzyl Alcohol Carbomer homopolymer type c Di-isopropol adipate Edetate disodium Hexylene glycol Methylparaben Oleyl Alcohol Polysorbate 80 Purified Water Sodium citrate Sodium hydroxide Sorbitan tristerate For a comparison spreadsheet with Soolantra click here.

Hi Liesie, Welcome to the RRDi. I recommend you try posting in natural treatments in the non prescription member forum which is shown below in this category: Forum Home > Forums > Member Forum > Rosacea Topics > Non Prescription > Natural Treatments You will find a number of posts on this subject that may be of interest to you. If you are recommending your own natural products, we do allow members to ask you about your products for rosacea if that is what you are referring to, which you can reply to but the purpose of the RRDi is to help rosaceans. If they are not your own products, instead, natural products for rosacea you have found then that is the spirit we need in our community. Rosaceans helping rosaceans. The purpose of the RRDi is not to profit from other RRDi members, and instead encourages community support. This is a grassroots, non profit, patient advocacy organization for rosacea sufferers.

"For instance, PDT is used to treat multiple dermatological and infectious diseases such as psoriasis vulgaris, Darier’s disease (DAR), cutaneous sarcoidosis (granulomatous disease), lichen planus, acne vulgaris, acne inversa, rosacea, sebaceous hyperplasia, verrucae vulgaris, cutaneous leishmaniasis, condyloma acuminatum (genital warts), and circumscribed scleroderma." Front Chem. 2021; 9: 691697. Photodynamic Therapy—Current Limitations and Novel Approaches Gurcan Gunaydin, M. Emre Gedik, Seylan Ayan

Good point. The papers on coffee point this out. There may be evidence that caffeine triggers a flush, but there is no evidence that coffee or tea causes a rosacea flareup. Usually the confusion is when rosaceans think flushing is rosacea or rosacea is flushing, which adds to this quandary. However, if avoiding flushing is important to a rosacean, then it would be prudent to carefully avoid caffeine induced flushing.

According to a paper on 'good skin quality,' "there are no standardized criteria for good skin quality." The authors of the paper then attempted "To establish a consensus for good skin quality parameters and measurement and treatment options, a virtual skin quality advisory board consisting of a global panel of highly experienced aesthetic dermatologists/aesthetic physicians was convened." The results were "strong consensus that good skin quality is defined as healthy, youthful in appearance (appearing younger than a person’s chronological age), undamaged skin and that skin quality can be described across all ethnicities by four emergent perceptual categories (EPCs): skin tone evenness, skin surface evenness, skin firmness, and skin glow." You may read the entire paper yourself: Clin Cosmet Investig Dermatol. 2021; 14: 643–654. Skin Quality – A Holistic 360° View: Consensus Results Kate Goldie, Martina Kerscher, Sabrina Guillen Fabi, Cyro Hirano,4 Marina Landau, Ting Song Lim, Heather Woolery-Lloyd, Kavita Mariwalla, Je-Young Park, Yana Yutskovskaya image courtesy of Clin Cosmet Investig Dermatol

Image of naturally burning oil shale on a coast near Kimmeridge, on 18th August 2000, courtesy of Wikimedia Commons What is Sodium Bituminosulfonate? "Ammonium bituminosulfonate or ammonium bituminosulphonate (synonyms of ichthammol, CAS#8029-68-3 brand name: Ichthyol) is a product of natural origin obtained in the first step by dry distillation of sulfur-rich oil shale (bituminous schists)." Wikipedia "There are also no systematic studies on the use of schist oil extracts such as ammonium bituminosulfonate and sodium bituminosulfonate;" [1] "Most tar compounds are derived from coal tars, but oil shale tars (ichthammol), juniper tars (cade oil), or pine tars are sometimes used." [2] Sodium Bituminosulfonate for Rosacea It is of interest to note that a paper states, "Sodium bituminosulfonate is derived from naturally occurring sulphur-rich oil shale and is used for the treatment of the inflammatory skin disease rosacea....The aim of this study was to address the molecular mechanism(s) underlying the therapeutic benefit of the formulation sodium bituminosulfonate dry substance (SBDS), which is indicated for the treatment of skin inflammation, including rosacea....In summary, SBDS reduces the generation of inflammatory mediators from human neutrophils possibly accounting for its anti-inflammatory effects in rosacea." [3] Another paper on this subject states, "The aim of this study was to address the molecular mechanism(s) underlying the therapeutic benefit of the formulation sodium bituminosulfonate dry substance (SBDS), which is indicated for the treatment of skin inflammation, including rosacea." [4] History of Sodium Bituminosulfonate "One of these “old” substances is ammonium bituminosulfonate, which was already introduced in 1882 as “Ichthyol”. Its pale analogue was made known in the 1930s as “Ichthyol, light”. However, the mechanism of the antimicrobial activity of bituminosulfonate is still unclear. These compounds are water-soluble substances obtained from the sulfur-rich oil shale and represent the two fractions, which are the pale sulfonated shale oil (PSSO) and the dark sulfonated shale oil (DSSO), from the dry distillation process. The few available publications on bituminosulfonate involve a variety of microbial species in outdated research experiments and give only very limited insights on the in vitro mechanism and activity. A recent publication by Idelevich and Becker focused on the in vitro activity of sodium bituminosulfonate within the scope of current recommendations for antimicrobial susceptibility testing (AST), revealing activity against Gram-positive pathogens. [bold added for emphasis] [5] "Revival of old antibiotic compounds is a promising strategy to strengthen the antimicrobial armamentarium in the era of increasing resistance and limited development pipelines. To exploit their full potential, their reinvestigation using current standards is needed. We aimed to investigate the in vitro activity of the old antimicrobial agent sodium bituminosulfonate in accordance with the current recommendations for antimicrobial susceptibility testing (AST) and to generate susceptibility data reflecting the current epidemiological situation." [bold added for emphasis] [6] Sodium Sulfacetamide - Sulfur has been used to treat rosacea for many years. [7] Etcetera Sulphur or Sulfur for Rosacea End Notes [1] Dermatological medication and local therapeutics Christof Schaefer, Gudula Kirtschig, in Drugs During Pregnancy and Lactation (Third Edition), 2015, Ichthammol, Science Direct [2] Dermatopharmacology and Topical Formulary William L. Weston MD, ... Joseph G. Morelli MD, in Color Textbook of Pediatric Dermatology (Fourth Edition), 2007, Ichthammol, Science Direct [3] If you cannot view the link above it is because you are not a registered, active member of the RRDi. Join the RRDi to view the article and become involved in our rosacea community. Learn more [4] Journal of Inflammation Research » Volume 14 Sodium Bituminosulfonate Used to Treat Rosacea Modulates Generation of Inflammatory Mediators by Primary Human Neutrophils Susanne Schiffmann, Sandra Gunne, Marina Henke, Thomas Ulshöfer, Dieter Steinhilber, Annette Sethmann, Michael J Parnham [5] Microorganisms, 8 December 2020; Published: 10 December 2020 Investigation of In-Vitro Adaptation toward Sodium Bituminosulfonate in Staphylococcus aureus Marko Blisse, Evgeny A. Idelevich, and Karsten Becker SBDS_microorganisms-08-01962-v2.pdf [6] Microb Drug Resist. 2020 Nov;26(11):1405-1409. doi: 10.1089/mdr.2019.0390. Epub 2020 Mar 17. In Vitro Activity of Sodium Bituminosulfonate: Susceptibility Data for the Revival of an Old Antimicrobial Evgeny A Idelevich, Karsten Becker [7} Sodium Sulfacetamide - Sulfur

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Usually, coffee is the trigger mentioned in rosacea social media groups, in any discussion about rosacea and sometimes even physicians mention coffee to their patients. However a recent study of 2063 participants (you should try to get that many participants together and get them to fill out a questionnaire) who were asked about tea consumption with their rosacea. The results of this study indicate, "non-fermented tea (aOR 2.172; 95% CI 1.562-3.022), and hot tea (aOR 2.793; 95% CI 1.796-1.344) were associated with an increased risk of rosacea. Further results showed that these tea drinking behaviours were significantly associated with an increased risk of flushing (aOR 1.41; 95% CI 1.07-1.87) and erythema (aOR 1.48; 95% CI 1.10-2.00). Tea drinking behaviour is closely related to rosacea." RRDi Membership is free. Learn more. Image courtesy of Wikimedia Commons.

"Glucocorticoids (GC) are generally envisioned as immunosuppressive, but in conditions such as rosacea and perioral dermatitis they can lead to increased skin inflammation...Viewed together, these findings demonstrate a mechanism by which GC induce expression of CCL20 in keratinocytes, which may contribute to the inflammation seen in steroid-exacerbated skin conditions." Glucocorticoids Promote CCL20 Expression in Keratinocytes