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"Head-to-head trials show that azelaic acid and ivermectin might be slightly better than metronidazole."
Topical treatments for rosacea.
Can Fam Physician. 2019 Nov;65(11):803
Fritsch P, Kolber MR, Korownyk C -
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"A variety of repurposed drugs and investigational drugs such as remdesivir, chloroquine, hydroxychloroquine, ritonavir, lopinavir, interferon‐beta, and other potential drugs have been studied for COVID19 treatment. We reviewed the potential dermatological side‐effects of these drugs."
Dermatol Ther. 2020 May 22 : e13476.doi: 10.1111/dth.13476 [Epub ahead of print]
Cutaneous sıde‐effects of the potential COVID‐19 drugs
Ümit Türsen, Belma Türsen, Torello Lotti==============================================
"The US now has more hydroxychloroquine than it knows what to do with following a series of studies that concluded the drug is an ineffective and potentially dangerous treatment for COVID-19. The federal government, which started stockpiling the drug in March, now has 63 million surplus doses of the drug, donated by companies including Novartis, and another 2 million doses of chloroquine, the New York Times reports. Some 31 million doses from the Strategic National Stockpile were distributed before the FDA withdrew its emergency authorization of the drug to treat the coronavirus. President Trump championed the drug for months, hailing it as a possible "game-changer" and announcing that he was taking it himself."
US Is Stuck With 63M Doses of Hydroxychloroquine, Rob Quinn, Newser
=============================================
With the recent news that oral hydroxycholoroquine is just as effective as oral doxycycline for rosacea, maybe we will be hearing more anecdotal reports of hydroxycholoroquine improving rosacea? A report published in the Journal of the American Academy of Dermatology reports that oral hydroxychloroquine is just as effective as oral doxycycline. [see post no 7 in this thread by scrolling down for the clinical paper source associated with this]
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There are different approaches offered by the various 'authorities' on rosacea diagnosis into phenotypes. [1] However, they all agree that the phenotype classification is superior to the subtype classification (used since 2002) initially proposed by the NRS 'expert' panel. [2] The phenotype classification began in November 2016.
The general consensus is "at least one diagnostic or two major phenotypes are required in order to diagnose a patient with rosacea." [3]
(1) Diagnostic Cutaneous Signs (only one required)
The ROSCO panel list includes persistent centrofacial erythema associated with periodic intensification by potential trigger factors as a minimum diagnostic feature of rosacea and phymatous changes are individually diagnostic of rosacea.
Fixed centrofacial erythema, papules and pustules, flushing or blushing, phymatous changes are included in the NRS panel diagnostic list.
Dr. Tan with the ROSCO panel, as well as the NRS Panel, and Dr. Del Rosso with the AARS panel both concur that facial erythema is essential to a diagnosis of rosacea. [4]
“Recent developments in rosacea call for clinicians to place greater emphasis on persistent facial erythema, one of the most common and troublesome features of the disorder, now designated as its most prevalent diagnostic phenotype.” [6]
The RRDi concurs that erythema is essential to a diagnosis of rosacea. Usually papules and pustules include erythema and so does phyamtous changes as well as flushing/blushing.
OR
(2) RRDi Phenotypes (two required)
(1) Flushing
(2) Persistent Erythema
(3) Telangiectasia
(4) Papulopustular (Papules/pustules Lesion Counts)
(5) Phymatous
(6) Ocular ManifestationsVariances in Phenotype Listings
The ROSCO panel has no numbering phenotype system but lists the above phenotypes. [1]The NRS 'expert' committee's approach has no numbering system and divides four phenotypes with three secondary phenotypes. [1] [5]
Galderma tweets four major phenotypes and four minor phenotypes. [1]
The AAD follows the NRS expert panel recommendations. [1]
The AARS has its own way of acknowledging the phenotype classification into six phenotypes with no numbering system:
"central facial erythema without papulopustular (PP) lesions;"
"central facial erythema with PP lesions;"
"the presence of phymatous changes,"
"ocular signs, and symptoms;"
"extensive presence of facial telangiectasias;"
"and marked, persistent, nontransient facial erythema that remains between flares of rosacea and might exhibit severe intermittent flares of acute vasodilation (flushing of rosacea)" [1]Medscape recognizes four major phenotypes and three secondary phenotypes following the NRS recommendations [1]
Secondary Phenotypes
“The presence of any two of the major phenotypes also may be considered diagnostic, and secondary phenotypes include burning, stinging, edema, and dryness. Rosacea therefore encompasses a multitude of possible combinations of signs and symptoms. ” [6]Conclusion
The phenotype classification is well established by recognized rosacea authorities and has surpassed the subtype classification. If your physician continues to parrot the subtype classification you may want to refer this page to your physician for his attention.End Notes
[1] ROSCOE Panel • NRS Expert Panel • Galderma • AAD • AARS • Medscape
[2] Phenotype Treatment is Superior
[3] Clinical, Cosmetic and Investigational Dermatology February 2020
[4] Phenotype Classification Uses Signs and Symptoms Better
[5] The four phenotypes the NRS lists are Papules and Pustules, Flushing, Telangiectasia, and Ocular manifestations. The secondary phenotypes are Burning or stinging, Edema, and Dry Appearance.
Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee.
[6] Update on Facial Erythema in Rosacea -
Stem cell colonies that are not yet differentiated. Image courtesy of Wikimedia CommonsOne of the many theories on the cause of rosacea is that it is caused by sun damaged skin. A paper published by Wolters Kluwer Health according to Science Daily states, "Some plastic surgeons have been using stem cells to treat aging, sun-damaged skin. But while they've been getting good results, it's been unclear exactly how these treatments work to rejuvenate 'photoaged' facial skin. A new study finds that within a few weeks, stem cell treatment eliminates the sun-damaged elastin network and replacing them with normal, undamaged tissues and structures." [1]
Controversial
"Stem-cell therapy has become controversial following developments such as the ability of scientists to isolate and culture embryonic stem cells, to create stem cells using somatic cell nuclear transfer and their use of techniques to create induced pluripotent stem cells. This controversy is often related to abortion politics and to human cloning. Additionally, efforts to market treatments based on transplant of stored umbilical cord blood have been controversial." [2]Regenerative Medicine
Stem-cell therapy is what is called regenerative medicine. To understand the basics of this therapy watch this short TED video:How much does it cost?
That is usually what most want to know the answer about before considering this treatment. The doctor from this clinic actually gives you a range of the cost since it depends on what your chief complaint issue is and various factors.Could 10K members of the RRDi get together and each donate a dollar to sponsor a stem cell therapy for rosacea clinical study? That would be less than the cost of a cup of coffee at Starbucks. Why not donate now?
Reply to this Topic
There is a reply to this topic button somewhere on the device you are using to read 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.
End Notes
[1] Stem cell treatments 'go deep' to regenerate sun-damaged skin, Science Daily
[2] Stem-cell Therapy, Wikipedia
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Menlo Therapeutics Inc. announced that the U.S. Food and Drug Administration (FDA) has approved ZILXI™ (minocycline) topical foam, 1.5%, for the treatment of inflammatory lesions of rosacea in adults. ZILXI, developed as FMX103 by Menlo’s wholly-owned subsidiary Foamix Pharmaceuticals Ltd. (“Foamix”), is the first minocycline product of any kind to be approved by the FDA for use in rosacea. Official Announcement
Zilzi is a tetracycline that has done well in clinical trials. You will need to ask your physician for a prescription.
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Update
"A massive study that raised health concerns over hydroxychloroquine, the anti-malaria drug touted by President Trump as a coronavirus treatment, is coming under scrutiny from scientists who are demanding to see the data behind it."
Massive hydroxychloroquine study raising health concerns about the drug under scrutiny from scientists, Tal Axelrod, The Hill, MSN
"After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure."
N Engl J Med DOI: 10.1056/NEJMoa2016638
A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19
David R. Boulware, M.D., M.P.H., Matthew F. Pullen, M.D., Ananta S. Bangdiwala, M.S., Katelyn A. Pastick, B.Sc., Sarah M. Lofgren, M.D., Elizabeth C. Okafor, B.Sc., Caleb P. Skipper, M.D., Alanna A. Nascene, B.A., Melanie R. Nicol, Pharm.D., Ph.D., Mahsa Abassi, D.O., M.P.H., Nicole W. Engen, M.S., Matthew P. Cheng, M.D., et al. -
Update
"In this study, a high-dosage of CQ (12 g) given for 10 days concurrently with azithromycin and oseltamivir was not sufficiently safe to warrant continuation of that study group. Age was an important confounder and might be associated with the unfavorable outcomes. We recommend that similar dosages no longer be used for the treatment of severe COVID-19, especially because treatment based on older patients with previous cardiac diseases who are receiving concomitant cardiotoxic drugs should be the rule. No apparent benefit of CQ was seen regarding lethality in our patients so far. To better understand the role of CQ or HCQ in the treatment of COVID-19, we recommend the following next steps: (1) randomized clinical trials evaluating its role as a prophylactic drug and (2) randomized clinical trials evaluating its efficacy against the progression of COVID-19 when administered to patients with mild or moderate disease. Even if we fail to generate good evidence in time to control the current pandemic, the information will affect how we deal with coronavirus outbreaks in the future."
JAMA Netw Open. 2020;3(4):e208857. doi:10.1001/jamanetworkopen.2020.8857
Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) InfectionA Randomized Clinical Trial
Mayla Gabriel, Silva Borba, MD; Fernando Fonseca Almeida Val, PhD, Vanderson Souza Sampaio, PhD -
A treatment for rosacea is being considered to treat coronavirus. "The second-generation tetracycline Dox has an anti-inflammatory and broad spectrum antimicrobial activity...It has minimal side effects and it is routinely prescribed for acne and rosacea...In ophthalmology, Dox is usually administered in patients affected by ocular rosacea and posterior blepharitis...Dox also has anti-angiogenic properties... It regulates cytokines and diminishes neutrophil chemotaxis too...Besides its well-known use in treating bacterial infections, some studies in the literature report that Dox possesses a broad activity against viral infection too...The first who described the Dox antiviral effect was Sturtz in 1998 (29), and this suggestion has been confirmed in several followed-up studies...In 2007, Suzuki et al. identified that coronavirus could be associated with anosmia,..."
"In our preliminary observation, the administration of Dox 200 mg once daily seems to improve respiratory symptoms and anosmia under Dox treatment in six patients completely recover after only 2 days of treatment. From our experience, it seems reasonable to continue the treatment at least 8 days. The mean patients' age was 35.8 ± 6.8 years, and 4 (66.7%) were females. One patient reported anosmia as the only COVID-19 manifestation; instead of the other five patients who complained about the loss of smell, in which it appeared 5–7 days after mild fever, dry cough, and malaise. The average time of the recovery COVID-19-linked anosmia after the administration of Dox in these patients was 2.5 ± 0.5 days. We noticed a sudden improvement in all symptoms after the administration of Dox, but our most exciting insight is about the rapid recovery of the smell."
Front Med (Lausanne). 2020; 7: 200.
Doxycycline: From Ocular Rosacea to COVID-19 Anosmia. New Insight Into the Coronavirus Outbreak
Chiara Bonzano, Davide Borroni, Andrea Lancia, and Elisabetta Bonzano -
Coconut Oil image courtesy of Wikimedia Commons"There is anecdotal evidence to support the use of coconut oil as a home remedy to treat rosacea." [1]
There are a number of anecdotal reports at RF of using coconut oil as a moisturizer after cleansing with a raw honey mask. [2]
Virgin Coconut Oil (VCO) vs Refined Coconut Oil (RCO), aka, Refined, bleached, and deodorized (RBD) oil
"The two main types of coconut oil you will come across are virgin coconut oil (VCO) and refined coconut oil (RCO). To make VCO, oil is cold pressed from the meat of the coconut. VCO has both the flavor and smell of coconut, and is often creamier. RCO is a mass produced oil obtained from dried coconut and is usually chemically treated. If you open a jar of RCO it will have no coconut aroma or flavor." [3] This same source says there is no such thing as extra virgin coconut oil since there is only one cold pressed 'virgin' version processed so any product that states this on its label is actually a misleading advertisement.Wikipedia explains there are two processes used to make coconut oil, the dry and the wet process. The wet process is more costly. Wikipedia also refers to the Virgin Coconut Oil (VCO) but calls the refined oil as Refined, bleached, and deodorized (RBD) oil. [4] RBD coconut oil can be processed further into partially or fully hydrogenated oil. Some RBD coconut oil can be fractionated into different fatty acids to isolate caprylic acid and capric acid (or to remove lauric acid). Caprylic acid and capric acid are medium-chain triglycerides, thus producing MCT Oil.
The benefit of VCO over RBD oil is further shown with its use in medicine and cosmetics. Be sure to use VCO if you are using it to treat rosacea or as a moisturizer. You may want to put a test amount on your inside wrist and wait several hours to see if you have an allergic reaction to coconut oil before putting it on your face.
Coconut Oil as Medicine
"Coconut oil has been shown to be as effective and safe as mineral oil when applied as moisturizers for mild to moderate xerosis." This same paper reports that coconut oil helps atopic dermatitis, improves skin barrier function, promotes wound healing through faster epithelization, increased neovascularization, fibroblast proliferation, pepsin-soluble collagen synthesis, and turnover of collagen in wounds, increases the expression of specialized cornified envelope and protects the skin from UV radiation. Coconut oil contains monolaurin, a monoglyceride derived from lauric acid, that comprises nearly 50% of coconut’s fat content. Monolaurin displays antimicrobial activity as well as exhibits antiviral and antifungal activity. [5]Another paper reports that virgin coconut oil has anti-inflammatory, analgesic, and antipyretic activities. [6] Coconut oil is among a list of plant oils that have antimicrobial, antioxidant, anti-inflammatory, and anti-itch properties. [7]
Coconut Oil is listed as one of the Biologic Treatments for Rosacea.
Virgin Coconut Oil (VCO) Treatments
Garden of Life Virgin Coconut Oil
Parachute Naturalz 100% Organic Virgin Coconut Oil
Premium Virgin Organic Coconut Oil
Proudly Pure Virgin Coconut Oil
End Notes[1] Using Coconut Oil to Treat Rosacea, Healthline
[2] Anecdotal Reports on Using Raw Honey, see first subheading, Coconut Oil Not the Focus
[3] This is How Coconut Oil for Skin Saved Me Time, Cash, and Face, Liz Thompson, Organic Authority
[4] Coconut Oil, Wikipedia
[5] Int J Mol Sci. 2018 Jan; 19(1): 70.
Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils
Tzu-Kai Lin, Lily Zhong,2, Juan Luis SantiagoAgero A.L., Verallo-Rowell V.M. A randomized double-blind controlled trial comparing extra virgin coconut oil with mineral oil as a moisturizer for mild to moderate xerosis. Dermatitis. 2004;15:109–116. doi: 10.2310/6620.2004.040
]6] Journal Pharmaceutical Biology
Anti-inflammatory, analgesic, and antipyretic activities of virgin coconut oil
S. Intahphuak, P. Khonsung & A. Panthong[7] Am J Clin Dermatol. 2018 Feb;19(1):103-117. doi: 10.1007/s40257-017-0301-1.
Natural Oils for Skin-Barrier Repair: Ancient Compounds Now Backed by Modern Science
Alexandra R Vaughn, Ashley K Clark, Raja K Sivamani, Vivian Y Shi -
<What is the butterfly effect in rosacea?>
click to read articleImage courtesy of Wikimedia Commons
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William Beaumont Hospitals is sponsoring two treatments used for rosacea, Naltrezone and Ketamine, in a clinical trial to treat coronavirus. [1]
Low Dose Naltrezone is used for rosacea in this post about flushing avoidance and in other prescriptions.
Ketamine 0.5% and Amitriptyline 1% in a Lipoderm cream used for Erythomelalgia has been reported anecdotally to improve rosacea in this post.
These two treatments above are included in a growing list of rosacea treatments considered to treat coronavirus.
End Notes
[1] Study of Immunomodulation Using Naltrexone and Ketamine for COVID-19 (SINK COVID-19), NIH, Clinical Trials
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Raw honey - image courtesy of Wikimedia CommonsHoney has been mentioned more often than not for Seborrheic Dermatitis, but there are some reports it improves rosacea.These anecdotal reports are mostily about using raw honey as a cleanser and coconut oil as a moisturizer. Not everyone finds this treatment works, which is what we call the X-Factor in Rosacea, but many do find it works for them. The only way is to try it yourself to see if you are successful. Anecdotal reports have been used for many, many years to be helpful to find a way to improve your SD or rosacea. If you do try this treatment, why not volunteer and find the green reply button and post your comment on this treatment. That is what volunteering to help other rosaceans is all about instead of just thinking about yourself. Do you have any idea how long it takes to make a post on this subject? Why not take a subject like this and try it sometime?
Coconut Oil Not the Focus
In many of the anecdotal reports about using a honey mask mention using coconut oil as a moisturizer, due to Auburn's recommendation, since honey dries the skin. Some report that the coconut oil irritates their skin, so do a test to see if you are allergic (patch test on inner wrist). Others say the coconut oil feeds the fungus in SD and advise not to use it, however, there is at least one report that coconut oil is an antifungal, just like honey. [1] Then, of course, there are others who rave about raw coconut oil as a moisturizer and simply love it. Based upon a cursory investigation of this subject, more report the coconut oil with negative reports, so we are focusing more on the honey cleansing treatment rather than using the coconut oil as a moisturizer in this post. If you really need help for Dry skin (Xeroderma) that is another issue which can be pursued in another post. Honey is the subject of this post, focusing on the healing properties (enzymes?) to cleanse your skin with anecdotal reports that it does work for some to improve not only SD but also rosacea. Think honey and don’t go coconuts. If you do want to go coconuts, see this post, Coconut Oil for Rosacea.How do I cleanse with raw honey?
1. Pour about a 1/4 teaspoon of raw honey in the palm of your hand.
2. With your other hand splash your face with non chlorinated water (if you live in the city, use bottled water for this step).
3. Rub hands together to spread the honey then massage onto skin for about 30 seconds.
4. Rinse (you may use tap water) and pat dry.The above are Auburn's instructions. If you note, heating the honey may lose all its healing properties and we are focusing on raw honey only.
Positive Anecdotal Reports Using a Honey Mask
Gathering positive anecdotal reports takes a lot of time and investigation. If you want negative reports, you will need to gather them yourself.
judworth [post no 1] "I am having amazing results with the raw honey mask and the virgin coconut oil as a moisturiser."
damien [post no 33] "My skin hasn't been this clear in years. It feels like a new layer of fresh skin is making its way through."
daminen [post no 41] "Sorry for not updating in awhile but my results have continued to be GREAT! I would recommend this treatment to anyone with SD. It works and it can make difference in your life if you do the full 4 weeks like your suppose to. And, the Coconut Oil is just as beneficial. I would say that my SD is about 85-90% better than it was before. NO BURNING, NO ITCHING, NO FLAKES."
damine [post 278] "I've been doing really with the honey treatment and going on three years now."
RedFaceKid [post no 44] "I'm happy to hear people getting great results. I started the treatment a couple of months ago and I would say my sed derm is about 75% better."
xcvq [post no 58] "The honey and coconut oil is also working for me. My redness has gone down a lot."
Auburn [post no 60] "As I was telling knightley79 the other day, when I discovered coconut oil, last year, I thought that, since it has the same properties as raw honey, it would work just as well but later I learned that it is the enzymes in the honey what really keeps the fungus at bay. The oil helps a great deal but it isn't nearly as effective on its own."
BPJS (Ben) [post no 326] "I stuck with the honey and coconut oil treatment to the letter...The 3-hour face masks were a God-send. The best results came from these....Interestingly enough - the first week I was using Manuka honey on my face and raw honey on my scalp. (There is a BIG difference in the active Manuka honey than there is in raw honey - I would strongly suggest you research this for yourself). The Manuka honey cleared up my face very fast. The raw honey did not clear up my scalp. After doing research, I started to understand that the active enzymes in the Manuka honey is what actually eats away at the bacteria - I had MUCH better results with this."
robertze [post no 327] "At this moment I'm trying the Honey mask and Coconut oil combination from Auburn's closed thread. I use it now for 4 weeks and I must say that it doesn't give me any spectacular results: the redness has been reduced a bit (let's say by 20%) and my skin feels less dry.
But what I do see as a big difference is that now after these 4 weeks of treatment I see spider veins on my nose which I never saw before."Birdie [post no 364] "I started with manuka as well and eventually after Many months tried local raw honey. It works very very well and is much gentler on my skin Than manuka honey. I use the manuka honey as my mask honey on my scalp and eyebrows. Everyone's skin reacts differently. The manuka honey is a great exfoliator and powerful, I would caution people to treat it like a prescription not just an organic " safe" product."
SarahS [post no 370] "And I must say, while I was skeptical about it working, my skin has never felt better even after only one week."
gils4 [post 396] "Hi Mlydells, I have had good results with the honey masks and I recommend them. Like Tom mentioned, DON'T use the coconut oil. I was using coconut oil to moisturize my face and lips before I knew that my condition was seb derm and it made everything a lot worse. I actually think it was a major contributor to the level my seb derm reached"
pmg [post no 413] "I just finished the 4 week treatment. All I can say it's amazing.
JRon2112 [post no 1] "...I did the honey treatment a couple years ago and it elimanted everything no redness at all."
dan pacifik [post no 14] "Do give the honey a go though, it certainly has helped alleviate some of my symptoms."
solutionquest [post no 20] "I can't tell you how well this works for me. When I wake in the morning my skin is so calm and cool."
LadyBee [post no 409 SIGNATURE] "Probiotics every day and honey masks every other day."
Wildscenery [post no 450] "Been trying the honeymask+coconut oil for about 4 weeks now, i see some improvement and my skin is not as easily irritated anymore..."
byte [post no 468] "I've been maintaning to use auburn's honey + virgin coconut oil. about 90% effective and sometimes there are SD breakouts when I don't use coconut oil for the whole day shift."
daneel.olivaw [post no 495] "I'm currently doing a honey mask weekly (after doing it every other day for about 2 months) and ketoconazol daily (even twice a day) and even though I can't say my skin looks perfect, it's been a tremendous improvement compared to what it used to be."
Honey Treatments
Steens Raw Cold Pressed Manuka Honey
Three Peaks New Zealand ManukaHoney UMF 10+
Three Peaks ManukaHoney UMF 10+
Three Peaks Manuka Honey UMF 20+
End Notes
[1] Tom Busby, SD expert extraordinaire on RF says [post no 395], "Don't use coconut oil, as it feeds malassezia."
Medical News Today reports that coconut oil not only has antibacterial properties but also is an antifungal.
Is coconut oil a good remedy for yeast infection? -
Low-temperature electron micrograph of a cluster of E. coli bacteria, magnified 10,000 times. Each individual bacterium is oblong shaped. Image courtesy of Wikimedia Commons.A recent paper on this subject concluded, "An altered fecal microbial richness and composition were observed in rosacea patients. The distinct microbial composition might be related to sulfur metabolism, cobalamin and carbohydrate transport."
J Formos Med Assoc. 2020 May 20;:
An altered fecal microbial profiling in rosacea patients compared to matched controls.
Chen YJ, Lee WH, Ho HJ, Tseng CH, Wu CY -
We are seeking a resident of Hawaii volunteer to be the registered agent for the RRDi to continue our non profit organization corporation status in the State of Hawaii. If you are able to volunteer for this, please contact us if you have a Hawaii mailing address.
We have our volunteer. We are locking this topic.
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Biologics image - stock.adobe.com"Over the coming years, the growth in the biologics market is projected to be rapid, reaching US $580.5 billion (approximately €513.5 billion) by 2026." [1]
What are the biologic treatments for rosacea?
First, what are we referring to? Biologic treatments are those derived from biological sources rather than from totally synthesized pharmaceuticals sources. [2] This post will include those that are biologic specifically for rosacea and those that might be considered helpful for rosacea but are not specifically for rosacea, instead these treatments might be used for rosacea or other diseases. The vast majority of treatments for rosacea are derived from synthesized pharmaceutical sources and are found in this category. If you know of any other biologic treatments for rosacea not listed below find the green reply button and be a RRDi volunteer!
Biologic Treatments for Rosacea
Cucumber [3]
Nonpathogenic E. coli strain Nissle 1917
Rose Hip Oil [4]
Reply to this Topic
There is a reply to this topic button somewhere on the device you are reading this post.
End Notes
[1] Rising to the Challenge of Biologic Drug Formulation, Felicity Thomas, Pharmaceutical Technology, Volume 43, Issue 3, pg 26–29
[2] "A biopharmaceutical, also known as a biologic(al) medical product, or biologic, is any pharmaceutical drug product manufactured in, extracted from, or semisynthesized from biological sources. Different from totally synthesized pharmaceuticals, they include vaccines, blood, blood components, allergenics, somatic cells, gene therapies, tissues, recombinant therapeutic protein, and living medicines used in cell therapy. Biologics can be composed of sugars, proteins, or nucleic acids or complex combinations of these substances, or may be living cells or tissues. They (or their precursors or components) are isolated from living sources—human, animal, plant, fungal, or microbial." Wikipedia
[3] “Cucumber was mentioned as early as 1649 as a treatment for facial redness in a text on herbal remedies by Nicholas Culpepper, an English botanist and physician, but cucumber has not been studied scientifically.” Natural Remedies for Rosacea?
BY THE NEW YORK TIMES JUNE 25, 2009 10:05 AM, Dr. Frank C. Powell[4] Dry Skin (Xeroderma), Rose Hip Oil End Note 3
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In summary, this multinational, observational, real-world study of patients with COVID-19 requiring hospitalisation found that the use of a regimen containing hydroxychloroquine or chloroquine (with or without a macrolide) was associated with no evidence of benefit, but instead was associated with an increase in the risk of ventricular arrhythmias and a greater hazard for in-hospital death with COVID-19. These findings suggest that these drug regimens should not be used outside of clinical trials and urgent confirmation from randomised clinical trials is needed.
Prof Mandeep R Mehra, MD
Sapan S Desai, MD
Prof Frank Ruschitzka, MD
Amit N Patel, MD -
In summary, this multinational, observational, real-world study of patients with COVID-19 requiring hospitalisation found that the use of a regimen containing hydroxychloroquine or chloroquine (with or without a macrolide) was associated with no evidence of benefit, but instead was associated with an increase in the risk of ventricular arrhythmias and a greater hazard for in-hospital death with COVID-19. These findings suggest that these drug regimens should not be used outside of clinical trials and urgent confirmation from randomised clinical trials is needed.
Prof Mandeep R Mehra, MD
Sapan S Desai, MD
Prof Frank Ruschitzka, MD
Amit N Patel, MDUpdate: June 4, 2020
Retraction: "Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis"
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Sunny Beach Treatment Increases RF Irradiation in Rosacea
A paper about RF irradiation may explain why short term sun can improve rosacea when you are on a vacation on a sun filled beach. When you are exposed short term on a vacation by the sun you are receiving more RF radiation in the form of radio waves along with the visible sun light due to you being on the beach. [1] This exposure may actually accentuate* your rosacea. Of course, over exposure to sun light and radio waves will trigger your rosacea, so you have to be careful to not get sun burned, which would exacerbate your rosacea. Balance is the key. A little sun can help your rosacea, not to mention reducing your stress level.
"Notably, blood vessel densities in the skins of UVB-treated mice and rosacea patients were significantly decreased by RF irradiation. These results provide experimental and molecular evidence regarding the effectiveness of RF irradiation for the treatment of rosacea." [2]
End Notes
[1] "All of the energy from the Sun that reaches the Earth arrives as solar radiation, part of a large collection of energy called the electromagnetic radiation spectrum. Solar radiation includes visible light, ultraviolet light, infrared, radio waves, X-rays, and gamma rays."
Lab Activity: Heat Transfer by Radiation, NOAA Earth System Research Laboratories (ESRL)
[2] Exp Dermatol. 2020 May 20;:
Radiofrequency irradiation attenuates angiogenesis and inflammation in UVB-induced rosacea in mouse skin.
Son M, Park J, Oh S, Choi J, Shim M, Kang D, Byun K* "Attenuate is a verb that means to make or become weaker. The effects of aging may be attenuated by exercise — or by drinking from the fountain of youth. The versatile word attenuate denotes a weakening in amount, intensity, or value." vocabulary.com
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* image"Since SARS-COV-2 pandemic began, frontline healthcare workers demonstrated to develop facial dermatoses, such as acne, rosacea and seborrheic dermatitis, secondary to prolonged use of personal protective equipment (PPE)."
Clin Exp Dermatol. 2020 Jul 13;:
Facial dermatoses in general population due to personal protective masks: first observations after lockdown.
Giacalone S, Minuti A, Spigariolo CB, Passoni E, Nazzaro GPersonal Protective Equipment (PPE)
Personal Protective Equipment (PPE) includes among other items a facial mask, safety glasses, gloves, etc.Issues with PPE and Rosacea Sensitive Skin
You may be concerned with how to protect your skin as well as the mucous membrane, especially if you have issues with a mask irritating your rosacea sensitive skin. One paper on this subject states, "Insufficient and excessive protection will have adverse effects on the skin and mucous membrane barrier." [1] Another paper calls this 'Surgical Mask Dermatitis." [2] One paper discusses an allergic reaction to the elastic bands from certain PPE masks and noted, "Allergic contact dermatitis caused by elastic bands mask FFP2 (SIBOL, NR‐D, NUEVA SIBOL, Zamudio, Spain) was diagnosed. Complete clearance of dermatitis was achieved within 2 weeks after changing the mask to a type with cotton cloth bands." [3]At least one report of a corneal abrasion from removing a face mask. [10]
"Of the people who wore face masks (three layers of surgical, cloth, respirators and half-face masks), 31.6% reported itch. Sensitive skin, atopic predisposition and facial dermatoses significantly predisposed users to the development of itch. The vast majority of subjects reported itch of moderate intensity. Itch in HCW may cause scratching and decrease the effectiveness of the necessary protection. The results indicate that face-mask-associated itch is an important problem, which should be addressed in future studies...Among the possible adverse effects of prolonged face mask use, authors frequently mention xerosis, rash, acne, facial dermatitis, pigmentation of the nasal bridge, chicks or chin and itching." [11]
"15.3% (360 individuals) reported skin changes on their faces during the pandemic. 4.9% of those with skin changes believed that they were due to the usage of face masks. However, the symptoms were mild for most (87.2%) of the patients. One hundred sixty-three of the participants were healthcare workers, and among them, 78.5% were working in hospitals." [12]
"Mask-related Koebner phenomenon is an important clinical sign to orient clinician's therapeutic protocols during COVID-19 pandemic, especially in patients with psoriasis." [13]
"Masks appear to trigger both acne and rosacea flares." [14]
"It has been reported that up to 97% of HCWs showed skin lesions (14), including acne, skin breakdown, rashes, contact and pressure urticaria, rosacea, perioral dermatitis, contact dermatitis, or aggravation of pre-existing skin disorders." [16]
Treatment for Skin Irritation Resulting from Using Protection
It has been recommended that, "using moisturizing products is highly recommended to achieve better protection." [1]. If you are concerned about wearing a mask, there are masks that may reduce skin irritation, i.e,, Anti-fog Full Face Shield, Anti-fog Adjustable Full Face Shield, Safety Face Shield. In using goggles, one source states, "Over‐tight using cannot enhance the protective effect but damage the skin and generate fogs instead." [1] Some prefer the disposable paper mask."Therapeutic measures for redness and swelling include hydropathic compress with three to four layers of gauze soaked by cold water or normal saline for about 20 minutes each time every 2 to 3 hours and then applying moisturizers. Avoid washing with over‐heated water, ethanol or other irritative products." [1] The paper recommends other therapeutic treatments if you are suffering from further damage to your skin.
"After 3 days of anti‐allergic treatment (oral desloratadine and topical desonide cream), the lesions almost completely disappeared. The patient switched to other masks without sponge strips which were tolerated. No recurrence was found after 3‐month follow‐up." [4]
There is a report of an experience to skin reactions caused by personal protective equipment (PPE) during COVID-19 pandemic from a tertiary hospital in Granada, Spain and mentions a therapeutic approach to resolve this. [5] These ten step recommendations were made:
1. Avoid using makeup and other similar cosmetics during the working day
2. Avoid wearing jewellery and other decorative materials during the workday
3. Use cotton gloves as the first layer, and on top put the vinyl or nitrile gloves.
4. Change gloves every 30-40 minutes, whenever possible.
5. Handwashing with mild syndet soaps or oils, fragrance-free, and with the fewest preservatives possible.
6. Shower with warm water, short baths of no more than 10 minutes in length
7. Light touch drying of the skin after the shower, avoiding intense skin friction
8. Apply an emollient cream after the bath to the entire body surface.
9. Wash the scalp with mild or balancing shampoo.
10. Hands must be cared for more thoroughly. Among the care, a good rinse during hand washing is essential, and the application of emollient creams 2-3 times a day. The best time to apply it will be right after breakfast (before the workday), after eating (after the workday), and before going to bed (at this time higher fat emollients can be applied to increase the hydration of the skin).One report states, "frontline healthcare workers demonstrated to develop facial dermatoses, such as acne, rosacea and seborrheic dermatitis, secondary to prolonged use of personal protective equipment (PPE)." [7]
"This study suggests that prolonged use of facemasks induces difficulty in breathing on exertion and excessive sweating around the mouth to the healthcare workers which results in poorer adherence and increased risk of susceptibility to infection." [8]
“We present a case of flare-up of rosacea in a nurse working in an Intensive Care Unit for COVID-19 patients, using FFP1 type mask at work and textile or paper mask outside the hospital.” [9]
Anecdotal Reports
"In the past week I am wearing Full Face Shield and it is much better." Obon, post no 7There are a couple of threads on this subject at RF. [6]
Why not volunteer for the RRDi and post your experience using masks or any helpful suggestions you might have. Did you know that volunteering actually has benefits for you if your motive is to help other rosacea sufferers?
Etcetera
"The World Health Organization (WHO) named the disease 2019 coronavirus disease (COVID‐19) in February 2020." [15]
Reply to this Topic
There is a reply to this topic button somewhere on the device you are reading this post.
End Notes
[1] Dermatol Ther. 2020 Mar 29 : e13310.
Consensus of Chinese experts on protection of skin and mucous membrane barrier for health‐care workers fighting against coronavirus disease 2019
Yicen Yan, Hui Chen, Liuqing Chen, Bo Cheng, Ping Diao, Liyun Dong[2] Contact Dermatitis. 2020 May 28. doi: 10.1111/cod.13626. Online ahead of print.
Surgical Mask Dermatitis Caused by Formaldehyde (Releasers) During the COVID-19 Pandemic
Olivier Aerts, Ella Dendooven, Kenn Foubert, Sofie Stappers, Michal Ulicki, Julien Lambert[3] Contact Dermatitis. 2020 Jun 1 : 10.1111/cod.13600. doi: 10.1111/cod.13600 [Epub ahead of print]
Allergic contact dermatitis caused by elastic bands from FFP2 mask
Francisco J. Navarro‐Triviño, Carolina Merida‐Fernández, Teresa Ródenas‐Herranz, Ricardo Ruiz‐Villaverde[4] Contact Dermatitis. 2020 May 26 : 10.1111/cod.13599. doi: 10.1111/cod.13599
Mask‐induced contact dermatitis in handling COVID‐19 outbreak
Zhen Xie, Yu‐Xin Yang, Hao Zhang
* image courtesy of the above source[5] Dermatol Ther. 2020 Jun 15;:e13838 PMID: 32543015
Therapeutic approach to skin reactions caused by personal protective equipment (PPE) during COVID-19 pandemic: An experience from a tertiary hospital in Granada, Spain.
Navarro-Triviño FJ, Ruiz-Villaverde R
The Full Text of this article is available as a PDF (1.3M).[6] How are you all coping with face masks?
New Here and Anxious About Face Masks at Work
[7] Clin Exp Dermatol. 2020 Jul 13 : 10.1111/ced.14376.doi: 10.1111/ced.14376 [Epub ahead of print]
Facial dermatoses in general population due to personal protective masks: first observations after lockdown
S. Giacalone, A. Minuti, C.B. Spigariolo, E. Passoni, G. Nazzaro[8] Indian J Otolaryngol Head Neck Surg. 2020 Sep 15 : 1–7.
Effects of Prolonged Use of Facemask on Healthcare Workers in Tertiary Care Hospital During COVID-19 Pandemic
P. K. Purushothaman, E. Priyangha, and Roopak Vaidhyswaran[9] Maedica (Bucur). 2020 Sep;15(3):416-417
Flare-up of Rosacea due to Face Mask in Healthcare Workers During COVID-19.
Chiriac AE, Wollina U, Azoicai D[10] Vis J Emerg Med. 2020 Dec 23 : 100958.
Corneal Abrasion from Removing Face Mask during the COVID-19 Pandemic
Sunny, Chi Lik Au, and Callie, Ka Li Ko[11] Biology (Basel). 2020 Dec; 9(12): 451.
Increased Prevalence of Face Mask—Induced Itch in Health Care Workers
Piotr K. Krajewski, Łukasz Matusiak, Marta Szepietowska, Rafał Białynicki-Birula, and Jacek C. Szepietowski[12] Dermatol Res Pract. 2020; 2020: 6627472.
The Prevalence and Determinants of Hand and Face Dermatitis during COVID-19 Pandemic: A Population-Based Survey
Mohammed Saud Alsaidan, Aisha H. Abuyassin, Zahra H. Alsaeed, Saqer H. Alshmmari, Tariq F. Bindaaj, Alwa'ad A. Alhababi[13] Dermatol Ther. 2021 Feb 02;:e14823
Mask-Induced Koebner phenomenon and its clinical phenotypes: a multicenter, real-life study focusing on 873 dermatological consultations during COVID-19 pandemics.
Damiani G, Gironi LC, Kridin K, Pacifico A, Buja A, Bragazzi NL, Spałkowska M, Pigatto PD, Santus P, Young Dermatologists Italian Network, Savoia P[14] Dermatol Ther. 2021 Feb 03;:e14848
COVID-19 related masks increase severity of both acne (Maskne) and rosacea (Mask rosacea): Multi-center, real-life, telemedical, observational prospective study.
Damiani G, Gironi LC, Grada A, Kridin K, Finelli R, Buja A, Bragazzi NL, Pigatto PD, Savoia P[15] Int J Clin Pract. 2020 Dec 26 : e13948.
Comparison of patients’ diagnoses in a dermatology outpatient clinic during the COVID‐19 pandemic period and pre‐pandemic period
Dursun Turkmen, Nihal Altunisik, Irem Mantar, Imge Durmaz, Serpil Sener, Cemil Colak[16] Front Public Health. 2021; 9: 815415.
The Dermatological Effects and Occupational Impacts of Personal Protective Equipment on a Large Sample of Healthcare Workers During the COVID-19 Pandemic
Paolo Emilio Santoro, Ivan Borrelli, Maria Rosaria Gualano, Ilaria Proietti, Nevena Skroza, Maria Francesca Rossi, Carlotta Amantea, Alessandra Daniele, Walter Ricciardi, Concetta Potenza, Umberto Moscato -
Benzyl Benzoate, a treatment for scabies, not available in the USA but is available in the UK, Australia and China, has been reported to be "a useful alternative treatment for rosacea as well as for demodicosis" according to a paper published in the May issue of the J Dermatolog Treat.
J Dermatolog Treat. 2020 May 19;:1-28
Effectiveness of benzyl benzoate treatment on clinical symptoms and Demodex density over time in patients with rosacea and demodicosis: a real life retrospective follow-up study comparing low- and high-dose regimens.
Forton FMN, De Maertelaer VBenzyl Benzoate is listed with Anti-parasitic Prescription Agents For Rosacea
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UPDATE
"President Donald Trump announced he was taking hydroxychloroquine, a drug he's repeatedly touted as a treatment for coronavirus, despite warnings about its effectiveness and safety."
Coronavirus live updates, Ryan W. Miller, USA TODAY
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Thought I would continue this discussion and try to stimulate any member to weigh in on this with further thoughts on this subject. We have 1333 members as of this date and basically hardly anyone is posting anything. Only a few, and I mean a few have ever posted anything in the last few months except me. Apurva Tathe, a board member, is the second most active member on the website. I have tried to gather rosaceans together to be united in doing something about rosacea but the members are silent which is so sad to me. I have repeatedly asked members to discuss why anyone thinks that a rosacea sufferer would go through the registration process and then not even make one post. There are spammers who join but we have taken the extra precaution of approving each post before it goes live because when we allowed anyone to post a spammer posted a bunch of posts on Viagra and Twitter suspended the account and I have repeatedly tried to get Twitter to unsuspend our account with no success. Twitter is one social media account that doesn't have a good help feature and ignores pleas to activate the account. If you would like to volunteer to straighten out this mess I sure could use the help. Are you a Twitter guru? I need help.
So I locked the forum and each post has to be pre-approved so we don't get spam. The last four members that joined have these user names:
Buy Kamagra Uk
rtstar
Kamagra4U
Kamagra Cheap
I think you get the idea. Obviously rtstar is the only legitimate member out of the four. So we try diligently to make the RRDi Forum a safe place where you won't have to see posts about viagra, kamagra, porn or other advertisements or links asking for your money. Wish someone would actually volunteer to be a moderator who could assist in all this. We have had volunteers who said they would be a moderator but have since become inactive. Can't even reach them by emai.Most of the data on rosacea has been collected since 2004 into posts/pages and categorized in logical subjects for your benefit either in the forums or on the site index. Many of the sources for anecdotal reports or subjects show the Rosacea Forum (rosaceagroup.org) with a link to RF because many years ago the RRDi had a sister relationship due to the fact that the original owner of RF, Warren Stuart, served on the board of directors of the RRDi and was also instrumental in setting up the RRDi website with Invision Power (now called Invision Community) back in 2004. We have continued to do this since the new owner of RF, David Pasco, has graciously allowed me to not only post at RF but to also refer to posts at RF with links on the RRDi website. Hence, RF has a wealth of rosacea knowledge that should be preserved, mainly for historical reasons, but also because there is a lot one can learn at RF since it has still remained somewhat active after all these years (currently about 145 active members).
To me the RF website uses basically the same interface as the RRDi website but some have told me that RF is more user friendly than the RRDi which I don't get, but obviously they do since they tell me that. So we paid for a private forum through Tapatalk who hosts rosaceans.org and we are not getting any activity over there and only a handful have joined it and never post. We will probably be dropping this by the end of 2020 since it costs $120/year to maintain it. We did this because supposedly the Tapatalk forum is the latest, state of the art 'forum' and is totally private.
The list of famous rosaceans continues to grow and not one of them has joined our cause, which is one of my wish lists. Of course, my biggest wish is for a rich donor to donate enough money so we can last another year or so. At the present rate we will dissolve some time towards the end of this year. I made this post in March to no avail and sent out the latest newsletter asking for a donation. I have been writing some fairly interesting posts and spent some time working with Model Tees to offer tee shirts (please be a rosacea warrior).
So, what is it that the RRDi should be doing that is not listed in this post and the previous post? What needs to be done to unite rosaceans into one rosacea grassroots non profit organization that can have an impact on the medical community to take us seriously as a rosacea patient advocacy group? Can someone with a little hutzpah please post a thought?
Furthermore, I have posted a lot about comparing non profit organizations with their mission and point out how few non profits spend very little on their mission and spend most of the donations on salaries, compensation to members, or private contractors. Can you comment on why you think rosaceans don't care about any of this?
Subungal Discoloration with Tetracycline Long Term Use
in Antibiotics
Posted
Subungal Discoloration with Hemotoma or Disease
A subungal discoloration usually is associated with a hematoma on finger or toe nails. [1] There are numerous images associated showing this available in a google search.
However, subungal discoloration can be associated with disease. "Subungual discoloration carries a broad differential including infectious, inflammatory, metabolic, malignant or systemic diseases. Knowledge of this side effect is crucial in order to avoid unnecessary testing in determining the etiology of the subungual discoloration. Knowledge of this side effect is crucial in order to avoid unnecessary testing in determining the etiology of the subungual discoloration." [2]
Subungal Discoloration with Tetracycline Long Term Use
The authors of one paper on this subject explain that it is important to let patients know that long term use of tetracyclines, i.e., doxycycline, minocycline, for rosacea this subungal discoloration may be one of the side effects and risks. The report states, "We report on a case of a patient who has been on long-term minocycline use for adult acne management. He was initially on minocycline for six years, but due to minocycline-induced hyperpigmentation of his ears and fingernails, he had switched to doxycycline. One year later, the skin hyperpigmentation of the ears regressed; however, the blue subungual hyperpigmentation of his hands progressively become more prominent without any other significant symptoms." [2]
End Notes
[1] Subungual hematoma, Wikipedia
[2] Cureus. 2020 Apr 24;12(4):e7810
Out of the Blue: A Case of Blue Subungual Discoloration Associated with Prolonged Tetracycline Use.
Ahmad Y, Boutros H, Hanna K