Guide

In a related news item, Ivermectin, another anti-parasitic drug, has been purported to treat coronavirus.

In a related news item, Plaquenil (Hydroxychloroquine), another anti-parasitic drug, has been purported to treat coronavirus. Read the third post in this thread. 

"It’s still not clear exactly how Ivermectin works. But it appears to stop the processes that allow proteins to move within the virus. These proteins would normally dampen the body’s antiviral response, allowing the virus to replicate and enhance the infection."

Head lice drug Ivermectin is being tested as a possible coronavirus treatment, but that’s no reason to buy it, April 6, 2020, Andrew McLachlan, The Conversation
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"Wagstaff cautions that these are very early test results and much more will need to be done, including clinical trials and human testing and will be necessary before any action can be taken. But, he says, it’s a sign of hope."

Researchers discover anti-parasite drug kills coronavirus in lab, Chris Patrick, Sunday, April 5, 2020, Trib
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"The team worked with the Peter Doherty Institute of Infection and Immunity. They showed that Ivermectin reduced COVID-19 viral RNA present in cell culture by as much as 93 percent after 24 hours and by 99.8 percent after 48 hours, at around a 5,000-fold reduction in coronavirus RNA, hinting that the medicine can potentially eradicate the virus."

Antiparasitic drug Ivermectin kills coronavirus in 48 hours, Angela Betsaida B. Laguipo, BSN, Apr 6 2020, News Medical

Please Note: The RRDi does not endorse ivermectin for treating Covid 19. Since ivermectin has been used to treat rosacea, we are interested in any of the treatments for rosacea that are also being considered in treating Covid 19. Treating Covid 19 with ivermectin is controversial. The RRDi has simply collected a list of articles for your consideration. This thread continues to be updated so scroll through the entire thread to the latest post on this subject. Add your thought by finding the REPLY TO THIS TOPIC button. 

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There are multiple news reports that ivermectin, a common drug used to treat rosacea orally and topically, has been found effective in treating the coronavirus (scoll down for more reports). Virus and rosacea has never, ever been ruled out. Ivermectin is just one treatment for rosacea that is being investigated along with other rosacea treatments. 

"Taken together, the concerns associated with ivermectin's application in clinical settings may be adequately addressed to declare it as a safe anti-viral drug at a safe dosage." [1]

A collaborative study led by the Monash Biomedicine Discovery Institute and the Doherty Institute found the drug Ivermectin stops coronavirus growing in cell culture." 

Warning issued as researchers reveal another potential treatment for coronavirus, ABC News Australia

"Researchers at Monash University in Melbourne, Australia have discovered that the antiparasitic drug Ivermectin can inhibit replication of SARS-CoV-2, the virus the causes COVID-19, according to a study published Friday in the journal Antiviral Research....Ivermectin has been widely used since the 1980s to treat head lice, scabies and several other infections caused by parasites. The drug is also used to treat the skin condition rosacea." [bold added]

"Researchers from Biomedicine Discovery Institute (BDI) at Monash University in Australia have found that an anti-parasitic drug called Ivermectin could kill the novel coronavirus, SARS-CoV-2, within 48 hours in a laboratory setting." 
Study finds anti-parasitic drug could kill coronavirus in 48 hours,  Pharmceutical Technology

ANTI-PARASITE DRUG USED SINCE 1980S MAY HELP STOP CORONAVIRUS, NEW STUDY SAYS
BY AILA SLISCO ON 4/3/20 AT 10:46 PM EDT,  3 April 2020, Newsweek 

The report by Caly et al is published in Antiviral Research, funded by a National Breast Cancer Foundation Fellowship, is cited below:

Antiviral Research
Available online 3 April 2020
The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro
Leon Caly, Julian D.Druce, Mike G.Catton, David A.Jans, Kylie M.Wagstaff

Science Daily • Drugs.com • Nature World News • EurekaAlert! • Futureism/Neoscope • Pharmaceutical Technology • SciTechDaily • PHARMAfield • The US Sun • Archyde • Metro News • MoneyControl • The Tecake • Coronavirus and Rosacea

End Notes

[1] J Mol Struct. 2021 Jun 12 : 130808.
COVID-19 and Ivermectin: Potential threats associated with human use
Tean Zaheer, Kaushik Pal, Rao Zahid Abbas,  María del Pilar Rodríguez Torres

There appears to be a shortage of Hydroxychloroquine (HCQ) according to several news sources. So if you somehow receive Hydroxychloroquine (HCQ) treatment for covid19 and your rosacea improves, please find the green reply button in this thead to post your results. Furthermore, virus has never, ever been ruled out in rosacea.

End notes

Physicians Seek to Reassure Amid Hydroxychloroquine Shortage, Jeff Evans, March 27, 2020, Medscape

FDA SAYS THERE'S A SHORTAGE OF HYDROXYCHLOROQUINE AND CHLOROQUINE 'DUE TO A SIGNIFICANT SURGE IN DEMAND, BY KASHMIRA GANDER ON 4/1/20 AT 11:58 AM EDT, Newsweek

As Trump touts an unproven coronavirus treatment, supplies evaporate for patients who need those drugs, By Christopher Rowland , March 23, 2020 at 1:02 p.m. CDT, The Washington Post

Update 

Now there appears to be plenty of stock and absolutely no shortage. 

"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

Frequently some are concerned that if they have a red nose that they will end up like WC Fields, the rosacea poster boy. This is due to a misunderstanding that rosacea progresses in stages which has been debunked. While it is possible if you don't treat your rosacea (or your red nose) it may get worse, it certainly does not mean that it will necessarily get worse or progress into 'stages'. Obviously WC Fields didn't care about whether his nose got redder or turned into rhinophyma, so it is good you are concerned about your red nose. The good thing about rhinophyma or what is more recently classified as Phenotype 5 is that this is the most successfully treated rosacea phenotype (scroll to the subheading TREATMENT in this post for the list). 

Coffee Extracts Protect Cells Against Oxidative Stress

One of the many theories on the cause of rosacea is the Antioxidant System Defect Hypothesis which is related to Oxidative Stress, Ferritin and Rosacea. One paper concluded the following;

"Further experiments using LPS-induced murine macrophages revealed that coffee extracts protect cells against oxidative stress by enhancing the content of the antioxidant GSH and stimulating expressions of the genes related with the cellular antioxidation system. Also, coffee extracts decreased the expression of proinflammatory cytokines and inflammatory mediators in LPS-stimulated RAW 264.7 cells. However, different roasting levels may dilute those effects by decreasing the concentrations of key compounds during the roasting procedures."

Journal of Medicinal Food
Cellular Antioxidant and Anti-Inflammatory Effects of Coffee Extracts with Different Roasting Levels
Jung Soohan, Kim Min Hyung, Park Jae Hee, Jeong Yoonhwa, and Ko Kwang Suk. Journal of Medicinal Food. June 2017, 20(6): 626-635. https://doi.org/10.1089/jmf.2017.3935
Online Ahead of Print: June 5, 2017
Published in Volume: 20 Issue 6: June 1, 2017

Is rosacea a condition or a disease? Technically, it depends on how you are referring to rosacea in a statement. 

Condition
"A medical condition is a broad term that includes all diseases, lesions, disorders, or nonpathologic condition that normally receives medical treatment, such as pregnancy or childbirth." [1]

One report says, “rosacea is not actually a disease, but rather a chronic dermatologic condition that predominantly affects the convexities of the central aspect of the face.” [2]

“Francis Wilkin of the FDA, whose serious studies have given us impressive insights into the nature and mechanisms of flushing, has proposed some concepts, which are inexplicable to most of us. He avers that rosacea is not a disease but a “condition”. He labels rosacea an ideotype, a cluster of signs and symptoms, apparently not a pathologic entity warranting a specific nosologic status. To be sure, rosacea is a multifactional disorder with many different clinical expressions. Nonetheless, it meets all the classical requirements of a pathologic process, most obviously the presence of chronic inflammation, both clinically and histologically. Calling rosacea a ‘condition’ downgrades the seriousness of the disorder, perhaps implying that it is only a cosmetic nuisance.” [3]

Disease
"A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not due to any immediate external injury....The term disease broadly refers to any condition that impairs the normal functioning of the body." [1]

Disorder
“Rosacea is a common and chronic disorder characterized by flushing, erythema, papules, pustules, and telangiectasia on the central part of the face. Because the facial skin of individuals with rosacea is particularly sensitive, irritants can trigger a worsening of the signs and symptoms of the disease.” [4]

“Once considered a variant of acne, this common skin disorder seems fairly well entrenched as a disease sui generis.” [5]

Terms Condition/Disease Used Interchangeably
“Most words of this type in medicine rooted in Latin from thousands of years ago do not have precise definitions!” [6]

“The terms disease & condition are often used interchangeably in the literature.” [7]

“…this is semantics: disease, affliction or condition all refer to the same meaning.” [8]

Conclusion
While both Dr. Millikan and Dr. Wilkin refer to rosacea as a 'condition' and not a 'disease’, there is no need to feel that somehow makes rosacea less important since the two words are used in most medical literature interchangeably. 

End Notes

[1] Disease, Wikipedia

[2] Skinmed 2003;2(1) 
The Proposed Inflammatory Pathophysiology of Rosacea: Implications for Treatment
Larry Millikan, MD

[3] A Personal Critique on the State of Knowledge of Rosacea
Albert M. Kligman , M.D., Ph.D.
Department of Dermatology, University of Pennsylvania, Philadelphia, PA, U.S.A.
The William J. Cunliffe Lectureship 2003—Manuscript
publikation_kligman.pdf

[4] J Dermatolog Treat. 2007;18(3):158-62. 
Beneficial use of Cetaphil(R) Moisturizing Cream as part of a daily skin care regimen for individuals with rosacea 
Laquieze S, Czernielewski J, Baltas E.

[5] Postgrad Med. 2002 Dec;112(6):51-8, 82; quiz 9. 
Unraveling the mystery of rosacea, Keys to getting the red out
Ken Landow, MD

[6] Robert T. Brodell, MD, RRDi MAC, post no 2

[7] Sandra Cremers, M.D., RRDi MAC, post no 3

[8] Marianne Boes, PhD, RRDi MAC (former member), post no 3

There are several acne treatments used to treat rosacea, i.e., Dapsone, Sarecycline, Azithromycin, Minocycline, and the list continues, not to mention the plethora of over the counter acne treatments to consider. A typical example of an acne treatment, Benzaclin, that is also used to treat rosacea is discussed in the following paper: 

“Based on the theory that rosacea shares the same inflammatory features of acne, a recent study showed that, just as the combination of benzoyl peroxide 1 percent and clindamycin 5 percent gel is a powerful treatment modality for reducing Propionibacterium acnes levels, it also significantly reduces the papules
and pustules of rosacea, according to Debra L. Breneman, M.D..… ‘Benzaclin, once daily, was found to be well tolerated and effective in the reduction of papules and pustules in patients with rosacea,’ said Dr. Breneman. ‘This lends credence to the theory that P. acnes is a potential aggravating factor in rosacea. This gives dermatologists a very effective treatment for rosacea.’ ” [1]

Herbal Extracts for Acne 

One report on the 'clinical efficacy of herbal extracts in treatment of mild to moderate acne vulgaris' concludes, "This herbal extracts can be a new therapeutic option for patients with mild to moderate acne vulgaris who are reluctant to use drugs." [2] 

The herbal extracts include:

Mangosteen extract
Lithospermum officinale extract
Tribulus terrestris L. extract
Houttuynia cordata Thunb extract

End Notes

[1] Dermatology Times Publish date: Apr 1, 2003
P. Acnes Possible Factor in Rosacea BenzaClin a significant Tx in lesion reduction
Beth Kapes

Another example similar to above paper discussing topical benzoyl peroxide 5%/clindamycin 1% (BP/C) gel (BenzaClin) concluded, "These results showed that BP/C was significantly more effective than vehicle in improving papules and pustules associated with rosacea.'

Cutis. 2004 Jun;73(6 Suppl):11-7.
Photographic review of results from a clinical study comparing benzoyl peroxide 5%/clindamycin 1% topical gel with vehicle in the treatment of rosacea.
Leyden JJ, Thiboutot D, Shalita A.

[2] J Dermatolog Treat. 2019 Oct 16:1-5. doi: 10.1080/09546634.2019.1657792. [Epub ahead of print]
Clinical efficacy of herbal extracts in treatment of mild to moderate acne vulgaris: an 8-week, double-blinded, randomized, controlled trial.
Yang JH, Hwang EJ, Moon J, Yoon JY, Kim JW, Choi S, Cho SI, Suh DH.

image courtesy of WikiMedia Commons

The RRDi financial situation is continuously posted at this url and as of this date, March 30, 2020, we have $771.42 in the bank. Based upon how we are spending donations (the income includes the small amount of affiliate fees we receive from Amazon) we will run out of funds in several months. So we are concerned about this and decided to first post this on our website before using the newsletter tool and send this same announcement to the members who have opted to receive our newsletter. You may wonder how much we are spending in donations currently and for the first three months of 2020 we averaged our expenses to $164/month. You can view how we spent donations for last year here. So you can see our current funds will only last us several months at the present rate of expenditure. 

Comparison of the RRDi Expenses vs NRS Expenses
So let's compare this with how much money the National Rosacea Society [NRS] spends its donations (who is one of the other non profit organizations for rosacea). The only way we can get an idea how the NRS spends its donations is to look at the last financial report filed by the NRS as shown on Form 990 that the NRS files with the Internal Revenue Service for 2018 which is available for public viewing (the NRS releases its 2019 Form 990 much later and when it does we always review it since we have been reviewing how the NRS spends its donations since 1998).  So let's compare how the NRS spends it donations, that is, the amount each month is spent with what the RRDi spends each month. 

For 2018, the NRS received in donations a total of $465,042. During this same period the NRS spent a total of $601,532 (yes the NRS can spend more than it takes in because of the assets they own which the NRS draws upon when the expenses are greater than donations). So on average, in 2018 the NRS spent over $50,000 each month! What did the NRS spend most of it donations on? The answer if you investigate is $432,408 was spent for the year (over $36,000 each month on average) on two private contractors owned by the director/president of the NRS, Sam Huff. So if you are happy with how the NRS is spending its donations that is just one of the other non profit organizations for rosacea that will continue if the RRDi runs out of funds and can't pay our monthly expenses. 

So the comparison is:

RRDi spends                           NRS spends
$164/month                           $50,000/month (of this amount $36,000 is spent on two private contractors owned by Sam Huff)

Just for the record, the NRS claims on its Form 990 for 2018 that 25.31% of the total donations received in 2018 were from public support.

What is one of the most interesting revelations found on the from its Form 990 for 2018 report is that it reveals how much money was received from the pharmaceutical companies in 'excess contributions' which is shown in a screen shot below:

The above screen shot doesn't reveal for how long a period each of the above pharmaceutical companies have been giving the NRS 'excess contributions' but it does reveal the amounts. So if you are happy the way these pharmaceutical companies are contributing to the NRS and the way the NRS is spending its contributions and if the RRDi runs out of funds to keep going, you will surely have the NRS since it has lots of money to spend, especially on two private contractors owned by Sam Huff, the director/president of the NRS. 

Conclusion
So it is simply up to you whether you want the RRDi to keep going or simply dissolve because of lack of funds. If you want to help out the RRDi here are two options:

(1) donate (if the 1300+ members each donated just one dollar we could last way over a year! Do you think the RRDi is worth one dollar?)

(2) volunteer (and help us get donations).

If you have any questions or concerns, why not find the reply button and post?

image courtesy of Free paper chain v.2 Stock Photo

We obviously aren't sure of what community support means to you, but we are trying to figure that out by forming a NON PROFIT organization for rosacea patient advocacy and encouraging rosaceans to come together by joining the RRDi and taking steps to obtain and disseminate community support for those who are suffering from rosacea. What has the RRDi done in this regard?

(1) Creating a website with pages of information, a public forum of rosacea topics, a community support category, a private forum, member driven rosacea blogs, galleries and clubs, as well as the tools discussed in the article, RRDi and the Medical Digital Revolution.  

(2) Journal of the RRDi and the ability for anyone (amateur or professional) to submit a paper on rosacea to be published.

(3) A legal non profit organization to allow donations to be tax deductible.

(4) Education grants and the ability to volunteer as a grant writer as a non profit organization grant writer (possibly being reimbursed for your effort). 

(5) A way for you to volunteer to help rosacea sufferers.

(6) Attracting sponsors to support our non profit organization.

(7) Instructions on how to use our forum. 

(8) Our charter allows members to be compensated for services if we have the funds to do this. 

So, what does community support mean to you? Please find the green reply button and post what it means to you? We would love to understand what you think community support means to you or what you think a non profit for rosacea should be doing? 

You may think that posting in a community of rosacea sufferers your experience with rosacea and getting some feedback is what community support means to you? If so, this is the correct forum category to do that by finding the green reply button and post your concern. 

"In a statement released Sunday night, the U.S. Department of Health and Human Services announced it had received 30 million doses of hydroxychloroquine sulfate and one million doses of hloroquine phosphate donated to a national stockpile of potentially life-saving pharmaceuticals and medical supplies. Hydroxychloroquine and chloroquine, which are oral prescription drugs used primarily to prevent and treat malaria, are both being investigated as potential therapeutics for COVID-19."

Coronavirus live updates: FDA gives anti-malaria drugs emergency approval to treat COVID-19
The two drugs are being investigated as potential treatments for COVID-19., By Morgan Winsor and Emily Shapiro, March 30, 2020, 8:05 AM, ABC News

FDA Letter

Virus has never been ruled out in rosacea. 

The president announced on March 19, 2020 that hydroxychloroquine (Plaquenil) has been approved by the FDA to treat COVID-19. 

Virus has never been ruled out in rosacea. 

CNN has a followup report on this. 

There is a paper that indicates using Hydroxychloroquine (HCQ) to treat rosacea "exerted satisfactory therapeutic effects on erythema and inflammatory lesions of rosacea patients, indicating that it is a promising drug for rosacea in clinical treatment." Duff Man told us about this a while back that it worked for him. 

Wouldn't it be incredible if any rosaceans who are treated with hydroxycholoroquine for COVID-19 also discovered that their rosacea improves or clears up! Is virus involved in rosacea?  If you do take hydroxycholoroquine and your rosacea improves, please let us know.

"Webster et al. report a multicentre, randomized, double‐masked, parallel‐group, vehicle‐controlled study to evaluate the safety and efficacy of minocycline gel 1% and 3%. Topical minocycline had insignificant systemic absorption but produced significant reductions in mean inflammatory lesion counts with both the 1% and 3% concentrations. The response rate in the vehicle group was quite high, as is often the case in diseases with fluctuating inflammation. However, the 3% concentration of minocycline showed a significantly greater proportion of patients achieving Investigator's Global Assessment success at week 12 compared with vehicle. A topical minocycline foam formulation is in development, and this may provide a further useful option for treating papulopustular rosacea. How topical minocycline compares with other topical rosacea treatments is as yet unclear."

Br J Dermatol. 2020 Mar 18;:
Expanding treatment options for rosacea.
Hampton PJ

The president announced on March 19,2020 that hydroxychloroquine (Plaquenil) has been approved by the FDA to treat COVID-19. As mentioned in the initial post in this thread, virus has never been ruled out in rosacea. CNN has a followup report on this. 

There is a paper that indicates using Hydroxychloroquine (HCQ) to treat rosacea "exerted satisfactory therapeutic effects on erythema and inflammatory lesions of rosacea patients, indicating that it is a promising drug for rosacea in clinical treatment." Duff Man told us about this a while back that it worked for him. 

Wouldn't it be incredible if any rosaceans who are treated with hydroxycholoroquine for COVID-19 also discovered that their rosacea improves or clears up! Is virus involved in rosacea?  If you do take hydroxycholoroquine and your rosacea improves, please let us know.

Coronavirus and Rosacea

"In this case report, we detail the response of a 37-year-old Caucasian man with an overlap of erythematotelangiectatic rosacea and telangiectatic photoaging to brimonidine tartrate gel. With the application of brimonidine only on half of his face, skin analysis images, clinician's and patient's assessment showed that there was significant improvement in the erythema. This case has lent insight into how brimonidine can be used to assess the extent of photoaging by eliminating the erythema of rosacea to some degree. We propose that it can be used as a non-invasive test to differentiate between the two conditions, sparing patients from skin biopsies and molecular analysis."

Australas J Dermatol. 2017 Feb;58(1):63-64. doi: 10.1111/ajd.12430. Epub 2016 Jan 13.
Rosacea or photodamaged skin? Use of brimonidine gel in differentiating erythema in the two conditions.
Oon HH, Lim ZV.

Telangiectatic Photoaging 

"Telangiectatic photoaging is characterized by less transient and nontransient erythema, a more lateral distribution of erythema and telangiectasia, less neurogenic mast cell activation, and less MMP-mediated matrix remodeling than ETR. These data demonstrate that TP is a distinct clinical entity from ETR that can be distinguished on the basis of clinical, histologic, and gene expression findings."

JAMA Dermatol. 2015;151(8):825-836. doi:10.1001/jamadermatol.2014.4728
Clinical, Histologic, and Molecular Analysis of Differences Between Erythematotelangiectatic Rosacea and Telangiectatic Photoaging
Yolanda R. Helfrich, MD; Lisa E. Maier, MD; Yilei Cui, PhD; et al

JAMA Dermatol. 2015 Aug;151(8):825-36. doi: 10.1001/jamadermatol.2014.4728.
Clinical, Histologic, and Molecular Analysis of Differences Between Erythematotelangiectatic Rosacea and Telangiectatic Photoaging.
Helfrich YR, Maier LE, Cui Y, Fisher GJ, Chubb H, Fligiel S, Sachs D, Varani J, Voorhees J.

JK Wilkin has a comment on the above article published in JAMA and another in the NEJM. 

Staphylococcus epidermidis image courtesy of Wikimedia Commons

Bacteria has been implicated and investigated as the leading microbe associated with rosacea for over sixty years. Antibiotics have been prescribed for rosacea, particularly tetracycline and more recently with doxycycline, along with many other antibiotics, which leads to the bacteria theory on the cause of rosacea. There has been a bias in most, if not all, the clinical papers investigating the skin microbiome in rosacea patients ignoring other microbes, i.e., virus, archea, fungus, protozoa.  Demodex mites have been the other most investigated microbe of the skin microbiome with a vast number of clinical papers. A typical paper indicating this bias towards chiefly investigating bacteria and demodex is the following conclusion on this subject:

"Although we were not able to pinpoint a causative microbiota, our study provides a glimpse into the skin microbiota in rosacea and its modulation by systemic antibiotics.' 

J Clin Med. 2020 Jan; 9(1): 185.
Published online 2020 Jan 9. doi: 10.3390/jcm9010185
PMCID: PMC7019287
PMID: 31936625
Characterization and Analysis of the Skin Microbiota in Rosacea: Impact of Systemic Antibiotics
Yu Ri Woo, Se Hoon Lee, Sang Hyun Cho, Jeong Deuk Lee, and Hei Sung Kim

The above paper only investigated bacteria and mentions demodex and ignores all other microbes of the skin microbiota. 

Bacteria and Rosacea Theory

Microorganisms of the Human Microbiome

image courtesy of Pinterest

Odd that a rosacea plant would have natural antibacterial properties. The photo above is one of Pyrus glabra while the one below is Pyrus syriaca:

image courtesy of Wikimedia commons

Topical ivermectin has been found effective in the treatment of T‐cell‐mediated skin inflammatory diseases. For more information. 

"Altogether, our results show that IVM is endowed with topical anti‐inflammatory properties that could have important applications for the treatment of T‐cell‐mediated skin inflammatory diseases."

Topical ivermectin improves allergic skin inflammation
E. Ventre  A. Rozières  V. Lenief  F. Albert  P. Rossio  L. Laoubi  D. Dombrowicz  B. Staels  L. Ulmann  V. Julia  E. Vial  A. Jomard  F. Hacini‐Rachinel  J.‐F. Nicolas  M. Vocanson

More on Ivermectin

Reply to this Topic
There is a reply to this topic button somewhere on the device you are reading this post. If you never heard about this topic and you learned about it here first, wouldn't it be a gracious act on your part to show your appreciation for this topic by registering with just your email address and show your appreciation with a post?  And if registering is too much to ask, could you post your appreciation for this topic by finding the START NEW TOPIC button in our guest forum where you don't have to register?  We know how many have viewed this topic because our forum software shows the number of views. However, most rosaceans don't engage or show their appreciation for our website and the RRDi would simply ask that you show your appreciation, please, simply by a post.  

Fictional parasitism: oil painting Parasites by Katrin Alvarez, 2011
image courtesy of Wikimedia Commons

For a long time microorganisms of the skin microbiome have been suggested as a cause of rosacea. The list includes, bacteria, virus, and demodex mites. Further, there are some papers that suggest that the gut microbiome may be involved in rosacea. [Microorganisms of the Human Microbiome]

"Antiparasitics are a class of medications which are indicated for the treatment of parasitic diseases, such as those caused by helminths, amoeba, ectoparasites, parasitic fungi, and protozoa, among others." Wikipedia

"Broad-Spectrum antiparasitics, analogous to broad-spectrum antibiotics for bacteria, are antiparasitic drugs with efficacy in treating a wide range of parasitic infections caused by parasites from different classes." Wikipedia

Bacterial, Viral, and Fungal Cutaneous Infections are classified as part of the Skin and soft tissue infections (SSTIs)." Bacterial skin and soft tissue infections (SSTIs) constitute approximately 20% of outpatient dermatology visits and are among the most common types of bacterial infection." [1]

Other prescription anti-parasitic drug therapies are Anticestodes, Antitrematodes, Antiamoebics, AntiFungals, and new drug therapies such as "triazolopyrimidines and their metal complexes have been looked at as an alternative drug to the existing commercial antimonials.' Wikipedia

Anti-Parasitic Treatments for Rosacea
Prescription Antinematodes include ivermectin.  

Prescription Antiprotozoals include metronidazole (also used for its antibiotic and anti-inflammatory effects), artemisinin, artesunate, chloroquine, hydroxychloroquine, and mepacrine.

These treatments have not yet been mentioned to treat rosacea: 
ornidazole, secnidazole, and tinidazole.

Anticestodes for Rosacea
Anticestodes treatments used to treat rosacea include Benzyl benzoate, Crotamiton, Permethrin, and Praziquantel. 

Antiviral Treatments for Rosacea
Acylovir has been reported to be effective in the treatment of Pityriasis rosea, a type of skin rash and at least one anecdotal report improves rosacea. 

Coronavirus and Rosacea
There are anti-parasitic agents used in the treatment for rosacea that are also being investigated in treating coronavirus, i.e., chloroquine, hydroxychloroquine, ivermectin, and metronidazole which we are adding TO THIS POST. 

AntiFungal Treatments (antimycotic medication) are listed under the same subheading on this post. 

Reply to this Topic

There is a reply to this topic button somewhere on the device you are reading this post. If you never heard about this topic and you learned about it here first, wouldn't it be a gracious act on your part to show your appreciation for this topic by registering with just your email address and show your appreciation with a post?  And if registering is too much to ask, could you post your appreciation for this topic by finding the START NEW TOPIC button in our guest forum where you don't have to register?  We know how many have viewed this topic because our forum software shows the number of views. However, most rosaceans don't engage or show their appreciation for our website and the RRDi would simply ask that you show your appreciation, please, simply by a post.  

End Notes

[1] "Over the past decade, there has been an increase in the incidence of SSTIs presumably due to the aging population, increase in number of immunocompromised people, and the emergence of multi-resistant pathogens. Data from 2012 showed that the total cost of SSTIs in the USA alone was $13.8 billion, mostly due to hospitalizations. Clearly, cutaneous infections and their management are a significant health and financial burden and providers should be educated on the most recent developments in order to provide effective, evidence-based care for their patients."

Curr Dermatol Rep. 2020; 9(2): 152–165.
New Developments in Bacterial, Viral, and Fungal Cutaneous Infections
Samuel Yeroushalmi, Joshua Yoseph Shirazi, Adam Friedman

Thanks BlackMamba24 for the update and so happy for you!

image courtesy of the CDC

Sugar is just as much a valid rosacea trigger as any of the other proposed rosacea triggers since Sugar = Rosacea Fire.
You will not learn that sugar is a rosacea trigger from any other rosacea non profit organization because the RRDi is the only one that lists sugar as a rosacea trigger. This post will help you understand how you can figure out better what added sugar is in the processed food or drink you might consume to see how much sugar you are allowing in your diet. 

We reported in 2015 how the FDA was considering make a a change on the nutrition facts label about how many grams of added sugar is in a food or drink (the eighth post in this thread dated Posted July 25, 2015). The FDA did change the Nutrition Facts Label to show added sugar with this announcement in October 2018 that allows certain manufacturers until 2021 to comply with the change. While there are six new differences in the label, item number 3 is about added sugar and note what the FDA states about this:

"3. Added sugars are now listed to help you know how much you are consuming. The 2015-2020 Dietary Guidelines for Americans recommends you consume less than 10 percent of calories per day from added sugars. That is because it is difficult to get the nutrients you need for good health while staying within calorie limits if you consume more than 10 percent of your total daily calories from added sugar." October 2018 announcement

Healthline had this to say about the above label change:

"Before this label change, different types of sugars were lumped into a total sugars category on the Nutrition Facts label. For example, many fruit yogurts contain sugars from three sources: lactose from milk, natural sugars from fruit, and added sugars. All of these were tallied as one figure under total sugars. The new labels will distinguish added sugars to help people understand exactly how much they’re eating, which shouldn’t be more than 10 percent of their daily calories, according to the FDA’s dietary guidelines." New Nutrition Labels Reveal How Much Added Sugar You’re Eating, Healthline, November 2, 2018

WebMD had this to say about the label change:

"It can be tough to recognize added sugars by looking at the list of ingredients on a label, the U.S. Centers for Disease Control and Prevention says.

Brown sugar, corn sweetener, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, honey, lactose, malt syrup, maltose, molasses, raw sugar and sucrose are just some of the many different ingredients that contribute added sugars to food, the CDC notes.

To make things simpler for consumers, the FDA proposed a new line on the Nutrition Facts label that totals up all these sources of added sugar." 'Added Sugars' Label on Foods May Save Many Lives, Dennis Thompson, WebMD

Later, the FDA allows manufacturers of certain "single-ingredient sugars and syrups and certain cranberry products' that "allow for the use of a “†” symbol immediately following the percent Daily Value declaration for Added Sugars, which leads consumers to a statement that provides information about the gram amount of Added Sugars, as well as information about how that amount of sugar contributes to the percent Daily Value." Statement on new guidance for the declaration of added sugars on food labels for single-ingredient sugars and syrups and certain cranberry products, Susan T. Mayne Ph.D., Director - Center for Food Safety and Applied Nutrition (CFSAN)

The CDC has this to say about the amount of added sugar you should consume each day: 

"Americans should keep their intake of added sugars to less than 10% of their total daily calories as part of a healthy diet. For example, in a 2,000 daily calorie diet no more than 200 calories should come from added sugars." Know Your Limit for Added Sugars

To convert calories to grams you should remember that there are 4 calories in one gram of carbohydrate. So the above recommendation from the CDC which is based upon the new FDA recommendation means that 10% of added sugar amounts to 50 grams of carbohydrate. Sugar is carbohydrate. Further, the added sugar is just what the label is pointing out to you besides the natural sugar or carbohydrate in the food or drink your are consuming. So if you look at the new label at the top of this post the TOTAL carbohydrate (sugar) contained in the item is 37 grams. Of that 37 grams there is included 10 grams of added sugar. In other words, if the product didn't add the 10 grams of sugar the food item still has 27 grams of carbohydrate (sugar). 

If you want to learn for your self whether reducing sugar (carbohydrate) in your diet improves your rosacea, looking at the Nutrition Facts Label can be an eye opener for many who are not aware how much carbohydrate (sugar) is in the diet. A simple test to discover that sugar (carbohydrate) is a rosacea trigger for you, reduce the amount of sugar (carbohydrate) in your diet to no more than 30 grams a day for 30 days. During this test you should see some improvement in your rosacea within the thirty days. After the thirty days, gorge yourself with all the sugar and carbohydrate you want and see if your rosacea comes back? That is the basic nutshell version of the Rosacea Diet. This post on the new label requirements for added sugar makes it easier for you to spot added sugar. 

The New York Times had this to say about added sugar:

"While you might think you’re not eating much sugar, chances are you’re eating a lot more than you realize. Added sugar lurks in nearly 70 percent of packaged foods and is found in breads, health foods, snacks, yogurts, most breakfast foods and sauces. The average American eats about 17 teaspoons of added sugar a day (not counting the sugars that occur naturally in foods like fruit or dairy products). That’s about double the recommended limit for men (nine teaspoons) and triple the limit for women (six teaspoons). For children, the limit should be about three teaspoons of added sugar and no more than six, depending on age and caloric needs." Make 2020 the Year of Less Sugar, Tara Parker-Pope, The New York Times, December 31, 2019

The above article also included a seven day challenge. 

There was a follow up article on the above article which added: 

"As an example, take a look at the label on whole milk, which shows 11 grams of sugar in a one-cup serving. That sounds like a lot, but the new label will make it clear that all that sugar occurs naturally as lactose and that the same cup of milk has zero grams of added sugar. A chocolate milk label will show 26 grams of total sugar, which includes 11 grams of lactose, and the extra information that a serving has 15 grams of added sugar." 
Dried Fruit, Oats and Coffee: Answers to Your Sugar Questions
Our 7-Day Sugar Challenge prompted a number of questions about cutting added sugar from our daily diet.
Tara Parker-Pope, The New York Times, Jan. 8, 2020