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sweat pore image courtesy of Wikimedia CommonsThere are some sources that state that rosacea causes large pores, particularly the pores on the nose. Here are some typical examples:
"Signs of the third stage of rosacea include persistent deep redness and many dilated veins, especially around the nose. An early sign of the third stage is fibroplasia -- growth of excess tissue -- which can produce enlarged pores." [1]
"The bumps and pimples, as well as skin thickening, that accompany rosacea causes pores to enlarge and become more visible." [2]
"The bumps and pimples, as well as skin thickening, that accompany rosacea cause pores to enlarge and become more visible." [3]
If you will note, two different sources state the exact same words!
The general consensus among rosacea authorities is that blackheads are not associated with rosacea. While large pores may be a concern to you, what can you do for this issue?
Nose Pores
"Unfortunately, there’s nothing you can do to literally shrink large nose pores. But there are ways you can help make them appear smaller." [4]
Treatment
Natasha Burton has ten natural treatments to reduce or minimize pores. [5]
Non-comedogenic skin care products (product won't clog your pores, i.e. oil free). [6]
Retinoids [7]
Clay Masks [8]
Hyaluronic Acid [9]
Gold nanoshell-mediated PTT [10]
Conclusion
Why not volunteer and post what you have done to reduce your large pores so others who are concerned with this issue can benefit. That is what this is all about, rosaceans helping rosaceans.
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.
End Notes
[1] A Fine Complexion Need Not Become A Distant Memory, Lynn Drake, MD, Rosacea Review Newsletter of the NRS, Summer 1997
[2] More Than Just a Red Face: Seven Signs of Rosacea, April 12, 2018, DermatologistOnCall
[3] More than just a red face: 7 signs of rosacea, MDLive
[4] What Causes Large Nose Pores and What Can You Do?, Healthline
[5] 10 Natural Remedies for Shrinking Your Pores, Natasha Burton, StyleCaster
[6] What Can Treat Large Facial Pores?, AAD
[7] "Certain products that have retinol [a derivative of vitamin A and well-known acne fighter and anti-ager] can make pores appear smaller," says Dr. Jaliman. "The way they work, as do other prescription strength retinoids, is to increase cell turnover so they unclog the pores, making them appear smaller."
Can You Shrink Pore Size? A Top Dermatologist Explains The Possiblities, Simone Kitchens, Updated September 21, 2017, Huff PostThe following retinol product is an example of reducing pores:
[8]
[9] "Overall, the study concluded that intradermal low molecular weight hyaluronic acid fillers do in fact have the potential to reduce pore size — and that's in addition to improving the skin's overall texture and radiance."
New Study Says Hyaluronic Acid Fillers Can Lead to Smaller Pores, Game-changing, BY KALEIGH FASANELLA, AllureAmazing Formulas Hyaluronic Acid
The Ordinary Hyaluronic Acid 2% + B5
Pure Hyaluronic Acid Serum Powder
Tree of Life Hyaluronic Acid Serum
Cosmedica Skincare Pure Hyaluronic Acid Serum
Eve Hansen Hyaluronic Acid Cream
[10] One paper on using gold nanoshell-mediated PTT for acne states, "The treatment of enlarged facial pores with gold nanoshell-mediated PTT produced excellent results with no side effects."
Gold nanoshell-mediated PTT -
On 2/1/2020 at 10:25 PM, BlackMamba24 said:
Thanks for the response. This is very helpful. I've been doing as you directed with the routine the last two days and it's been OK. One new small blemish but other blemishes seem to be clearing a bit, so I'm optimistic the ZZ cream will make a difference. I do like the way it feels when it's on - like I can tell something is actually happening in my skin!
Additionally I did purchase Andalou Naturals Face Cream with Probiotic C Renewal. I've read it can be very good for this type of skin and it was on the list of topical probiotics. I'm going to test it tomorrow morning after I rinse. Any experience with this cream?
To answer your questions, I believe I am phenotype 4. It's mostly just the acne at this point. My dermatologist says other people have it much worse, but my case is extremely stubborn and other treatments that have worked for his other patients aren't doing the trick for me yet. The worst part is it can flare at anytime and when it does, it impacts my confidence especially at work.
I purchased the original ZZ cream. I'm wondering how long the little jar will last. It looks like it's not available on Amazon right now, so I guess I will need to make it last. Is it going to be that hard to re-purchase?
Thanks for the other tips on the diet. I'm reluctant to give up the carbs at that rate, but we'll see how this progresses. I've already cutback a great deal on the sweets and dairy, but haven't gone completely cold. This may be my next move and I think I will request a copy of the diet.
I'll definitely stay engaged on the forum. ZZ cream has given me some new hope. I have a dermatoligist appointment in a couple weeks and will see what he thinks about the ZZ cream and if I should continue with the doxycycline. I did have a couple other questions:
Do you have an acarid soap you recommend?
Do you recommend taking Lutein or any other OTC vitamins?
Do you take a probiotic for your gut?
Thanks again for your help!
You can still purchase the ZZ cream from Demodex Solutions by clicking here. I will send you a copy of the Rosacea Diet. Unless your dermatologist is open minded I doubt if he will have anything good to say about the ZZ cream. The Acarid Soap from Demodex Solutions is good. I take this Lutein every day. I also take a cheap probiotic twice a day. I used to purchase the expensive one but I can't afford it anymore. I also take a huge handful of vitamins and supplements every day, so just read what I list in the Rosacea Diet book. Also read this post about nutritional deficiencies in rosaceans. I also take ElaineA's salt/borax bath just about every day. Keep us posted on your progress.
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Results of Two Phase 3, Randomized, Clinical Trials, FMX103 1.5%, conclusion:
FMX103 1.5% was efficacious for moderate-to-severe papulopustular rosacea, while maintaining a favorable safety profile
The authors of the paper add this limitation, "The generalizability of these data from a controlled clinical trial should be examined in a real-world setting."
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FMX101 4% for Acne
"In conclusion, the topical formulation of minocycline in FMX101 4% represents a unique treatment for acne vulgaris and a viable alternative to oral administration."
J Clin Aesthet Dermatol. 2020 Apr; 13(4): 14–21.
Formulation and Profile of FMX101 4% Minocycline Topical Foam for the Treatment of Acne Vulgaris
Leon Kircik, MD, James Q Del Rosso, DO, Jonathan S Weiss, MD, Vassilis Stakias, PharmD, Anat London, PhD, Rita Keynan, Yohan Hazot, Russell Elliott, PhD, and Iain Stuart, PhD -
On 1/29/2020 at 7:52 PM, BlackMamba24 said:
Hello Brady, this is my first post but I've been reading your posts for over a month.
I have suffered from rosacea or adult acne for about one year and after trying all of the dermatologists ideas (doxy, minocycline, azithromycin, bactrim, as well as soolantra, metro gel and retina), I stumbled onto this forum and saw that you suggested the ZZ cream. I went online and purchased.
After using for a couple days, everything seems to be getting worse. I read this might be what happens, but I was disappointed today to see several new blemishes and very dry skin. I have some questions I'm hoping someone with more experience might be able to help answer.
I think what I'm really looking for is the complete regimen for using ZZ cream? From which soap, to which moisturizer, to which sunscreen .... I'm really lost on how to proceed.
Is it OK to use an acarid soap with ZZ cream or is that too much sulfur? I did both for a couple days but my skin is now extremely dry so I've gone back to my original Cetaphil soap.
I'm just really struggling to find any relief. I had some success with my first IPL treatment, but my second (v-beam) and third didn't work so well. I had great success for a couple weeks with bactrim, but it gave me a terrible rash.
I'm not 100 percent positive it's demodex, but that's my hunch as i often have itchy feeling. My doctor really isn't helping me get to the root cause of the issue. He's all out of antibiotics and doesn't seem to have any other solutions. I'm hopeful the ZZ cream can work, but the dryness is extremely difficult to hide.
Any recommendations on regimen for using ZZ cream would be helpful. Thank you.
Yes, if you are suffering from demodectic rosacea, IT GETS WORSE BEFORE IT GETS BETTER. A significant number of rosaceans who use the ZZ cream complain of dry skin and, of course, the ZZ cream contains sublimed sulfur which dries the skin even more. You may want to try this regimen:
(1) Just before bed, wash face with acarid soap and rinse with lots of water.
(2) Apply the ZZ cream on face especially the red areas and pimples. Let it dry before you lay your face on a pillow. Be careful when applying around your eyes, and if you do get near your eyes, close your eyes and then go to bed asap. ZZ cream causes tearing of the eyes.
(3) In AM, wash the ZZ cream off with just water. Then apply your favorite moisturizer. Many have recommended rose hip oil or shea butter or whatever your favorite moisturizer.
Repeat steps 1 thru 3 each day.
Also, avoid eating sugar/carbohydrate for just thirty days. Try to reduce your intake to less than 30 grams of carbohydrate a day. You should notice improvement in your skin. Drink lots of water. If you want a free copy of my Rosacea Diet use the contact form and request a copy. Also you may want to think about taking oral and topical probiotics to help your gut. While demodectic rosacea is a valid rosacea variant, also GUT Rosacea is a variant.
You may want to start your own post on your experience in this same category in our forum, or create your own blog or club. I will be one of your followers.
Questions, what phenotype do you have? Which ZZ cream did you purchase, Original or Cosmetic?
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Davvidml at RF started a thread about using Protopic (Topical Tacrolimus) mentioning it helps reduce his facial swelling and states, "My first post here, diagnosed with Rosacea 6 years ago, type 1 with severe flushing on my cheeks and swelling that makes my face look huge. I have tried numerous treatments over the year, antibiotics, soolantra with nothing helping at all. For the past three weeks I have been using Protopic and (after the 15 days) I have a MASSIVE reduction in swelling of my cheeks. My skin can still flush and turn red but the swelling is almost none existant. My face looks the same size it did 6 years ago before I had Rosacea. I really thought my cheeks had permanently enlarged. Others on here who have bad swelling or Rhinophyma might want to try this."
redtere pointed out in the same thread above started by Davvidml in post no 4, ""These results have profound implications for lymphedema treatment as topical tacrolimus is FDA-approved for other chronic skin conditions and has an established record of safety and tolerability," and refers to a medical journal on this subject. [2]
Precooling topical calcineurin inhibitors tube; reduces burning sensation
"Among the topical agents, metronidazole was the most prescribed agent during 2007-2012, whereas calcineurin inhibitors were favored most during 2013-2018." [bold added] [4]
We need more anecdotal reports like the above to substantiate this. Furthermore, it needs to be established if this is a short term benefit and what the long term risks of taking topical Tacrolimus are.
Cautions
"However, previous case reports have demonstrated an association between granulomatous rosacea (GR) and topical tacrolimus use." [1]
"On the one hand, the immunosuppressive properties of tacrolimus might facilitate overgrowth of follicular Demodex in susceptible patients, as suggested by the predominance of the pustular component in the flares (Figure 1B) and the abundance of Demodex in 2 patients who underwent biopsy. Rosacealike demodicosis has been reported in local and systemic immunosuppression, which suggests that Demodex proliferation is facilitated by local or systemic immunosuppressive factors. We recently observed a case where a flare of rosaceiform dermatitis during treatment of facial atopic dermatitis with 1% pimecrolimus cream was associated with the appearance of Demodex, and the good response of patients to oral doxycycline is another indication of the pathogenic role of Demodex. On the other hand, tacrolimus ointment has vasoactive properties, and facial flushing is a significant adverse reaction to the treatment. As local vasomotor instability is a feature of rosacea, tacrolimus ointment may in the long term constitute an additional risk factor in sensitive patients. This may explain the insidious development of rosacea during long-term treatment, as was seen in our patient 6 and in the report of Bernard et al. Moreover, the occlusive properties of the tacrolimus ointment base may play an aggravating role, especially in patients with seborrhea." [3]
End Notes
[1] Journal of Drugs in Dermatology/ 2015;14(6):628-630.
Severe Tacrolimus-Induced Granulomatous Rosacea Recalcitrant to Oral Tetracyclines
June 2015 | Volume 14 | Issue 6 | Case Reports | 628 | Copyright © June 2015
Lissy Hu BA, Christina Alexander BA, Nicole F. Velez MD, F. Clarissa Yang MD, Alvaro Laga Canales MD MMSc, Stephanie Liu MD, and Ruth Ann Vleugels MD MPH[2] Nature Communications, 2017;8:14345. Published 2017 Feb 10.
Topical tacrolimus for the treatment of secondary lymphedema
Jason C. Gardenier, Raghu P. Kataru, Babak J. Mehrara[3] End note 287 in the first post of this thread (you are currently reading the second post in this thread, so simply scroll up to the first post)
[4] PubMed RSS Feed - -Patient Visits and Prescribing Patterns Associated with Rosacea in Korea: A Real-World Retrospective Study Based on Electronic Medical Records
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An article published in Photobiomodulation, Photomedicine and Laser Surgery in January 2020 states, "Our video directly demonstrates the effect of IPL on a live Demodex mite extracted from a freshly epilated eyelash. The results suggest that IPL application with settings identical to those used for treatment of DED due to MGD causes a complete destruction of the organism."
Photobiomodul Photomed Laser Surg. 2020 Jan 27;:
Real-Time Video Microscopy of In Vitro Demodex Death by Intense Pulsed Light.
Fishman HA, Periman LM, Shah AA -
Walter Freyne, the owner of Demodex Solutions, has assisted me in comparing the Original ZZ cream ingredients with the cosmetic version and has approved this comparison which is now published through the RRDi. While I love the original ZZ cream, I think the cosmetic version is better because it dissolves better and feels creamer or softer.
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"A generic version of Soolantra has been approved by the FDA. However, this does not mean that the product will necessarily be commercially available - possibly because of drug patents and/or drug exclusivity. The following products are equivalent to Soolantra and have been approved by the FDA:
ivermectin cream; topical
Manufacturer: TEVA PHARMS USA
Approval date: September 13, 2019z" Source: Drugs.com
Teva 1% Ivermectin Cream -
The RRDi is please to announce that Tara O'Desky, D.C., has graciously volunteered for the RRDi MAC. She has a website where she explains how the Rosacea Forum helped her control her rosacea. We are grateful for Dr. O'Desky who volunteers for our non profit organization as a medical advisor.
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Nicholas,
Thanks for the link to the article, which is a good find! I have added artemesinin to the list of anti-malaria treatments used for successful rosacea treatment. Technically, artemisinin is not an anti-viral, but an anti-malaria treatment used on Plasmodium falciparum, a protozoa. Hopefully, we will hear of anecdotal reports of Rosaceans using artemisinin for rosacea with positive results. Your volunteering to post such articles is what the RRDi is all about, helping rosaceans with rosacea research!
Artemisinin is available over the counter and considered one of the Anti-parasitic Prescription Agents.
"Artemisinin derivatives are known for their ability to suppress immune reactions such as inflammation." Wikipedia
More information on Artemisinin (ART)
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.
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13 hours ago, Mandy Kimber said:
I have just been diagnosed with bvFTD a form of early dementia .... developed rosacea at the beginning of the year when my bvFTD was getting worse, frighening to realise they are linked
Welcome to the RRDi,
What treatment are you using for your rosacea? Is it working?
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"Nonprofits often make money, but what they do with the money they make separates them from for-profit businesses...In other words, any profit a nonprofit makes can't be returned to investors in the form of profits or dividends. Instead, the money is used to grow the organization and further support its mission." Have You Ever Wondered..., How does a nonprofit work?, Wonderopolis
There are some familiar non profit organizations you probably without a doubt have heard of, such as United Way, Mayo Clinic, Red Cross and the list goes on. These non profits collect private donations in the billions of dollars and ranking them has been reported by Forbes and The Public Interest Foundation and others.
Most large non profits pay salaries to their employees and directors. For example, one of the larger non profits, United Way, in 2018, according to Form 990 (available to the public) received in total revenue (donations, program services and other revenue) a total of over $218 million dollars. This non profit paid out in salaries, other compensation, employee benefits a total amount of over $32 million, which is 14.6% of the money spent. The president and CEO of United Way, Brian Gallegher, received a total of $777,692 in compensation and $299,178 from other compensation making a total of over a million dollars. This is typical of the large and small non profit organizations. [1] Read the United Way Form 990 for 2018 yourself:
There are non profits that have all volunteers, like The Erythromelalgia Association and, of course the Rosacea Research and Development Institute, however, these volunteer non profits are fewer since it is difficult to get volunteers to actually volunteer.
You may want to also read these posts:
What is your idea of what a rosacea non profit should be doing?
Comparing Non Profit Organizations with their Mission
End Notes
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The Netherlands has endorsed the new phenotype classification of rosacea, as published in the British Journal of Dermatology, January 2020 • For more information.
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An article about any conflict of interest (COI) with the authors of dermatological textbooks is an interesting read, highlighting the need for more transparency acknowledging the funding of the authors. [1]
Note this paragraph:
"In recent years, dermatologists’ relationship with industry has increased immensely. The global pharmaceutical market in dermatology is projected to exceed $34 billion per year by 2023 (Prescient & Strategic Intelligence, 2018). The relationship with industry is a complicated subject. Support from industry has been important for the advancement of dermatology and has provided funding support for a range of activities, including clinical trials, educational materials, and travel support for residents and fellows. These funds are integral for the growth and maintenance of the specialty. For example, exhibit revenue from technical exhibits at large meetings helps support registration and educational costs for attendees and provides funding for other non-income-producing activities. The pervasiveness of industry is incontrovertible and spans a gamut ranging from continuing medical education programs to educational grants to advertisements in journals (Sams and Freedberg, 2000)."
Here are some highlights of the study:
(1) The study was limited to eight textbooks and states about these that all eight "are listed on the American Academy of Dermatology (AAD) website as board preparation resources recommended by members of the AAD Resident and Fellows committee under the category of general dermatology textbooks."
"The most recent editions of eight commonly used books were selected and are listed as follows: Dermatology (4th edition, 2017), Andrews’ Diseases of the Skin: Clinical Dermatology (12th edition, 2015), Dermatology Secrets Plus (5th edition, 2015), Genodermatoses: A Clinical Guide to Genetic Skin Disorders (2nd edition, 2004), Comprehensive Dermatologic Drug Therapy (3rd edition, 2012), Hurwitz Clinical Pediatric Dermatology: A Textbook of Skin Disorders of Childhood and Adolescence (5th edition, 2015), Dermatology: Illustrated Study Guide and Comprehensive Board Review (2nd edition, 2017), and Clinical Dermatology: A Manual of Differential Diagnosis (3rd edition, 2003)."
(2) "The total compensation for 381 authors in 2016 was $5,892,221....The top 10% of dermatologists who collected payments received $5,267,494, which represented 89% of the total payment amount.....The payment distribution was skewed with a minority of dermatologists receiving the majority of payments."
(3) "Given the financial incentives of pharmaceutical companies, the pharmaceutical industry has a particular interest in targeting young physicians in training as they foster their own disease treatment and prescribing patterns."
(4) "This study helps to further characterize the relationship between authors of general dermatology textbooks and industry. Continued discussion to foster transparency among physicians, regulators, and the public with regard to various topics, such as policies, physician behaviors, and the potential for CoI in educational resources, is important."
The paper acknowledges the limitations such as only USA physicians were included and other limitations. But you do get an idea of why transparency should be acknowledged in the textbooks that dermatologists are using so that as the authors of the study put it, "Whether industry payments to authors affect the quality of information in dermatology textbooks for better or for worse remains uncertain" so that "readers can draw their own conclusions."
End Notes
[1] International Journal of Women's Dermatology
Conflicts of interest among dermatology textbook authors
Jorge Roman, MD, David J. Elpern, MD, and John G. Zampella, MDEtcetera
Related to skin industry funding of textbook authors are the following two posts:
Rosacea Research in Perspective of Funding
Rosacea Research in Perspective of Idiopathic Diseases
Skin Industry & Rosacea Research & Social Media -
Interesting that Actinic Folliculitis should be considered in a differential diagnosis with rosacea. It has been suggested that photo damage may be responsible in rosacea which is one of the threories.
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Mosquitoes and Virus and Imiquimod Cream
As noted in the post on Protozoa and Rosacea, treatment for malaria [protozoa] has improved some cases of rosacea using mepacrine, chloroquine, and hydroxychloroquine. An article published in Science Daily [1] points out, "There are hundreds of viruses spread by biting mosquitoes which can infect humans...At present, there are no anti-viral medicines and few vaccines to help combat these infections." The article discusses using a skin cream with the active ingredient imiquimod and reports, "By applying skin cream after a bite, researchers found that they could pre-emptively activate the immune system's inflammatory response before the virus becomes a problem. The cream encouraged a type of immune cell in the skin, called a macrophage, to suddenly spring into action to fight off the virus before it could spread around the body."
Wouldn't it be novel for 10K RRDi members to get together and each donate a dollar and then sponsor a clinical researcher to investigate if using imiquimod as the active ingredient might improve rosacea? Do you think any pharmaceutical company or other rosacea non profit organization would ever investigate this? How do you get 10K RRDi members to come together and all agree that this should be done?
Maybe we might learn that some rosaceans somehow apply this imiquimod cream by diluting it with a moisturizer, coconut oil, shea butter, or something to see if this improves their rosacea. If so, then possibly, as this thread points out, could a virus be connected to rosacea?
End Notes
[1] Mosquito-borne diseases could be prevented by skin cream, Science Daily -
Phage injecting its genome into bacteria - image courtesy of Wikimedia CommonsBacteriophage are a particular virus that are included in the human microbiome that "have been used for over 90 years as an alternative to antibiotics in the former Soviet Union and Central Europe as well as in France." Human Microbiome, Brady Barrows
Some researchers are trying to find foods that encourage bacteriophage to act as an antibiotic in the gut, for example, stevia, they say as the "most potent prophage inducer" and explains, "The ability to kill specific bacteria, without affecting others, makes these compounds very interesting."
"These findings are important. Scientists now know that the microbiome can influence our physical and mental health; it can also cause inflammation and increase cancer risk. If scientists can work out how to alter the microbiome in specific ways, they can, in theory, remove or reduce these risks."
Common foods alter gut bacteria by influencing viruses, MedicalNewsToday
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"Retinoids have the potential to cause varying degrees of myositis and their rapid identification could prevent major complications." Source
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On 1/17/2020 at 5:31 AM, Antonia Turner said:
Can you send me the Amazon link for the injectable one?
Sent using Tapatalk
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Antonia,
The general consensus is that the mites on cats or dogs are a different species, however, as pointed out above, scabies and other demodex can infect a human from a pet. There should be more research on this but as it stands now the data shows that the species of mites on humans are different than on pets, generally speaking. Each mammal usually has its own species of demodex mites. The point of this post is that since we do know that mites can travel from pets to humans, there is a possibility that demodex do indeed infect humans from pets. No one certainly wants to be infected with scabies and avoids any contact with an infected human or pet.
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3 hours ago, Antonia Turner said:
I also am trying Tumeric Supplements now and a probotics.
Sent from my SM-N910V using Tapatalk
I didn't read this till after my previous post. Good you are taking Tumeric and probiotics. Keep taking them.
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3 hours ago, Antonia Turner said:
Hello thank you for replying. I just ate a Blueberry Kind Bar and got red blotchy cheeks, so much for "good grains". I tried Finacea, Mirvaso, trying Soolantra all generic brands. Natural products I tried pumpkin seed extract, licorice root, Madagascar Centella, vitamins a thru all. I am not sure I have those 2 autoimmune diseases but a skin doctor told me maybe I have one of those too being I flare get red no matter what I eat and even if I dont eat I sit at work and can get red for mo reason (not stress). I am taking Doxycycline right now my doctor tried to switch me over to Minocycline which was a nightmare my skin freaked out so I am back on Doxycycline. I cant even find a local doctor to help or make a diagnosis if I have them besides Rosacea. I am premenopausal and I hear that as a excuse from doctors. I dont see why no matter what I do or dont do my skin is like this. I wil try no sugar.
Sent from my SM-N910V using Tapatalk
Not sure which Blueberry Kind bar you are eating but I found the above Nutrition Facts Label to show you how much carbohydrate is in this bar which shows 24 grams in a 35 gram serving. You can subtract the 2.5 grams of dietary fiber since fiber has no significant energy to consider.* So technically the above serving is 21.5 grams of carbohydrate in a 35 gram serving. That means this bar is 61% carbohydrate. This is a high carbohydrate food. When you carefully go through the Nutrition Facts Label for everything you eat in a day, you are probably, without a doubt eating a high carbohydrate diet. There is ample evidence that sugar/carbohydrate is a rosacea trigger in anecdotal reports. For that matter, any proposed rosacea trigger is based upon surveys or anecdotal reports, therefore, listing sugar/carbohydrate as a rosacea trigger is just as valid as any other proposed rosacea trigger, no matter who makes the list.
So usually the question is what should you eat for thirty days to see if reducing sugar/carbohydrate improves your skin? Eat high protein and fat. Eating high protein/fat for thirty days poses absolutely no health risk contrary to what you might learn from any source. After the thirty days you can then decide based upon what you learn whether this improves your rosacea and other issues. This will not be easy because sugar is an addiction. So you simply have to balance whether having your skin issues improve is worth the effort to get off of sugar for just thirty days.
Also since you are taking doxycycline, you will need to build up your good flora with probiotics, which is now an accepted medical treatment for rosacea. Short term antibiotics for rosacea may be required to control rosacea, but long term antibiotic treatment for rosacea can produce some unwanted side effects and risks. You need to decide whether taking long term antibiotics are worth those side effects and risks. Probiotics offer an alternative.
How long did you use Soolantra? Why did you stop using it?
It is good you are taking supplements, herbals and vitamins. Have you read this post?
Don't give up, you will find a way to control your rosacea and other issues.
*To learn why fiber is not a significant source of energy, read the article, Carbohydrate Not Essential For Human Survival
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Methanobrevibacter smithii image courtesy of Cedars SinaiBacteria has been implicated in rosacea with a huge amount of clinical papers on this subject. Demodex is now without a doubt linked to a significant number of rosacea cases. At least one fungus has been associated with rosacea, and we have papers indicating treatment for one particular protozoa improves rosacea, however virus has not been ruled out in rosacea.
The human microbiome includes the skin which contains a number of different microbes. [1] One microbe that has generally been totally ignored is archea, which has never been ruled out as having anything to do with rosacea.
Archea and Rosacea
"Methanobrevibacter smithii is the predominant archaeon in the human gut."
The general public has little if any knowledge of this microbe which has been known to exist in the human microbiome for some time now. "Archaea are a major part of Earth's life. They are part of the microbiota of all organisms. In the human microbiota, they are important in the gut, mouth, and on the skin. They may play roles in the carbon cycle and the nitrogen cycle." [2] The chief reason that archea is basically totally ignored as having anything to do with rosacea is that there is no known archea human pathogen. Furthermore, due to the bias the scientific community has towards bacteria which focuses research on bacteria ignoring most of the other microbes, including archea, little is known about archea.
"A deeper knowledge of human microbiome composition and microbe-host interactions will contribute to clarify the mechanism of development of rosacea and possibly will provide innovative therapeutic approaches." [3]
Basically we have no idea what role archea plays in the skin microbiome due to a lack of investigation into this subject. Hence, little is known of what role archea may play in rosacea. There is absolutely no motive to investigate this since who would fund such a study? Hopefully someday some research will discover the role archea plays in the human microbiome and whatever revelations are discovered may alter our understanding of archea.
Do you want to fund such a study? Could 10K members of the RRDi get together and each donate one dollar to fund such a study? Only with your help could we reach such a goal. Think about it. [4]
End Notes
[1] "Microorganisms inhabiting superficial skin layers are known as skin microbiota and include bacteria, viruses, archaea and fungi."
Future Microbiol. 2013 Feb;8(2):209-22. doi: 10.2217/fmb.12.141.
Skin microbiota: overview and role in the skin diseases acne vulgaris and rosacea.
Murillo N, Raoult D."In the GI tract, the microbiome is made up of trillions of microbes including bacteria and other microbes such as fungi and archaea. The skin is also colonized by an equally complex microbiome that varies with host genetic and environmental influences. Emerging research suggests that the collection of microbial communities that populate the skin and GI tract, rather than single microorganisms alone, is responsible for disease."
Dermatol Pract Concept. 2017;7(4):31–37. Published 2017 Oct 31. doi:10.5826/dpc.0704a08
Diet and rosacea: the role of dietary change in the management of rosacea
Emma Weiss and Rajani Katta"Human skin hosts a diverse ecosystem of bacteria, fungi, viruses, mites, and archaea."
Skin Microbiota and Your Health, by Chris Kresser, Kresser Institute[2] Archea, Wikipedia
[3] Journal of Clinical Gastroenterology 48 Suppl 1, Proceedings From The 7th Probiotics, Prebiotics & New Foods Meeting Held In Rome On September 8-10, 2013:S85-S86 · November 2014; DOI: 10.1097/MCG.0000000000000241
Skin Microbiome and Skin Disease The Example of Rosacea
Mauro Picardo[4] More thoughts on this subject to think about:
Rosacea Research in Perspective of Funding
Rosacea Research in Perspective of Idiopathic Diseases
Metronidazole, the Central Nervous System, Neuropathy & the Brain
in Metronidazole
Posted
The papers below are discussing ORAL metronidazole, however, you should be aware of these studies with regard to the Central Nervous System, the brain, neuropathy and treatment with metronidazole (considered one of the Anti-parasitic Prescription Agents).
"This microdialysis study describes the steady-state brain distribution of metronidazole in patients and confirms its extensive distribution....These findings demonstrate that the extensive distribution of metronidazole within brain ECF contributes to the CNS toxicity observed occasionally during treatments with this antibiotic. " [1]
"Metronidazole is a potential cause of reversible autonomic neuropathy." [2]
"Cerebellar toxicity is a rare adverse event in patients treated with metronidazole." [3]
"Metronidazole is a commonly used antimicrobial drug. When used excessively, it can cause encephalopathy." [4]
"Nevertheless, six cases of peripheral neuropathy with metronidazole have been reported, and we describe here a further patient with peripheral neuropathy due to metronidazole." [5]
"Metronidazole is distributed extensively within CSF, with a mean CSF to unbound plasma AUC0-τ ratio of 86% ± 16%." [6]
End Notes
[1] Frasca D, Dahyot-Fizelier C, Adier C, et al. Metronidazole and hydroxymetronidazole central nervous system distribution: 1. microdialysis assessment of brain extracellular fluid concentrations in patients with acute brain injury. Antimicrob Agents Chemother. 2014;58(2):1019–1023. doi:10.1128/AAC.01760-13
[2] J Child Neurol, 21 (5), 429-31 May 2006
Metronidazole: Newly Recognized Cause of Autonomic Neuropathy
Lisa D Hobson-Webb, E Steve Roach, Peter D Donofrio
PMID: 16901452 DOI: 10.1177/08830738060210051201
[3] Int J Infect Dis. 2008 Nov;12(6):e111-4. doi: 10.1016/j.ijid.2008.03.006. Epub 2008 Jun 3.
Cerebellar ataxia following prolonged use of metronidazole: case report and literature review.
Patel K, Green-Hopkins I, Lu S, Tunkel AR.
[4] Kalia V, Vibhuti, Saggar K. Case report: MRI of the brain in metronidazole toxicity. Indian J Radiol Imaging. 2010;20(3):195–197. doi:10.4103/0971-3026.69355
[5] Br Med J. 1977 Sep 3; 2(6087): 610–611. doi: 10.1136/bmj.2.6087.610 PMCID: PMC1631560, PMID: 198056
Metronidazole neuropathy.
W G Bradley, I J Karlsson, and C G Rassol
[6] Antimicrob Agents Chemother. 2014;58(2):1024-7. doi: 10.1128/AAC.01762-13. Epub 2013 Nov 25.
Metronidazole and hydroxymetronidazole central nervous system distribution: 2. cerebrospinal fluid concentration measurements in patients with external ventricular drain.
Frasca D, Dahyot-Fizelier C, Adier C, Mimoz O, Debaene B, Couet W, Marchand S.