Guide

There are no known articles that have actually studied whether rosacea is contagious but any papers published about this question says that rosacea is not contagious. "Rosacea is not catching." [1]

There are some communicable skin conditions and here is a list. A recent paper published by Cell Host & Microbe states, "In a new study, researchers at the University of Pennsylvania have shown for the first time that, not only can infection with the Leishmania parasite alter the skin microbiome of affected mice, but this altered microbial community can be passed to uninfected mice that share a cage with the infected animals." An article discussing this paper says, "To my knowledge, this is the first case where anyone has shown that a pre-existing skin microbiome can influence the outcome of an infection or a disease," said Elizabeth Grice, co-senior author and assistant professor in the departments of Dermatology and Microbiology in Penn's Perelman School of Medicine. "This opens the door to many other avenues of research." "

Obviously we need better understanding of Microbiome-based therapeutic strategies.

Demodectic Rosacea May Be Contagious

Danners points out in post #10, "This question has been asked several times on this forum, with similar experiences described by the person posing the question. Doctors and online medical articles say these are not communicable diseases, however there are several, if not hundreds of anecdotal posts on acne.org, reddit and this forum that say otherwise." Are we discussing demodectic rosacea now?

A point worth mentioning is that babies do not have demodex mites. So how do most humans have demodex mites on their skin if they are not transferred? So therefore, isn't it possible to 'catch' demodectic rosacea, which is a variant of rosacea?

One paper on this subject states, "The transfer of Demodex mites between individuals appears to happen less frequently than the transfer of lice (Pediculus humanus), another human-associated arthropod species, as would be expected considering the more external habitat of lice in comparison with these pore-dwelling mites." [2] Another paper explains, "Conversely, if Demodex lack strong geographic structure, it suggests the movement of mites among humans must occur very frequently (perhaps even with social greeting rituals) and across large geographic distances." [3] This same source states the following about transmission of mites between humans: 

"Little is known about the transmission of mites among humans. Recent studies find that many symbiotic microbes are passed directly from mother to offspring during breast-feeding or during birth (especially if birth is vaginal), and dogs acquire their Demodex mites as nursing pups. In light of this, the same means of mite transmission seems possible in humans, supported by the fact that in one study, Demodex mites were found in 77% of nipple tissue from mastectomies. Yet that we found mites on all adults but only 70% of 18 year olds, suggests that perhaps mite colonization does not strictly occur vertically, from parent to child. These results are in line with earlier morphological (largely postmortem) studies in which mites were found to be more prevalent on adults than on children. Mites could be more ubiquitous on children than noted in postmortem studies or herein but at levels or in locations that make the mites difficult to detect even with the use of molecular approaches. One study of Demodex mites on Tokelau islanders found that mites were present on a greater number of children than on adults. These conflicting findings highlight our limited understanding of how and when mites move onto and among human bodies." [3]

"Presumably, Demodex passes to newborns through close physical contact after birth; however, due to low sebum production, infants and children lack significant Demodex colonization....Infestation of both species is more common in males than in females, with males more heavily colonizing than females (23% vs 13%) and harboring more D. brevis than females (23% vs 9%)....The mites are transferred between hosts through contact of hair, eyebrows, and sebaceous glands on the nose." [4]

"Although Demodex mites are considered to be highly host species-specific, cross-infections between humans and animals have been documented." [5]

Logic concludes that demodectic rosacea may be contagious. However, why does one human (a) with rosacea who cohabits and consorts with another human (b) for many years not pass on rosacea to human (b) ? Obviously in such cases rosacea is not infecting human (b). So how can we prove beyond any doubt that demodectic rosacea may be contagious? A peer reviewed, double blind, placebo controlled clinical study should suffice to answer this question. How can this be done? 

Conclusion

So, wouldn't it be nice if say ten thousand rosacea sufferers got together and each donated a dollar and then paid a physician to study this subject and write an article that nails the coffin on this? That brings us to a different subject, 'how do you bring together 10,000 rosacea sufferers together who can publish their own research on rosacea?' Can the RRDi do this? Why not join the RRDi and join in on this 

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dicussion?

End Notes

[1] British Skin Foundation, Rosacea

[2] PNAS | December 29, 2015 | vol. 112 | no. 52 | 15963
Global divergence of the human follicle mite Demodex folliculorum: Persistent associations between hostancestry and mite lineages
Michael F. Palopolia,, Daniel J. Fergusb, Samuel Minota, Dorothy T. Peia, W. Brian Simisond, Iria Fernandez-Silvad, Megan S. Thoemmesc, Robert R. Dunnc, and Michelle Trautweind

[3] PLoS ONE 9(8): e106265
Ubiquity and Diversity of Human-Associated Demodex Mites
Megan S. Thoemmes , Daniel J. Fergus, Julie Urban, Michelle Trautwein, Robert R. Dunn
https://doi.org/10.1371/journal.pone.0106265

[4] Indian J Dermatol. 2014 Jan-Feb; 59(1): 60–66.doi:  10.4103/0019-5154.123498 PMCID: PMC3884930
Human Demodex Mite: The Versatile Mite of Dermatological Importance
Parvaiz Anwar Rather and Iffat Hassan

[5] Iran J Parasitol. 2017 Jan-Mar; 12(1): 12–21.
PMCID: PMC5522688
Human Permanent Ectoparasites; Recent Advances on Biology and Clinical Significance of Demodex Mites: Narrative Review Article
Dorota LITWIN,  WenChieh CHEN, Ewa DZIKA, and Joanna KORYCIŃSKA

For more information on the study of demodex mites, read Megan Thoemmes, PhD Student | Dunn Lab

"Red man syndrome is the most common adverse reaction to the drug vancomycin (Vancocin). It’s sometimes referred to as red neck syndrome. The name comes from the red rash that develops on the face, neck, and torso of affected people." Healthline

"The great thing about infrared saunas is that they can also help people who have rosacea, a condition that causes redness, and sometimes pus-filled bumps on your face. According to Spa Lé La’s website, infrared saunas offer the benefit of being anti-inflammatory, and therefore, it’s not irritating to the skin."

This is how going to the spa can help with rosacea, pain, and stimulating collagen, by Alyssa Morin, Hello Giggles

Prescription costs for acne and rosacea medications for Medicare patients were higher from specialists compared with primary care physicians in family medicine or internal medicine, according to recently published study results in the Journal of the American Academy of Dermatology.

Costs for acne, rosacea prescriptions for Medicare patients higher with specialists vs. PCPs, Healio Dermatology
Zhang M, et al. J Am Acad Dermatol. 2017;doi:10/1016/j.jaad.2017.4.1127.

"I find myself struggling with a response. I know they think they’re giving me a compliment, so I don’t want to embarrass them by saying that I have a skin disease.

Ask Amy: They think it’s a compliment when they mention my disease, By AMY DICKINSON | Tribune Content Agency, The Mercury News

"While the definitive cause of rosacea is unknown at this time, there are a few factors that are prevalent among those who suffer from this common skin condition."

Twelve top tips for dealing with rosacea, Chris Barry, Starts at 60

Avenova is for dry eye syndrome. For more info click here. 

"Over 30 million Americans share these chronic symptoms which may be due to blepharitis,  meibomitis also known as meibomian gland dysfunction (MGD) often described more simply as dry eye syndrome...there is a new weapon called Avenova® that is designed for removal of microorganisms and debris that contribute to these conditions such as dry eye, MGD, blepharitis, Meibomitis and Stye." Avenova is made by NovaBay Pharmaceuticals 

Rebate – Pay no more than $35*. Rx Only

"Another possibility was that Raja’s eye problems stemmed from inflammation, Ngo thought; this could explain why both eyes were affected. Ocular rosacea, a type of the condition better known for causing red skin on the face, might make sense."

When eye irritation is more than it seems at first glance, By ALLISON BOND, Stat

"Exercise can trigger a bout of flushing, facial redness and itchy skin - the key symptoms of rosacea - because it increases your body's core temperature. Indeed, 80 per cent of people in a survey by the National Rosacea Society said it aggravated theirs, particularly if it was high-intensity aerobic exercise. To retain the health benefits of exercise, the National Rosacea Society recommend sufferers do low- to medium-intensity exercise - like Pilates - instead. Similar to yoga, Pilates works by strengthening, stretching, and stabilising key muscles."

Rosacea treatment: THIS form of exercise could significantly improve your skin, by LAUREN CLARK, Express

"I wish I could say I was the perfect skin regiment person. I work at night usually, so when I wake up it’s like noon. I will usually wash my face, just with water, to wake myself up. I do like to moisturize right off the bat. I’m very simple when it comes to my product. I’ll use Neutrogena, I’ve used Shiseido. Those are my favorite two that I vacillate between. And now I use Rhofade as part of my daily routine as a person who has had rosacea for years, and nothing ever really worked. (Chenoweth is a spokesperson for the brand.) With consistent use, this works. So I put on Nivea chapstick, I put on my lashes, and call it a day. On a daily basis, I don’t wear makeup—I let my skin breathe."

Kristin Chenoweth On Her Skincare Secret, Fashion Tricks, And Her Dream Role, Celia Shatzman, Forbes

A Journal of Family Practice article says, "Using intention-to-treat analysis, permethrin 5% cream was as effective as metronidazole 0.05% gel and significantly superior to placebo at improving erythema (change from a baseline score of 2.60 to 1.34), papules (change from baseline count of 6.04 to 1.73), and pustules (change from baseline count of 2.30 to 0.56)." This same article reports, "Permethrin 5% cream is superior to metronidazole 0.75% gel and placebo in decreasing Demodex folliculorum, and is as effective as metronidazole 0.75% gel in treating erythema and papules."

This may be a prescription or a non prescription treatment for rosacea. Ask your doctor. For more information read this post. 

Permethrin has been used on a pregnant patient. For more information. 

"Permethrin, sold under the brand name Nix among others, is a medication and insecticide." Wikipedia

Permethrin is included in with the Anti-parasitic Prescription Agents used to treat rosacea. 

A Journal of Family Practice article says, "Using intention-to-treat analysis, permethrin 5% cream was as effective as metronidazole 0.05% gel and significantly superior to placebo at improving erythema (change from a baseline score of 2.60 to 1.34), papules (change from baseline count of 6.04 to 1.73), and pustules (change from baseline count of 2.30 to 0.56)." This same article reports, "Permethrin 5% cream is superior to metronidazole 0.75% gel and placebo in decreasing Demodex folliculorum, and is as effective as metronidazole 0.75% gel in treating erythema and papules."

For more information read this post. 

Em270 from Canada, at RF, posted a link to Kate's Rosacea non prescription treatment for rosacea blog, permethrin 5% scabies, which lists a long list of over the counter treatments for your consideration. If anyone confirms this works for rosacea, please post in this thread. 

I can't find any product at the USA Amazon site that comes close to this treatment. If anyone does find something at Amazon, please post in this thread. Kate says she uses Quellada Lotion available in Australia. She says it is available outside of Australia as Kwellada-P or available at Amazon Canada, but no such item is available. 

U Michigan article
PubMed article

The prescription Permethrin 5% Cream is mentioned in the Journal of Family Practice article, which says, "Using intention-to-treat analysis, permethrin 5% cream was as effective as metronidazole 0.05% gel and significantly superior to placebo at improving erythema (change from a baseline score of 2.60 to 1.34), papules (change from baseline count of 6.04 to 1.73), and pustules (change from baseline count of 2.30 to 0.56)." This same article reports, "Permethrin 5% cream is superior to metronidazole 0.75% gel and placebo in decreasing Demodex folliculorum, and is as effective as metronidazole 0.75% gel in treating erythema and papules." More information.

It is apparently odd that you can't purchase this product over the counter in the USA, however, according to this article you can purchase it on ebay. 

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Until she was about 25, Chenoweth had never dealt with skin problems, so when she started experiencing bumpy, itchy redness on her face, she treated it with over-the-counter meds. "I tried all the wrong things, of course Cortisone, oils, you name it—anything over the counter I tried it." When she finally saw a dermatologist several years later, she received an instant diagnosis: rosacea. Since then she's tried almost every remedy out there to keep her inflammation at bay, recently settling on a solution that just gained FDA approval, RHOFADE, for which Chenoweth is now the celebrity ambassador. "My redness has gone way down along with the bumps, itchiness, and this has been week four. I use it right after my moisturizer and it keeps my redness in check all day long."

Yes, Windy Weather Can Trigger Rosacea—and So Can These 6 Other Things
Grammy- and Tony-winning star Kristin Chenoweth opens up about her battles with rosacea—here's what you need to know about what triggers it, and how you can treat this pesky skin condition.
BY JENN SINRICH, Reader's digest

"...But did you also know that retinol is used for acne, brown spots and rosacea?....There are also different strengths of retinol..."

What Every Skin Care Product Junkie Should Know About Retinol, News Tribune, Illinois

"The aim of this prospective study was to evaluate the impact of the skin conditions of patients with various skin diseases affecting their face (scars, acne, rosacea, melasma, vitiligo, hypo or hyperpigmentation, lentigines, etc) on their QOL and the improvement afforded by the use of corrective makeup for 1 month after being instructed on how to use it by a medical cosmetician during an initial medical consultation....Our results suggest that dermatologists should encourage patients with disfiguring dermatoses to utilize appropriate and safe makeup to improve their appearance and their QOL. Corrective makeup can also complement the treatment of face dermatological diseases in order to improve patient’s adherence."

Clin Cosmet Investig Dermatol. 2012; 5: 123–128.
Published online 2012 Sep 7. doi:  10.2147/CCID.S33172
PMCID: PMC3459545
Interest of corrective makeup in the management of patients in dermatology
S Seité, P Deshayes, B Dréno, L Misery, P Reygagne, P Saiag, F Stengel, AM Roguedas-Contios, and A Rougier

"The literature documents significant emotional benefits using medical therapy in conditions such as acne, psoriasis, vitiligo, and rosacea, but there is little evidence documenting similar results with the use of cosmetic camouflage.....Cosmetic camouflage provides a significant emotional benefit for patients with facial skin conditions, and this is substantiated by a literature review and personal experience....Camouflage therapy serves as a mechanism to help give immediate satisfaction to patients, although many physicians/residents do not consider this as a validated therapy....It is important for dermatologists to provide this option to patients upon initial consultation because it provides immediate results and can be helpful while awaiting effects from medical treatment.....By increasing awareness and knowledge of cosmetic camouflage, physicians will be able to offer additional services and treatment options for patients suffering from skin lesions causing emotional distress, help to build confidence in the patient-physician relationship, improve patient QoL, and increase compliance with concurrent medical therapies."

Clin Cosmet Investig Dermatol. 2012; 5: 173–182.
Published online 2012 Nov 1. doi:  10.2147/CCID.S33860
PMCID: PMC3496327
Emotional benefit of cosmetic camouflage in the treatment of facial skin conditions: personal experience and review
Lauren L Levy and Jason J Emer

The RRDi has collected a number of cosmetics to consider in your search by using our affiliate store. 

"Dry eye is one of the most commonly encountered problems in ophthalmology....Patient-specific considerations involve relevant history of autoimmune disease, refractive surgery or use of oral medications, and allergies or rosacea.....Given a complex presentation and a variety of signs and symptoms, it would be beneficial if there was an inexpensive, readily available, and reproducible diagnostic test for dry eye."

Dovepress
Diagnosis of dry eye disease and emerging technologies
Maya Salomon-Ben Zeev, Darby Douglas Miller, Robert Latkany

"Although there are many conditions for the dysfunction of the meibomian glands, one particular skin condition, rosacea, can block the functioning of the meibomian gland.

The species Demodex folliculorum found in follicles of the hair and in meibomian glands is present in larger quantities in rosacea patients. The over deposit of these species may possibly prompt the immune system, as in many rosacea patients the eyes may appear red or watery (ocular rosacea) and patients have a feeling of irritation in the eyes.

The two species of Demodex, the genus of tiny mites, are responsible for blepharitis. Anterior blepharitis is caused by Demodex folliculorum and posterior blepharitis is caused by Demodex brevis. While the Demodex mite creates direct damage, it also carries the bacteria Staphylococci that cause Staphylococcal infections."

Blepharitis Types and Causes, By Susha Cheriyedath, MSc, News Medical Life Sciences

A recent report concluded, "As a result, the Demodex count was significantly higher in the primary demodicosis and rosacea patients than the control group. We think that every Demodex-positive patients should be evaluated for also eyelash mites to prevent a possible chronic blepharitis."

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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.  

Purpose: To evaluate the efficacy of Farmaka Rosacea Cream (FRC), a novel topical formulation for rosacea....Conclusion: Improvement of rosacea symptoms was noted with FRC application. The main film-forming ingredients of FRC (trehalose, cholesterol, ceramide, and fatty acids), combined with other soothing and calming ingredients and ultraviolet filters, could explain its efficacy. What we know about trehalose from PubMed, PLOS and Wikipedia. Hydramemory Cream Gel or Maxclinic Trehalose Vita Drop Cream contains trehalose. 

Dovepress
Preliminary open-label clinical evaluation of the soothing and reepithelialization properties of a novel topical formulation for rosacea
Adele Sparavigna, Beatrice Tenconi, Ileana De Ponti
PubMed

FRC
Dermalex which is the brand name contains FRC. 

"Natural cosmeceutical options serve as an additional branch of the market available to rosacea patients. Natural ingredients reported in the literature that provide hydrating, anti-inflammatory, and antioxidant properties capable of calming the inflammatory manifestations of rosacea include colloidal oatmeal, niacinamide, feverfew, licorice, teas, coffeeberry, aloe vera, chamomile, turmeric, and mushroom extracts.43 Further, a novel topical lotion (Redness Neutralizer®, SkinCeuticals, New York, NY, USA) containing caffeine, zinc gluconate, bisabolol, Eperua falcata bark extract, and palmitoyl tripeptide-8, was used twice daily in a group of 25 patients with PPR who had been previously treated successfully with topical or oral therapy, but were unsatisfied with the remaining background erythema. All efficacy categories demonstrated statistically significant improvement between baseline and follow-up at weeks 4 and 8. Although one patient developed burning and increased erythema and withdrew from the study, the remaining 24 patients found the treatment very tolerable without clinical signs of irritation. Overall, 95% of patients were satisfied with the products and the results after 8 weeks of twice-daily use.

In another single-center, open-label study, a group of 30 patients with rosacea of variable severity were treated with 4% Quassia amara extract topical gel for 6 weeks. Reportedly, Q. amara possesses antiparasitic and anti-inflammatory properties that have the capability to decrease the inflammatory response with few complications. Efficacy comparable with that of first-line topical treatments like azelaic acid and metronidazole was observed after Q. amara treatment, with superb tolerability. Finally, a formulation of low molecular weight hyaluronic acid sodium salt 0.2% cream (Bionect® Cream, Innocutis Holdings, Charleston, SC, USA) applied twice daily for 8 weeks showed a statistically significant reduction in papules, erythema, burning, stinging, and dryness in a small study. Along with excellent tolerability, a reduction in papules, erythema, burning/stinging, and dryness was clearly apparent by week 4 and remained by the final visit at week 8. Notably, erythema was reduced by the greatest amount, with an approximate 50% improvement by week 2. This study demonstrates the importance of skin barrier maintenance and repair in the pathogenesis of rosacea. With a hydrophilic structure, low molecular weight hyaluronic acid penetrates the stratum corneum where it interacts with fibrin and collagen to support remodeling of the extracellular matrix. This mechanism, along with induction of the antimicrobial peptide ²-defensin 2 release from keratinocytes, ultimately accelerates re-epithelialization and reduces pain and edema."

Dovepress
Update on the management of rosacea
Allison P Weinkle, Vladyslava Doktor, Jason Emer
Accepted for publication 13 January 2015
Published 7 April 2015 Volume 2015:8 Pages 159—177
DOI https://doi.org/10.2147/CCID.S58940

A study published in 2015 by a group in Europe that "proposed a dermocosmetic active ingredient to mitigate some aspects of the rosacea and particularly for erythematotelangiectatic rosacea [ETR]." Using a patented process of three basic ingredients, rosmarinic acid, gallic acid, and caffeic acid (hence the acronym RGC with the trade name Endothelyol) this group formulated a serum (calling it RGC Serum) to treat ETR and tested it on volunteers. The report concluded, "these studies have shown that RGC active could be a dermocosmetic help, especially for erythematotelangiectatic rosacea armamentarium. Indeed, 2% of RGC topically applied on face for 28 days improved erythematotelangiectatic rosacea symptoms either by decreasing them (in half of the volunteers, vessels are less visible) or by limiting their development (any neovessels seen). RGC acts by decreasing inflammation (inhibition of IL-8 and TNF release), decreasing degranulation of mast cells (inhibition of histamine release), and limiting the angiogenesis process (inhibition of VEGF production and neovessel formation)."

Dovepress
Combination of new multifunctional molecules for erythematotelangiectatic rosacea disorder
Hanane Chajra, Mahdi Nadim, Daniel Auriol, Kuno Schweikert, Fabrice Lefevre
Accepted for publication 6 August 2015
Published 1 October 2015 Volume 2015:8 Pages 501—510
DOI https://doi.org/10.2147/CCID.S92326

ProTec Ingredia, part of the LPC Group, reports on its website that "Endothelyol is an active ingredient to reduce skin redness and rosacea. It works by targeting VEGF, Histamine, TNF-alpha, Interleukin 8 and Prostaglandin E2." You can download a pdf of this product to review which points to Induchem as the manufacturer and sells Endothelyol to cosmetic companies on this page. Givaudan Active Beauty apparently sells Endothlyol according to Coptis and Prospector.  

SVR Sensifine AR

One product that contains Endothelyol is SVR Sensifine AR. 

"85% of patients displaying positive responses to brimonidine tartrate.....Emphasizing that this clinical therapy is not intended to eradicate papules, pustules or phymatous changes of rosacea, or to eradicate oiliness on the face, is important....In our clinics, approximately 4%–15% of patients have complained of worsening erythema or flushing, and some of these patients decided to discontinue treatment with brimonidine tartrate, which led to resolution of these side effects usually within 4–24 hours....Sometimes the initial cause of the flare was that the patient had applied too much of the medication, too frequently, without applying sunscreen or without continuing to avoid common triggers of rosacea flushing. This highlights the importance of providing clear and comprehensive counseling to the patient....Brimonidine tartrate has been associated with temporary worsening of erythema in a few cases (approximately 12 hours after the initial application)....In order to see the true measure of response on an individual basis, a small sample of brimonidine tartrate can be provided for the patient to try at home and to monitor their response over a few days. In the authors’ opinion, there has been a predictable response in each individual patient, and this response has continued with subsequent applications. Most of the adverse events related to brimonidine tartrate have occurred within the first 1–2 weeks, and none of the adverse events have produced long-term sequelae that adversely affect the course of the disease."

Dovepress
The role of brimonidine tartrate gel in the treatment of rosacea
J Mark Jackson, Melissa Knuckles, John Paul Minni, Sandra Marchese Johnson,, Kevin Tate Belasco
Accepted for publication 24 April 2015
Published 23 October 2015 Volume 2015:8 Pages 529—538
DOI https://doi.org/10.2147/CCID.S58920

"The role of ivermectin in the treatment of rosacea may be as an anti-inflammatory and anti-parasitic agent targeting Demodex mites. In comparing topical ivermectin and metronidazole, ivermectin was more effective; this treatment modality boasted more improved quality of life, reduced lesion counts, and more favorable participant and physician assessment of disease severity. Patients who received ivermectin 1% cream had an acceptable safety profile. Ivermectin is efficacious in decreasing inflammatory lesion counts and erythema." [1]

"Head-to-head trials show that azelaic acid and ivermectin might be slightly better than metronidazole." [2]

[1] Dovepress
New developments in the treatment of rosacea – role of once-daily ivermectin cream
Leah A Cardwell, Hossein Alinia, Sara Moradi Tuchayi, Steven R Feldman
Accepted for publication 11 January 2016
Published 18 March 2016 Volume 2016:9 Pages 71—77
DOI https://doi.org/10.2147/CCID.S98091

[2] Topical treatments for rosacea.
Can Fam Physician. 2019 11;65(11):803
Authors: Fritsch P, Kolber MR, Korownyk C