Guide

There is an interesting thread at RF started by HunkeyMonkey about a cheap and easy home test for demodex. It is good that rosaceans are figuring out novel ways to view demodex mites. Here is a video uploaded by HunkeyMonkey at Vimeo. 

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"This meta-analysis gives strong evidence that IVM 1% cream is the most effective topical treatment above other alternatives and it satisfies the impairment of social and working life with a sustained better QoL." [1]

"Topical ivermectin cream 1% given daily is an effective and safe therapy against rosacea." [2]

Gets Worse Before it Gets Better

In many anecdotal reports from users of Soolantra [ivermectin] complain that it gets worse before it gets better. This may cause some to stop the treatment. It is not uncommon for Soolantra users to say the first week or more of Soolantra use their rosacea actually got worse. This might be the result of the ivermectin killing the mites. However, in time, usually within a month, you will know whether or not Soolantra is improving your rosacea. If you do stop the treatment you should notify your physician. 

If you think you may be allergic to Soolantra, a good test is to dab a little Soolantra on the inside of your wrist and see if within a few hours whether your skin turns red and gets inflamed. If so, you may be allergic to Soolantra and you should notify your physician of this fact. If not, then just because your facial treatment of rosacea using Soolantra gets worse before it gets better, the only way is to continue your facial treatment of topical Soolantra and usually within a month you will see some improvement. However, total clearance takes time, at least 12 weeks or longer. 

"After 16 weeks, blepharitis (P = .004), and conjunctival redness (P = .008) had strongly improved, and grade 1 was seen in all patients until the end of follow-up." "The follow-up was 8 months (range: 5-12 months)." [2] 

On the Soolantra web site there are clinical studies indicating that it may take at least 12 weeks or longer to see positive results from Soolantra. Look for the following: 

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End Notes

[1] Dermatol Ther. 2019 Dec 20;:e13203
Efficacy of topical ivermectin and impact on quality of life in patients with papulopustular rosacea: A systematic review and meta-analysis.
Husein-ElAhmed H, Steinhoff M

[2] Ocul Immunol Inflamm. 2020 Apr 07;:1-5
Efficacy of Topical Ivermectin for the Treatment of Cutaneous and Ocular Rosacea.
Sobolewska B, Doycheva D, Deuter CM, Schaller M, Zierhut M

Traumatic brain injury (TBI) is one of the leading causes of disability and death in infants and children in the United States, with more than half a million affected annually, according to the Centers for Disease Control and Prevention. Those under age 4 who experience brain trauma can suffer lifelong problems with memory, attention and other executive functions.

While there are no drugs available to treat these injuries, scientists have shown that certain antibiotics -- which inhibit the brain's inflammatory response -- can improve outcomes for adult animal models that have suffered a blow to the head.

However, this treatment seems to negatively affect brains that have not yet developed, according to a new study from Drexel University College of Medicine. When administered to newborn rats immediately after head injury, the FDA-approved antibiotic minocycline exacerbated cognitive deficits, says the study, which was published in the journal Experimental Neurology.

Antibiotics targeting brain’s inflammatory response may exacerbate cognitive deficits in children, Published on January 11, 2017, Drexel University, News-Medical.Net 

The Regenlite Transform Laser is now available in Colorado at Aria Integrative Health.  Many other lasers purposely do harm to your skin, forcing your body to heal.   This laser actually stimulates your body's natural ability to produce healthy regeneration. It helps with fine lines and wrinkles, rosacea, eczema, and acne.

Change your skin from the inside out
POSTED 11:51 AM, JANUARY 10, 2017, BY TRAVIS DOOLEY HARRISON, Fox 31 Denver

A 52-year-old Colombian woman, a patient with psoriasis, undergoing phototherapy with (ultraviolet B narrowband) UVBnb, presented with a symptomless solitary diffuse erythaematous plaque on her nose for 3 months. Initially, she was treated with pimecrolimus 1% cream for 8 weeks, which was then combined with metronidazole cream for 4 weeks, with the initial diagnosis of UV-triggered rosacea, without improvement. A punch biopsy was performed and the histology showed a pseudolymphomatous reaction. The diagnosis of nasal pseudolymphoma of borreliosis was confirmed with PCR. The lesion completely resolved following oral doxycycline therapy.

BMJ Case Rep. 2015; 2015: bcr2014205688.
Published online 2015 Jan 7. doi:  10.1136/bcr-2014-205688 PMCID: PMC4289773
Case Report
Borrelial pseudolymphoma of the nose
Mosab Tariq Mohanna, Jivko Kamarashev, and Günther F L Hofbauer

I know it's tempting to slather flaky skin in moisturizing oil, but a lot of oil blends feature fragrances, which can cause flare-ups, resulting in itchy, red, inflamed skin. The same goes for rosacea. Someone with rosacea should just be using mild non-soap cleansers and fragrance-free moisturizers. Essential oils and botanicals, though natural, can make the skin angrier and redder. 

Should You Stop Using Argan Oil On Your Skin?, By Mona Gohara, MD | Lifestyle/Beauty, Shape

5 hours ago, Rory said:

Hi Brady

I see a nice improvement at day 45. The 2 month mark seems ok but still a fair improvement from baseline. I look forward to the 3 month finish line. But I don't think you should stop there. Remember the Soolantra extended study? 40% of patients were clear/almost clear at 12 weeks and a further 30%, who saw improvement at 12 weeks, were clear/almost clear at 52 weeks.

Rory, 

Thanks for the encouragement. I guess you are probably right. 90 days simply isn't enough time. I do see a little improvement but it is a tough regimen to go through. Breaking out with rosacea after using it isn't exactly my cup of tea, but I have read several other anecdotal reports that many go through similar flareups after applying Soolantra. One year is a long time to be patient for results. Did you go through all this with Soolantra?

You Have an Untreated Skin Condition
Feel like you’ve tried everything and your red, sensitive skin still isn’t calling it quits? Zeichner recommends a visit to your dermatologist to see if an undiagnosed skin condition like rosacea might be the cause. 
“Rosacea is a condition characterized by facial flushing and redness, burning and stinging, and bumps and pus pimples,” he says. “Genetically, the skin is more sensitive to the environment and overreacts to triggers like spicy food and changes in temperature. If you think you have rosacea, visit your dermatologist to discuss treatment options.” 

Why your skin is suddenly so sensitive, Health Tips, Pulse.com.gh 

There are anecdotal reports that oil of oregano helps heal rosacea. 

Anecdotal Reports

I have the papulopustular subtype, I find oregano oil has worked super well for me as well...I take 6 super strength P73 Oreganol gelcaps a day (I had to work up to that, it made me sick at first). I find that I can skip several days without my rosacea coming back; I think the OO stops some sort of inflammatory process. I've experimented, and after about a week and a half my skin starts to flare again if I don't take the OO. - Michelle - post #6

Last september i went on heavy dose of oregano oil - 6 times a day x 7 drops. i noticed significant improvement ...added heavy dose of ginger tea(mushed up ginger in hot water) and pau darco tea. Now my symptoms are almost all gone.....thats continuous since late october....I really think oregano oil is doing main work. My wife almost forgot i had that disorder.....Michael - post # 1

more info on oil of oregano

I spoke to expert Dr. Craig Kraffert, Board Certified Dermatologist and President of Amarte about the benefits of sulfur, and here's what he said: "Sulfur is a periodic table element that is an essential part of all living organisms. A broad spectrum antimicrobial with unique anti-inflammatory and exfoliative properties, purified sulfur is very effective in the treatment of acne, rosacea, and seborrheic dermatitis. A multi-tasker, this element is also a skin brightener that helps decrease sebum production."

I Tried Adding Sulfur To My Skin Care Routine To Reduce The Redness On My Face, By KELLY DOUGHER, Bustle

Christine123 recommends using Nu-Stock, tea tree oil and zinc oxide cream to eradicate demodex in a thread at RF. 

It is difficult for rosacea patients to discern which products and ingredients will be beneficial to their skin and which products will lead to an exacerbation of the signs and symptoms of rosacea. In this paper, the authors provide a brief overview of rosacea, its pathogenesis, signs and symptoms, and the management of the two major rosacea subtypes—erythematotelangiectatic rosacea and papular pustular rosacea. Reviewed in greater detail are the common ingredients used in over-the-counter cleansers and moisturizers with discussion of how these ingredients potentially benefit or harm the skin of patients with rosacea. 

J Clin Aesthet Dermatol. 2011 Aug; 4(8): 31–49.
PMCID: PMC3168246
A Guide to the Ingredients and Potential Benefits of Over-the-Counter Cleansers and Moisturizers for Rosacea Patients
Jacquelyn Levin, DO and Richard Miller, DO

Rosacea.pdf

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People who often tilt their heads low for long hours and whose blood vessels in the skin are more prone to vasodilation (widening of blood vessels) may suffer from facial skin redness because of poor blood circulation caused by bad posture, Liu said.
“Not all facial redness is caused by rosacea, although many people seek medical treatment because they are worried that they might have rosacea,” Liu said.
A 2014 US study showed that only 31 percent of cases of red-face syndrome are due to rosacea, Liu added.

Your phone might be making your face red: doctor, By Lee I-chia , Taipei Times

It has been two months now using Soolantra, every night at bedtime. There is some improvement after sixty days. I just got my third tube of Soolantra which lasts about a month and will give it one more month. 

A chronic condition that’s more common after age 30, rosacea can lead to redness, bumps and pustules, usually on the face. Some people experience dryness, stinging, itching and burning. “The skin of rosacea patients is very sensitive,” says John Wolf, chair of dermatology at Houston’s Baylor College of Medicine. Triggers include cold or hot weather, indoor heat, stress, sun, wind, alcohol, hot baths, vigorous exercise and spicy food.

What to do about dry, itchy skin?, By Consumer Reports, The Washington Post

Watch out for rosacea. Rosacea can also be exacerbated by cold, dry weather. Rosacea causes small blood vessels in your face, scalp, neck and ears to swell, making the skin look flushed. While rosacea never goes away, you can fight the inflammation with prescription antibiotic or retinoid creams and light therapy.

Fighting Dry Skin: 10 Tips for Beating the Itch of Winter, By Lynn Allison, Newsmax

November 2016

The RRDi is the first non profit rosacea organization to endorse the new phenotype classification of rosacea in November 2016 after the ROSCO panel published its recommendation in the British Journal of Dermatology in October 2016 [epub ahead of print edition].

Identification of the ROSCO panel.

Galderma acknowledged the phenotype classification in October 2017. 

For a history on categorizing rosacea from subtypes to phenotypes click here. 

Scroll through the posts below to review any new updates on phenotype classification of rosacea, especially of medical authorities and rosacea organizations that are recognizing this superior classification of rosacea, i.e., National Rosacea Society, American Acne and Rosacea Society, Medscape. 

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"Run a cool-mist humidifier. Or place pans of water near heating vents to moisten indoor air. Humidity should be 30 to 60 percent (40 to 50 percent if you have allergies or asthma)."
What to do about dry, itchy skin?, By Consumer Reports, The Washington Post

“For added hydration, use a humidifier because skin that has rosacea tends to be sensitive and needs moisture,” said Dr. Jaliman. “A noncomedogenic (meaning that it won’t clog pores) moisturizer with ceramides also seals moisture into the skin.”
What People With Rosacea Need To Know About Concealing Redness & Treating Flare-Ups, Dana Oliver, The Huffington Post

"Run a cool-mist humidifier. Or place pans of water near heating vents to moisten indoor air. Humidity should be 30 to 60 percent (40 to 50 percent if you have ­allergies or asthma)."
Dry Winter Skin: Eczema, Psoriasis, and Rosacea Explained, Catherine Winters, Consumer Reports

"To replace moisture in the air, invest in a humidifier, and turn it on every time you turn on the heat, especially at night. This will help alleviate dry skin and dry eyes (especially important if you suffer from ocular rosacea)." 
Rosacea Treatment During Cold Weather Months, Dr. Jessica Wu, Everyday Health

"Use a humidifier. There are “whole house” humidifiers you can install which will work with your heater. If that isn’t possible, look for cool-mist humidifiers you can keep in each room to keep moisture in the air. There are also small, desktop humidifiers you can use at work."
Winter Rosacea: Symptoms and Tips for Managing, Eileen Bailey, Health Guide, Health Central

"Use a humidifier. If you have a home humidifier that comes with your heating system, make sure it’s turned on. Otherwise, buy portable units at Home Depot or Lowes. The extra humidity they put into the air will be absorbed by your skin and hair, says Youn."
Fighting Dry Skin: 10 Tips for Beating the Itch of Winter, By Lynn Allison, Newsmax

Amazon Humdifiers

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In 1967, the zoologist Desmond Morris1 declared that “Flawless skin is the most universally desired human feature,” explaining the primordial human need to “advertise” health, well being, and fertility with an even-toned, clear, and radiant complexion. In the quest to achieve perfect skin, consumers of all ages are constantly searching for the “best” skincare products. Whether they shop at drug stores, department stores, or online, consumers are faced with a paradox of choice. They look to their friends, physicians, or favorite bloggers for independent recommendations, often purchasing expensive products that fail to live up to their reputed benefits.

Plast Reconstr Surg Glob Open. 2016 Dec; 4(12 Suppl): e1152.
Published online 2016 Dec 14. doi:  10.1097/GOX.0000000000001152
PMCID: PMC5172479
Skincare Bootcamp: The Evolving Role of Skincare
Katie Rodan, MD, Kathy Fields, MD, George Majewski, and Timothy Falla, PhD

"There is some newer data showing that there is bacterial overgrowth that is linked with irritable bowel syndrome (IBS) and it’s also linked with rosacea. They’ve found that rosacea gets better with treatment for IBS. The same with gluten and dairy, et cetera—even though you might not truly have Celiac disease or be positive for the antibodies, there are a lot of people that swear that changing their diet, avoiding gluten and sugars, can definitely affect the skin and acne and rosacea and inflammation."
Dr. Monica Bedi (Dermatology Associates)

"Stress levels lead to a cortisol release, which can certainly make people break out, with acne and rosacea." 
Dr. Emily Arsenault (Arsenault Dermatology)

Skin Deep, Go below the surface with expert local dermatologists. BY AVIEL KANTER, SRQ MAGAZINE | JANUARY 2017  IN HEALTH & WELLNESS

Other anecdotal reports using this treatment for rosacea

"To give a quick update, I have been using the compound cream 2x daily so far (started last Thursday evening, only four applications thus far), and I have no doubt that it is already helping my skin." BVokey post #s 82, 85, 90 and more

"The only thing out of 25 or so drugs/medications that worked is a cream base that contains... Ampitriptyline 1.0%/ Ketamine 0.5% cream in a 1 to 1 ratio. In just one week I went from being a tomato to a piece of paper and finally my skin can heal. If you are suffering from Rosacea this might be an amazing/safe treatment for you! Please see your derm." charles delacruz

Watch out for rosacea. Rosacea can also be exacerbated by cold, dry weather. Rosacea causes small blood vessels in your face, scalp, neck and ears to swell, making the skin look flushed. While rosacea never goes away, you can fight the inflammation with prescription antibiotic or retinoid creams and light therapy.

Fighting Dry Skin: 10 Tips for Beating the Itch of Winter, By Lynn Allison, NewsMax Media

She had seen various doctors over the past two years. Most of them had told her she had eczema and prescribed steroid-based creams that did help, but not for long. When she stopped applying them, the flushing returned with a vengeance. There was nothing wrong with the creams - it was the diagnosis that was incorrect. Once, a doctor told her she had acne. The topical medication that was given to her made her redness and sensitivity worse. This is the classic history of a person who is suffering from rosacea, which is often mistaken for other skin diseases. A rosacea patient may be misdiagnosed and wrongly treated for years.

Don't be red-faced over rosacea, Lynn Teo, The Strait Times, Singapore

We have published the results of the 2016 Rosacea Survey. Thanks for everyone who participated in the survey. 

Aren't they Cute? image courtesy of Huffington Post Australia

"In most cases there should be no symptoms. However, these mites are sometimes linked to skin conditions, especially rosacea. We still don't know if mites can cause rosacea, or just do really well with people with rosacea."

"People with suppressed immune systems can also suffer from these mites, with a condition called demodicosis. One of the better and fairly safe treatments for mites seems to be tea-tree oil, which causes mites to evacuate their follicles and roam -- and when a mite leaves the safety of its home, it's highly vulnerable to being washed or scrubbed off," Seeman said.

There Are Tiny Little Mites Living On Your Eyelashes, Leigh Campbell, Huffington Post Australia Edition

For more information on mites and rosacea.