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    Welcome to the Rosacea Research and Development Institute [RRDi] official web site. The RRDi is a 501 (c) 3 non profit organization. If you suffer from rosacea you are a rosacean. Join us to find the cure. 

    Where to Begin Your Search
    Rosacea Topics • Community Support • About Us • What Causes Rosacea? • What Should I Ask My Physician?  Rosacea Newbies  Gold Standard for Rosacea Treatment • When Rosacea Resists Standard Therapies • Rosacea X-Factor • Famous Rosaceans  Rosacea in the News  Tapatalk • Contact us
    Suggest you read our FAQs for at least a half hour. After that browse our member forum for another half hour. 

    What is Rosacea?
    Rosacea is a chronic and sometimes progressive disorder of the face, characterized by some or all of the following symptoms:

    Extremely sensitive facial skin with blushing, flushing, permanent redness, burning, stinging, swelling, papules, pustules, broken red capillary veins, red gritty eyes (which can lead to visual disturbances) and in more advanced cases, a disfiguring bulbous nose. Men and women of all ages can be affected, with over 415 million estimated rosacea sufferers worldwide

    "Rosacea is probably a collection of many different diseases that are lumped together inappropriately." Zoe Diana Draelos, MD. 
    Dr. Draelos is a member of the ROSIE [ROSacea International Expert] Group that says the subtype classification of rosacea is controversial. Dr. Draelos is also a member of the RRDi MAC. Just because you have a red face might mean you have another skin condition instead of or with rosacea, since other skin conditions may co-exist with rosaceamimic rosacea or you might have a rosacea variant (over a dozen variants to differentiate).  

    "Rosacea is a multifactorial, hyper-reactivity, vascular and neural based disease with a broad range of facial manifestations where normal vasodilation is greater and more persistent and involves an autoimmune component of microscopic amounts of extravasated plasma induce localized dermal inflammation that may induce repeated external triggers, vasodilation, telangiectasias, redness with eventual fibrosis and hypertrophic scarring of the dermis." Sandra Cremers, M.D., F.A.C.S., RRDi MAC Member.

    If you note, there are different definitions of what constitutes rosacea which is common. Clarity with phenotypes (see below) helps in a differential diagnosis

    Phenotypes
    In November 2016, the RRDi endorsed the phenotype classification of rosacea which was announced by the ROSCO panel as a better approach of diagnosising rosacea than using subtypes. If your dermatologist still refers to subtypes, he/she is not keeping up with the latest classification of rosacea and you should point this out to your physician. Learn more about phenotypes

    Rosacea Differential Diagnosis and Misdiagnosis
    Your physician should differentiate rosacea from a plethora of other skin conditions. If you need photos of rosacea click here.

    Sometimes rosacea is misdiagnosed.

    Treatment
    'There are a number of topical, oral and systemic treatments available. Yet, treatment for rosacea remains difficult." Expert Opinion Pharmacotherapy 

    “There’s no one treatment that’s going to work for everybody, but we evaluate each patient individually and try to select the treatments from our armamentarium that we think will be the simplest and safest for long-term control.” John Meisenheimer, MD, Orlando, The City's Magazine

    ""Ultimately, rosacea is a subjective and entirely individual experience." Rosacea: Beyond the visable

    There are prescription, non prescription and natural or alternative treatments (check out our affiliate store) for rosacea that the RRDi keeps up with and posts on our website. Volunteer Members also contribute to the website. You will not find any other website about rosacea that has more information on rosacea than the RRDi. None. The RRDi website is a wealth of rosacea data found no where else on the internet (you can google and find rosacea information and the results will include what is categorized in appropriate places on our website). Volunteers make sure of this. You can join and continue to add to the rosacea data. Isn't that what volunteering is all about? 

    Cause of Rosacea
    No one really knows what causes rosacea and there are a number of theories for your consideration. Our latest article on this subject, Rosacea Theories Revisited is worth your time to consider. 

    What will the RRDi Do For Me?
    If you are a rosacea newbie read this post. You can view the list of prescription treatments prescribed for rosacea. There is a list of non prescription treatments for rosacea to consider. We have an affiliate store dedicated to rosacea books, treatments and odd and ends. You can browse our public member forum and learn about rosacea. The digital medical revolution can assist you in your search for a treatment to improve your condition. Your rosacea is an individual case and you may find what treatment will work for your rosacea and not a treatment aimed at the masses. Rosaceans can come together and share data, using collaboration tools that the RRDi offers for free. If you have the volunteer spirit and want to become part of this innovative non profit, learn how you can volunteer and be part of this digital medical revolution. You can post in our member forum if you join and register simply with an email address. If you have concerns regarding your privacy, please consider this post.

    Once you join you have a number of tools to collaborate with other members. You can create your own rosacea blog, with easy step by step directions on how to do this. Our Gallery application lets members share photos and videos with the community. One other tool you can use is setting up your own Club

    Volunteers who contribute their time and energy may receive a free G Suite account through a generous contribution of Google, one of our sponsors.  

    You may receive a free ebook, Rosacea 101: Includes the Rosacea Diet as a gift from the founder/director if you mention in your registration application that you want the free ebook (write in the volunteer box you want the free ebook).

    You can post in our member forum about your rosacea experience. However, we want real members, not spammers, hackers or trolls. We provide a safe, secure forum for our members, so our membership registration is very secure requiring your accepting our terms for membership.

    Our 2016 Rosacea Survey is completed and available for public viewing.  You may review a list of our education grants. Finally, ask not what the RRDi can do for you, ask.....

    What Can You Do for the RRDi?
    Your joining and registering with our organization will increase our membership. All that is required to join is an email address (your email address is private and members never see your email address nor does the RRDi give your private email address out to anyone). Our goal is to reach a membership of 10,000 members. Think about that, 10,000 rosacea sufferers joined together as a non profit organization and you are member. We need you to join to help us reach this goal!

    The RRDi is a volunteeer member driven organization and invites rosacea sufferers to become involved. Volunteering is the force that drives the organization and is an integral spirit of the RRDi philosophy. The RRDi warmly invites rosacea sufferers to participate in this non profit which you can become a part of. You are not required to volunteer when you join, since we still want you to join even if you can't volunteer. If all you can do is become a member, that will increase our membership which is helpful in itself. So if you can volunteer, let us know on when you register. Or just join with an email address and let us know later you want to volunteer. Please join

    Please carefully read the next subheading on how to join and if you have concerns about privacy. 

    How to Join
    Members may now join with just an email address and a display name (your first and last name is no longer required to be a non voting member and you can set up a anonymous or cryptic display name so that no one knows who you are). To post in our Member Forum or submit articles for publication you must register to join to become a member. The RRDi no longer requires that you provide us with your contact info and mailing address to be a non voting member. However you still need to agree to our policies, rules, etc., since you become a member of the RRDi whether a voting member or not. If you want to vote, simply include all the profile contact fields. We have over 1000 members who are voting members, so we have plenty. It is your choice if you want to vote or not. 

    If you need assistance contact us. Our volunteers will be happy to assist you. 

    Your privacy is our utmost concern and we will take precautions to ensure your privacy will never be violated. Our Privacy Policy is solid. If you have concerns regarding your privacy, please consider this post.

    Once you have joined you can post in our secure members forum which will allow you to post questions to the Medical Advisory Consultants (MAC) and to fellow members or to submit articles for our journal. Yes, members may have an article published on our web site or in our journal. You may receive a free G Suite account with our organization if you have the volunteer spirit. 

    Charter and Mission Statement
    The Charter of the Corporation states the purpose and Mission Statement which clearly outlines the goals of our non profit corporation. If you are interested in the history of how and why this non profit organization was formed click here for more information

    Of course there are expenses to keep this non profit organization going. Any donation you give will assist us to continue to keep this web site going, publish our journal, and sponsor education grantsMahalo for your donation. even if it is small. Every dollar helps us keep going.  

    The RRDi is registered at GuideStar

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  • Posts

    • Erbium-doped Yttrium Aluminium Garnet (Er:YAG) Laser Resurfacing Restores Normal Function and Cosmesis in Patients with Severe Rhinophyma. J Clin Aesthet Dermatol. 2019 Jul;12(7):28-33 Authors: Mathis J, Ibrahim SF Abstract Background: Rhinophyma is a dermatologic condition that can lead to severe disfiguration and psychological distress. Many therapies, both medical and surgical, have been reported, but few with acceptable and reproducible cosmesis. Objective: We assessed the efficacy of erbium-doped yttrium aluminium garnet (Er:YAG) laser resurfacing as a treatment modality for rhinophyma of all degrees. Design, Setting, and Participants: Eleven Caucasian male patients were classified into categories of mild, moderate, or severe rhinophyma and were treated at the University of Rochester Medical Center with a dual mode Er:YAG fully ablative laser. Measurements: Severity was graded as mild, moderate, or severe, based on the degree of distortion of normal anatomy. Results: The Er:YAG laser allowed for increased ablative precision, a decreased risk of complications, shorter downtime, and improved outcomes compared to currently available treatments. Conclusion: Our results suggest Er:YAG laser resurfacing is an effective treatment modality, with low risk and excellent, reproducible cosmetic outcomes, for patients with rhinophyma of any severity. PMID: 31531160 [PubMed] {url} = URL to article
    • Recognizing Rosacea: Tips on Differential Diagnosis J Drugs Dermatol. 2019 Sep 01;18(9):888-894 Authors: Johnson SM, Berg A, Barr C Abstract Rosacea is a common chronic inflammatory dermatosis with a variety of clinical manifestations. Rosacea primarily affects the central face, and includes papules, pustules, erythema, telangiectasias, perilesional redness, phymatous changes, and even ocular involvement. Symptoms may vary among different patients and even vary over time in an individual patient. Central facial redness affects many adults and can be an indicator of the chronic inflammatory disease rosacea. Rosacea is a clinical diagnosis based on the patient’s history, physical examination, and exclusion of other disorders. It is under-diagnosed, particularly in individuals with skin of color. The goal of this article is to provide clinicians with the tools and understanding needed to correctly identify rosacea and differentiate it from other conditions that have overlapping signs and symptoms. J Drugs Dermatol. 2019;18(9):888-894 PMID: 31524344 [PubMed - as supplied by publisher] {url} = URL to article
    • Anti-Inflammatory Dose Doxycycline Plus Adapalene 0.3% and Benzoyl Peroxide 2.5% Gel for Severe Acne J Drugs Dermatol. 2019 Sep 01;18(9):924-927 Authors: Kircik LH Abstract Acne is primarily an inflammatory disease. Anti-inflammatory dose doxycycline (40mg: 30mg immediate release and 10mg delayed release beads) is approved for the treatment of rosacea but with demonstrated efficacy for acne. Fixed combination adapalene 0.3% and benzoyl peroxide 2.5% gel is a once-daily formulation approved for the topical management of acne vulgaris. It has both anti-inflammatory and anti-comedogenic properties. Options for management of severe acne are somewhat limited; many patients are not candidates for or refuse treatment with isotretinoin. Systemic antibiotics may be indicated; acne treatment guidelines emphasize antibiotic stewardship in light of increasing concerns about antibiotic resistance and call for the judicious use of conventional systemic antibiotics. This single-center, open label pilot study involving 20 subjects with severe acne assessed the effects of combination treatment using anti-inflammatory dose doxycycline plus adapalene 0.3% and benzoyl peroxide 2.5% gel on IGA scores as well as inflammatory lesion, non-inflammatory lesion, and nodule counts. By week 12, 95% of subjects had at least a 2-grade improvement in IGA scores. Reductions in inflammatory and non-inflammatory lesion counts were statistically significant beginning at week 4 and continuing through week 12. By week 4, the percentage of patients with 0 nodules was 70%, compared to baseline of 20%. Further improvements were seen through week 12. Treatment was well-tolerated with no serious treatment-related adverse events. Combination treatment with anti-inflammatory dose doxycycline plus combination adapalene 0.3% and benzoyl peroxide 2.5% gel is safe and effective for management of severe acne. J Drugs Dermatol. 2019;18(9):924-927. PMID: 31524349 [PubMed - as supplied by publisher] {url} = URL to article
    • Intralesional Steroids for the Management of Periorificial Granulomatous Dermatitis J Drugs Dermatol. 2019 Sep 01;18(9):955 Authors: von Csiky-Sessoms S Abstract A 42-year-old male with skin type I and a history of rosacea and eczema presented with crusting, erythema, and pustules distributed on the left oral commissure. Angular cheilitis was diagnosed and regular petrolatum use recommended until resolution of the lesion. Eight days later, with no improvement in symptoms, fungal and bacterial cultures were performed which resulted in the growth of cutibacterium acnes, a variant of p. acnes. PMID: 31524997 [PubMed - as supplied by publisher] {url} = URL to article
    • The gut microbiome alterations in allergic and inflammatory skin diseases - an update. J Eur Acad Dermatol Venereol. 2019 Sep 14;: Authors: Polkowska-Pruszyńska B, Gerkowicz A, Krasowska D Abstract The human microbiome is a wide range of microorganisms residing in and on our body. The homeostasis between host immune system and the microbial environment allows mutual benefits and protection. Physiological bacterial colonization is essential for the establishment of organism immunity. The human microbiota ecosystem can be divided into several compartments, out of which intestinal flora strongly affects our health and plays a crucial role in the pathophysiology of many diseases. The gastrointestinal tract, being a major guardian of the immune system, maintains the homeostasis with the commensal microorganisms by tolerating the typical flora antigens. The dysbiosis may trigger an inflammatory response followed by tissue damage or autoimmune processes. The gut microbiome alterations are linked to the pathogenesis of the allergic, cardiovascular, gastrointestinal, metabolic, neurodevelopmental, psychiatric and neurodegenerative diseases and cancer. Moreover, there is increasing evidence connecting the skin condition with the gastrointestinal microbiome, which has been described as the skin-gut axis. The aim of this study was to review the literature regarding the role of the gut microbiome alterations in the pathogenesis of selected allergic and inflammatory skin diseases. PMID: 31520544 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Erythema of Rosacea Affects Health-Related Quality of Life: Results of a Survey Conducted in Collaboration with the National Rosacea Society. Dermatol Ther (Heidelb). 2019 Sep 11;: Authors: Baldwin HE, Harper J, Baradaran S, Patel V Abstract INTRODUCTION: Persistent facial erythema associated with rosacea may negatively impact quality of life (QoL), self-esteem, and self-confidence. We evaluated burden and health-related QoL (HRQoL) impacts of centrofacial erythema of rosacea. METHODS: A cross-sectional, Web-based survey conducted in collaboration with the National Rosacea Society enrolled adults who self-reported having received a physician diagnosis of rosacea and self-evaluated their current erythema as mild to severe on the validated Subject Self-Assessment for Rosacea Facial Redness. Sociodemographic and clinical characteristics, rosacea symptoms, and their impacts on QoL [validated Impact Assessment for Rosacea Facial Redness (IA-RFR)] and HRQoL [validated Dermatology Life Quality Index (DLQI)] were recorded. RESULTS: A total of 708 eligible respondents completed the survey (white/Caucasian, 93.5%; female, 83.1%; mean age, 52.4 years). Respondents had mild (59.2%), moderate (33.2%), or severe (7.6%) erythema. The most bothersome symptoms were persistent facial erythema (69.2%) and blushing/flushing (60.9%). Mean IA-RFR scores showed negative impacts across all severities of erythema. The mean (standard deviation) total DLQI score was 5.2 (6.0) overall [mild erythema, 3.8 (4.9); moderate, 5.7 (5.4); severe, 13.4 (8.9); P < 0.0001]. CONCLUSION: Centrofacial erythema of rosacea represents a substantial HRQoL burden, especially for those with more severe erythema. FUNDING: Allergan plc, Dublin, Ireland. PMID: 31512178 [PubMed - as supplied by publisher] {url} = URL to article
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