Wednesday, December 13, 2006

[rosacea] RE: No evidence that rosacea is primarily a vascular disorder

Thanks for the link Brady, Very interesting.

They say that there is no direct evidence that rosacea is primarily a vascular disorder. I've seen it in a few places referred to as 'Weak, Leaky capillaries'. Dan pointed out previously that Telangiectasia refers directly to permanently dilated vessels, not broken or leaky vessels, so the following quote from the article seems to make sense.

Quote

"The basic abnormality seems to be a microcirculatory disturbance of the function of the facial angular veins"

I guess if they have located a recurrent abnormality, then resolving this issue could prove beneficial.

I take an anit-histamine every day, and part of my diet restrictions include avoiding foods that are high in histamine, or would cause the body to release histamine. I am not sure if I read this correctly, but a quoted line of text says

Quote

"The response of the facial vessels to adrenaline, histamine and acetylcholine is normal, and the vessels do not seem abnormally fragile, so the main abnormality is probably in the dermis surrounding blood vessels rather than in vessel walls."

Which to my understanding suggested histamine was not an agonist to facial flushing.

And they then say this

Quote

"Among the mediators proposed to be involved in the erythematous response are substance P, histamine, serotonin, and prostaglandins but the trigger remains unknown."

Does this mean that although histamine is not directly related to facial flushing, that it is related to swelling/inflammation (erythematous response) of the surrounding skin?

And I see there is a new subtype, "Gram Negative Rosacea'. Is this any of your doing Dan?

Another couple of paragraphs that caught my attention were the reference to Demodex Folliculorum.

Quote

"As stated above, we do not think that Demodex folliculorum mites have a causal role in rosacea. However, massive infestations may aggravate the condition. A check for mites is best done with the skin-surface biopsy technique (place a drop of cyanoacrylate on a glass slide, cover with immersion oil, and examine with the 10 x or 20 x objective in the light microscope)"

"The mites are satisfactorily controlled with lindane (y-hexachlorocyclohexane), crotamiton, or benzyl benzoate once daily for two to five days."

The statement shows a satisfactory control of mites with the application of lindane, crotamiton or benzyl benzoate (toxic insecticides I am assuming) in five days. If a Rosacea patient has been checked and confirmed to be mite infested, this seems like a MUCH better treatment option (Of course recommended by a Derm or Doctor and applied with supervision) than the long and hard process Tamara has been going through.

Matt.

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Re: [rosacea] Success?

Did you have IPL or IPL with RadioFrequency (RF)? Do you know the difference
between the two? I just had a FotoFacial RF and its been about a week and,
although red and swollen at first, I am starting to see a bit of
improvement. Thanks for the help and I hope every thing goes well. Happy
Holidays.
J

>From: Liz Crawford <projectliz@yahoo.com>
>Reply-To: rosacea-support@yahoogroups.com
>To: rosacea-support@yahoogroups.com
>Subject: Re: [rosacea] Success?
>Date: Sat, 9 Dec 2006 20:36:30 -0800 (PST)
>
>I had a lot of success with IPL treatments (3 in
>total). Last summer my rosacea was totally out of
>control (full facial flushing, ocular symptoms, and
>swelling on my cheeks and chin), despite the fact that
>I was taking an oral antibiotic (minocycline) and
>using a topical treatment. The IPL worked so well
>that even my dermatologist was shocked by my
>improvement. I have minimal flushing across my cheeks
>and nose in response to heat but that's about it. And
>I'm no longer taking an oral antibiotic or using any
>topical treatments (although I do still use restasis
>eye drops).
>
>That said, I should note that following each laser
>treatment my symptoms would always get worse before
>getting better. Right afterwards I was okay. Then
>about a week or so later I would start to flush, etc.,
>which would gradually taper off over the next few
>weeks.
>
>Regarding my experience more generally, the big issue,
>in addition to cost (I spent $1,200 overall), was
>finding a competent laser practitioner. That's one
>thing I got from reading the posts on this site- how
>important it is to go to someone who's good. I went
>to Vein Solutions in Indianapolis, IN (Dr.
>Finkelmeier).
>
>So for me, the IPL was definitely worth it (I think I
>was especially lucky in that I tolerated the laser
>really well - no burning, etc.). I was so depressed
>this past summer every time I looked in the mirror at
>my red and swollen face. I'm not 100% cured (still a
>bit of redness and enlarged pores), but it is so much
>better- really looks pretty normal.
>
>I hope this isn't too much detail. I just know that
>it was very helpful for me to read about other
>people's experiences with IPL (and other treatments)as
>well as their comments on various doctors.
>
>Best of luck.
>
>Liz
>
>--- hothead907 <jordanhuss@msn.com> wrote:
>
> > Has anyone actually had any success in beating their
> > rosacea without a
> > myriad of pills, vitamins, or topical solutions?
> > What about laser
> > treatments or IPLs or other forms of therapy? I
> > highly doubt anybody
> > who has had success even visits this group anymore,
> > but for those
> > people who have beat it and still visit the forum,
> > please let us know
> > what worked for you. Thanks.
> >
> >
>
>
>
>
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[rosacea] Prednison, thin skin

Hello,
A few days ago I questioned the statement by some over whether
prednisone (systemic corticosteroid) use was well documented and
established to cause steroid induced rosacea.
I was surprised to hear this and so did a quick literature search
using the appropriate drug resources ( I did not check the package
insert to prednisone as some of the infomation from the following
sources comes from the inserts and also the inserts aren't always
updated, anyway):
1)LexiComp DIH, 2006: Skin atrophy <1% (This is a new update, as this
was not mentioned in the 2005 verson of the DIH).
2)American Hospital Forulary Service (AHFS 2005): Thin skin
3)Micromedex, 2006: Skin atrophy
4)Manual of Dermatologic Therapeutics, 2002: No mention (This is
really dated...I think a more recent version is already available). I
incl. this reference bc it is a respected therapy-based (as opposed
to physiology-based)quick reference.
5)Facts and Comparisons, 2006: No mention
6)Rxlist.com (updated 2006)Regarded by most PharmD's as the most
complete online drug monograph tool, available to anyone. I highly
recommend it: Facial erythema.
NOTE: Under "Indications and dosage" check out the new dosing method
for long-term users, "Alternate Day therapy".
So, I would say that since 4 of 5 VALID sources list skin thinning,
atrophy, or erythema, that I was wrong in saying that SIR was not
well supported in the literature.
I still feel a good delving into the primary literature to find the
details of SIR and predisone may yield revealing data (et at what
doses does this most commonly occur?)
This is a good question for Artist...what dosing regimen are the
patients with facial redness ususally on?
If I find any more info...I'll post.
Thanks for the heads-up ya'll.
Perry
Perry

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Re: [rosacea] Salt intake

Donna
Im glad! heck I laugh at it too. when the water goes there, I just make sure I get it out of my system FAST! I look and say, wow the water is gone, its nice to feel flat chested again!
haha hope your morning gets better! oh by the way, im flat today YIPEEEEEEE
Ricky (no salt for me today)

Donna Collins <donna9142002@yahoo.com> wrote:
Ricky,

Thanks for making me laugh heartily this morning...it has been a rough one .

Donna

Ricky Butler wrote:
I always eat saltless eggs! I do notice salt for me, makes me flush/break out a bit
I love pringles potato chips..but the salt gets me! salt does this more than sugar, for me.
I am thin built, usually 160 - 162 lbs at 5"9" but salt makes me retain more water than the hoover dam!! it goes to my chest , the excess water, I feel like Dolly Partons brother! haha

nurse_artist wrote:
Anyone notice improvement when eating less salt? My thinking is that
lower salt intake leads to less edema (swelling), which might help
rosacea symptoms because less fluid would be retained to leak out of
the capillaries.

I started thinking about this and ate my eggs without
salt at breakfast today. Not as good.. he he he!

Cheers!

Artist

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Re: [rosacea] cleaning the house/ what do you use??

wow a maid! well arthritis and rosacea can certainly take a toll. I absolutely love cleaning now, no longer a chore because of what I use now. tamara

kemx@sbcglobal.net wrote: with all my other tendon and arthritis problems + rosacea i have a maid come in once a month for thourough cleaning.
other wise i use those clorox wipes in citrus, and a green clorox softscrub bleach gel.
also i use 7th generation fragrance free dish washing liquid for hand wash, and also for washing our hands here at home [i put it in pump bottles].
----- Original Message -----
From: tamara
To: rosacea-support@yahoogroups.com
Sent: Tuesday, December 12, 2006 8:34 PM
Subject: [rosacea] cleaning the house/ what do you use??

Hey guys, I just wanted to mention that I know I use to always flare
up around certain cleaning products to clean my house, and hated the
smell too, (very strong).
Well for about at least over a year now, and I am sure it has helped
me because ever since I made the change from buying over the counter
cleaning supplies, I now use my own (i make it myself and love it, no
longer having irritated skin and runny nose). for glass, I use vinegar
and water,(half and half) instead of what i use to use (windex).
For cleaning counters and bathroom and so on, I make a solution with
water, real lemon, few drops of tea tree oil, baking soda, and
vinegar.... it does a great cleaning and smells fresh. I read this in
a magazine and will never change back, and ive saved alot of money as
well. Just thought it was worth mentioning, especially our sensitive
skin, besides who needs all these added chemicals anyway? and look
what they used back in the olden days, certainly not all this junk.
This is my opinion, I am a strong beleiver in taking care of our
environment and have you seen the latest on oprah and global warming?
very interesting. Good night guys, tamara

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Re: [rosacea] my update on the z cream

Brian, if you can find a doctor to check your skin, and if these mites show up in abundance, then just imagine you can start this z cream and at least you will know for sure whats going on. Worth it for sure!! tamara

Brian Shaffner <brianshaffner@earthlink.net> wrote: Yes, it does, thanks. Those are amazing results! May be time for a test
patch soon... :)
----- Original Message -----
From: rose jill
To: rosacea-support@yahoogroups.com
Sent: Tuesday, December 12, 2006 7:46 PM
Subject: Re: [rosacea] my update on the z cream

Brian thanks. The z cream is helping with the flushing meaning when I eat
or drink something I react less and dont get red as easily as i did. My skin
is still dry and still healing but the layers of my skin is soft and looking
more normal and pinky instead of red. As for the little veins, i have some
very small though, I am not sure if they are smaller, to me they seem less
visible but I am not 100% sure on that. Lately I had 2 glasses of wine to
see what would happen, I use to flush like redd, this time I had a mild
flush. not as long and red either, hope this helps you. tamara

Brian Shaffner
wrote: Tamara,

Congrats on your perserverence and success!

I am very curious about something. My own rosacea consists mainly of
persistant pinkness in the rosacea areas, flushing when triggered, a
little
telegenta (um, I know I just slaughtered the spelling... the veins!) and
dermatitas, the latter which has pretty much been handled now. For
whatever reason I really have not had much in the way of P&P. Has the Z
addressed any of the kinds of symptoms I mentioned? I know it works really
well on the P&P for quite a few people. What about the other symptoms? I
asked this question months back on the Z cream board, but no one answered.
When you say 'rosacea flares' do you mean outbreak of papules, flushing,
or
both?

----- Original Message -----
From: tamara
To: rosacea-support@yahoogroups.com
Sent: Monday, December 11, 2006 8:28 PM
Subject: [rosacea] my update on the z cream

Hey everyone, Its been now about 3 months and 2 1/2 weeks since I
have started using the z cream. The last post I had indicated I was
50% better. I am here to say my skin is even better now since then,
which I am really ecstatic about, since I have been suffering with
this rosacea for around or close to 10 years give or take. Again, I
am type 2 (meaning papular rosacea). To be quite frank, over the
many years of having rosacea, it was always controllable for me
until the past 2 years where it became worse, and I had more
triggers that I could not comprehend. I have always wanted to stay
clear of antibiotics, and I am a firm believer in a more natural way
to go, although when I was younger I did use metrocream which I had
to get off of very quickly due to a metallic taste on my tonque. I
have never used any form of laser, and Ive always used natural
remedies to treat it. Anyway, the past few years, I became fed up
and just plain sick and tired of worrying about the very thing I
never use to be bothered about, especially due to the fact I use to
travel alot, and was in the sun alot, enjoyed having a drink, and
never had problems. Anyway, to make a long story short, I am pleased
to say this Z cream has been a life saver for me and my rosacea
flares are occurring less than they use to. I even ate and drink
things I always had problems with, and nothing so far. My skin is
looking better, and I am just grateful of this, I am planning on
using nightly until 150 days and then maintenance to keep them away!
I want you all to know that if you have not tried this, BELIEVE!!
dont give up, and I just hope it gets better and better and gone, no
more worrying. Love you all, I will keep you all posted. Tamara

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Re: [rosacea] z cream

Melissa, if you tested negative for the mites, then you would not use the z cream to treat it. You would need to test positive, an overabundance of mites, then use the z cream, and yes it is also called z ointment. hope this helps. Did you have your skin checked under a microscope with your doctor? tamara

melissawohlbattista <melissawohlbattista@yahoo.com> wrote: Hi guys,
This question is mainly for Tamara (or anyone else who knows the answer)
Do you know if the Z cream works on rosacea even if you tested negative
for the demodex mites?? Also, I checked out the websit and could only
find the z ointment. Is that the same thing as the z cream??
Any info is much appreciated. Thanks.
Melissa

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[rosacea] Re: No evidence that rosacea is primarily a vascular disorder

Hi Brady & Artist,

Drs Plewig and Jansen were definitely ahead of their time, and I
believe we owe them a huge amount of thanks. Unfortunately this
study is now @ 10 years old, however. Some more recent studies have
layered on additional details, and I think this sequence of events,
presented by Collagenex Pharmaceuticals, explains very well some of
the latest details in the pathologic sequence of events in rosacea:

"Sequence of Events

While the evolution of the inflammatory response in rosacea has not
been precisely elucidated, investigators suspect a sequence of events
similar to the following:

* Vasodilation of dermal capillaries, possibly mediated by
histamine, prostacyclin, prostaglandin E2, nitric oxide, or other
vasoactive compounds, causes initial erythema
* Prolonged dilation weakens capillary walls, allowing neutrophils
and proinflammatory cytokines such as TNF-&#945;, IL-1, and IL-6 to leak
into the surrounding dermis
* Extravascular fluid builds up, overwhelming lymphatic vessels,
and results in edema
* Additional neutrophils are recruited by chemotactic factors
released from inflamed dermal tissues
* Activated neutrophils release degradative compounds, including
matrix metalloproteinases (collagenases and gelatinases), reactive
oxygen species, and nitric oxide—that exacerbate the inflammatory
response and lead to tissue damage5,6,7"

The full page can be found at the following link (notice they quote
Drs Plewig and Jansen's study on this page):

http://www.rosaceatoday.com/RoleofInflammation.asp

What's really interesting was that I was "chatting" online with a
microbiologist recently, and this person mentioned that rosacea seems
to share a very similar pathology to other inflammatory disorders such
as MS, Crohn's Disease and Interstitial Cystitis, whereby chronic
inflammation allows for the degradative compounds of the inflammatory
infiltrates to cause tissue damage in localized tissues (the brain in
MS, the intestine in Crohn's Disease, the bladder in Interstitial
Cystitis, and of course the dermal tissues in rosacea).

It's unfortunate that medicine is so specialized. Sharing of
knowledge across the specialties of neurology, gastroenterology,
urology, dermatology, etc might really help us out...

Dan

--- In rosacea-support@yahoogroups.com, "nurse_artist"
<nurse_artist@...> wrote:
>
> Wow. Interesting! "the vessels do not seem abnormally fragile so
> the main abnormality is probably in the dermis surrounding blood
> vessels rather than in vessel walls." Maybe it's with the collagen.
> Collagen supports vessels. Over time, RLT enlarges the collagen
> fibers. Maybe that's part of why it helps, along with the anti-
> inflammatory effects.
>
> Cheers!
>
> Artist
>
> --- In rosacea-support@yahoogroups.com, "Brady Barrows" <brady@>
> wrote:
> >
> > According to Thomas Jansen, MD and Gerd Plewig, MD, "there is no
> direct
> > evidence that rosacea is primarily a vascular disorder." This to me
> is news
> > since I have been hearing for so long that rosacea is primarily a
> vascular
> > disorder.
> >
> > Here is part of what the article says:
> >
> > "The pathogenesis of rosacea thus remains obscure. What is certain,
> however,
> > is that rosacea patients are constitutionally predisposed to
> blushing and
> > flushing. The basic abnormality seems to be a microcirculatory
> disturbance
> > of the function of the facial angular veins. Statistical
> associations between
> > rosacea-related flushing and migraine suggest a shared disorder of
> vascular
> > regulation but there is no direct evidence that rosacea is primarily
> a vascular
> > disorder. The response of the facial vessels to adrenaline,
> histamine and
> > acetylcholine is normal, and the vessels do not seem abnormally
> fragile so
> > the main abnormality is probably in the dermis surrounding blood
> vessels
> > rather than in vessel walls. In addition, the distribution of
> rosacea is not
> > identical with the flush area. A very important background feature
> is
> > sun damage. Rosacea is always associated with solar elastosis and
> often with
> > heliodermatosis. Fair-skinned patients with rosacea type I will
> often give a
> > history of sun sensitivity. " > Rosacea: classification and
> treatment,
> > Thomas Jansen, MD and Gerd Plewig, MD
> >
> > source >
> >
> > http://www.pubmedcentral.nih.gov/picrender.fcgi?
> artid=1296179&blobtype=pdf
> >
> > html version >
> >
> > http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1296179
> >
> > For more information on the cause of rosacea go to this url >
> >
> > http://www.rosaceans.com/html/cause.html
> >
> > Dr. Plewig is a member of the Medical Advisory Committee for the
> RRDi >
> >
> > http://www.irosacea.org/mac.php
> >
>

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RE: [rosacea] Success?

Hi Melissa,

No, I have not had any laser procedures done, from what I hear and read, it
is not always a cure. But, really, nothing is with rosacea.

Again, with me, it appears to be diet related, you can eat healthy, but that
doesn't mean that what you are eating is NOT causing the problem. I have
eliminated lots from my diet, and discovered that some of these were
triggers, i.e. tomatoes are a big one for me, as also lots of fruit.

A good way to start before investing tons of money in cures and ointments is
to start a daily log of what you ingest, along with your activities, this
will help in pinpointing. When I starting addressing the rosacea with
dietary changes I saw results early on. For example after taking 5-10
minutes of sauna proceeding a workout I would not remain as flushed to the
point that I would only be flushed for a couple minutes after the sauna.
Prior it would be flushed until well after a shower & shave.

Aging apparently may be a factor in the sense that our bodies do not
assimilate food or environmental factors as they used to. Not to sound
holistic, but there maybe something to all that mumbo jumbo. There is a
yahoo group you whose files you may want to review. It's called Candida
support, I came across it after I had a serious yeast overload from high
levels of antibiotics (for rosacea) and it has some interesting facts on
nutrition, etc. Bottom line is the person who runs the group believes
candida is responsible for everything from cancer to skin disorders, along
with some other untraditional beliefs such as high cholesterol being ok.
Check the site out, but as I mentioned take it with a grain of salt, because
I don't believe all she states as 100% true, at least not with my body. We
need to be able to read the signs our bodes send out.

Good luck, if I remember or come across anything I'll forward it to you.

nerio

Nerio DeLeon
212-355-4055
nerio@att.net

-----Original Message-----
From: rosacea-support@yahoogroups.com
[mailto:rosacea-support@yahoogroups.com] On Behalf Of melissa wohl-battista
Sent: Monday, December 11, 2006 6:32 PM
To: rosacea-support@yahoogroups.com
Subject: RE: [rosacea] Success?

Hi Nerio,
Have you had any laser procedures done? I was doing some research and
there seems to be some reduction in flushing and overall pinkness with
certain procedures i.e. IPL RF.
I have always eaten very healthfully (and I gave up all alcohol when my
flushing became a problem a few months ago) and exercised every day. My
flushing is becoming a real problem. My main trigger is when I get warm,
even though stress can also bring on a flush- but less so.
Thanks for any input,
Melissa

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[rosacea] Re: No evidence that rosacea is primarily a vascular disorder

Wow. Interesting! "the vessels do not seem abnormally fragile so
the main abnormality is probably in the dermis surrounding blood
vessels rather than in vessel walls." Maybe it's with the collagen.
Collagen supports vessels. Over time, RLT enlarges the collagen
fibers. Maybe that's part of why it helps, along with the anti-
inflammatory effects.

Cheers!

Artist

--- In rosacea-support@yahoogroups.com, "Brady Barrows" <brady@...>
wrote:
>
> According to Thomas Jansen, MD and Gerd Plewig, MD, "there is no
direct
> evidence that rosacea is primarily a vascular disorder." This to me
is news
> since I have been hearing for so long that rosacea is primarily a
vascular
> disorder.
>
> Here is part of what the article says:
>
> "The pathogenesis of rosacea thus remains obscure. What is certain,
however,
> is that rosacea patients are constitutionally predisposed to
blushing and
> flushing. The basic abnormality seems to be a microcirculatory
disturbance
> of the function of the facial angular veins. Statistical
associations between
> rosacea-related flushing and migraine suggest a shared disorder of
vascular
> regulation but there is no direct evidence that rosacea is primarily
a vascular
> disorder. The response of the facial vessels to adrenaline,
histamine and
> acetylcholine is normal, and the vessels do not seem abnormally
fragile so
> the main abnormality is probably in the dermis surrounding blood
vessels
> rather than in vessel walls. In addition, the distribution of
rosacea is not
> identical with the flush area. A very important background feature
is
> sun damage. Rosacea is always associated with solar elastosis and
often with
> heliodermatosis. Fair-skinned patients with rosacea type I will
often give a
> history of sun sensitivity. " > Rosacea: classification and
treatment,
> Thomas Jansen, MD and Gerd Plewig, MD
>
> source >
>
> http://www.pubmedcentral.nih.gov/picrender.fcgi?
artid=1296179&blobtype=pdf
>
> html version >
>
> http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1296179
>
> For more information on the cause of rosacea go to this url >
>
> http://www.rosaceans.com/html/cause.html
>
> Dr. Plewig is a member of the Medical Advisory Committee for the
RRDi >
>
> http://www.irosacea.org/mac.php
>

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Re: [rosacea] Salt intake

Ricky,

Thanks for making me laugh heartily this morning...it has been a rough one .

Donna

Ricky Butler <classics_guy@yahoo.com> wrote:
I always eat saltless eggs! I do notice salt for me, makes me flush/break out a bit
I love pringles potato chips..but the salt gets me! salt does this more than sugar, for me.
I am thin built, usually 160 - 162 lbs at 5"9" but salt makes me retain more water than the hoover dam!! it goes to my chest , the excess water, I feel like Dolly Partons brother! haha

nurse_artist <nurse_artist@yahoo.com> wrote:
Anyone notice improvement when eating less salt? My thinking is that
lower salt intake leads to less edema (swelling), which might help
rosacea symptoms because less fluid would be retained to leak out of
the capillaries.

I started thinking about this and ate my eggs without
salt at breakfast today. Not as good.. he he he!

Cheers!

Artist

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