Rosacea News April 2007

1. Chlamydia pneumoniae (Cpn) and azithromycin
PAPER: The role of Chlamydia pneumoniae in the etiology of acne rosacea: response to the use of oral azithromycin.

As a followup to the recent note pathogen infection (Chlamydia pneumoniae) cause theory, comes a recently published paper, the first to address Cpn and Rosacea. This paper is very preliminary, but at least now Cpn is on the map.

http://rosacea.ii.net/news/2007/04/chlamydia-pneumoniae-cpn-and.html

2. Pyratine 6 (vs. Kinetin) reduces redness and acne lesions

WEB Site: The internet Press Release sites are full of an announcemet from Senetek about a product called Pyratine 6 and its possible use in treating rosacea. The announcement is based on a comparison of Pyratine 6 with another of Senetek's products - Kinetin.

http://rosacea.ii.net/news/2007/04/pyratine-6-vs-kinetin-reduces-redness.html

3. IPL excellent for treating red face and broken blood vessels

This 2007 paper confirms another study which was published in the same journal in 2003.

PAPER: Objective Evaluation of the Effect of Intense Pulsed Light on Rosacea and Solar Lentigines by Spectrophotometric Analysis of Skin Color.

http://rosacea.ii.net/news/2007/04/ipl-excellent-for-treating-red-face-and.html

4. anti-flammatory actions of tetracyclines

This article, just published is adding to body of research of the anti-inflammatory actions of the tetracycline family.

PAPER: Anti-Inflammatory Activity of Tetracyclines

http://rosacea.ii.net/news/2007/04/anti-flammatory-actions-of.html

5. oxytetracycline (Terramycin) joins low dose antibiotics

This paper (sadly only available in Polish) highlights the fact that one more tetracycline - oxytetracycline is joining the ranks of proven low dose antibiotics. A normal dose of oxytetracycline is 250-500mg four times a day.

PAPER: Oxytetracycline--mechanism of action and application in skin diseases

http://rosacea.ii.net/news/2007/04/oxytetracycline-terramycin-joins-low.html

6. cutanix goes offline, gets letter from FDA

A few people have noticed that Cutanix seems to have vanished off the face of the internet. Their web sites at cutanix.com, tvdepot.com are offline, and their corporate web site at bioformmedical.com no longer even mentions Cutanix.

http://rosacea.ii.net/news/2007/04/cutanix-goes-offline-gets-letter-from.html

7. flavay anthogenol hydrates and reduces skin stress

I thought this product sounded interesting, especially as it is professionally promoted, readily available, but little is known about how well it works for rosacea stressed skin. Anything that has been proven to reduce oxidative stress and help hydration could also help in rosacea.

http://rosacea.ii.net/news/2007/04/flavay-anthogenol-hydrates-and-reduces.html

flavay anthogenol hydrates and reduces skin stress

I thought this product sounded interesting, especially as it is professionally promoted, readily available, but little is known about how well it works for rosacea stressed skin. Anything that has been proven to reduce oxidative stress and help hydration could also help in rosacea. Some of the other claims like ;

"In addition to being a potent antioxidant, ANTHOGENOL is best known for the nutritional support it gives to the vascular system, especially to the thin and delicate capillaries where all the system’s essential functions culminate."

[Proven Health Benefits for Circulatory System]

also sound interesting.

Only time and user feedback will tell how well this supplement works. If you do try Anthogenol please post over at rosacea-support and let us know how you get on.

Anthogenol is made from pine bark and grape seed extract ;

Dr. Masquelier received several patents for the commercial extraction and isolation of OPCs from pine bark and grape seeds. It is these highly defined complexes that have been subject to intensive biological, toxicological, pharmacological and analytical research; and approved in Europe as over-the-counter medicines.

[Masquelier on OPCs and grape seed extracts and pine bark extracts]

The web sites are professional looking so the company is investing in the promotion of this product.

One relevant looking study is below ;

Anti-Inflammatory and Skin-Hydrating Properties of a Dietary Supplement and Topical Formulations Containing Oligomeric Proanthocyanidins, B. Hughes-Formella, O. Wunderlich, R. Williams, Bioskin GmbH, Hamburg, Germany. Skin Pharmacology and Physiology 2007;20:43-49

Background: Anti-inflammatory and skin hydration properties of a dietary supplement and 2 topical formulations (Anthogenol) with oligomeric proanthocyanidins were investigated.

Methods: Forty-two subjects were randomized into 2 groups: one taking the dietary supplement (100 mg/day) and the other without supplement. After 4 weeks, erythema was induced using UV radiation followed by treatment with topical cream or lotion. Erythema was measured for up to 72 h after irradiation. Skin hydration after 1 and 2 weeks of application of the cream and lotion was also measured in separate test fields.

Results: Both topical formulations led to a significant suppression of erythema formation and the dietary supplement led to an additional slightly stronger suppression. Thus 72 h after UV exposure and compared to the control fields of patients that had not taken a dietary supplement, erythema was slightly (13.2%) lower in the subjects that had taken a dietary supplement. The cream resulted in a maximal reduction of erythema of 45.9% (p = 0.0015), while the lotion resulted in a maximal reduction of 53.1% (p = 0.0002). Both topical formulations also increased skin hydration (by nearly 20%; p < 0.002 for all combinations of dietary supplementation and topical treatment) and the hydration was higher in the group taking the dietary supplement.

Conclusion: The regular use of Anthogenol products may help to protect from free-radical-mediated skin inflammation and to increase skin hydration.

Further Reading ;

• In the US: http://www.masquelier.us/
• Australia: http://www.anthogenol.com.au/
• UK: http://www.anthogenol.co.uk/
  
• grape seed extract + quercetin and vascular function
• treating rosacea with herbs
• grape seed extract + vitamin C increases blood pressure
• focus on calendula (califlora)
• boswellia and endothelial inflammation

ocular demodex, tea tree oil as a treatment

ocular demodex, tea tree oil as a treatment

This recently published paper suggests that a variety of ocular symptoms might be caused by demodex infestation. Six patients all having demodex present, and suffering with recalcitrant symptoms (including 4 diagnosed with rosacea) were given tea tree oil for a weekly eyelid scrub and tea tree shampoo for a daily scrub. All patients showed a large decrease in demodex counts and relief from their symptoms. Other recently published studies are showing that tea tree oil kills demodex.

Eucerin Redness Relief: product reviews

Eucerin Redness Relief: product reviews In 2005 a new range of skin care products from Eucerin (Beiersdorf Inc) called Eucerin Redness Relief was released. They are claimed as "Safe for sensitive skin and appropriate for Rosacea".

aveeno ultra calming with feverfew: product reviews

aveeno ultra calming with feverfew: product reviews There is a lot of interest from rosacea sufferers in treating their rosacea with natural or herbal therapies and remedies. Many shy away from treatments like antibiotics and metrogel. So far the best collection of information about natural products I've found is a paper called Treatment of Rosacea with Herbal Ingredients. One of the herbs mentioned in that paper was Feverfew.

Rosacea News March 2007

Rosacea News March 2007

1. Xolegel for treating seborrheic dermatitis (seb derm)

PAPER: Anti-inflammatory effects of ketoconazole: Clinical benefits in
the treatment of seborrheic dermatitis

http://rosacea.ii.net/news/2007/03/xolegel-for-treating-seborrheic.html

2. wanted: 11-18 year olds for survey about online support

SURVEY: Fiona Fox, who is a PhD student at The Centre for Appearance
Research, University of the West of England, Bristol, UK, is looking
for young people with a skin condition to take part in some research
online.

http://rosacea.ii.net/news/2007/03/wanted-11-18-year-olds-for-survey-about.html

3. ocular rosacea difficult to cope with

PAPER: Quality of life impact of ocular rosacea,

http://rosacea.ii.net/news/2007/03/ocular-rosacea-difficult-to-cope-with.html

4. aveeno ultra calming with feverfew: product reviews

REVIEWS: Aveeno has released 3 products from their `Active Naturals
Feverfew' range ; Ultra-Calming Daily Moisturizer with SPF 15,
Ultra-Calming Moisturizing Cream and Ultra-Calming Foaming Cleanser.

http://rosacea.ii.net/news/2007/03/aveeno-ultra-calming-with-feverfew.html

5. lavender, arnica, aloe vera, tea tree oil, and calendula ; do they work ?

MAGAZINE: Natural first aid: Are natural first-aid remedies effective?'

http://rosacea.ii.net/news/2007/03/lavender-arnica-aloe-vera-tea-tree-oil.html

6. pathogen infection (Chlamydia pneumoniae) cause theory

COMMENTS: A really interesting thread is going on in the
rosacea-support group. Dan is airing some of his thoughts on how a
pathogen might lead to the chronic inflammation we see in rosacea.

http://rosacea.ii.net/news/2007/03/pathogen-infection-chlamydia-pneumoniae.html

7. so just how does metrogel work ?

COMMENTS: Actually the way that metronidazole works is well known. How
the effect of metrogel leads to a benefit in rosacea, well, that is
something worth exploring some more later on.

http://rosacea.ii.net/news/2007/03/so-just-how-does-metrogel-work.html

8. exotic and expensive cosmetics, do they work ?
WEB SITE: Golf for Women: First Annual Skin Care Awards.

http://rosacea.ii.net/news/2007/03/exotic-and-expensive-cosmetics-do-they.html

9. ocular demodex, tea tree oil as a treatment

PAPER: Corneal Manifestations of Ocular Demodex Infestation
PAPER: Clinical treatment of ocular demodecosis by lid scrub with tea
tree oil
PAPER: In vitro and in vivo killing of ocular Demodex by tea tree oil.

http://rosacea.ii.net/news/2007/03/ocular-demodex-tea-tree-oil-as.html

pathogen infection (Chlamydia pneumoniae) cause theory

A really interesting thread is going on in the rosacea-support group. Dan is airing some of his thoughts on how a pathogen might lead to the chronic inflammation we see in rosacea. Even though Dan clearly states he has no medical background (and indeed it is worth remembering this point) it is clear that he has done a lot of reading on this topic.

• Message 93555: Rosacea and pathogen link? (be sure to read the followup posts at the bottom of the thread too).

Some more thoughts on a possible link: Chlamydia pneumoniae and Rosacea: A potential link?

Chlamydia pneumoniae may be something new to many (it was to me), so also see the wikipedia page: Chlamydophila pneumoniae

lavender, arnica, aloe vera, tea tree oil, and calendula ; do they work ?

Australia's Choice magazine is an independent magazine that reviews products from the point of view of the consumer. Recently they published an articled titled `Natural first aid: Are natural first-aid remedies effective?'

The summary of the article ;

There’s plenty of anecdotal evidence from years of traditional use, but scientific evidence for the clinical effectiveness of natural first-aid remedies is generally lacking.

Most of the world relies mainly on natural medicines, and their popularity is growing in the west. You can easily find natural first-aid remedies in pharmacies and healthfood shops. But can you be sure that they’ll work?

Something I hadn't heard of before is a body called `Commision E'. Where available the article cites findings from Commission E.

Commission E

An exception to the lack of scientific study of natural remedies is Commission E, a German government regulatory agency composed of scientists, pharmacists, toxicologists, physicians and herbalists that has produced a series of documents known as herbal monographs — essentially formal reviews of medicinal herbs based on the available scientific evidence as well as evidence from traditional use, case studies and the experience of modern herbalists. The monographs are considered to provide authoritative information including approved uses of the herbs and their side effects, interactions and doses.

See the full article for examples of where Commission E has published relevant information.

Some of the remedies in this article have been discussed in the past as possible treatments for rosacea. Unfortunately there isn't much in this well written article suggesting that any of these natural remedies have been proven as effective for inflammatory skin diseases. 

Following are some interesting extracts ; 

Aloe Vera

The evidence is mixed, but it probably can’t hurt to try certified aloe vera gel (or aloe vera juice squeezed directly from the plant, if you have one) on minor wounds and burns/sunburn — and it might work.

Arnica

Arnica montana is a medicinal herb with a long history of use for treating swelling and bruising resulting from blows, and injuries such as sprains. Arnica flower is commonly available in both herbal and homeopathic preparations.

Clinical evidence for arnica as an effective first aid treatment is lacking, but people with osteoarthritis might want to give it a go.

Calendula

Calendula officinalis, or marigold, is a member of the daisy family (Compositae/Asteraceae). Its preparations have been used since ancient times to treat inflammatory skin conditions and accelerate wound healing.

Lavender oil

Oil from the lavender flower (Lavandula angustifolia) has been used as an antiseptic in medicine since ancient Arabian, Greek and Roman times.

The clinical evidence for its effectiveness as an antiseptic is lacking, though sprinkling lavender oil in your bathwater to help you relax is likely to be safe enough.

Tea tree oil

Australian Aborigines have used the leaves of the Melaleuca alternifolia plant for medicinal purposes for many centuries. Tea tree oil’s traditional use is as an antiseptic for preventing and treating minor skin infections.

The evidence so far is encouraging, though not definitive. It may be worth a try on insect bites and minor skin infections.

Further Reading ;

• treating rosacea with herbs
• jojoba oil has anti-inflammatory properties
• hardy kiwi fruit extract may help atopic dermatitis
• focus on calendula (califlora)
• focus on golden chamomile (Chrysanthellum indicum)
• Eucerin Redness Relief: product reviews
• aveeno ultra calming with feverfew: product reviews

so just how does metrogel work ?

I have mentioned a few times in the past that the way that metrogel helps rosacea is unknown. This statement deserves some clarification. Actually the way that metronidazole works is well known. How the effect of metrogel leads to a benefit in rosacea, well, that is something worth exploring some more later on.

You may wonder why there is so much emphasis on the metronidazole based products ? As much as metrogel and its friends metrocream, metrolotion, rozex, noritate (and indeed generic metrogel, also from fougera) are not a panacea for rosacea, they do represent the single most proven treatment specifically for rosacea. Thus newly diagnosed rosacea sufferers are quite likely to leave their doctor's surgery with a script for metro-something. All the studies show that in many cases metrogel does indeed work. Further, other studies clearly show that combining metrogel with antibiotics results in better clearance.

So back to `how does it work ?'  Well my one sentence summary is "metronidazole breaks down into a substance that kills the DNA of the cells of some particular bacteria and protozoa".

Thanks to Dan for sending me the following links ;

From DrugBank: Metronidazole

Pharmacology: Metronidazole, a synthetic antibacterial and antiprotozoal agent of the nitroimidazole class, is used against protozoa such as Trichomonas vaginalis, amebiasis, and giardiasis. Metronidazole is extremely effective against anaerobic bacterial infections and is also used to treat Crohn's disease, antibiotic-associated diarrhea, and rosacea.

Mechanism of Action: Unionized metronidazole is selective for anaerobic bacteria due to their ability to intracellularly reduce metronidazole to its active form. This reduced metronidazole then disrupts DNA's helical structure, inhibiting bacterial nucleic acid synthesis and resulting in bacterial cell death.

From Antibiotics that Inhibit Nucleic Acid Synthesis

Figure 11-8. Structure of metronidazole and its mechanism of action. Metronidazole enters an aerobic bacterium where, via the electron transport protein ferrodoxin, it is reduced. The drug then binds to DNA, and DNA breakage occurs.

(An anaerobic organism is any organism that does not require oxygen for growth. Protozoa are a particular type of single cell organisms.)

This naturally leads to the followup question - if eliminating the substances that metronidazole (and for the purposes of this argument, lets include systemic antibiotics as well) is active against leads to relief from some rosacea symptoms, what does that say about the possible cause of rosacea ? Now, that is a question that there isn't much agreement about and something worth talking about some more, later.

Further Reading ;

• focus on metronidazole
• metrogel less irritating than finacea
• collagenex: rosacea is a chronic inflammatory disease
• 1 percent metrogel from galderma
• generic metrogel soon - Fougera
• metrogel, metrolotion, metrocream, noritate, once and twice per day - all the same same
• focus on finacea (azelaic acid 15%)
• periostat and metrogel better than metrogel alone
• low dose doxycycline hyclate (SDD)

ocular demodex, tea tree oil as a treatment

This recently published paper suggests that a variety of ocular symptoms might be caused by demodex infestation. Six patients all having demodex present, and suffering with recalcitrant symptoms (including 4 diagnosed with rosacea) were given tea tree oil for a weekly eyelid scrub and tea tree shampoo for a daily scrub. All patients showed a large decrease in demodex counts and relief from their symptoms.

Other recently published studies are showing that tea tree oil kills demodex. See ;

• Clinical treatment of ocular demodecosis by lid scrub with tea tree oil., Cornea. 2007 Feb;26(2):136-43. Conclusions: Demodex is resistant to a wide range of antiseptic solutions. Weekly lid scrub with 50% TTO and daily lid scrub with tea tree shampoo is effective in eradicating ocular Demodex.
• In vitro and in vivo killing of ocular Demodex by tea tree oil. [full text], Br J Ophthalmol. 2005 Nov;89(11):1468-73  Conclusions: Demodex is resistant to a wide range of antiseptic solutions. Weekly lid scrub with 50% TTO and daily lid scrub with tea tree shampoo is effective in eradicating ocular Demodex.

I have always pushed the line that demodex mites have thus far only been proven to be innocent bystanders in rosacea symptoms. In order to prove that the mites are responsible for some ocular symptoms we now need double blind studies to show 2 things - firstly that killing demodex does lead to a reduction in ocular rosacea symptoms and secondly some studies that show how tea tree oil works. We also now need larger studies that confirm that tea tree oil is a safe therapy for ocular symptoms.

Corneal Manifestations of Ocular Demodex Infestation, Kheirkhah A, Casas V, Li W, Raju VK, Tseng SC., Ocular Surface Center, Miami, Florida. Am J Ophthalmol. 2007 Mar 19

PURPOSE: To report the corneal manifestations in eyes with Demodex infestation of the eyelids.

DESIGN: Noncomparative, interventional case series.

METHODS: This retrospective review included six patients with Demodex blepharitis who also exhibited corneal abnormalities, which led to suspicion of limbal stem cell deficiency in three cases. All patients received weekly lid scrubs with 50% tea tree oil and a daily lid scrubs with tea tree shampoo for a minimum of six weeks. Improvement of symptoms and corneal and conjunctival signs were evaluated.

RESULTS: All six patients exhibited ocular irritation and conjunctival inflammation, while meibomian gland dysfunction (n = 5), rosacea (n = 4), and decreased vision (n = 3) also were noted despite prior treatments with oral tetracycline, topical steroids with antibiotics, and lid scrub with baby shampoo. These patients were proven to have Demodex folliculorum (n = 6) and Demodex brevis (n = 3) by microscopic examination of epilated lashes. Their corneal manifestation included superficial corneal vascularization (six eyes of five cases), marginal corneal infiltration (two eyes of two cases), phlyctenule-like lesion (one eye of one case), superficial corneal opacity (two eyes of two cases), and nodular corneal scar (two eyes of two cases). After treatment, the Demodex count was reduced from 6.8 +/- 2.8 to 1 +/- 0.9 (standard deviation; P = .001). All patients showed dramatic resolution of ocular irritation, conjunctival inflammation, and all inflammatory, but not scarred, corneal signs; three patients showed improved vision.

CONCLUSIONS: A variety of corneal pathologic features together with conjunctival inflammation, commonly noted in rosacea, can be found in patients with Demodex infestation of the eyelids. When conventional treatments for rosacea fail, one may consider lid scrub with tea tree oil to eradicate mites as a new treatment.

Further Reading ;

• treating rosacea with herbs
• Alternative Treatments for Demodex Mites
• lavender, arnica, aloe vera, tea tree oil, and calendula ; do they work ?
• demodex mites ivermectin effective treatment ?
• demodex mites treatment ?
• demodex mites, ivermectin (stromectol) and its use in dermatology
• MMP-9 and demodex - the missing link ?
• demodex mites and blepharitis eye lashes

Rosacea News February 2007

Rosacea News February 2007





1. demodex bacteria - could that be the cause ?





PAPER: Electron microscopic investigation into the possible etiology of


rosacea and the implication for treatment,





http://rosacea.ii.net/news/2007/02/demodex-bacteria-could-that-be-cause.html





2. red face and photodynamic therapy (PDT)





PAPER: Topical photodynamic therapy for treatment of facial erythema


with acne vulgaris





http://rosacea.ii.net/news/2007/02/red-face-and-photodynamic-therapy-pdt.html





3. topical antihistamine reduces oily skin and acne





PAPER: A 4-week, randomized, double-blind, parallel group trial


evaluating the efficacy and tolerability of sebum control product in


male and female subjects with oily skin appearance and mild to moderate


acne vulgaris





http://rosacea.ii.net/news/2007/02/topical-antihistamine-reduces-oily-skin.html





4. revlon (Almay) sensitive skin cream helps rosacea





PAPER: Use of a liquid cream improves sensitive rosacea-prone skin





http://rosacea.ii.net/news/2007/02/revlon-almay-sensitive-skin-cream-helps.html





5. Mariah Carey has rosacea ? celebrities as advocates ?





MAGAZINE: I’ve got thighs and buttocks, I'm never going to be a size zero





http://rosacea.ii.net/news/2007/02/mariah-carey-has-rosacea-celebrities-as.html





6. rambazole dose and side effects being studied





PAPER: Tolerability, safety, and pharmacokinetics of single and


multiple oral dosages of R115866 in healthy volunteers





http://rosacea.ii.net/news/2007/02/rambazole-dose-and-side-effects-being.html





7. cleansing your SD skin with a sonic brush (Clarisonic)





PAPER: An efficacy assessment of a novel skin cleansing device in


seborrheic dermatitis,





http://rosacea.ii.net/news/2007/02/cleansing-your-sd-skin-with-sonic-brush.html
_______________

[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.
> >
> >
>
>
>
>
>__________________________________________________________
>Do you Yahoo!?
>Everyone is raving about the all-new Yahoo! Mail beta.
>http://new.mail.yahoo.com

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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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