Rosacea Treatments - Non-Approved Therapies

Treatment - Non-approved therapies

The following treatments have been described in literature as successful in
rosacea patients, but they have not been approved for this disease, and large
controlled surveys are lacking. These suggestions should not in any way
encourage or promote the off-label use of these products.

Topical
Tacrolimus, an immunomodulator which, as a topical agent, is approved for
the treatment of atopic eczema, has been shown to be effective in patients
with steroid-induced rosacea. Tacrolimus ointment has been applied in a
concentration of 0,075% and 0,1% for rosacea.

Ascomycin, another immunomodulator, has been reported to be effective
in rosacea in a concentration of 1%.Infestation with demodex folliculorum
mites has been discussed as an etiologic factor in some cases of rosacea or
rosacea-like skin lesions.

Thus, antiinfectives such as permethrin 5% cream, lindane and benzoyl
benzoat have been recommended for stage II-rosacea.

Systemic
Dapsone, an antibiotic and antiparasitic agent, has been reported effective
in a dosage of 100 mg daily in rosacea fulminans.

Clonidine, a centrally active antihypertensive agent, has been shown to
reduce facial flushing. However small doses, which do not cause a decrease
in blood pressure, are said to have little or no effect.

Propranolol, a non-cardioselective beta-blocker has also been reported to
be helpful in reducing flushing. A dosage of 40 mg twice daily has been
recommended for this indication.

Orally administered metronidazole has been reported effective in a dosage
of 500 mg daily for stages II and III. A treatment duration of up to 20 – 60
days was required. This drug is not approved for a treatment duration
longer than 6 days, and it displays considerable side effects.

More can be found at:
http://rosacea.dermis.net/content/e04treatment/
e10non_approved/index_eng.html

Rosacea Revealed

Rosacea Revealed: Dermatologist Addresses Common Condition That Makes America Blush

NEW YORK, Oct. 13 /PRNewswire/ -- For most people, a flushed face is a typical reaction to emotions ranging from excitement to embarrassment and sometimes even anger. Yet for an estimated 14 million Americans, facial redness and swelling are characteristics of rosacea, a condition that many times goes untreated due to lack of awareness about this common skin disorder.
Speaking today at the American Academy of Dermatology's (Academy) Derm Update 2004, dermatologist Michelle T. Pelle, M.D., clinical associate professor of dermatology, University of California, San Diego, discussed the warning signs and the latest treatment options for rosacea.
"Because it is so noticeable on a person's face, rosacea can be socially and emotionally distressing," said Dr. Pelle. "While the cause is unknown, the good news is that this condition can be controlled if people know and look for the symptoms, as well as follow a supervised treatment plan."
Rosacea is a chronic and often progressive skin disease that causes redness and swelling on the face. Most people affected by the condition are fair-skinned between the ages of 30 and 50. Rosacea often runs in families, with women being affected more than men. Men, however, often get more severe forms of rosacea.
Often incorrectly referred to as "adult acne," rosacea may begin as a tendency to flush or blush easily, and progress to persistent redness in the center of the face that may gradually involve the cheeks, forehead, chin and nose. As the disease progresses, tiny blood vessels and pimples without blackheads begin to appear on and around the reddened area.
In more advanced cases, a condition called rhinophyma may develop. Less common in women, rhinophyma is characterized by a bulbous, enlarged red nose and puffy cheeks. Thick bumps also can develop on the lower half of the nose and cheeks. Approximately 50 percent of rosacea patients experience eye involvement and have burning and grittiness of the eyes as the result of a condition known as conjunctivitis. Left untreated, this condition can lead to serious eye impairment.
"There is no cure for rosacea and it can become significantly worse without treatment," advised Dr. Pelle. "The key is to identify the condition early. When the skin doesn't return to its normal color and when other symptoms such as tiny blood vessels and pimples become visible, it's time to see a dermatologist for professional treatment."
The best prevention for rosacea may be to avoid "triggers," or things that make the face red or flushed. Triggers can vary from person to person, however common ones include hot or spicy foods, alcohol, sun exposure, physical exertion, extremes of emotion, rubbing the face and using irritating topical products and cosmetics. Menopause also has been known to be a trigger for rosacea. In addition, it is important for rosacea patients to care for their skin by using gentle facial products that do not cause excessive dryness or contain additives such as glycolic acid or alcohol that may further irritate the skin.
Rosacea flare-ups also can be minimized by protecting skin from the sun. Dermatologists strongly recommend the daily use of a broad-spectrum (UVA and UVB protective) sunscreen with a Sun Protection Factor (SPF) of 15 or higher, seeking shade when possible and wearing protective clothing such as a long-sleeved shirt and wide-brimmed hat.
Standard medical therapies for rosacea include topical and oral anti-inflammatory and antibiotic medications. Treatment regimens are specific to each patient depending upon the severity of his or her condition. The three main topical medications approved by the Food and Drug Administration (FDA) for rosacea include topical metronidazole, the newer topical azelaic acid, and sodium sulfacetamide and sulfur formulations that include cleansers and lotions for the skin. If symptoms persist, dermatologists may prescribe oral medications in combination with topical therapies to bring rosacea symptoms under control.
"Oral antibiotics such as tetracycline tend to produce faster results than topical medications," explained Dr. Pelle. "The idea is to use them in conjunction with topical medications to initially bring a patient's condition under control and then go back to a strictly topical medication for long-term management." Dr. Pelle advises her rosacea patients to apply an emollient cream in combination with a topical retinoid cream before bedtime to achieve the best outcome.
Newer approaches to rosacea treatment include laser and light therapies that treat persistent redness and dilated blood vessels following initial topical therapy and have been known to achieve longer-lasting improvements. According to a new study published in the October 2004 issue of the Journal of the American Academy Dermatology (JAAD), pulsed dye laser (PDL) therapy in particular was found to be a safe and effective treatment for the symptoms of rosacea and resulted in a significant improvement in facial appearance and quality of life.
Vascular lasers, including PDL, emit specific wavelengths of light that target the tiny visible blood vessels just under the skin. Heat from the laser's energy builds in the vessels, causing them to collapse. Intense-pulsed light therapy uses multiple wavelengths of light to treat dilated blood vessels in the face. Both vascular laser treatment and intense-pulsed light therapy take approximately 15 to 30 minutes and are performed at six- to 12-week intervals. Patients may require several initial treatments and then return annually for treatment of new blood vessels.
"While newer rosacea treatments are longer-lasting, it is important to remember there is no cure for this condition," cautioned Dr. Pelle. "However, patients can reduce the incidence of flare-ups by avoiding their personal trigger factors and following through on a dermatologist-supervised treatment regimen."
For more information about rosacea, visit the Academy's patient education Web site at http://www.skincarephysicians.com and select "RosaceaNet."

Safe Sun Care

edited from an article by Anastasia Stephens, daily Mail

Many commercial sun creams damage your skin AND your health! use of PABA and other chemicals have even been shown to alter the DNA structure of the skin and lead to a host of health problems.

After a rise in allergic reactions, sunscreen makers were urged to remove a chemical called methyl dibromo glutaronitrile. Used in leading brands of sunscreen, it can cause rashes and swelling, say European Commission scientists.
So what are the common ingredients - which should be listed on the bottle? How safe are they and what are the alternatives?

UVB FILTERS
UVB filters, or cinnamates, such as cinoxate, octocrylene and octyl methoxycinnamate (OMC) work by absorbing UVB light, deflecting harmful radiation from the skin.
However, they are common skin irritants and a study published in the New Scientist found cinnamates can cause some cells to die prematurely.
The Norwegian Radiation Protection Authority tested mouse skin and found that half the cells died after contact with a weak dose of OMC, while shining a lamp on the impregnated cells, to simulate sunshine, made the chemical twice as toxic.
No tests have been undertaken on human skin, but these results imply OMC could be toxic, especially if left on the skin for long periods of time.

UVA FILTERS
UVA filters, or benzophenones, are a family of chemicals including oxybenzone, dioxybenzone and butylmethoxydibenzoylmethane which are commonly used in suncreams to absorb UVA light.
They can sensitise the skin, making it prone to inflammation, rashes and allergic reactions. Some experts believe that, when exposed to UV rays, sunscreen ingredients such as oxybenzone can break down into chemicals which destroy or inhibit the skin's natural defences against sunlight.
This leaves it vulnerable to the free radical damage produced by sun exposure, which, far from protecting you from the sun, could exacerbate the risk of skin cancer and premature aging.

SUNBLOCKS
Zinc and titanium oxide are mineral-derived sun blocks which reflect light, bouncing it away from the skin.
Mineral sunscreens were traditionally very messy, but the new high-tech formulations contain fine micro-pigments which make them smoother, light and easy to blend. They are less irritating than most chemicals and thought to be fairly safe.

SUNBURN PREVENTERS
Many suncreams contain salicylates - aspirin-like chemicals which help prevent sunburn and act as antiseptics.
'These chemicals are found naturally in almonds, apples, and apricots and won't harm most people,' says Charlotte Vohtz, who formulates suncreams for Greenpeople, a natural cosmetics company.
'However, those who are sensitive to aspirin may find they are also allergic to suncreams containing similar chemicals.' They may experience similar allergic reactions such as rashes and irritation.
Commonly used salicylates are ethylhexyl salicylate, homosalate, octyl salicylate, isotridecyl salicylate and neohomosalate.

SKIN PROTECTORS
Skin protectors such as PABAS, including p-aminobenzoic acid, ethyl dihydropropyl PABA, padimate-O, padimate A and glyceryl PABA, are used in suncreams to help prevent skin damage. They also act as a local anaesthetic in sunburn products.
However they can irritate skin and form formaldehyde and other carcinogenic substances when combined with chemical ingredients such as DEA and TEA.
'They can cause skin irritation, allergic eczema and a sensitivity to light experienced as a rash or swelling,' says Charlotte Vohtz.

PRESERVATIVES
Parabens are among the most widely used preservatives. Derived from plant and petroleum sources, they may trigger irritation on sensitive skins.
More worryingly, there is now research suggesting they are xenoestrogens, or hormonedisruptors, substances which, when absorbed through the body, mimic the female hormone oestrogen, disrupting the hormone balance.
Such chemicals, which have a cumulative effect, are thought to be linked to increases in cases of breast cancer and a fall in male sperm counts. Some parabens are suspected carcinogens.
Trisodium Edta is another preservative used in suncreams to prevent titanium or zinc oxide from breaking down and not working properly. But it can irritate the skin.

SCENT
Fragrances added to suncreams are normally listed as 'parfum' and frequently contain artificial musks. These can cause watery
eyes, reddened skin, and allergic reactions.
Asthmatics, in particular, should choose scentfree suncreams.
Many artificial scents contain hormone disrupters which accumulate in the body's fat and may enter a woman's milk when she breastfeeds.

SO, SHOULD I STILL USE SUNSCREEN?
Questions over the safety of chemicals and research showing that sunscreens encourage people to overexpose their skin to the sun implies that the sunscreen-only strategy isn't the best way to protect your skin.
Research in the British Medical Journal found that people who use sunscreen most are more prone to skin cancer - because it gave them a false confidence which encouraged them to sunbathe for longer and in the heat of the day.
While all suncreams contain filters to cut out UVB radiation - the type that causes sunburn - they don't all contain adequately strong filters for UVA radiation, which doesn't burn skin, but is equally carcinogenic and ages the skin.
In other words, relying on suncreams only could be dangerous if your cream isn't cutting out sufficient amounts of UVA.
Children's skin is particularly susceptible to sun damage as well as the potentially toxic or irritating effects of sunscreen ingredients - the skin absorbs up to 60 per cent of what is put on it and because many children's sun lotions have a high SPF, they also contain higher quantities of irritating chemicals.
Nonetheless, there is virtually no doubt that sunscreen provides extremely valuable protection against UV radiation.
The key to sun safety is to use natural suncreams, but don't rely on them alone. Covering up your body with clothes which block UV rays will reduce reliance on suncreams and any irritating ingredients in them.
If you're on the beach, wear a shirt and sarong after a few hours and protect your face by wearing a hat and sunglasses.
Avoid direct sunlight between 11am and 3pm when the sun is at its strongest - special protective tents or umbrellas on the beach will ensure you have somewhere to sit out of the sun
Even if it's cloudy, you should beware as high levels of UV radiation can pass though clouds. Remember, you are not protected from UV radiation when you are in a car, because the sun's rays can pass directly through glass.
You should use an SPF15 suncream as the minimum protection - there is no point using products below this. An SPF15 blocks out most of the sun's rays, although it does allow the skin, over time, to tan.

IS THERE A SAFER ALTERNATIVE?
Health-conscious and organic cosmetic companies now have suncream ranges which keep irritating or potentially toxic suncream ingredients to a minimum but are still effective at blocking out UV rays.
For any product to quote an SPF, it must have a listed protection ingredient that is Government-approved.
The safest suncreams will use the least irritating ingredients from this list, such as titanium oxide or cinnamates derived from cinnamon oil.
You should also look out for natural formulations that are rich in vitamin or herbal antioxidants as these protect the skin from free-radical damage caused by exposure to UV light.
Be aware that the list of ingredients in any suncream should not be too long - say, up to 15 ingredients.The more ingredients, the more likely you are to have a sensitive reaction.

INGREDIENTS FOR ROSACEA TREATMENT

Rosacea sufferers have very specific needs in terms of their rosacea skin care. Some products while often prescribed or used for the treatment of rosacea, may in fact have ingredients which are irritating to rosacea skin. Some ingredients that have been shown to be irritating to rosacea sufferers include but are not limited to: retinol, vitamin A or vitamin C, alcohol, any type of acids, benzoyl peroxide. Many other ingredients in the right amounts are quite effective and very user friendly. Some of the prefered ingredients include: sulfur, zinc, and jojoba oil. These are certainly by no means a complete list.

Many times finding the right product or treatment can depend not only on what ingredients you may react to but also in what concentration or amount you react to them. Other treatments or products you may be using either for your rosacea or in the treatment of other skin conditions can also affect how well a teatment works for you.

Can the pH of food affect the skin?

THE pH REGULATORY SYSTEM OF THE BODY

The pH balance of the human bloodstream is recognized by all medical physiology texts as one of the most important biochemical balances in all of human body chemistry.pH is the acronym for "Potential Hydrogen". In definition, it is the degree of concentration of hydrogen ions in a substance or solution. It is measured on a logarithmic scale from 0 to 14. Higher numbers means a substance is more alkaline in nature and there is a greater potential for absorbing more hydrogen ions. Lower numbers indicate more acidity with less potential for absorbing hydrogen ions.

Our body pH is very important because pH controls the speed of our body's biochemical reactions. It does this by controlling the speed of enzyme activity as well as the speed that electricity moves through our body. The higher (more alkaline) the pH of a substance or solution, the more electrical resistance that substance or solution holds. Therefore, electricity travels slower with higher pH.

All biochemical reactions and electrical (life) energy
are under pH control.

If we say something has an acid pH, we are saying it is hot and fast. As an example, look at the battery of your car. It's an acid battery. On cold days you want it to be hot and ready, and you want your car to start fast. Alkaline pH on the other hand, biochemically speaking, is slow and cool. Compare it to an alkaline battery in a flashlight. You want that battery to be cool, and to burn out slowly.

Here is an example of how pH can control. Look around you at society in general. Do you see people getting exhausted, burned out, and quick to anger? Do you see a rise in violence? In part it could be due to the fact that people today lean to an acid pH. As a society we are running hot and fast. How did we get there? We guzzle coffee for breakfast (acid), burgers for lunch (acid), wash it down with king size colas (acid), and have a pizza (acid) for dinner. In fact, with this scenario, you could easily correlate the rise of violence in our society with the increasing number of fast food restaurants on every corner. But I digress. However, this does lead me to the second part of the pH and digestive metabolic equation. pH is under the direct control of what we put into our mouths. Kind of makes sense doesn't it?What we eat and drink will impact where our body's pH level falls, and our body's pH will control the activity of every metabolic function happening in our body. pH is behind the body's electrical system and intracellular activity as well as the way our bodies utilize enzymes, minerals, and vitamins.

That is why pH is one of the first things to be looked at if you are experiencing unbalance in your body in any way, shape, or form. And since our body's pH level is a direct result of what we eat and drink, anytime we are experiencing imbalance, we need to look at what we have historically been eating and drinking because this impacts our pH. It's a circle. You can't look at one without looking at the other.What we eat and drink is directly tied to the functioning of our digestive system. From our mouth through our small intestines and through our colon, that system plays the most important part in our physical well being. This system, what we feed it, and how it impacts our pH, is the essential core that determines whether we have perfect health or not. It is really so simple.

Now you may be thinking that all of this makes perfect sense. It is so simple that you would think that modern medicine could look at it, put two and two together and simply attempt to bring people back into balance through the food that they eat.

If it were only so simple. Modern medicine has gotten to where it is today in part through a scientific and philosophical debate that culminated in the 19th century. On one side of the debate was French microbiologist Antoine Bechamp. On the other side was French microbiologist Louis Pasteur. Bechamp and Pasteur strongly disagreed in their bacteriological theories. They argued heatedly about who was correct.

The Argument that Changed the Course of Medicine.

Pasteur promoted a theory of disease that described non-changeable microbes as the primary cause of disease. This is the theory of monomorphism. This theory says that a microorganism is static and unchangeable. It is what it is. Disease is solely caused by microbes or bacteria that invade the body from the outside. (This is the germ theory.) Bechamp held the view that microorganisms can go through different stages of development and they can evolve into various growth forms within their life cycle. This is the theory of pleomorphism. He discovered microbes in the blood which he called microzymas. These microbes would change shape as individuals became diseased, and for Bechamp, this was the cause of disease; hence disease comes from inside the body.

Another scientist of the day, Claude Bernard, entered into the argument and said that it was actually the "milieu" or the environment that is all important to the disease process. Microbes do change and evolve, but how they do so is a result of the environment (or terrain) to which they are exposed. Hence, for Bechamp, microbes, being pleomorphic, will change according to the environment to which they are exposed. Therefore, disease in the body, as a biological process, will develop and manifest dependent upon the state of the internal biological terrain. At the core of that terrain, is pH.Both men acknowledged certain aspects of each other's research, but it Pasteur was the stronger, more flamboyant, and more vocal opponent when compared to the quiet Bechamp. Pasteur also came from wealth and had the right family connections. He went to great lengths to disprove Bechamp's view. Pasteur eventually managed to convince the scientific community that his view alone was correct. Bechamp felt that this diverted science down a deplorable road - a road that held only half the truth.

On his deathbed, Pasteur finally acknowledged Bechamp's work and said, "Bernard was correct: the microbe is nothing: the terrain is everything." It was a 180 degree turnaround. With his death imminently at hand, he as much as admitted that his germ theory had flaws. But his admission fell on deaf ears. It was far too late. It could not reverse the inertia of ideas that had already been accepted by mainstream science at that time. Allopathic (drug based) medicine was firmly entrenched on the road that was paved by Pasteur.The result of that road is what you see today practiced as medicine. When a body is out of balance, doctors attempt to put it back into balance, first through drugs, then through surgery. The general effect is to remove the symptoms, not to deal with the ultimate cause of the ailment.

More on this can be found at:
http://biomedx.com/microscopes/rrintro/rr1.html

Adverse effects of IPL

I had IPL with an AWFUL doctor in August 2003. She put shallow dents into my skin and left me with looser skin, nasolabials and strangetexture under my eyes. I've consulted with other docs and derms and they've said it might be fat loss.

I am putting this up as a warning for everyone not to just assumeIPL is noninvasive and cannot do damage. You really have to find a good doctor by reputation and by speaking with many of their patients. I went online and found someone damaged by my doc as well. I'm not sure if I can post her name here, but if so I will let people know so they can stay away. She works with reputable doctors, so I mistakenly assumed it would be ok.

Found at:
http://health.groups.yahoo.com/group/rosacea-support/message/63118

Some Dermatologists are all about money

Steven Snyder Owens Mills, MD. 20 minutes signing at least 20 times and initials that I will pay him. 5 minute visit with him.

Did not introduce himself except for "what are you here for?" I guess nobody even bothers to write down why I drove 3 hours to be there or he didn't feel like reading. Without looking at my face, he said "yes we can work on that."I asked what about my neck and he said "sure, that's another $250."

He proceded to stare at my chart and not say a thing. So I asked if he had an idea of how affective it would be. He said I would be "cured." "Somewhere between 10 and 90% improvement. ????

I think we have an opening.. lets go to the front counter. So I followed. Yes, we can do this in 15 minutes. I'm not sure what the heck I was thinking.. but I said sure. I had reasons for believing he was one of the best. So after waiting I was taken aside to sign two more forms. A: Not our fault for any problems and no promises of any results. B: You owe me no matter what.

Then would you believe after all those forms of promised payment, I had to PAY IN ADVANCE before even being allowed into the IPL room?I guess I lost my mind and paid. I don't know what I was thinking.Next I get taken into an IPL room.

The same one who took my moneysaid she was doing the procedure. What? He's not even doing theprocedure??? No.. several of us in the office are trained to doit. So here I am.. cornered.

All these forms signed that guarantees payment, plus I've already paid!!!! They play the game well, and I did not.

The procedure feels like a rubber band being snapped on your skin 50 times. It's not horrible, but you are sure glad when it's over. She explained things such as the "yellow one hurts more than the green one" during the treatment. Very helpful. She lost her place a few times and had to ask if she did that area already.

So.. I'm sorry I don't have anything to report yet on the results. But if you want personal service, to ask questions, to be treated bythe doctor himself, this is not the doctor to visit.

Cost was $96.00 for his 5-7 minutes and $550.00 for thephotofacial.

Oh.. and when I asked for a reciept I got one of those Office Depot generic write-in slips.

I don't mean to be so negative. Maybe the drive through hamburger approach applies to laser surgery too. Since it took me 3 months just to save up for one visit, I guess I was hoping for a little more attention for 1.5 hours of their time. It's not like they even have insurance woes to deal with. It's all cash.

Found at: http://health.groups.yahoo.com/group/rosacea-support/message/63108

The many causes of facial redness

Found an interesting article on the many causes of facial redness. See below:

The following other conditions can have symptoms similar to rosacea:
According to the American Academy of Dermatology, Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and even the upper arms. Acne affects most teenagers to some extent, but can also affect adults in their 20s, 30s and 40s. While there is no permanent cure for acne, it is controllable.
According to the American Academy of Dermatology, Psoriasis causes the skin to become inflamed, while producing red, thickened areas with silvery scales. This persistent skin disease occurs most often on the scalp, elbows, knees, and lower back. In some cases, psoriasis is so mild that people don't know they have it. At the opposite extreme, severe psoriasis may cover large areas of the body.
According to the American Academy of Dermatology, the word Eczema is used to describe all kinds of red, blistering, oozing, scaly, brownish, thickened, and itching skin conditions.
The word atopic describes a group of allergic or associated diseases that often affect several members of a family. These families may have allergies such as hay fever and asthma, but also have skin eruptions called Atopic Dermatitis. The disease can occur at any age, but is most common in infants to young adults.
Eczema/Atopic Dermatitis in infants occurs mainly on the face and scalp, although spots can appear elsewhere. In teens and young adults, the eruptions typically occur on the elbow bends and backs of the knees, ankles and wrists and on the face, neck and upper chest.
According to the American Academy of Dermatology, Poison Ivy Rash is caused by a substance called urushiol, found in the sap of Poison Ivy, Poison Oak and Poison Sumac. In those who are sensitive, urushiol causes a reaction in the form of a line or streak of rash (sometimes resembling insect bites) within 12-48 hours. Redness and swelling will be followed by blisters and severe itching. In a few days, the blisters become crusted and begin to scale. The rash will usually take about ten days to heal, sometimes leaving small spots. The rash can affect almost any part of the body, especially areas where the skin is thin.
Insect Bites and Stings can produce local inflammatory reactions that may vary in appearance. Acute reactions may appear as hives; more chronic reactions may appear as inflammatory papule (circumscribed, solid elevations on the skin) or may be characterized by a blister or blisters.
"The key to controlling rosacea is awareness and early intervention," Dr. Joseph Bikowski said.

For the complete article you may want ot visit:
http://www.internationalrosaceafoundation.org/