Recent Headlines: Rosacea News, Rosacea Information
and Rosacea Research by Dr. Nase

Press Release: Dr. Patrick Bitter, Sr. MD Joins Dr. Nase and Rosadyn : 06-26-09 Rosadyn to be released on July 1, 2009 : 06-26-09 Key Rosadyn Ingredient Reduces Rosacea Redness & Skin Dryness: 05-31-09 Rosadyn Launch: We are pleased to announce that Rosadyn is finished and was shipped to the Rosadyn Research Focus Group participants.  As the final stage of our pre-launch market analysis, Dr. Nase and Vascular Health Specialists have recruited a large group of rosacea sufferers to participate in a Rosadyn Research Focus Group for overall feedback.  Immediately after feedback is gathered and analyzed, Rosadyn will be launched to the general public.   Please continue to subscribe to the Rosadyn newsletter to receive ongoing launch information on Rosadyn and special introductory discount offers.  Vascular Health Specialists LLC is a professional firm dedicated to the oral and topical treatment of rosacea and other vascular-based disorders.  The team is comprised of experts and specialists across many different disciplines, including a seasoned product development and operations manager, a financial backer with a background in early stage venture capital investments and investment management, and a Clinical Dermatologist/Rosacea Treatment Specialist to oversee testing and future growth of this Vasculokinetic Company.  Dr. Nase is a Full-Partner and Board Member of this firm and will focus his expertise on the advancement of rosacea treatments which will include a wide range of topical and cleansing treatments for rosacea sufferers.  Clinical Study on Rosadyn: As the bio-functional, phyto-medicinal herbal extracts in Rosadyn have very real physiological actions (structure/function actions in the human body), Vascular Health Specialists will perform a Randomized, Double-Blind, Placebo-Controlled Study this summer to evaluate objective and subject effects of Rosadyn on facial and ocular rosacea symptoms.  Utilizing the latest Non-Invasive Dermatological Research Equipment we will be able to evaluate symptom changes and positive changes that occur to skin cells, blood vessel density, blood vessel health, angiogenesis, pro-inflammatory mediators and cellular changes at each level of the skin.  We are very excited about the potential of this novel treatment for vascular, ocular, and papulo-pustular rosacea, a result of more than 2 1/2 years of research and development. Rosadyn has incorporated premium grade ingredients, including those from Indena, a phyto-pharmaceutical company that specializes in the isolation, extraction and development of medicinal extracts. We have numerous Rosadyn test subjects who have achieved excellent improvement after only two to three months of daily Rosadyn treatment (utilizing three of our key active ingredients).   Rosadyn's Opextan & Recent Studies on Rosacea Redness & Skin Dryness:  While Rosadyn incorporates 14 bio-functional extracts for a total of 1,500 mgs per serving, Opextan TM, one of Rosadyn's key phyto-medicinal ingredients has recently stolen the spotlight.  At a recent National Meeting in Munich, Germany on April 21-23, 2009, for "Next-Generation Phyto-Medicinal Extracts", Opextan TM, made by a Pharmaceutical company (Indena) and incorporated into our Rosadyn Nutraceutical as a 'Skin Health Nutraceutical' was shown to have a significant effect on rosacea redness (couperose skin)  and skin inflammation.  This one ingredient contains several bio-functional co-factors such as verbascoside, polyphenols, hydroxytyrosol, caffeic acid and oleuropein that all act in synergism to target multiple causes of blood vessel-induced skin redness and inflammatory skin processes.  In addition, this unique Mediterranean Olive Fuit Extract is an excellent skin moisturizer when taken orally; it helps combat uncomfortable dry skin resulting from increases in blood glucose (e.g. rosacea food triggers and glucose spikes) and hormonal fluctuations.  This novel ingredient should reduce rosacea dermatitis and relieve skin discomfort caused by dryness and irritation.  The doseage of Opextan and Verbascoside concentration are extremely important to this Nutraceutical's efficacy.  To our knowledge, we are the only US-based manufacturer that incorporates clinical doses of Opextan and uses only the highest Verbascoside concentration (5%).  Verbascoside is a fascinating extract as it blocks male and female androgen fluctuations during rosacea flares and stressful events (via blockade of 5-alpha-reductase activity) -- this, in turn, reduces skin breakouts and inflammatory papules. Verbascoside is also one of the most effective oral antioxidants studied to date and has strong anti-inflammatory actions in inflammatory skin disorders by blocking leukotriene formation and production (e.g. a potent inflammatory substance intimately involved in rosacea inflammation and flares). "Indena is the world's leading company dedicated to the identification, development and production of active principles derived from plants, for use in the pharmaceutical, health-food and cosmetics industries.  The key to Indena's success is its research, covering: the screening of medicinal plants for their pharmacological benefits; the identification of new active principles; and the development of extraction and purification systems at the cutting-edge of industrial application. One of the main strategic objectives of the research is the development of new active herbal extracts for pharmaceutical applications."  Opextan is one of their newest discoveries and is already being hailed as the premiere skin beautifying medicinal exract for its ability to scavenge free radicals, decrease inflammatory skin processes, reduce uneven skin tone/blotchiness, and moisturize the skin: http://www.in-cosmetics.com/ExhibitorLibrary/88/opextan_3.pdf http://www.allianceingredients.com/pdfdocs/Opextan.pdf http://www.opextan.info/ The details of this study will be included on our new site:http://www.rosadyn.com. New Website:  Additional information about Vascular Health Specialist personel, Rosadyn formulation and synergism of ingredients, bio-functional actions of extracts on facial and ocular rosacea, and clinical/scientific studies on aforementioned extracts will be published on our new site which should be up very soon. Please check back for daily updates:  http://www.rosadyn.com/ Dr. Nase Remission Photo (2009) I had severe rosacea symptoms and triggers for over a decade.  After a myriad of rosacea treatment protocols, my symptoms and triggers have been in complete remission for over eight years.  I believe that my continued remission is a direct result of cutting-edge herbal extracts that I take orally on a daily basis; ‘blood vessel repair nutraceuticals', 'blood vessel protection extracts', 'vascular strengthening extracts, ‘skin repair cofactors’, 'skin growth nutraceuticals', ‘angiogenesis inhibitors’ (phyto-medicinal extracts that prevent blood vessel regrowth), and 'neuro-humoral calming extracts'.  We are incoporating all these active ingredients into a single oral treatment called Rosadyn.   Rosacea sufferers finally have an oral treatment option.   Rosadyn Ingredients proving to be beneficial for vascular and inflammatory symptoms of ocular rosacea    03-10-09 Rosadyn treatment shown to help trial participants with blood shot eyes and eyelid inflammation. Dr. Nase thanks Vascular Health Specialists for collaboration in the development of Rosadyn    03-10-09 Vascular Health Specialists is a professional group focused on developing treatments for a wide range of vascular and skin-related disorders. New Rosacea Book:  Beating Rosacea II (2009) to be released 1st quarter of 2009.  Beating Rosacea II is completely revised and updated.  Symptom- and Trigger-focused treatment recommendations.   02-27-09 Beating Rosacea II (2009) contains the most advanced treatment information in a focused step by step program.  To be released in the 1st quarter of 2009.  Click on the following link to be placed on the 'Notification List' for Beating Rosacea II.  Please label your subject heading "Beating Rosacea 2009":  drnase1000@hotmail.com   Dr. Nase Signature Rosacea Line -- RosadynTM Oral & Topical Pharmaceutical- Grade Nutraceutical for Rosacea Redness, Flushing, Papules, Ocular Symptoms, Neural Burning & Hypothalamic Overdrive:    02-27-09 RosadynTM: Vasculokinetic Rosacea Support.  Dr. Nase spent 2.5 years of collaboration with seven nutraceutical companies, one pharmaceutical company and Vascular Health Specialists LLC to develop Rosadyn.  This has resulted in a revolutionary rosacea supplement that addresses rosacea redness, flushing, inflammation, papules, ocular inflammation, swelling, and Hypothalamic overdrive.  Oligomeric peptides were developed to physically incorporate themselves into arterioles, capillaries, venules, lymph vessels and skin nerves to help strengthen blood vessels, reduce the chronic immune attack seen in rosacea facial skin, lessen rosacea symptoms, reduce new blood vessel growth, and break the dermal inflammatory cycle. These medicinal extracts also have the inherent ability to enhance the blood vessel repair mechanisms and strengthen the natural blood vessel defenses (in rosacea our genetic predisposition negatively affects the repair & defensive mechanisms).  Rosacea Consultation Package:   02-27-09 In-depth consultations for rosacea redness, flushing, papules, pustules, neural burning and triggers by Rosacea Specialist, Rosacea Consulting Specialists LLC.  Established in 2002 -- several hundred successful consultations.  Rosacea E-Book Series:   02-27-098 Multiple E-Books will be available. (1) Advanced Rosacea Treatments (2009):  (2)  Insurance Coverage for Laser Treatments:  (3)  OTC Product Reviews -- The Good, Bad and the Ugly.

 

Dr. Nase Photo Update:  The First Photo was taken on October 2006 and the Beach Vacation with Family Photo Series in August 2006.  Rosacea Sufferers can Achieve Complete Remission -- 7 years and Counting.

The most common question I receive is.... "Can rosacea be put into remission?"  In almost all cases I can state emphatically..... "Yes!".  The only caveat is that most moderate to severe rosacea sufferers need aggressive treatments aimed at their specific rosacea subtype.  Treatment with one topical or one oral every 6 months just cant undo the years of microvascular, neural and dermal damage caused by rosacea.  To beat the Rosacea Beast you must treat it with a multi-tiered approach aimed at addressing the rosacea subtype, symptoms, severity, triggers and skin type.  With the proper treatments most rosacea sufferers can achieve complete remission of rosacea.  I have been in remission for 7 years with no rosacea symptoms or triggers of note.  There is hope. 

 

 

August 2006 Photo of family after day at the beach

 

My dad and I playing some serious beach paddle ball

 

Game Point!

 

 

My Niece going for a ride -- No tokens required

 

August 2006 Time Stamp Folded Over from Back of Film

 

Rosacea can be stopped dead in its tracks!

 

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Multiple New Drug Applications for G-Protein Response Modifiers Submitted in Fourth Quarter of 2006:  G-Protein Therapy for Coupling or Uncoupling G-Protiens is Currently the Hottest Area of Treatment Study.

Reading literature on G-Proteins is like having your teeth pulled at the Dentist's office.  It is hard, confusing and extremely difficult to get information on G-Protein Therapy in this new world of trademarks, patents and intellectual property battles:  it is comparable to a Secret Service Guarded Testing Facility because no company wants to let any other company know their specific drug or their results on the Scientific Bench and in Human Clinical Studies. 

However, multiple New Drug Applications are being submitted in the fourth Quarter of 2006 and first Quarter of 2007 for these very important biological response modifiers.  Approval of New Drug Applications allows human testing to be performed.  With regards to rosacea and facial flushing disorders one primary target is a single subtype of heterotrimeric G protein–coupled receptor that controls both nitric oxide and endothelium-derived hyperpolarizing factor production by the vascular endothelium leading to dilation. Complete blockade can be achieved by blockade of - and ß-subunits of the G protein which serve as distinct intermediates to produce NO and EDHF. Treatment is focused on selective blockade of the q/11-subunit and the i1-2-subunit. 

Is G-Protein therapy a "pie in the sky idea".  Absolutely not.  There are actually at least 11 known G-Protein targetted therapies already approved and in use for human disease.  This is here AND now.

Below is some cutting-edge information about the importance of G-Protein Therapy and the explanations are in laymans terms:

"Where will the new drugs come from? One area to watch: G protein-coupled receptors (GPCRs). GPCRs are embedded in the membranes of nearly every cell and are the most common conduit for signaling pathways found in nature.

Two-thirds of all drugs target these receptors." The beta-blocker drug propranolol lowers blood pressure by preventing adrenaline from binding to its GPCR. Drugs that are given to relieve symptoms of Parkinson’s disease act through a GPCR that binds dopamine.

Parkinson’s disease also utilizes G-Protein Biological Response Modifier Therapy.  While at Merck Research Laboratories, where he was head of neuroscience, Conn and his colleagues found that activating a particular GPCR that binds the neurotransmitter glutamate – mGluR4 – relieved symptoms of Parkinson’s disease in animals. However, they could not find a compound that binds only to mGluR4, and does not activate other glutamate receptors elsewhere in the brain.

Allosteric modulation might solve the problem. This tongue twister refers to the ability of some compounds to bind to a secondary site on a receptor in a way that “modulates” its activation by a primary “ligand” such as a neurotransmitter or hormone. Primary ligands fit into the receptor’s main binding site like a key fitting a lock, and “turn it on.”

The modulator, on the other hand, acts like the dimmer switch in an electrical circuit, adjusting the intensity of the receptor’s activation. The anti-anxiety drugs Valium, Xanax, Librium and Ativan, for example, “potentiate” or turn up the activity of the benzodiazepine receptor G-Protein when it binds to its primary ligand, the neurotransmitter gamma-aminobutyric acid (GABA).

Conn wondered whether he could find an allosteric potentiator that was specific for mGluR4. However, “my department could only handle a maximum of three programs at any given time,” he says. “And to take a kind of half-baked idea ... and decide we’re going to really pull the trigger on a drug discovery program was such a high risk.”

Then, in 2003, he saw an opportunity to pursue his idea at Vanderbilt. A generation ago, Conn might have spent his entire career searching for a compound that could modulate mGluR4 activity. Now, thanks to the recent installation of a high-throughput screening facility at Vanderbilt, he and his colleagues can test tens of thousands of small molecules for drug-like activity in a single day.

Ultra low volume liquid handlers squirt nanoliter amounts of the compounds into 384-well “microplates” containing their target. Reactions are detected via fluorescence or luminescence as the plates are maneuvered by articulated robots through the screening system.

Compounds that bind to the allosteric site on mGluR4 will be tested in animal models of Parkinson’s disease to see if they actually relieve muscle rigidity and restore coordination. Conn admits that there is considerable skepticism among his colleagues in industry about “whether we can really pull it off ... it’s very high risk.” That hasn’t discouraged universities across the country from developing similar capabilities for screening compounds.

“This is where we fill the gap,” he explains. “I think we are at a turning point in the whole drug discovery industry ... We are at a point where different players in the whole therapeutic discovery arena can start to bring a lot more to bear to this process ...“I see it as a really challenging time. But mostly I see it as a very exciting time.”

Brief Summary:

The greatest potential source of new drugs are compounds that interact with G-proteins. G-proteins are intracellular molecular switches, involved in nearly every physiological – and presumably, pathological – process. They translate and transmit signals from the receptor to the “response machinery” deep inside the cell.

Here’s how they work: When a neurotransmitter or hormone binds to its G protein-coupled receptor on the surface of a cell, the receptor, in turn, activates G proteins that bind to it inside the cell. The proteins actually split into two active parts – alpha subunits and beta/gamma subunits – both of which can stimulate independent signaling pathways. This is not the future, it is already upon us and being used currently in certain hypertensive and diabetic drugs to alter blood vessel responsiveness.

Dr. Nase -- Recognized for Excellence as Rosacea Consultant Specialist for GLG Health Care Organization

In May 2005 Dr. Nase accepted a position on the Council of Advisors for GLG Healthcare to be a Rosacea Consultant and Board Member.  His function is to educate Pharmaceutical Companies, Medical Physicians, Biotech Companies and Investors on all facets of rosacea and to suggest future directions to take in rosacea research and treatment. This is imperative as it helps guide funding and investments towards the best rosacea studies and rosacea treatments. The GLG Healthcare Council is an association of more than 50,000 healthcare professionals and physicians who educate and consult on all current healthcare issues.

 

In June 2006, Dr. Nase was recognized by the GLG Healthcare Organization for his excellence as a Rosacea Consultant:

"Thank you for your participation in the Gerson Lehrman Group Councils as a rosacea consultant.

 

Based on the quality of your work, our clients have nominated you to participate in the GLG Educators Program. This new Council Member Program is only available to those Council Members specifically identified by our clients as valuable educators whose interactions have been particularly enriching.  You are currently recognized as a GLG Educator and are eligible for these benefits:

 

 

The GLG Educators Program recognizes and rewards some of our most valuable Council Members and improves their GLG experience in the following ways:

 

Status and recognition as a "GLG Educator" — A GLG Educator status marker will be highlighted next to your name in all client materials:

 

Dr. Geoffrey Nase

 

1.       In-person Meetings: Events, Visits and Education Seminars

2.       Consultations and surveys

3.       Clients and Council Member On-Call

4.       Access to unique industry research and information"

 

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Dr. Nase & Dr. Bitter starting VEGF Testing and Treatment Laboratory for Rosacea and Inflammatory Skin Disorders?

 

Dr. Patrick Bitter Sr. approached me two years ago to be the Director of a Biotechnology Laboratory to develop one of the most promising near-cures for rosacea -- a Vascular Endothelial Growth Factor Inhibiting Oligonucleotide (blocking the primary genetics behind rosacea redness, flushing and papules).  I would have accepted the position, but I had just accepted a Directorship position to research and treat rosacea sufferers with Dr. Darm at the Rosacea Research and Treatment Institute of Oregon.  After the Institute was sabotaged by a competing physician (yes folks, it is a very competitive world out there), I focused my energy on my rosacea consulting firm and was in the process of settting up a Rosacea Research and Treatment Forum.

However, once again, Dr. Bitter and I have started seriously discussing the VEGF Biotechnology laboratory.  In fact, we just had an in-depth discussion about this endeavor on June 1, 2006.  We are both excited by the prospects and have already performed much of the research on the laboratory equipment, personel, researchers and area to set up the Biotechnology Laboratory. 

The goal of this treatment would be topical application of gene blockers that would permanently turn off VEGF, a clinically proven "bad guy'' involved in almost every aspect of rosacea development and progression. A second important point to emphasize is that preliminary clinical studies have demonstrated that VEGF is probably the most potent dilator involved in the blushing response.  VEGF is premade and stored in granules that once activated are released instantly during the blushing mechansim.  Thus the speed of the blush, the intensity of the redness and the duration are intimately controlled by VEGF.  With this technology it would only take one treatment and no further maintenance required.  No promises yet, but please check back for updates.

 

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Unmasking Rosacea Symptoms

 

Introduction

Rosacea is an inflammatory skin disorder that affects approximately 45 million people worldwide. Rosacea is a mysterious disorder that continues to receive very little focus by the general medical community.  At every turn, rosacea is surrounded by unproven theories and speculation.  Much of this information is disseminated by physicians who are not specialists in rosacea research and treatment.  To make matters worse, dozens of new rosacea sites are popping up on the Internet every day.  Many of them are created by non-medical lay people that do not have the expertise to write on the subject; while other Web sites are commercial sites selling skin care products and thus have a hidden agenda. 

Newly diagnosed rosacea sufferers are literally choked by the amount of information on the Internet, the conflicting reports in the medical literature, and the web sites trying to sell snake oils.  How are rosacea sufferers supposed to understand their disorder when they are bombarded by an endless number of proposed triggers and causes:

• Demodex mites
• Bacteria
• Sebaceous gland abnormalities
• Yeast abnormalities in the skin
• Blood vessel damage
• Nerve dysfunction
• Epidermal barrier dysfunction
• Systemic infection
• Gastrointestinal abnormalities
• Systemic infection
• Systemic autoimmune disorder
• Local abnormalities in the skin immune system
• Psychological disturbances
• Liver problems
• Leaky gut syndrome
• Collagen damage
• Sun damage
• Skin irritation
• Hormonal imbalances
• Stress
• Facial parasites
• Blood toxins
• Liver dysfunction
• Cardiovascular abnormalities
• Food allergies

 

The Heart of Rosacea -- Rosacea is a Vascular Disorder

Rosacea is a disorder of the facial blood vessels. This is the only thing that all rosacea sufferers have in common.  Medical experts from across the world agree that vascular abnormalities are central to all stages and symptoms of rosacea.  Two main changes take place in rosacea blood vessels:

1. Rosacea blood vessels often experience changes in function. These blood vessels become hyper-responsive to internal and external stimuli. This hyper-responsiveness lays the foundation for rosacea, resulting in increased blood flow through the facial skin.

2. Clinical studies on rosacea sufferers demonstrate that in addition to the above listed functional changes, rosacea blood vessels also undergo extensive structural changes. Experts stress that these changes are ultimately responsible for the progression of all rosacea symptoms.

 

Secondary Changes that take place in Rosacea

After months or years of dermal inflammation from bouts of facial flushing, secondary changes may take place within the skin.  This is where the confusion takes place.  These changes are a direct result of blood vessel abnormalities.  They are NOT the cause of rosacea, but are secondary to blood vessel dysfunction:

1. Chronic dermal inflammation may activate sensory fibers in the facial skin -- resulting in pain sensations, itch sensations and burning sensations.

2. Dermal inflammation may alter the epidermis' ability to grow -- resulting in a thin, dysfunctional outer barrier.

3. Dermal inflammation may activate sebaceous glands, causing them to proliferate and clog.

4. Dermal inflammation may alter the skin's immune system -- causing the recruitment of pro-inflammatory immune cells into the facial skin.

5. Dermal inflammation may provoke mites or bacteria within the skin's pores -- causing the release of lipase and other inflammatory enzymes.

 

Summary

There are many products that claim to treat rosacea.  Some are prescription products and others are over-the-counter skin care products.  Many of them claim to treat rosacea by reducing bacteria, mites, inflammatory immune cells, clogged sebaceous glands, etc.  Remember though, these are not the cause of rosacea....... so, they are not really treating the heart of rosacea.  They are treating secondary symptoms.  There is only one cause of rosacea -- blood vessel abnormalities in the facial skin.

 

 

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Rosacea Subtypes

 

Introduction

The Rosacea Society Medical Committee has recently developed a "Rosacea Classification System" to help diagnose rosacea subtypes. This system helps rosacea sufferers better understand their symptoms and find the proper treatments. Below is a summary of each subtype adapted from the Journal of the American Academy of Dermatology. 2002; 46:584-587. While not officially recognized yet, a fifth subtype, Neuropathic Rosacea will soon be added to the Classification System.

 

 

Rosacea Subtypes	Rosacea Symptoms
Erythematotelangiectactic Rosacea	Facial Redness
Papulopustular Rosacea	Papules & Pustules
Phymatous Rosacea	Facial Skin Growth/Thickening
Ocular Rosacea	Eye Symptoms
Neuropathic Rosacea	Facial Burning/Stinging Sensation

 

 

Subtype 1: Erythematotelangiectatic Rosacea

Erythematotelangiectatic rosacea is mainly characterized by flushing and persistent central facial redness. The appearance of telangiectasia is common but not essential for a diagnosis of this subtype. Central facial edema, stinging and burning sensations, and roughness may also occur. A history of flushing alone is common among patients presenting with erythematotelangiectatic rosacea.

 

 

Subtype 2: Papulopustular Rosacea

Papulopustular rosacea is characterized by persistent central facial redness with transient papules or pustules. The papulopustular subtype resembles acne vulgaris, except that comedones are absent. Burning and stinging sensations may be reported by patients with papulopustular rosacea.

This subtype is often reported in combination with subtype 1, including the presence of telangiectasia. The telangiectasia may be obscured by persistent redness, papules, or pustules.

  

 

Subtype 3: Phymatous Rosacea

Phymatous rosacea includes thickening of the nose skin, irregular surface nodularities, and enlargement. Rhinophyma is the most common presentation, but phymatous rosacea may occur in other locations, including the chin, forehead, cheeks, and ears.

  

 

Subtype 4: Ocular Rosacea

The diagnosis of ocular rosacea should be considered when a patient's eyes have one or more of the following signs and symptoms: watery or bloodshot appearance, foreign body sensation, burning or stinging, dryness, itching, light sensitivity, blurred vision, telangiectasia of the conjunctiva and lid margin. Blepharitis, conjunctivitis, and irregularity of the eyelid margins also may occur.

 

 

Subtype 5: Neuropathic Rosacea

The classification system has proven helpful to many general dermatologists. However, a gaping hole has been left in the system setup. This system has excluded one of the most important rosacea subtypes. It's important that all dermatologists become aware that a new clinical subtype has recently been identified. Though not officially recognized yet, Neuropathic Rosacea (Subtype 5) is believed to be the most debilitating form of the disorder.

Hallmarks of Neuropathic Rosacea include bouts of centrofacial burning and pain sensations following exposure to triggers. Such bouts usually last longer than 30 minutes. More serious cases can become semi-permanent if dermal inflammation or various inflammatory cytokines damage or permanently activate sensory nociceptors. In severe cases, underlying facial inflammation may trigger these sensory nociceptors in the absence of external triggers. It must be stressed that this subtype can cause physical disability comparable to diabetic neuropathy and other painful peripheral neuropathies.

Rosacea sufferers with Neuropathic Rosacea are best treated by a collaborative effort between dermatologists, neurologists with peripheral nerve treatment training and pain specialists.

 

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Rosacea and its Effect on Quality of Life

 

Introduction

General physicians who do not treat rosacea sufferers on a daily basis, or who do not sit down and spend quality time with their patients, often trivialize rosacea. They do not understand that the innocent 'healthy glow' of rosacea can quickly turn into permanent facial damage and severe burning sensations. Rosacea experts warn general physicians that rosacea is not a trivial disease.

 

1. Rosacea experts warn general physicians that rosacea can cause permanent damage to the face, resulting in facial deformity.

2. Experts also warn general physicians that rosacea sufferers can experience chronic and/or intense facial burning sensations. They stress that these sensations can become debilitating in some sufferers

 

 

Impaired Quality of Life

Medical physicians have documented the effect of rosacea on the general quality of life of their patients. Below are a few examples:

 

• One sufferer reports that rosacea is, "A devastating condition.... I was so embarrassed that I retired as early as possible to avoid social contact."

• Another sufferer states, "I quit my job because of how my face looked. One day I was helping handicapped kids board a bus headed for summer camp. After just an hour in the sun I came inside and my face was neon pink. My co-workers were so concerned they thought I was going to have a heart attack."

• A different rosacea sufferer reports, "For me, rosacea is the most socially destroying disease I have ever experienced.

• Other rosacea sufferers have reported, "There was such swelling and redness it actually changed the way I look."

•  A different sufferer states, "Rosacea is a heartache for people. This disease took over my life for two years."

• Another sufferer emphasizes, "I take my rosacea into consideration when planning daily events."

• A different rosacea victim reports, "I started to resemble Rudolph."

• One sufferer states, "My face was burnt-looking.... I was tired of facing people who kept asking me what was wrong." 

• Others mention, "I was totally distraught by rosacea. I was so depressed, that I didn't want to leave the house."

• There are numerous descriptions in the medical literature of rosacea sufferers postponing business meetings due to rosacea flare-ups.

• There are numerous reports in the medical literature of people quitting their jobs due to rosacea.

• A model who was dependent on her appearance, reported that rosacea frequently interfered with her career, and may have resulted in a loss of income

• There are several medical reports detailing that rosacea sufferers will often do anything to avoid social activities and professional appointments if they know that these events will trigger a flare.

 

Problem with this Misconception

General physicians often downgrade rosacea into a trivial disorder because it is not life threatening. These same physicians often consider rosacea to be a minor cosmetic nuisance, or a "cute" disorder that causes a healthy facial glow. Well, these physicians need a different perspective; they need to understand rosacea better and learn more about its effect on our quality of life. First , there are no other inflammatory skin disorders that are more obvious to the world - rosacea affects the center of the face. Second , there are very few cosmetic diseases that can result in as much disfigurement (moderate to severe inflammation, extreme tissue growth, rhinophyma, intense swelling, and disfiguring pustules and nodules). Third , there are very few diseases that have as many potential triggers for progression. Anything that increases facial blood flow is a trigger for this disorder..... do physicians realize the hundreds of potential triggers for this reaction? Fourth , rosacea does result in physical pain that can be chronic, intense, and disabling. The real-life perspective on this disease is that once it has progressed into the moderate or severe stages, "It can ruin lives".

 

 

Summary

In a 1999 medical report in the Journal of the American Academy of Dermatology, Dr. Rapp boldly challenges physicians and pharmaceutical companies to strive for better treatment of patients with inflammatory skin disorders. He indicates that these disorders can cause reductions in physical and mental functioning comparable to that seen in cancer, arthritis, hypertension, and heart disease. He stresses that physicians must take into account the 'quality of life' of their patient (the patient's ability to achieve a level of functioning that allows the individual to pursue valued life goals and that is reflected in general well being). Dr. Rapp states, "The historically narrow use of health care to reduce symptom severity has given way to a more comprehensive view that effective treatment should also improve the patient's functional level and overall well being." Furthermore, he states, "Measuring the impact of a disease on a person's quality of life requires measuring its impact on disease-specific parameters (symptoms), as well as physical, psychological, and social functioning." With the above said, standard rosacea therapy falls far short of satisfying the above criteria because this therapy only decreases some of the superficial symptoms (i.e., it does not treat the underlying disorder and certainly does not allow most patients to restore their quality of life). Rosacea interferes with daily functioning, generates psychological distress, disrupts family and social relationships, and causes physical pain sensations.

 

 

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Rosacea Dermatitis

 

A new form of skin inflammation has recently been identified. It is referred to as rosacea dermatitis. Rosacea dermatitis is caused by chronic dermal inflammation from damaged or dysfunctional blood vessels. Over time this can alter the skin's immune system, the health of the dermal cells and the growth rate of epidermal cells.

 

Rosacea dermatitis is often confused with atopic dermatitis, eczema or seborrheic dermatitis. A rosacea sufferer with rosacea dermatitis is much more prone to itching, burning, stinging, "angry face syndrome', and scaling. In certain areas of the face rosacea dermatitis can result in extremely thin skin by slowing the growth of epidermal cells and in other areas of the face can result in dry patches of skin from a natural protective reaction to the inflammatory cycle. Physicians must now consider this dermatitis also instead of just making a quick diagnosis of atopic dermatitis, eczema, or seborrheic dermatitis.

 

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Elidel Treats Rosacea Redness & Papules

 

Overview of Article: 

12 treatment-resistant rosacea sufferers with facial redness, papules, pustules and swelling where treated with topical Elidel for 3 to 4 months.  10 of 12 patients showed substantial improvement with facial redness and swelling.  5 of 6 patients noted an 80% decrease in papules and pustules.  Elidel is an excellent topical anti-inflammatory medication for treating multiple rosacea symptoms.

 

Skinmed. 2005 May-Jun;4(3):147-50.

 
Pimecrolimus for treatment of acne rosacea.

Crawford KM, Russ B, Bostrom P.

Dermatology Clinic, Malcolm Grow Medical Center , Andrews Air Force Base, MD kevin.crawford@mgmc.af.mil.

Background. Rosacea is a common disease, which is often resistant to treatment. Topical calcineurin inhibitors have been efficacious in the treatment of other inflammatory disorders of the skin, and tacrolimus has been reported as an effective treatment option for erythrotelangiectatic rosacea. Objective. Because of the benefits seen with tacrolimus in previous publications, we investigated the efficacy of a closely related compound, pimecrolimus, in patients with erythrotelangiectatic, papulopustular, and edematous rosacea. Methods. Twelve patients with erthryotelangiectatic or papulopustular rosacea who had failed conventional therapy were treated with topical pimecrolimus cream twice daily for 12-18 weeks. No patients had used any other treatment for rosacea within 30 days of the start of therapy. During the course of the study, no other topical or systemic treatment of rosacea was allowed. Results. Ten of 12 patients showed substantial improvement of erythema, while five of six patients with a papulopustular component noted at least an 80% decrease in the number of lesions. Conclusions. It appears pimecrolimus may be efficacious in the treatment of erythrotelangiectatic and papulopustular rosacea and may be considered in patients with recalcitrant disease.

 

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The New Age of Ocular Rosacea Treatment -- Laser Eye Correction Specialists (Treatment of Eyelids and Ocular Surface)

 

Ocular rosacea can be divided into three categories:

 

1. Ocular Rosacea associated with flushing and blood vessel dysfunction

2. Ocular Rosacea associated with Blepharitis or Meibomian Gland dysfunction

3. A combination of the two

 

The Vascular form is triggered by increased blood flow in the central areas of the face. It causes flushing and telangiectasia inside the eyelids and on the thin membrane of the eye (conjunctiva) which makes you look like you have red eye. These blood vessels no longer have a positive function as they do not deliver nutrients or oxygen to the eye. They are deleterious because they release inflammatory substances onto the surface of the eye that disrupt the tear film layer and cause many ocular rosacea symptoms.

 

The second form is related to dysfunction of the oil glands under the eyelashes that help protect the ocular surface. Ironically, in many cases, the meibomian gland dysfunction is caused by the vascular inflammation.

 

The latest microlasers used by Laser Eye Corrective Specialists (Ophthalmology Laser Specialists) hold the ability to reverse and put ocular rosacea into remission. The new microlasers by Lumenis can easily and safely treat both upper and lower eyelid vessels, inflammation and swelling. This also has a positive effect on meibomian gland health. They can also selectively destroy the red dilated vessels on the surface of your eye via pinpoint accuracy. You only need to treat each vessel once in the center and it will photocoagulate and be removed by the body.

 

This is extremely new, so you may have to do quite a bit of searching to find the right Laser Eye Specialist. At the date of this publication, Lumenis is considered the leader in microlasers used to treat eye and eyelid disorders. Below is there best machine for ocular rosacea sufferers.

 

 

 

 

Photocoagulators cauterize blood vessels with heat generated by the laser beam. The laser creates tiny, controlled burns that destroy blood vessels. The Lumenis line of eye photocoagulators and delivery devices are designed to give ophthalmologists the breadth and depth they need to treat several types of conditions including:

Telangiectasia on eye surface and eyelids

Age-related macular degeneration (AMD)
Proliferative diabetic retinopathy
Retinopathy of prematurity
Retinal tears and detachments
Retinal vein occlusion
Endophotocoagulation

 

How it Works

Photocoagulators are especially well suited for delicate eye and eyelid work. Photocoagulation can dry up leaking vessels, as in the case of proliferative diabetic retinopathy, or destroy diseased retinal tissue. Photocoagulation can also be used for age-related macular degeneration.

 

 

World's First Three Color Photocoagulator

 

The Novus® VariaT keeps pace with your practice, keeping your focus on the treatment, not the system with:

	An industry-leading intuitive interface for easy access of all three wavelengths using a touch screen display, or a remote control
	An advanced optical system that instantly changes laser parameters and wavelengths
	Dual fiber ports for rapid changing and smart sensing of different delivery devices.

 

The Novus Varia operates with the full range of optical accessories designed by Coherent Medical, including:

	LaserLinkT with SureSpotT optics providing a sharply-defined and evenly-distributed power on the retina, with low power density on the cornea and lens.
	ClearViewT filters that optimize your view of the treatment site.
	Three-color Laser Indirect Ophthalmoscopes (Heine or Keeler)

 

Red Wavelength

	Better penetration through hemorrhage
	Longer wavelength (659 nm) may be focused deeper in the choroid
	Treatment for ocular melanoma
	Retinopathy of Prematurity

Yellow Wavelength

	Better penetration through nuclear sclerotic cataracts
	Excellent penetration through fluid and pigmentary disturbances
	Minimal absorption in macular xanthophyll producing an optimally controlled treatment
	Accurate closure of microaneurysms
	Less dispersion of energy in the neurosensory retina
	Less discomfort to the patient
	Greater margin of safety

Green Wavelength

	Clinically proven
	Proliferative Diabetic Retinopathy
	Retinal Vein Oclusion

 

 

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Green Tea Extract Cream for Rosacea Treatment of Facial Redness, Papules, Pustules, Burning Sensations and Skin Hypersensitvity

 

 

 

Green Tea Extract Cream Shows Benefit for Rosacea

Presented at the 2005 American Academy of Dermatology Meeting

 

Feb. 23, 2005 - In a small study, patients with papulopustular rosacea treated with a hydrophilic cream containing 2% polyphenone (green tea extract) experienced a significant reduction in mean inflammatory lesion count compared with patients applying vehicle cream, according to results reported here at the 63rd annual meeting of the American College of Dermatology.

Women randomized to the green tea extract cream had a 70% improvement in rosacea compared with women in the vehicle cream group ( P < .0001) , said Tanweer Syed, MD, PhD, an associate professor of dermatology at the University of California at San Francisco . Dr. Syed developed the polyphenone cream.

"This is tantalizing," said Guy Webster, MD, moderator of the poster session at which the data were presented and vice chairman of dermatology at Jefferson Medical College in Philadelphia , Pennsylvania . "These women obviously had rosacea and blushing. There is not much you can do for this. But the faces were looking distinctively red [at baseline] and they are coming out not distinctively red," he said, referring to images on the poster. Dr. Webster was not involved in the study.

While he found the results encouraging, Dr. Webster cautioned that the findings are from a small study. Larger studies with multiple investigators will be required to confirm the results.

The study recruited 60 women aged 25 to 50 years. All women had visible signs of papules and pustules, 20 had erythema, and 17 had telangiectasia. Half of the women were randomized to treatment with the 2% polyphenone cream and half to vehicle cream. The women applied the cream to their faces twice a day for four weeks.

Cure was defined by the absence of clinical signs of inflammation.

After four weeks, marked beneficial improvement was observed in both groups. But the active cream yielded a statistically significantly higher reduction in mean inflammatory lesion count than the vehicle cream measured by a standard global assessment score, Dr. Syed said.

The cream not only has been shown to improve rosacea, but green tea extract also has natural anti-aging and anti-acne properties as well as a sun protection factor (SPF) of 50, Dr. Syed claimed. "The green tea has a soothing quality that helps the redness."  The difference between this product and others on the market, Dr. Syed said, is that the green tea leaves are picked and used within five hours, before they turn dark and ferment.

Dr. Syed concluded that the cream is safe, well tolerated, and effective.

The study was 75% funded by Syed Skincare Inc.

AAD 63rd Annual Meeting: Poster 19. Presented February 20, 2005 .

Reviewed by Gary D. Vogin, MD

Summary of Findings:

 

• Hydrophilic cream containing 2% polyphenone (green tea extract) developed by MD, PhD Dermatologist
• Randomized, placebo-controlled study showed excellent improvement in rosacea papules, pustules, facial redness and skin sensitivity within just 4 weeks
• Impressive findings and presentation
  

Critique of Study:

• Study only recruited 60 rosacea sufferers - follow up larger scale study is needed
• 75% of the study was funded by Dr. Syed Skincare - need independent studies to back findings

 

 

Anecdotal Report sent to me from Medical Physician with Rosacea:

Below is an email from Dr. Ruth Grant MD, an Internal Specialist who is a treatment-resistant rosacea sufferer. Her symptoms include facial redness, papules, pustules, burning sensations and skin hypersensitivity. As you will read, the green tea cream dramatically reduced all rosacea symptoms and she is now off antibiotics:

"I saw the report on Medscape entitled "Green Tea Extract Cream Shows Benefit for Rosacea," which was about Dr. Syed's presentation at the Am College of Dermatology annual meeting and though skeptical, ended up e-mailing Dr Syed. As you know, rosacea sufferers can get so desperate they'll try anything, including snake oil, even when trained as a physician."

"I've been using the Green Tea Extract Cream that he compounded for me based on history and close up digital photos sent over the internet since March and the results have been dramatic!  I was at the point of thinking about traveling afar for Photoderm Laser treatments/ I was so wretched, but have enjoyed a degree of relief so pronounced that I wouldn't consider it now. The facial burning and stinging sensations are decreased about 80 to 90% and are tolerable, so much so that I'm back to an occasional glass of wine.. The papules, pustules, and erythematous patches are very few to none - finally off doxycycline . . Even the telangectasias seem a little less obvious (subjective) and I've stopped getting new ones."

Dr. Ruth Grant, MD

 

Contact Information for Special Green Tea Cream which must be Custom Made:

"I asked Dr Syed it was OK with him if I told you about my experience and he seemed to like the idea. In case you want to contact him, his email is: tasdermatologist@aol.com and his phone is 415-336-0314. He is very friendly, accommodating, and willing to share his knowledge. His studies thus far involve a relatively small number of patients, but more studies are ongoing. I realize one testimonial does not a scientific study make, but in my own mind am positive that my improvement on his cream couldn't be a placebo effect."

 

Disclaimer:

This cream is quite expensive and he does not give out samples. He has graciously sent me a sample to test. I will keep everyone posted on my thoughts of the cream. He does have a website with a green tea cream, but this is not the proper one for rosacea nor is it the one clinically tested. I am in no way affiliated with Dr. Syed or receiving any form of compensation.

 

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