Frequently Asked Questions

Written by on July 4, 2007 with 163 Comments

1. What is Rosacea ?

Rosacea (said rose-ay-shah) is a potentially progressive neurovascular disorder that generally affects the facial skin and eyes. The most common symptoms include facial redness and inflammation across the flushing zone – usually the nose, cheeks, chin and forehead ; visibly dilated blood vessels, facial swelling and burning sensations, and inflammatory papules and pustules.

Rosacea can develop gradually as mild episodes of facial blushing or flushing which, over time, may lead to a permanently red face.

Ocular rosacea can affect both the eye surface and eyelid. Symptoms can include redness, dry eyes, foreign body sensations, sensitivity of the eye surface, burning sensations and eyelid symptoms such as chalazia, styes, redness, crusting and loss of eyelashes.

A panel of experts have agreed on a standard classification system for Rosacea. This system is a brief text that is not intended to be exhaustive, but is a place to start.

“Rosacea is a chronic cutaneous disorder, primarily of the central face. It is often characterized by remission and exacerbation and it encompasses various combinations of such cutaneous signs as flush, erythema, telangiectasias, edema, papules, pustules, ocular lesions, and rhinophyma. Primary features considered as necessary for diagnosis include flushing, erythema, papules, pustules, and telangiectasias. A variety of secondary features are listed that may be absent or present as a single finding or in any combination.”

Common Misspellings: roacea, rosae, rocase, rocacea, roace, roscea, rosacia.


1.1 Are there different types of Rosacea ?

The panel of Rosacea experts agreed on the following broad, non exclusive text (i.e. there may be other factors and types that come into play).

“The system divides rosacea into four subtypes: erythematotelangiectatic, papulopustular, phymatous, and ocular. As presently worded, papulopustular rosacea is noted as often being observed following or with erythematotelangiectatic disease and phymatous rosacea as following or occurring together with either erythematotelangiectatic or papulopustular rosacea. However, Dr. Wilkin emphasized that while those descriptions are consistent with common concepts about rosacea natural history, they are provisional and subject to change.”

“In its current iteration, the classification system excludes rosacea fulminans, steroid-induced acneiform eruptions, and perioral dermatitis without rosacea signs from the diagnosis of rosacea.”


1.2 What is the difference between acne and rosacea ?

As rosacea is a neurovascular disorder it affects the flushing zone.

Is is common that Rosacea does not present with blackheads that are seen with Acne Vulgaris. Also the age of onset, and the location of redness is a clue. Rosacea is commonly an adult disease, and is generally restricted to the nose, cheeks, chin and forehead. It can coexist with acne vulgaris.

Some rosacea sufferers have a significant acne component in their symptoms so it can be easily confused with acne vulgaris. The papules and pustules of rosacea tend to be less follicular in origin.

Rosacea will probably have an underlying redness that is related to flushing and thus looks different to acne vulgaris. Acne sufferers normally do not have the accompanying redness.

Rosacea usually begins with flushing, leading to persistent redness.

As both conditions are inflammatory, the treatment for rosacea and acne vulgaris can be somewhat similar, but some of the acne vulgaris regimes are too harsh for rosacea affected skin and can severely aggravate the condition.

Rosacea sufferers are cautioned against using common acne treatments such as alpha hydroxy acids (glycolic and lactic acids), topical retinoids (such as tretinoin, Retin-A Micro, Avita, Differin), benzoyl peroxide, topical azelaic acid, triclosan, acne peels, chemical peels. Additionally the caution extends to topical exfoliants, toners, astringents and alcohol containing products.


1.3 What is the difference between Rosacea and Seborrheic Dermatitis ?

Seborrheic Dermatitis and Rosacea are closely related, they both involve inflammation of the oil glands. Rosacea also involves a vascular component causing flushing and broken blood vessels.

Seborrheic Dermatitis may involve the presence of somewhat greasy flaking involving the T zone, crusts, scales, itching and occasionally burning, and may also be found on the scalp, ears and torso. It does not usually involve red bumps as in Rosacea.

The T zone is the area shaped like a `T’ composed of your forehead, nose and around your mouth.

Just to confuse things further, the two conditions are often seen together. See also: seb derm, elidel and protopic : a warning.


1.4 What causes Rosacea ?

There are a few theories, but none are yet conclusive. Popular theories include rosacea being caused by how frequently we flush and how our blood vessels cope with this flushing ; an over active inflammatory response to some unknown pathogen.

The fact that rosacea’s cause is unknown thankfully hasn’t stopped the development of some excellent treatment regimes.


1.5 How does rosacea progress ?

“Rosacea normally progresses in the same generalised fashion, frequent dilation of facial blood vessels leads to vascular hyper-responsiveness
and structural damage.”

Rosacea experts talk about rosacea symptoms appearing in 4 stages. Over time rosacea can progress from one stage to the next.

From Dr. J Wilkin:

“Most textbooks and literature citations characterize rosacea as a disease that gradually evolves from early to later subtypes. However, there is not conclusive evidence to substantiate that course and we want to know if it really occurs. Nevertheless, the individual features within a subtype can get worse, so early treatment is advocated, even if there is not progression from one stage to the next,”


2. How can Rosacea be treated ?

The best answer is “working with the support of your registered health professional”. There are medications available that control the redness and reduce the number of papules and pustules associated with rosacea.

Current run-of-the-mill treatment might include oral antibiotics and topical metronidazole. One study showed that the use of topical metronidazole alone can help some sufferers to reduce rosacea flare-ups once the rosacea is brought under control.

For those sufferers that do not benefit from the metronidazole based treatments, there are many other options. Quite a few treatments options are often discussed on the rosacea-support email group.

Experts agree that a gentle cleansing regime is very important. Avoiding chemicals that aggravate the rosacea, but will clean and moisturise the skin is a step in the right direction. See also: mild cleanser is important.

As the sun is a strong trigger for many rosacea sufferers, a good non-irritating sunscreen used daily is very important. For those who react badly to chemical sunscreens, a physical sunscreen may be more suitable. Physical sunscreens rely on the reflective properties of the main ingredients (rather than the ability of some chemicals to absorb the sun’s energy). The most common physical sunscreens are based on zinc oxide or titatinium dioxide.

The vitamin A derivative isotretinoin (known as Accutane or Roaccutane), has been shown to be effective against severe papopustular rosacea. It works by inhibiting sebaceous gland function and physically shrinking the glands. It also has potent anti-inflammatory properties, making it ideal to treat resistant rosacea. At low doses, accutane has also been shown to reduce other symptoms such as facial burning and redness. Accutane is a strong drug, and even at the low doses found beneficial to rosacea, should be used under strict supervision of your doctor.

Low does accutane may be more suitable than the regular dose, as there are less side effects and lesser chance of aggravating redness. See also dramatic results with low dose accutane and focus on low-dose accutane.

The mixed light pulse laser – Photoderm is showing promise as a treatment for the vascular component of rosacea. It works by targeting facial microvessels that are damaged.

One treatment that has been shown to help some is Rosacea-LTD III. It is the third generation of topical mineral salt based treatment. The minerals shrink facial vessels as well as reduce papules and pustules. More information is available at http://www.rosacea-ltd.com

For those wanting to treat the flushing side of their rosacea, 2 drugs are worth investigating. Monoxidine and Clonodine are 2 anti-hypertensives that you could look at with your doctor.

From a subjective view of the rosacea-support list members it would appear that one person’s treatment does not necessarily suit another, so your mileage may vary with any recommended treatment. Experiment a little and find what helps you. Depending on the stage of your rosacea, some treatments may be aggravating, while for others the same treatment may not cause problems. Every rosacea patient is unique and needs individual treatment.

Whatever path you choose, the support of a doctor or dermatologist that is willing to work with you will be very important, so shop around until you
are happy with your health professional.


2.1 What about steroids ?

Steroids have long been prescribed for rosacea because of their perceived quick relief. Milder (1% hydrocortisone) over the counter preparations are also popular as they are thought to be safer than the prescription strength treatment.

It is worth bearing in mind the following warnings:

over the counter steroids can cause steroid induced rosacea.

“After observation of long-term facial application of even low-dose corticosteroids, we have see many adults and children with a rosacea diathesis in whom severe burning and itching develop, along with bright red papules and nodules.This may occur after long-term application of even low-potency topical corticosteroids.

Application of topical corticosteroids causes immediate vasoconstriction and reduces the redness seen in rosacea and many other skin conditions. However, when patients discontinue usage of the topical corticosteroid, symptoms immediately reappear, and the symptoms are often much worse than those seen in the original condition.”


2.2 Can you be cured of Rosacea ?

Perhaps not cured in the sense of cured of a cold, but you can reduced your symptoms to a manageable level. There are plenty of treatment options out there, you may just need to experiment with a few.


3.3 Are there any Books about Rosacea I should read ?

There are very few books about Rosacea. In the last year of so there has been a couple of `self help’ books written about rosacea. You can find a
review of a couple of these at http://rosacea-support.org/book-reviews


4. Are there any non-profit organisations devoted to Rosacea ?

The National Rosacea Society is a non profit organisation set up to provide information about Rosacea. You can find them at http://www.rosacea.org/ They publish newsletters online as well as conduct surveys about rosacea sufferers. Also they make published information available to sufferers via regular mail. The National Rosacea Society are an introductory organisation that are a good first point of contact for information. In the past the NRS has awarded grants for 37 studies into rosacea.


4.1 Are there any support groups related to Rosacea ?

There is an email support group that you can subscribe to. This email group is free and unmoderated. Currently there are about 7000 users. To find out more information about the list, visit http://rosacea-support.org or go straight to the email hosting page at http://health.groups.yahoo.com/group/rosacea-support/


Rosacea Reading Glossary

As you read more about Rosacea, you might come across lots of terms that are new to you. Below is a short list of some of the terms you might come across.

accutane: a powerful vitman A derivate that was originally prescribed for severe acne vulgaris. Has been used effectively for rosacea as well. Also known as roaccutane. for more info http://www.rocheusa.com/products/accutane/. See also: focus on low-dose accutane

aczone: (dapsone) a topical treament for acne vulgaris.

ascomycin: a new macrolactam immunomodulator showing some promise for inflammatory skin disorders.

azelaic acid: the active ingredient in finacea and other rosacea treatments.

blepharitis: inflamation and crusting of the eyelid.

boswellia: also known as boswellin or “Indian frankincense,” comes from the Boswellia serrata tree that grows in the dry hills of India. Known the anti-inflammatory properties of the tree bark’s gummy resin, called salai guggal.

cutaneous: pertaining to the skin.

demodex mites: (demodex folliculorum and demodex brevis): microscopic mites that lives in the skin. Many theories relate the involvement of demodex mites to rosacea, but so far after many years of research a causative link has not been found. See also demodex mites

DMSO: (dimethyl sulfoxide) a solvent approved by the FDA for organ transplant preservation and interstitial cystitis (a bladder disease).

chalazion: a lump on the eyelid that is caused by a clogged duct of one or more of the meibomian glands on the eyelid.

clonidine: an anti-hypertensive, which works by controlling nerve impulses along certain nerve pathways. As a result, it relaxes blood vessels so that blood passes through them more easily.

clarithromycin: a macrolide antibiotic used to treat tonsillitis and other bacterial infections. Clarithromycin is available under several brandnames for example Biaxin, Biaxin XL and Klacid.

conjunctivitis: inflammation of the conjunctiva (the thin transparent lining in the front of the eyeballs and eyelids).

cutanix: makers of the Dramatic Relief Multi-Action Skin Therapy targetted for eczema and rosacea sufferers

dapsone: sulphone antibiotic medication available for many years to treat leprosy. also used in a topical (aczone) to treat acne.

diflucan: (fluconazole) is used to treat fungal infections, including yeast infections of the vagina, mouth, throat, esophagus, abdomen, lungs, blood, and other organs.

diroseal: (Avene Eau Thermale Diroseal Treatment Cream) is a anti-redness cream containing Retinaldehyde and Dextran Sulfate. See also diroseal now available in australia.

DRL: dramatic relief lotion, now known as Dramatic Relief Multi-Action Skin Therapy, topical product for rosacea and eczema from Cutanix.

dry eye: a condition brought about by abnormal production in the quantity or quality of tears.

edema: presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body, especially wrt subcutaneous tissues.

elidel: (pimecrolimus) a topical treatment for atopic dermatitis and erythrotelangiectatic, papulopustular, and edematous rosacea. See also: seb derm, elidel and protopic : a warning.

epifacial: another term referring to a full face treatment using photoderm.

epilight: a treatment very similar to photoderm, originally intended for hair removal. differs by using different filters to photoderm. For more information see http://www.skinandhealth.com

epitan: a drug development company, owners of Melanotan and EPT1647, a synthetic peptide which stimulates the body to make eumelanin, the dark pigment of the skin.

erythema: inflammatory redness of the skin.

erythematotelangiectatic: having symptoms of both erythema and telangiectasias

Ester-C: a form of vitamin C that contains both ascorbic acid and metabolites.

ESB: Endoscopic Sympathetic Block, clamps used to block the transmission of the neural impulses in the sympathetic chain. Is considered a reversible procedure. See http://privatix.magenta.net

ETS: Endoscopic Transthoracic Sympathectomy (or endoscopic transthoracic sympathicotomy) a procedure where a surgeon excises the major sympathetic nerves that supply the hands, neck and face. Main indications for ETS are blushing and hyperhidrosis. One place for more information: http://www.sweaty-palms.com/ets.htm

finacea: azelaic acid 15%, a topical treatment for rosacea, proven to reduce the number of inflammatory papules and pustules associated with rosacea. See Also focus on finacea (azelaic acid 15%).

fotofacial: a treatment regime using photoderm pioneered by Dr. Patrick Bitter Jnr., for more information, see http://www.fotofacial.com

grape seed extract: a source of an ntioxidants bioflavanoid known as proanthocyanidins (PCO bioflavanoids)

Helicobacter pylori: bacteria that live in the cell lining of the stomach. Part of the folklore of rosacea is that it is caused by H. pylori. This theory is confused by the fact that treating h. pylori also has some benefit for rosacea symptoms. So far no causative link between h.pylori and rosacea has not been found.

hyperhidrosis: a disorder characterized by excessive sweating caused by an overactivity of the sympathetic nervous system of the sweat glands.

hypertrophy: the enlargement or overgrowth of an organ or part due to an increase in size of its constituent cells.

hyperemia: abnormally increased blood flow

Intendis: the manufacturers of finacea.

IPL: Intense Pulse Light, a description of the technology used in the family of machines made by ESC. For more information, see http://www.skinandhealth.com

isotretinoin: the a vitamin-A derivative that is the active ingredient in accutane (also known as roaccutane). See also focus on low-dose accutane

iontophoresis: therapy that uses a local electric current to introduce the ions of a ionic therapeutic agents through the skin.

keratitis: infection or inflammation of the cornea of the eye.

ketoconozole: the active antifungal ingredient in nizoral, helpful for seborrheic dermatitis and dandruff.

klaron: a topical treatment containing sodium sulfacetamide.

lumenis: a laser manufacturer, responsible for the IPL range of machines such as Vasculight, Quantum and Lumenis One.

lupus: an auto-immune disease that causes inflammation in various parts of the body such as the skin, joints and kidneys. Skin flushing is an important symptom of lupus.

melanotan: a brand name for a drug developed by epitan which stimulates the body to make eumelanin, the dark pigment of the skin.

metrolotion: (metronidazole 0.75%), a topical treatment for rosacea, closely related to metrogel and metrocream.

metrogel: a 0.75% metranidazole treatment. For more information http://www.metrogel.com/aboutmetrogel/ See also metrogel.

metrocream: (metronidazole 0.75%), a topical treatment for rosacea, closely related to metrogel and metrolotion.

metronidazole: a topical treatment for rosacea. Has been found by some to effective against rosacea. Has a yet to be understood anti-inflammatory action. Is the active ingredient in metrogel, metrocream, metrolotion, rozex and noritate. See also focus on metronidazole.

meibomitis: inflammation of the oil producing meibomian glands of the eye.

MSM: (methylsulfonylmethane) a derivative of DMSO.

Multilight: a member of the Intense Pulsed Light family, along with the photoderm machine. For more information see http://www.skinandhealth.com Can also be used for hair removal.

naturopathic: a treatment philosophy that avoids use of pharmaceutical medication and surgery in favor of natural alternatives

noritate: a 1% metronidazole treatment. for more info http://www.dermik.com/prod/noritate/Noritate.jsp

novacet: a topical treatment containing sodium sulfacetamide.

ocular: of the eye.

oracea: a new variant of periostat, targetted for inflammatory skin conditions like acne and rosacea.

papulopustular: having symptoms of both papules and pustules.

papule: a small, solid, elevated skin lesion, less than 0.5cm in diameter.

perioral dermatitis: perioral refers to the area around the mouth, and dermatitis indicates redness of the skin. In addition to redness, there are usually small red bumps or even pus bumps and mild peeling.

periostat: (doxycycline hyclate) originally developed to combat periodontal disease, also used for its anti-inflammatory properties for acne and rosacea.

photoderm: an intense light source, fired at the facial skin to reduce flushing associated with rosacea. a new treatment for rosacea that is producing some exciting results. For more information see http://www.skinandhealth.com

photofacial: a treatment regime using photoderm, pioneered by Dr. Patrick Bitter Snr.

photorejuvenation: a broad term used describe Intense Pulsed Light treatments. photorejuvenation treatments are aimed at stimulating collagen formulation.

phymatous: having symptoms of abnormal growth, as found in rhinophyma.

pimecrolimus: the active ingredient in elidel, a topical treatment for atopic dermatitis and erythrotelangiectatic, papulopustular, and edematous rosacea. Pimecrolimus, is derived from ascomycin, a natural substance produced by the fungus Streptomyces hygroscopicus var. ascomyceticus. Pimecrolimus selectively blocks the production and release of cytokines from T-cells. These cytokines in the skin cause the inflammation, redness and itching associated with eczema.

plexion: a cleanser from Medicis containing sodium sulfacetamide and sulfur. It is indicated in the topical control of acne vulgaris, acne rosacea and seborrheic dermatitis, for those patients without sensitivities to sulfonamides or sulfur. The exact mode of action of sulfur in the treatment of acne is unknown, but it has been reported that it inhibits the growth of Propionibacterium acnes and the formation of free fatty acids.

protopic: a topical treatment for rosacea containing tacrolimus.

pustule: a vesicle filled with cloudy fluid, such as pus, often associated with a hair follicle but can exist independently.

pycnogenol: an antioxidant extracted from the bark of the French maritime pine (Pinus maritima) and the Canadian Spruce (Tsuga canadensis)

Quadrinone: the patented active ingredient in Cutanix Dramatic Relief

Quantam SR: a member of the Intense Pulsed Light family, along with the photoderm machine. For more information see http://www.skinandhealth.com

rhinophyma: abnormal growth of the soft tissue of nose, caused by sebaceous gland hypertrophy and hyperplasia (increased growth and number of sebaceous glands).

roaccutane: a powerful vitman A derivate that was originally prescribed for severe acne vulgaris. Has been used effectively for rosacea as well. Also known as accutane. for more info http://www.roaccutane.com.au. See also focus on low-dose accutane

rosacea fulminans: a rare form of rosacea that appears very quickly.

rosac cream: a topical preparation from Stiefel Laboratories that contains sodium sulfacetamide 10% and sulfur 5% cream with sunscreens.

rosaliac: a treatment containing vitamin CG (ascorbyl glucoside, a slow-release form of vitamin C); xanthine, a caffeine derivative that works as a vasoconstrictor; and vitamin B3, which acts as an anti-inflammatory agent. Manufactured by La Roche-Posay.

rosanil: a cleanser from Galderma containing sodium sulfacetamide and sulfur. It is indicated in the topical control of acne vulgaris, acne rosacea and seborrheic dermatitis, for those patients without sensitivities to sulfonamides or sulfur.

rosula: a sodium sulfacetamide and sulfur based topical treatment used in the treatment of acne, rosacea, and seborrheic dermatitis

rozex: 0.75% metronidazole based treatment also known as metrogel. for more info http://www.medsafe.govt.nz/consumers/cmi/r/rozexgel.htm

rosacea-ltd: a non-prescription topical treatment for rosacea, see http://www.rosacea-ltd.com

rosacure: an anti-redness and moisturizing face cream. Originates from Italy, where it is called Synchrorose. Contains Silymarin (Lady’s Thistle Extract) which is a bioflavonoid, and hyaluronic acid which provides hydration to the skin, are all contained in an oleosome delivery system.

sansrosa: a company producing treatments for inflammatory skin diseases. One such product is SR101 or SR110 a rosacea anti-redness cream.

seborrheic dermatitis: an inflamatory skin condition, associated with itchy flaking skin. See also:seb derm, elidel and protopic : a warning.

sebaceous gland: a gland often associated with a hair follicle, that produces sebum.

sodium sulfacetamide: a topical treatment used for acne, dandruff and seborrheic dermatitis.

stromectol: (ivermectin) a highly active broad-spectrum anti-parasitic agents used to treat infections caused by roundworms, threadworms, and other parasites.

stye: inflammation of an eyelash follicle on the edge of the eyelid.

subcutaneous: under the skin.

tacrolimus: the active ingredient in protopic, a topical treatment for atopic dermatitus and steroid induced rosacea.

telangiectasias: damaged micro blood vessels, often visible on the surface of the skin.

tetracycline: an antibiotic often prescribed for rosacea.

V-beam: the fifth generation (hence roman 5=V) of the pulse dye laser. for more information, see http://www.vbeamlaser.com

vascular: of the blood vessels.

vasculight: a IPL+laser machine that can be used to give mixed wavelength and fixed wavelength treatments. Can target large and deep blood vessels. For more information see http://www.skinandhealth.com

VEGF: vascular endothelial growth factor, one of the number of genes associated with angiogenesis.

versapulse: a type of laser, for more information, see http://www.coherentinc.com

wobenzyme N: (wobenzym) a multi-enzyme supplement.

YAG laser: (yttrium aluminum garnet, uses a Neodymium (Nd) ion) thought to be good for treating deep and large blood vessels esp. in leg veins.

zileuton: (zyflo) a treatment originally developed for asthma that was targetted to also be useful to treat acne and subsequently rosacea.

ZincO: (ZincO Cream) a micro-fine zinc oxide dimethicone sunscreen formulated by Linda Sy to be used by rosacea sufferers.

zithromax: (azithromycin) is in a class of drugs called macrolide antibiotics, used to treat many types of bacterial infections.

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About the Author

About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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163 Reader Comments

  1. Sequoia says:

    Thanks Jo, I plan to buy the L-lysine at the GNC and give it a try. I’m open for any suggestions at this point. Sometimes I think changing Dr’s might help but I’ve been with this one for 30 years, I’d feel bad. But I plan to write down any info I read to show him and maybe we can figure out what works best. Right now he told me to stop taking minocycline for a week and take zithromax (zpac) thinking this might calm it down. What exactly is L-lysine and is there any side effects? Also can you buy the skin care products (malin and Goetz) here in the US? And what have you heard about Roaccutane? If it works, I’d give it a try, no matter the cost!
    Thanks for your help,

  2. Barbara says:

    I have been using Mario Badescu’s calming cream for the last couple of weeks and it is soooo soothing and has calmed the redness. My metrocream still has not arrived from Planet Pharmacy so I have been unmedicated for at least 6 weeks and if not for the Badescu products (I use the cleanser also) I am sure it would be much worse. There is a line by Rosacea Care that also has wonderful products and great customer service.
    I am going to try some L-Lysine too.
    Oh, and Pur Minerals makeup is a great line for hiding that nasty redness!

  3. Jo says:

    L-lysine is an amino acid. I would stick your Doc if he has been helpful. I know when my rosacea has gone out of control Tetracycline has helped me. It seems different treatments work for everyone. Malin & Goetz is made in US so you should be able to get in any of the big stores, you can google it. They sell it SPACE NK Apothecary over here. I am using AVENE anti redness extra gentle cleanser and moisturiser and Mineral Powder makeup which helps confidence.

    I have also noticed if I drink bad quality wine, particularly white with sulphites then the little red bumps seem to appear!

    Roaccutane is a retinoid and used for Acne. It can only be prescribed by a consultant dermatologist over here, as you need to have monthly blood tests to check for liver function and it strongly contraindicated in pregnancy. You could try googling the Daily Mail online to read about Laura Tennant and Eve Cameron and how it helped them.

    GoodLuck

  4. Sequoia says:

    Thanks Jo and Barbara,
    I started using the z-pac yesterday and it seems to be working although it could be that my bumps are disappearing on their own and gearing up for another attack. lol
    (really not funny) Anyways I looked on line about L-Lysine and it seems to have alot of positive things about it, including helping your bones. But the drawbacks are kidney problems and it could interfere with meds I’m already taking. So I’m going to call the doc tomorrow and see. I went to GNC today and bought a bottle anyways.
    I talked to the woman who works there and she said alot of people buy it for cold sores, which I already knew, But she also said an elderly woman bought Alpha Lipoic Acid and said it helps to control her rosacea. Did you ever hear of that?
    I have been using the following lotions and potions for years and through trail and error found they work the best for me: Basis sensitive skin soap, Aveeno ultracalming foaming cleanser and Aveeno ultra calming daily moisturizer. and I couldn’t live with out Mary Kay extra emollient night cream. It actully isn’t a cream, more like vaseline, but where I live we have very cold winters, so I use it day and night. For some reason it takes the redness, even the swelling down on my face. love it. I do know I can’t use any of these new products wih pro-retional ( for wrinkles) I haven’t figured out what I’m suppose to do about looking younger! Oh Well, Thanks again, let me know if you’ve heard of Alpa Lipoic Acid. Bye.

  5. Jo says:

    I think that Alhpa Lipoic Acid is Omega 3 which is in Fish Oils. It has anti inflammatory. I already take fish oil supplements which i think include Omega 3, 6 and 9. On its own I don’t think it helps the rosacea but because I think generally I have inflammation in my body which is a contibutory factor with rosacea I think, then I take these supplements too.

    Glad your skin seems to be improving fingers crossed.

  6. Sequoia says:

    I asked my Dr. about L-lysine and he said to give it a try, couldn’t hurt. So I’ll start taking 1 aday? They are 1000mg. Maybe 2 aday if that doesnt help. Thank’s for all the info and support! This is has been my first time emailing a support group and even though there’s not much anyone can do to take Rosacea away, It really does help to know I’m not the only one going through this. I think thats what always bothered me before, not knowing a single person who had it too and could understand what I was going through. Thanks… Have a great face day!

  7. yag says:

    hi fellow suffers!
    i am still confused as to whether i have rosacea or not! its really upsetting to have rosacea i e if it is! i want to have a free life! i am still in college, i still have my part of enjoyment left but i spend days hiding in my room when my friends go out and enjoy! i am sad! i wish i didnt have it! sob sob! whats a pretty face with rosacea?

  8. Jo says:

    Sorry to hear that it’s getting you down. Be patient and just try some of the suggestions given above. The best thing you can do is treat yourself to some mineral face powder and a good brush. Something like Bare Escenscuals or Jane Iredale or Bobbi Brown. It really can give good camoflage much better than foundation creams, and is not aggravating to rosacea. Get out there and enjoy yourself the best you can. Most people don’t notice it as much as you think and we as individuals are much more self conscious about it. Drink plenty of water and try not to be sad. I always console myself with the facts that other people have much bigger problems. Has your doc diagnosed Rosacea? A 3 month course of anti biotics should help it and then you can try and keep on top of it with some of the prescribed topical skin producats and rosacea skincare products. Good Luck

    • KRC says:

      My skin always itched when using these mineral powders, even pre rosacea. Everyone’s situation is so different, yet do similar. So weird.

  9. Sequoia says:

    Dear Yag, I know where your comming from and I sympathize!! It doesn’t help when your in collage and have to walk from class room to classroom outside. Jo gave good advice, find a doctor, preferably a dermatologist, one who knows what your dealing with. Find one thats reliable because if it’s Rosacea, you’ll be seeing him/her for years to come. Just remember, Rosacea is a trial and error kind of condition, what works for some may not work for you. Be gentle to your skin when washing and I found that in the summer months my rosacea improves 100% as long as I always wear sunscreen and a visor to shade my face. In the winter I always wear a scarf around my face, making sure nothing but my eyes are showing,because the wind and cold is the worst! And stay away from Hot drinks and soup, I found that really makes it flair up. I just bought a cream that is approved by the National Rosacea Society. Its called Eucerin redness relief, you can buy it at any drug store and it doesnt cost alot. When it comes out of the bottle it’s green but once you apply it, the green goes away. it works really well,seems to take the redness away right away. Believe me I’m a hermit because of Rosacea, but take heart, there are better days ahead. Once you get it under control and know your triggers there will be days you forget you have rosacea. But always take care to baby your skin and protect it. So for now Calm down, and know your not alone.

  10. Felix says:

    Just wondering if anyone has had success with Finacea 15% Gel. I was recently diagnosed with Rosacea.

    One of the possible side effects of Finacea is hair growth and I really don’t want hair growing on my nose and the sides of it, although, with a hairy nose I wouldn’t see the bumps or thin red lines… Anyway, any thoughts or experiences would be appreciated.

    Also, was wondering if anyone has heard of a brand called Suki for cleaners/moisturizers?

  11. Jo says:

    I have been using Finacea Gel for over 3 years. It suits me and keep the rosacea at bay. Never heard of the hair growth side effect and can assure you that I have never had any problems with extra facial hair! Can’t help with Suki products as have no experience. Best products for me are the Avene anti redness range and La Roche Posay Rosaliac range. Good luck.

  12. Sequoia says:

    Dear Felix,
    I used Finacea for 6 months last year and it made my face worse. It seemed to take away the bumps faster (than other topical meds. I’ve used) but as soon as 1 bump left 3 more would appear! Now, that’s just me, everyone is different. I never heard of hair growth. I didn’t grow any hair on my face. (whew!)
    I started another antibiotic called Droxy. and I thought it was going to work but its been 4 weeks and Im all bumpy AGAIN! Ill give it 6 weeks.
    I never heard of Suki but like I said before, try the Eucerin redness relief products ( night cream, soothing cleanser, and lotion) they really work and their recommended by the National Rosacea Society.
    Good Luck to you!

  13. Sequoia says:

    Has anyone had good results with the antibiotic ” Doryx” ( delayed released) 150mg?

  14. Felix says:

    Thanks Jo & Sequoia – I appreciate the feedback! Wishing you all the best.

  15. Cathy says:

    I am 53 years old and have struggled with rosacea for many years … fortunately, I have been able to mostly keep it under control (with metrogel and Mario Badescu’s Calming Mask for the redness, and Glytone for the breakouts) but there is always some redness, which I disguise with make up.

    I recently starting taking Wobenzyme for a problem that I’ve been having with my foot and am amazed to find that a side effect is that the Rosacea has COMPLETELY cleared from my skin. Wobenzyme works on clearing inflammation from the body, so in hindsight, it makes sense. I just found this website as I was doing a Google search to see if others have experienced this improvement in Rosacea with Wobenzyme, and I see that I am not the first. My eyes seem brighter, too — I’ve been diagnosed with dry eye and tried Restastis (suspect I have some ocular rosacea, too) to no avail.

    Today is only my fourth day on the Wobenzyme … as for my foot, it is still a bit painful but I think it is also improving. I believe Wobenzyme is available at Whole Foods although I ordered mine from Amazon.

  16. David Pascoe says:

    Comment via email from Barbara.

    “I have had success with Metrocream aka Rozac from an online pharmacy and my skincare from Rosaceacare.com. Created just for us. Very gentle. “

  17. Jo says:

    Thanks for that info Cathy. Very interesting I may well give Wobenzyme a go particulary as I also have trouble with dry eye although diagnosed with ocular rosacea I have my suspicions there is a link. Are you based in UK?

  18. Cathy says:

    Hi Jo

    No, I am in the US (Washington, DC).

    As for my eyes, I found I was unable to continue wearing contact lenses 10 years ago because my eyes had become progressively drier, and at that time I opted to have LASIK surgery. I’ve read some people have worse dry eye after LASIK, but for me, that wasn’t the case … I would say the dryness stayed about the same but stopped being uncomfortable because it was only the contact lens wear that was uncomfortable. Fortunately, now the dryness for me is mostly a cosmetic problem because my eyes are sometimes embarrassingly bright red — especially if I travel to a very dry climate.

    Happily, I would say that my eyes — and skin — are continuing to look clear … I am really so pleasantly surprised about that. I’ve been on the Wobenyzm for about a week now.

    Cathy

  19. Jo says:

    Thanks for that Cathy. I keep my eyes moist with Optive eye drops during the day and Lacri Lube last thing at night. That helps avoid the red look! Had a great time in Washington last June, got to visit the WHite House!

  20. Steve says:

    Hello Everyone
    Is there anyone out there that has a Grandma treatment, all these pharmacutical companies dont want to know about such things, what did our ancestors do before the drug companies.
    Steve

  21. David Pascoe says:

    Hi Steve,

    I think actually out ancestors mostly just suffered terribly with acne and rosacea with very few options.

    It seems to me that drug companies will make anything that will work and they can sell, so grandma’s secret remedies are not ignored by them. Also the cost of developing a drug is so ridiculous that we have to put up them making a profit to be able to even undertake the R&D required. It does hurt though when you see the full non-subsidised price of prescriptions.

    dp.

  22. Jo says:

    I did hear that WIllow Bark can be helpful. Not sure that this is a Grandma remedy as I don’t know any old timers that suffered with rosacea. I was actually told this by someone who worked in Space Apothecary NK.

  23. Sequoia says:

    I think they just suffered and tryed to cover it up with the “pancake” makeup they had back then. They may not have known what it was. And back in the olden days they could have tryed just about any thing regardless if it was dangerous. My mother wore a string soaked in kerosene, around her neck for the croup, ( for God’s sake!)
    I have read that W.C. Feilds had very bad Rosacea, especaily on his nose.

  24. Sj says:

    Hi. I have rosacea from past 5 years. And im just 17 :(
    I used to have mild rosacea which did not bothered me. I think i got rosacea because of pro long use of steroid cream which my doctor prescribed. I used it for 2 years. :(
    And then when i got rosacea again these doctors gave me steroids and my mild rosacea which actually looked pretty :P transformed into moderate rosacea. Actually my rosacea is kind of permanent on my nose. The redness on cheeks goes away.. Triggers: sun,heat. I have terribly dry skin. Very very very dry. So um, i have steroid induced rosacea, i guess :(
    Can this be cured? :( and yeah, any precautions for ocular rosacea? I think im getting it.
    I currently use nothig for my fsce except for cetaphil cleansing lotion and elovera cream for dryness. I’ve heard this way my rosacea can get worse without treatment. My skin reacts to almost anything. What should i use? Im really depressed pla help me:( rosacea has ruinedy teenage life my school life.. :(
    Feel like dying sometimes.

    • KRC says:

      To help prevent ocular rosacea you need to use eyelid wipes. You can purchase these at the pharmacy. They are different than just makeup remover wipes ask at the pharmacy. Eyelids become too oily and little white bumps can form if not cleaned. In a pinch watered down baby shampoo and q tips may be used, but apparently this is not recommended for regular use.

  25. Sj says:

    Ruined**

  26. Jo says:

    Dear sj

    So sorry that it is getting you down. Are you in UK? You really need to ask/persist for a referral to a dermatologist and have your skin care regime reviewed.

    WHen my rosacea gets bad I take a course of anitbiotics Tetracycline for 3 months and then use finacea gel. However reading other comments above Finacea gel does not suit every one. Not sure if you are male or female but there is some excellent mineral powder by Jane Iredale and Laura Mercier that does a very good cover up job.

    I always shade my face on sunny days either with a baseball cap or straw hat as sun is one of the worst triggers as well as cheap wine, wine with sulphites in.

    You could also try L-lysine supplements 3 times a day. They seemed to help me too.
    Avene products are do an anti redness range, cleanser and moisturiser for very dry skin. Available at boots the chemist and good pharmacist.

    Your ocular rosacea may be helped by keeping your eyes hydrated with Optive eye drops of Celluvisc eye drops. I find staring at the computer screen for too long aggravates my eyes.

    Ddrink plenty of water and try not to get stressed about it. Maybe take up yoga to help you to relax about stuff.

    Read all the stuff above and it may give you some more ideas. I really sympathise with you sj. My daughter had really bad acne in her teens for several years until she went on a powerful drug called Roaccutane, nasty side effects including very dry skin but it has done the trick.

    Good Luck.

  27. Sj says:

    Thanks a lot Jo!
    By the way, i live in india. And im a female.
    I’m thinking of talking to my aunt who lives in houston. She has a very good friend who is a very good dermatologist there. I’ll talk to her through e-mails because very frankly, i have consulted 4-5 dermatologists here ad they alll were giving me steroids. So i’ll talk to her through emails i hope that works. I want to try finace. Metrogyl irritated my skin very badly. I hope i dont develop rhiophyma.. As my nose is the only affected region :(
    Well alll the very very best to u and to your daughter!!
    Take care :)

  28. Jo says:

    Hi Sj

    Yes definitely talk to your aunt’s dermatologist. I think the steroids may be too strong for your face. My rosacea is mainly on my nose and if i forget to use my Finacea gel the little spots appears again. My skin did not like Metrogel either. I am not showing any signs of rhinoma thank goodness and hopefully you will not if you get it under control.

    You are in teh right place for yoga!

    Best of luck and let me know how you get on. Jo

  29. Sequoia says:

    Dear SJ,
    I have been on and off antibiotics for Rosacea for about 20 years. My derm. dr. has never perscribed steroids. I’m pretty sure from what I have read in different articles, that steroids can cause acne and make rosacea worse!
    Recently I just had enough of the antibiotics, and decided to stop , except for the topical gel I use ( Sodium Sulfacetamide, Sulfur Suspension) which works well for me. Well with out the antibiotics my whole face erupted!! BIG TIME. So I told the doctor ( while sobbing) that I needed something quick to take away the redness, hideious bumps, and swelling. He put me on Clindamycin HCL 150 mg. twice a day and within 24 hours my face started to clear and after 18 days now I remain clear! BUT, he told me you can get a very bad diarrhea that could kill you ( C-Diff) because it kills the good and bad bacteria. But it works!
    That is just a suggestion,… I know how depressing Rosacea is :( No one understands unless they have it. And it’s like a snowball effect.. you try not to stress out but trying not to stress out makes you stress out even more!
    I truly hope you find the right meds that will work. and remember to aviod the triggers, Sun, Wind, Cold, Hot,Spicey foods, Hot drinks, ect. if you flare up avoid it.
    Also wash your face in cool water, don’t rub dry.
    Best of luck, stay in touch…. Sequoia

  30. Sj says:

    Thanks sequoia!!
    All these gels n cream irritate my skin a lot.. I have very very dry skin that no moisturiser can control. N i live in india n its realllly hot in here..and i go to school so i cant avoid my no.1 trigger- heat n sun. :(
    Can u suggest me any moisturiser for very very dry skin type which is at the same time acne prone. ? And is sweet almond oil good for rosacea? Cus im using it in the morning n evening nowadays. Reply soon :)

  31. Christine says:

    Hello

    I’m 57 and a rosacea sufferer on roaccutane. Does anyone have any tips on how to remove facial hair around chin and lips?

  32. Tracey Nelson says:

    Hi
    I am taking Doxycycline for Ocular Rosacea. I am taking 100mg 2x day for now but my eye doctor going to drop me to 20mg a day.
    Is it safe to take life long since the specialist said my Ocular Rosacea is life long and I will have to take Doxycycline lifelong.
    Thanks in advance for the help.
    Tracey Nelson

  33. Sequoia says:

    Hi Tracey,
    My doctor always told me he has patients on antibiotics ( including doxycycline) for many years. as long as there are no problems. I need to share this story about myself to explain the problems with antibiotics, maybe you will want to talk to your doctor about this. I’ve been on so many different antibiotics for 30 years due to Rosacea, and it finally caught up with me. This summer I needed something to get rid of a severe breakout before attending a wedding and my doctor put me on Clindamycin(pills) 150mg 2x aday. I LOVED IT!! instantly my face lost all redness and pumps ( especailly around my eyes) First time in 30 years I didnt have to wear makeup! For 2 months I was free of Rosacea!!! Then in August I had terrible intestinal problems. I went to the Drs., had to take stool samples to the hospital,(disgusting, I know) The tests showed I had C-Diff ! See, from taking antibiotics for so long and then taking Clindamycin, which is strongly assiociated with C-Diff, I killed off all the good bacteria in my intestines and the Bad bacteria took over. Sooo, they had to put me on antibiotics to rid me of the C-Diff ( Flagyl and Vancomycin) it took me 2 months to feel better. C-Diff can be deadly. But this is not to scare you, Just if the Drs plan to keep you on doxy or any antibiotic for a lifetime,
    mention to them about what the dangers are. C-Diff does not happen to everyone, also if a dr feels you’ve been on a certian antibiotic for to long they usually switch you to something eles. Good Luck with doxycycline and your Rosacea!!
    Ps I wonder why your eye Dr. lowered the mg’s when your med.Dr thought 100mg
    would work better?

  34. Sequoia says:

    Has anyone used Aczone (dapsone) gel 5% Did it work for you? Did it work right away or did it make your rosacea worse ? any comment appreciated, Thanks

  35. Mair says:

    On the suggestion of my Optometrist I have been taking Omega 3′s for a few months …have to take the enteric coated ones that dissolve in the intestines as I don’t have a gall bladder so can’t tolerate the ones that dissolve in the stomach….my dry irritated eyes have improved so much I now only have to use my drops once in awhile where I was using them at least twice a day. Make sure you check that they won’t interfere with your other meds tho.

  36. Mair says:

    cont. from above….Sorry, forgot to say the Omega 3′s (enteric-coated softgels) I take are fish oil from Anchovy and Sardines (little fishies). Make sure it is a brand that you can trust…mine also states it has been tested for contaminates (larger fish are more likely to have heavy metals, dioxins and PCBs). Feel it has also helped with my red face. Again my Optometrist is the one who suggested I probably had Rosacea….not my G.P., Oncologist, or the Opthamologist. Hope this info helps someone.

  37. KC says:

    Oh god I dunno what to say, apart from I am just diagnosed and this is a horrible disease, the itchiness is awful at night? During the days it burns. Will cucumber cool the burn? I have tried cool compresses and the only one that helps a little is cold green tea. I pray this goes away..’I am tired.

  38. Tiffany says:

    I was wondering if anyone has felt Oracea may in fact increase progression of symptoms noticed after stopping Oracea? A difficult process to track especially if it is reducing symptoms during use. Any opinions or known studies that have indicated this?

    • KRC says:

      I don’t know Tiffany, but the doctor I saw said I would be on a Rosacea for life. That is a scary thought. An expensive one too!

  39. David Pascoe says:

    Comment via email.

    “I’m now on isotretinoin tablets and having great results. Hardly any inflammation or red spots. Dry skin though.”

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