Path: senator-bedfellow.mit.edu!bloom-beacon.mit.edu!nycmny1-snh1.gtei.net!cpk-news-hub1.bbnplanet.com!news.gtei.net!fu-berlin.de!newsfeed.iinet.net.au!news.iinet.net.au!not-for-mail From: dp@NOSPAMii.net (David Pascoe) Newsgroups: alt.skincare.acne,alt.support.skin-diseases,alt.skincare,sci.med,sci.answers,alt.answers,news.answers,alt.med.vision,sci.med.vision Approved: news-answers-request@MIT.EDU Subject: Rosacea Frequently Asked Questions v1.12 Date: Thu, 27 Sep 2001 14:10:32 GMT Expires: Wed, 31 October 2001 00:00:00 GMT Message-ID: <3bb33305.1232797@news.m.iinet.net.au> X-Newsreader: Forte Free Agent 1.21/32.243 Lines: 407 NNTP-Posting-Host: 203.59.160.94 X-Trace: news.iinet.net.au 1001599921 31808 203.59.160.94 Xref: senator-bedfellow.mit.edu alt.skincare.acne:41735 alt.support.skin-diseases:3644 alt.skincare:9353 sci.med:309481 sci.answers:13500 alt.answers:57980 news.answers:216131 sci.med.vision:60100 Archive-name: medicine/rosacea Posting-Frequency: monthly Last-modified: 2001/06/16 Version: 1.12 URL: http://rosacea.ii.net/faq.txt Maintainer: David Pascoe CVS Version: $Id: faq.txt,v 1.12 2001/06/22 13:46:48 davidp Exp $ ---------------------------------------------------------------------------- Disclaimer: the following information is a guide only. Self diagnosis is a dangerous pastime without all of the information. This Frequently Asked Questions is a simple guide to rosacea, and a pointer to more information. It should not be used in the place of professional advice from registered practitioners. ---------------------------------------------------------------------------- 1. What is Rosacea ? Rosacea (said rose-ay-shah) is a progressive vascular disorder that affects the facial skin and eyes. The most common symptoms include facial redness across the nose, cheeks, chin and forehead, visibly damaged blood vessels, facial swelling and burning sensations, and small red inflammatory papules and pustules. Rosacea develops gradually as mild episodes of facial blushing or flushing which, over time, may lead to a permanent red face. Ocular rosacea can affect both the eye surface and eyelid. Symptoms can include foreign body sensations, sensitivity of the eye surface, burning sensations and eyelid symptoms such as chalazia, styes, redness, crusting and loss of eyelashes. ---------------------------------------------------------------------------- 1.1 How is Rosacea different to Acne Vulgaris ? 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 mostly an adult disease, and is generally restricted to the nose, cheeks, chin and forehead. 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 are leaking immune cells that are causing inflammation, whereas in acne vulgaris, papules and pustules can be more folicular in origin. Rosacea will probably have an underlying redness that is related to flushing and thus looks different to acne vulgaris. The treatment for rosacea and acne vulgaris can be somewhat similar, but some of the acne vulgaris regimes are too harsh for rosacea and can severely aggravate the condition. ---------------------------------------------------------------------------- 1.2 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 flaking, burning and occasionally itching, and may also be found on the scalp, ears and torso. It does not usually involve red bumps as in Rosacea. Just to confuse things further, The two conditions are often seen together. ---------------------------------------------------------------------------- 1.3 What causes Rosacea ? From "Beating Rosacea, Vascular, Ocular and Acne Forms", by Geoffrey Nase PhD, Nase Publications 2001. "Rosacea is primarily a disorder of the facial blood vessels. Experts from across the world agree that vascular abnormalities are central to all stages and symptoms of rosacea". To paraphrase further: Rosacea blood vessels undergo changes in function and become hyper-responsive to internal and external stimuli. These changes are ultimately responsible for the progression of all rosacea symptoms. ---------------------------------------------------------------------------- 1.4 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. ---------------------------------------------------------------------------- 1.5 What are the stages of rosacea ? Dr. Nase talks about 4 stages, called Pre-Rosacea, Mild Rosacea, Moderate Rosacea and Severe Rosacea. Pre-Rosacea: the first cardinal sign of rosacea: blood vessels dilate to more stimuli, open wider and stay open for longer periods of time compared to normal persons. No visible damage can normally be seen. Mild Rosacea: begins when the facial redness induced by flushing persists for an abnormal length of time - usually 1/2 an hour or more after a trigger. Those who have frequent pre-rosacea flushing are highly susceptible to progressing to mild rosacea. Moderate Rosacea: as facial flushing becomes more frequent and intense, vascular damage occurs. This can result in long lasting redness, swelling and inflammatory papules and pustules. Telangiectasia may be noticed in the areas where flushing is worst. Severe Rosacaea: characterised by intense bouts of facial flushing, severe inflammation, facial pain, swelling and burning sensations. Also inflammatory papules, pustules and nodules may be present. Some experience a bulbous enlargement of the nose, known as rhinophyma. ---------------------------------------------------------------------------- 2. How can Rosacea be treated ? The best answer is "by your registered health professional". There are some medications available that control the redness and reduce the number of papules and pustules. 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 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. Some of their posts can be found under the `Treatments' node on the list highlights page see - http://rosacea.ii.net/toc.html 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. The vitamin A derivate 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 resistent rosacea. The mixed light pulse laser - Photoderm is showing promise as a treatment for the vascular component of rosacea. It works by targetting 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 papopustular lesions. More information is available at http://www.rosacea-ltd.com 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. Dr. Nase's book will serve as a valuable resource - it contains detailed and proven current rosacea treatment information. ---------------------------------------------------------------------------- 2.1 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. If you want to feel encouraged that Rosacea really can be practically cured, check out Geoffrey Nase's before and after photographs at http://rosacea.ii.net/gnase/index.html ---------------------------------------------------------------------------- 3. What information is available on the Internet about Rosacea ? There are some pages that are worth visiting. You can find a list of reviewed Internet resources relating to Rosacea as part of the Open Directory at http://dmoz.org/Health/Conditions_and_Diseases/Skin_Disorders/Rosacea There you will find sections on companies offering treatment products, research results as well as medical texts on rosacea. ---------------------------------------------------------------------------- 3.1 Are there any newsgroups relating to Rosacea ? Not exclusively for Rosacea. Perhaps the best 2 to try are alt.skincare.acne and alt.support.skin-diseases. You can read and post to these forums using the Google Groups facility at http://groups.google.com ---------------------------------------------------------------------------- 3.2 Are there any email mailing lists relating to Rosacea ? Yes, see http://rosacea.ii.net/ml.html or go straight to the email group hosting page at http://groups.yahoo.com/group/rosacea-support Many interesting and useful discussions have taken place on the mailing list since it was created in October 1998. There are 2 Doctors on the list who have hugely contributed to the group and posted great articles. You can see the list highlights categorised by treatment, symptoms and more at http://rosacea.ii.net/toc.html There is a Rosacea forum for those who use AOL as their internet company. The address is aol://5863:126/mB:144806 If you are interested in Hyperhidrosis and Facial Blushing, visit their bulletin board via the redirect at http://www.clik.to/sympathetics (This currently leads you to the Yahoo! Group http://groups.yahoo.com/group/sympathetics) ---------------------------------------------------------------------------- 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.ii.net/reviews.html A recently published book by Dr. Geoffrey Nase is destined (we believe) to become a seminal text on Rosacea. You can read a detailed discussion of the contents of the book at http://www.drnase.com The book is titled "Beating Rosacea, Vascular, Ocular and Acne Forms". It is only available from his web site. ---------------------------------------------------------------------------- 3.4 Is this Frequently Asked Question list on the Internet ? Yes, you may find a more up to date listing if you check http://rosacea.ii.net/faq.txt You can find the official html'ised archived version of this FAQ at http://www.faqs.org/faqs/medicine/rosacea Also, you can get this FAQ via email. The address of the faq server is mail-server@rtfm.mit.edu First, get the directory listing with the `index' command, and then fetch the latest version of the FAQ with the `send' command. You should include the commands in the _body_ of the message, the subject will be ignored. All messages to the mail server should be on one line only, if your email program inserts carriage returns because the line is too long, you may find retrieving the FAQ difficult. For example, to get version 1.12 of the FAQ you would send the following texts in the body of 2 emails (first one to get directory and second, once you know the filename you want). index usenet-by-group/alt.support.skin-diseases send usenet-by-group/alt.support.skin-diseases/Rosacea_Frequently_Asked_Questions_v1.12 ---------------------------------------------------------------------------- 4. Are there any support groups related to Rosacea ? You may want to check out The National Rosacea Society and the rosacea-support email list. 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/home.html 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. Their depth and breadth of information that they make available is something that we hope that they will be able to devote some resources to. There is an email support group that you can subscribe to. This email group is free and unmoderated. Currently there are about 1700 users and about 10-40 messages per day. Digest versions are available. To find out more information about the list, visit http://rosacea.ii.net/ml.html or go straight to the email hosting page at http://groups.yahoo.com/group/rosacea-support An alternative list archive on the web is also located at http://www.escribe.com/health/rosacea-support this site has a slightly more traditional feel to it, you may prefer to read from this archive. 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. blepharitis: inflamation and crusting of the eyelid. demodex mites: (demodex folliculorum and demodex brevis): microscopic mites that lives in the skin. Some have suggested that this is the cause of rosacea, but most experts discount this theory. According to Dr Nase, "This theory has now been disproved. Rosacea expers all agree that this mite plays no real role in the development or progression of rosacea (except for the odd pustule).", pg. 110 in Beating Rosacea. chalazion: a lump on the eyelid that is caused by a clogged duct of one or more of the meibomian glands on the eyelid. conjunctivitis: inflammation of the conjunctiva (the thin transparent lining in the front of the eyeballs and eyelids). dry eye: a condition brought about by abnormal production in the quantity or quality of tears. fotofacial: a treatment regime pioneered by Dr. Patrick Bitter Jnr., see http://www.fotofacial.com edema: swelling erythema: inflammatory redness of the skin. ETS: Endoscopic Transthoracic Sympathectomy, major surgery in a surgeon cuts the major sympathetic nerves that supply the hands, neck and face. Helicobacter pylori: are bacteria that live in the cell lining of the stomach. According to Dr. Nase, "Most rosacea specialists now conclude that H. Pylori only play a small role in a minor number of rosacea patients." pg. 109 in Beating Rosacea. hypertrophy: abnormal growth. hyperemia: abnormally increased blood flow IPL: Intense Pulse Light, a description of the function of the photoderm treatment. keratitis: infection or inflammation of the cornea. ketoconozole: the active antifungal ingredient in nizoral, helpful for seborrheic dermatitis and dandruff. metronidazole: a topical treatment for rosacea. Has been found effective against rosacea. Is the active ingredient in metrogel, metrocream and metrolotion, rozex and noritate. meibomitis: inflammation of the oil produicing meibomian glands of the eye. ocular: of the eye. papule: a small, solid, elevated skin lesion, less than 0.5cm in diameter. 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. photofacial: a treatment regime using photoderm, pioneered by Dr. Patrick Bitter Snr., see http://www.photofacial.com 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. pustule: a vesicle filled with cloudy fluid, such as pus, often associated with a hair follicle but can exist independently. rhinophyma: abnormal growth of the soft tissue of nose, caused by sebaceous gland hypertrophy and hyperplasia (increased growth and number of sebaceous glands). rosacea-ltd: a non-prescription topical treatment for rosacea, see http://www.rosacea-ltd.com seborrheic dermatitis: an inflamatory skin condition, associated with itchy flaking skin. sebaceous gland: a gland often associated with a hair follicle, that produces sebum. stye: inflammation of an eyelash follicle on the edge of the eyelid. telangiectasis: damaged micro blood vessels, often visible on the surface of the skin. tetracycline: an antibiotic often prescribed for rosacea. vascular: of the blood vessels. " vim:tw=74:et -- David Pascoe, dp@ii.net, South Perth, Western Australia Remove NOSPAM from email address to reply.