Rosacea Blog

Subantimicrobial dose doxycycline: a unique treatment for rosacea.

Periostat, a sub-microbial "antibiotic" (doxycycline) has been successfully used to treat rosacea in the study above, putting to rest any ideas that it is the anti-biotic function of these drugs that account for their positive impact on rosacea.

Quote:

"Recently, subantimicrobial dose doxycycline 20 mg twice a day (SDD) has been used to treat rosacea because of its anti-inflammatory properties".

Pfizer is developing a drug to treat "hot flashes" which may be helpful to rosaceans:

http://www.news-medical.net/?id=6100

Quote:

"The University of Rochester was granted a "method of treatment" patent in 2001 that covers the use of drugs that treat hot flashes by targeting a specific group of cells in the hypothalamus, the region of the brain that regulates body temperature. The proposed link between those cells and hot flashes was suggested by Thomas Guttuso, Jr., M.D., who had been conducting research in the University of Rochester's School of Medicine and Dentistry as part of a fellowship program in Neurology."

For the nerds amongst us who use RSS, please note this blog is available as XML (e.g. to use in something like http://www.bloglines.com which I use)

http://www.rosacea.co.uk/blog/atom.xml

Dan posts about his experience with ivermectin.

He seems pretty positive about his experience. It will be interesting to follow his and others' progress.

The old-style pulsed dye lasers caused purpura (brusising) which took up to two weeks to clear. More modern lasers and IPL devices coagulate the blood vessel without bursting it so cause no bruising and are more gentle.

Interesting post from Sophia who reports that donating blood helped her rosacea.

What is "Iontophoresis"? This will apparently allow the drug to be delivered with more accuracy to the right depth in the skin. As someone who has had botox injections experimentally to try and treat rosacea and rosacea flushing, this is a step forwards. I had a frozen face for 2-3 months and effect on flushing was difficult to gauge. There have been very mixed reports on botox for facial flushing and redness, based on my personal experiences I would not recommend this to others (for the face).

This powerpoint presentation gives a useful background to iontophoresis

News article on rosacea and laser (v-beam) treatment

Quote:

"The only treatment that gets at the heart of the cause, in my opinion, is laser because it removes the blood vessels, and it removes them for good," said Dr. Eric Bernstein, a laser surgeon.

Another study that mentions laser / IPL as an important rosacea therapy

Advances in the topical treatment of acne and rosacea

Abstract below

J Drugs Dermatol. 2004 Sep-Oct;3(5 Suppl):S12-22.

Advances in the topical treatment of acne and rosacea.

Ceilley RI.University of Iowa, West Des Moines, Iowa, USA.

Acne and rosacea are common skin diseases which may present similarly and both involve inflammation. Both can result in significant cosmetic impairment and lead to quality of life decrements if not optimally treated. The conventional approach for both diseases involves the use of topical therapy to treat inflammatory lesions in combination, when needed, with a systemic or topical antibiotic. An important issue in the management of both diseases at present is the need to reduce antibiotic usage due to the increasing problem of bacterial resistance. One of the emerging treatment paradigms that is becoming increasingly useful as an antibiotic-sparing strategy is the use of procedural therapies in combination with medical management. Such procedural modalities include lasers, intense pulsed light (IPL), and photodynamic therapies (PDT). Topical regimens are used pre-treatment and following physical modalities for maintenance of remission.

Another new study:

Laser treatment of rosacea: a pathoetiological study.

Conclusion:

"Laser treatment of rosacea that destroys small vessels has a good medical relevance because it reduces the unpleasant symptoms of the sensitive skin"

Abstract below:

Arch Dermatol. 2004 Nov;140(11):1345-9.

Laser treatment of rosacea: a pathoetiological study.Lonne-Rahm S, Nordlind K, Edstrom DW, Ros AM, Berg M.Unit of Dermatology and Venereology, Department of Medicine, Karolinska Hospital, Stockholm, Sweden.

OBJECTIVE: To study the effect of laser treatment on rosacea, a common facial skin disease with symptoms of blushing, redness, telangiectasis, papules, pustules, and diffuse swelling of the skin, we focused on the stinging sensation and performed immunohistochemical evaluation of nerve density and neuropeptide expression. DESIGN: Clinical investigation as well as the lactic acid (stinger) test was performed before and 3 months after the treatment with flashlamp pulsed dye laser, when skin biopsy specimens were also taken. SETTING: University hospital. PATIENTS: Thirty-two patients with rosacea, all with positive results from the lactic acid "stinger" test, were treated by flashlamp pulsed dye laser. MAIN OUTCOME MEASURES: The biopsy specimens were taken from the stinger-positive areas in the nasolabial folds, fixed in Lanas fixative (10% formalin and 0.4% picric acid), and analyzed for the expression of protein gene product 9.5 (general nerve marker), substance P, calcitonin gene-related peptide, and vasoactive intestinal polypeptide, using a biotinylated streptavidin technique. RESULTS: Thirty-one patients who were stinger positive before treatment showed decreased scores after treatment, and 1 patient had the same stinger test score before and after treatment. The number of protein gene product 9.5-positive fibers in the epidermis (P< .05) as well as the papillary dermis (P< .01) was decreased. This was also the case for substance P in the papillary dermis (P< .001), whereas no evident difference was noted for vasoactive intestinal polypeptide and calcitonin gene-related peptide. No difference was found for contact between nerves and vessels (factor VIII positive). CONCLUSIONS: Laser treatment of rosacea that destroys small vessels has a good medical relevance because it reduces the unpleasant symptoms of the sensitive skin. A neurogenic etiology of stinging may be possible.

Interesting new study. Nice to see IPL / laser getting more coverage for rosacea treatment.

Combination therapy in clinical and cosmetic dermatology: the marriage of device and drug

J Drugs Dermatol. 2004 Sep-Oct;3(5 Suppl):S4-11.

Combination therapy in clinical and cosmetic dermatology: the marriage of device and drug.Nestor MS.Center for Cosmetic Enhancement and University of Miami School of Medicine, Department of Dermatology and Cutaneous Surgery, Miami, Florida 33180, USA.

The first generations of lasers used in clinical and cosmetic dermatology achieved their effects by means of epidermal and dermal ablation. While effective in removing some of the stigmata of photodamage including pigmentary changes and rhytides, vascular abnormalities associated with such conditions as melasma and rosacea, were not sufficiently effective. The new generation of laser and non-laser light devices (eg, intense pulsed light or IPL) offer excellent results in the management of clinical and cosmetic conditions, including significant changes in improvement in vascular conditions such as rosacea and actinic damage and stimulating dermal collagen production, without significant injury to the epidermis. The combination of light therapies and topical agents adds to the efficacy of these procedures, particularly in post-procedural maintenance. Light-based therapies have been an important addition to the anti-acne armamentarium as they are effective and do not add to the increasing bacterial resistance problem.