> These articles are really nicely written overview of the standard
> classification, some known treatments and some personal comments
from Linda's clinical experience. Exactly the sort of information
that should be compulsory for those newly diagnosed.
>
> davidp.



I agree David. These are excellent articles for those just getting
their feet wet in the rosacea arena. There is a general trend now
to treat rosacea differently according to the subtype. This means
that if you are primarily Subtype I with background facial redness
and flushing, you should be treated with specific medications; but
if you are primarily Subtype II with papules and pustules, you
should consider alternative treatments. This is a wise
scientific/medical approach, but it often gets lost that everyone,
no matter what subytpe, has to be extremely cautious about provoking
the underlying vascular disorder.

There is considerable controversy over the use of retinoids and
tretinoin. In my eight years as a rosacea sufferer and one who has
listened carefully to thousands of rosacea sufferers and clinically
seen many rosacea sufferers at IU Medical School with
Dermatologists, it is my opinion that retinoids and tretinoin have
NO place in rosacea treatment of any subtype. Acclimation of the
skin, blood vessels and nerves rarely occurs and then you are stuck
with a bright red flushed, burning face. This is where the articles
fall short. Their response to these patients who are now in
physical pain is, "Well, we dont know what to do -- you should go
see a neurologist". Then you are classified as having idiopathic
flushing syndromes and idiopahtic neural burning syndromes
(idiopathic means of no known origin), when in fact it is just
rosacea in a ticked off state. These rosacea sufferers then fall
through the cracks for years. There are many documented articles
from the Mayo Clinic, from the Rosacea Experts such as Dr. Wilkin,
etc. about these cases of angry face syndrome, burning face
syndrome, sun burn like responses, etc. to those physicians who
unwisely treat patients with retinoids.

Rosacea sufferers at all stages still need to be very wary of
rosacea medical advice because physicians are still "experimenting"
with us and if you are on the bottom of the learning curve, a
physician's treatment can turn a cosmetic disorder into a totally
different beast. When you hear retinol and tretinoin and benzoyl
peroxide, perk your ears up, take a step back and approach with
caution. We have several hundred if not over a thousand members on
this one board who have fought through the retinol and tretinoin-
induced irritation because of the sundamage theory (an unproven
theory where sun supposedly caused damage to blood vessels and
collagen and this can be reversed by these products). If this was
truly the case, then deep chemical peels or deep CO2 laser peels to
remove all the decades of sun damage would cure rosacea.......to my
knowledge not one single case has ever improved with these deep sun
damage treatments; to the contrary, these are the rosacea sufferers
living a painful existence.

As yo will find out, avoiding rosacea irritants is just as important
as actively treating the disorder. I literally shutter for rosacea
sufferers at the hundreds of OTC retinol products that are causing
cumulative damage to their skin for temporary changes in wrinkles
and skin smoothness. Rosacea is a genetic disorder that is brought
to the top via cumulative insults. This is known. Rosacea is also
much more prevalent then it was several decades ago -- is this from
skin care products designed for wrinkles, smaller pores and acne?

Regards,

Geoffrey
______________________________

Dr. Geoffrey Nase
Ph.D. Neurovascular Physiologist
http://www.drnase.com
______________________________