Did anyone else receive it. I hope to discuss some of the points with my derm

tomorrow.

As a sideline, can any recommend  dimethicone and/or cyclomethicone skincare and

foundation/sunscreen mentioned in the article for those of you who have the more

of the erythema subtype rosacea.

If you don't receive Dr. Sy's newsletter, it is available at her site

www.lindasy.com





[Non-text portions of this message have been removed]

The article on Linda Sy's web site is in 3 parts.



Rosacea: I. Etiology, pathogenesis, and subtype classification

Rosacea: II. Therapy

Commentary on Rosacea II. Therapy by Dr. Linda Sy



You can go to her website at http://www.lindasy.com and take the link

to `Skin411 Digest' on the left hand side or the following URL should

work as well - http://tinyurl.com/4xyft



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.

> 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

______________________________

Oh, forgot to mention that our large dermatology group at IU School

of Medicine is dumbfounded at the number of rosacea sufferers

discontinuing Finacea for less irritating treatments.  One doctor

told me the return rate is close to 70%.  Their papules clear

beautifully with a small drop of this cream, but the patients' faces

burn during the morning showers, flushing is more intense and some

patients have lapsed into angry face syndrome.  I hope our

dermatology group publishes on this side effect, even though Berlex

representatives are there with pamphlets, free samples and other

promotional material every month.  Do not believe the hype on this

product.  Feel free to try it, but use very small amounts and don't

fight through burning, stinging, flushing -- the chances of rosacea

skin to acclimate are not good.



It is a shame that we dont find more time to focus on treatments to

cure the disorder.  Right now it is just as important for me (and

others) to warn rosacea sufferers about products that are actually

used for rosacea treatment but are more harmful to the disorder.

The honest truth is that dermatologists are humans and they have

been trained for decades to treat acne, so papulopustular rosacea

automatically triggers the "acne treatment mode" in most

dermatologists and then the remaining redness and burning is not

addressed, told there is nothing to do with it, or told that it is

just you skin's physical makeup.



Regards,



Geoffrey

______________________________



Dr. Geoffrey Nase

Ph.D. Neurovascular Physiologist

http://www.drnase.com

______________________________