Sunday, June 15, 2014

Evolving Newer Treatments for Rosacea, Ivermectin Cream

Redness over central face area? Comes and goes? Later on turns to permanent uneven, hard, rough and red skin?
It may be rosacea. Rosacea looks like several acnes concentrated in a small area of face but, it is not. The biggest difference is that rosacea may have acne, while acne does not have the extra blood vessels (called telangiectasias) found in rosecea.
Rosacea typically first appears after 30 years of age as a sustained flush, blush or redness on the cheeks, nose, forehead or chin that may come and go.
Over time, the redness becomes ruddier and more persistent, and telangiectasia (visible blood vessels) may appear. Some cases, red domed papules (small bumps) and pustules, red gritty eyes, burning and stinging sensations, and in some advanced cases, a red lobulated nose (rhinophyma), may develop. Rosacea, when have acne with it, called acne rosacea.
There are four forms of rosacea, which are defined by the following range of symptoms:
1. Mild (Erythematotelangiectatic) The main symptoms are facial flushing and redness that may come (Flares) and go. In addition, there may some swelling, burning and stinging, roughness, and visible red blood vessels.
2. Moderate (Papulopustular) This is a more advanced form of rosacea that is marked by persistent redness and pimplelike bumps (often mistaken for acne), as well as burning and stinging.
3. Severe (Phymatous) In some individuals, rosacea may affect the nose, causing the skin tissue to thicken (giving an enlarged appearance) and become bumpy. This advanced form of rosacea is called rhinophyma.
4. Ocular rosacea In addition to skin symptoms, rosacea may also affect the eyes and eyelids. It may cause redness to the surrounding skin tissue but also burning or stinging, dryness, light sensitivity, blurred vision, and watery, bloodshot eyes.
Rosacea is a chronic, inflammatory and vascular disorder affecting the face, with facial erythema (redness) being a prominent characteristic.
While the exact cause of rosacea is unknown; it may run in families, but genetic predisposition has not been established. Small Intestinal Bacterial Overgrowth (SIBO) by Helicobacter specis) is also thought to be one of the causes.
Several triggers have been identified that may make the condition worse.
These include; identifying and avoiding those can be a useful way of controlling the symptoms.
  • Exposure to sunlight
  • Stress
  • Strenuous exercise
  • Cold weather (wind)
  • Heat, hot and humid weather
  • Menopause
  • Certain medications, such as vasodilator drugs
  • Hot drinks
  • Alcohol and caffeine
  • Spicy foods
  • Dairy products
Download Rosacea Trigger Tracker for you from Canadian Dermatology Association.
Recently, some researchers attribute rosacea to a tiny spider-like 8 legged bug (A mite) called demodex folliculorum that appears from the pores of the skin and crawls over the face to mate, as we sleep. It is just 0.01mm to 0.04mm long and is harmless to most people.

About 70 per cent of adults aged 50 plus have been shown to have the mite, but previous studies have found that rosacea sufferers have up to ten times more demodex mites on their skin than unaffected carriers.
When it dies, the creature releases a bacteria, bacillus bacterium, which triggers inflammation in patients who have rosacea, leading to the most severe form of the condition, papulopustular rosacea.
There has been no perfect cure for this condition. Some time back, in February, 2014, one more topical gel Mirvaso® (brimonidine) was approved by European Commission for marketing in Europe.
Recently, there has been strong evidence that Ivermectin that kills the demodex mite has a role to play in the treatment of rosacea through 12 weeks.
Studies have concluded that Ivermectin 1% cream was effective and safe in treating inflammatory lesions of papulopustular rosacea.
There has been several other treatment options with varying results;
  1. Metronidazole cream or gel (topical metronidazole)
  2. Azelaic acid that helps unblock pores and reduce inflammation (redness and swelling).
  3. Antibiotics like tetracycline and Erythromycin
  4. Laser and intense pulsed light (IPL) treatment
  5. Thickened skin (rhinophyma) may require the attention of a plastic surgeon.

  1. Choose products that are non-drying, free of alcohol or astringents.
  2. Use a mild cleanser and do not rub or scrub skin.
  3. Make a habit of using sunscreen (SPF 30 or higher) every day.
  4. Moisturize your skin, especially during the colder months when the air is dry.

Don't s:

  1. Do not try acne creams because may dry out and irritate your skin even more.
  2. Alcohol consumption. Alcohol is a known trigger, so, it can worsen symptoms in individuals with rosacea.
  3. Use medications for blood pressure thinking that the flush is due to high blood pressure.
  4. Over cleansing with an idea that rosacea results from unclealiness.
  5. Assume that you have sunburned skin.

    There are so many celebrities living with this condition. Let us try ivermectin inrosacea, which has manifold use; from treating scabies, nematodes, lice and immunomodulation to its' potential role as angiogenesis inhibitor in cancer treatment.


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