Guest guest Posted April 9, 2002 Report Share Posted April 9, 2002 You can get rosacea at an early age... I was diagnosed with it at age 15. Now I'm 21 and its fairly well under control (there are always the blips here and there with lifestyle and hormone changes). The important thing to remember about cea is that it is much easier to keep it under control than to reverse damage done. For that reason alone, I would be concerned as well with a doctor saying you are too young to be treated for rosacea. Maybe you should consider a second opinion. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2002 Report Share Posted April 9, 2002 You can get rosacea at an early age... I was diagnosed with it at age 15. Now I'm 21 and its fairly well under control (there are always the blips here and there with lifestyle and hormone changes). The important thing to remember about cea is that it is much easier to keep it under control than to reverse damage done. For that reason alone, I would be concerned as well with a doctor saying you are too young to be treated for rosacea. Maybe you should consider a second opinion. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2002 Report Share Posted April 9, 2002 You can get rosacea at an early age... I was diagnosed with it at age 15. Now I'm 21 and its fairly well under control (there are always the blips here and there with lifestyle and hormone changes). The important thing to remember about cea is that it is much easier to keep it under control than to reverse damage done. For that reason alone, I would be concerned as well with a doctor saying you are too young to be treated for rosacea. Maybe you should consider a second opinion. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 , acne rosacea in a 20 year old is possible but very rare -- far, far more common is acne vulgaris. Also far more common is chronic flushing/blushing that doesn't have a disorder associated with it, is just a characteristic of the person, perhaps an inherited tendency or trait. Both acne and easy blushing/flushing occur so commonly in the young that there's no compelling reason to link them together. Having all the symptoms of a condition doesn't mean you have that condition, not by a long shot. Plus, if there's any question on a diagnosis, the better medical management would favor the conditon that is more amenable to treatment (in your case, acne vulgaris), then to jump immediately to the condition that has no great treatment -- especially when the first is so common in the patient population, and the second is so rare. Does that logic make sense to you? Clindagel is a topical antibiotic, like Metrogel commonly prescribed for rosacea, just a different antibiotic (clindamycin rather than metronidazole). Why are you sure it will irritate you -- have you had bad experiences with topical clindamycin in the past? Topical antibiotics are anti-inflammatory, but only clindamycin will kill off the bacteria that commonly causes acne vulgaris. (cea isn't thought to be caused by bacteria). I know nothing about photoderm treatments. Why is he recommending them for you? Marjorie Marjorie Lazoff, MD > Hello y'all: > > I just went to the top rated dermatologist in Nashville and he > said that at my age(20) rosacea is almost impossible to have and that > what I have is some acne and a flushing/blushing predisposition that > can be helped by Zyrtec. He prescribed me the Zyrtec and Clindagel for > the acne. I'm worried. So many people say that people my age can get > it, and I do have all the characteristic symptoms of rosacea....is this > another clueless derm? He also advised getting photoderm at his clinic, > likely at a 550 wavelength. I'm sure the clindagel will irritate > me...I'm confused. Any advice would be appreciated. > > - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 , acne rosacea in a 20 year old is possible but very rare -- far, far more common is acne vulgaris. Also far more common is chronic flushing/blushing that doesn't have a disorder associated with it, is just a characteristic of the person, perhaps an inherited tendency or trait. Both acne and easy blushing/flushing occur so commonly in the young that there's no compelling reason to link them together. Having all the symptoms of a condition doesn't mean you have that condition, not by a long shot. Plus, if there's any question on a diagnosis, the better medical management would favor the conditon that is more amenable to treatment (in your case, acne vulgaris), then to jump immediately to the condition that has no great treatment -- especially when the first is so common in the patient population, and the second is so rare. Does that logic make sense to you? Clindagel is a topical antibiotic, like Metrogel commonly prescribed for rosacea, just a different antibiotic (clindamycin rather than metronidazole). Why are you sure it will irritate you -- have you had bad experiences with topical clindamycin in the past? Topical antibiotics are anti-inflammatory, but only clindamycin will kill off the bacteria that commonly causes acne vulgaris. (cea isn't thought to be caused by bacteria). I know nothing about photoderm treatments. Why is he recommending them for you? Marjorie Marjorie Lazoff, MD > Hello y'all: > > I just went to the top rated dermatologist in Nashville and he > said that at my age(20) rosacea is almost impossible to have and that > what I have is some acne and a flushing/blushing predisposition that > can be helped by Zyrtec. He prescribed me the Zyrtec and Clindagel for > the acne. I'm worried. So many people say that people my age can get > it, and I do have all the characteristic symptoms of rosacea....is this > another clueless derm? He also advised getting photoderm at his clinic, > likely at a 550 wavelength. I'm sure the clindagel will irritate > me...I'm confused. Any advice would be appreciated. > > - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 , acne rosacea in a 20 year old is possible but very rare -- far, far more common is acne vulgaris. Also far more common is chronic flushing/blushing that doesn't have a disorder associated with it, is just a characteristic of the person, perhaps an inherited tendency or trait. Both acne and easy blushing/flushing occur so commonly in the young that there's no compelling reason to link them together. Having all the symptoms of a condition doesn't mean you have that condition, not by a long shot. Plus, if there's any question on a diagnosis, the better medical management would favor the conditon that is more amenable to treatment (in your case, acne vulgaris), then to jump immediately to the condition that has no great treatment -- especially when the first is so common in the patient population, and the second is so rare. Does that logic make sense to you? Clindagel is a topical antibiotic, like Metrogel commonly prescribed for rosacea, just a different antibiotic (clindamycin rather than metronidazole). Why are you sure it will irritate you -- have you had bad experiences with topical clindamycin in the past? Topical antibiotics are anti-inflammatory, but only clindamycin will kill off the bacteria that commonly causes acne vulgaris. (cea isn't thought to be caused by bacteria). I know nothing about photoderm treatments. Why is he recommending them for you? Marjorie Marjorie Lazoff, MD > Hello y'all: > > I just went to the top rated dermatologist in Nashville and he > said that at my age(20) rosacea is almost impossible to have and that > what I have is some acne and a flushing/blushing predisposition that > can be helped by Zyrtec. He prescribed me the Zyrtec and Clindagel for > the acne. I'm worried. So many people say that people my age can get > it, and I do have all the characteristic symptoms of rosacea....is this > another clueless derm? He also advised getting photoderm at his clinic, > likely at a 550 wavelength. I'm sure the clindagel will irritate > me...I'm confused. Any advice would be appreciated. > > - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 Ok, I've heard this twice now in the last day or so. What is the difference between flushing/blushing predisposition + acne vulgaris vs having cea? Isnt cea just the predisposition to flushing/blushing that eventually if left untreated long enough will lead to other problems such as papules/telengiectasia/swelling etc? I don't see a difference. Dr. Nase says in his book on page 182 under the heading MISCONCEPTION #3: ROSACEA DOES NOT AFFECT PEOPLE UNTIL THEY ARE IN THEIR 40's OR 50'S: " This is an extremely common misconception. Most general medical articles report that rosacea is a disorder of the middle-aged. This is Absolutely Wrong! It is Very common for teenagers and young adults to have classic cea. This disorder Usually starts to rear its ugly head in the late teens and early 20's. " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 Ok, I've heard this twice now in the last day or so. What is the difference between flushing/blushing predisposition + acne vulgaris vs having cea? Isnt cea just the predisposition to flushing/blushing that eventually if left untreated long enough will lead to other problems such as papules/telengiectasia/swelling etc? I don't see a difference. Dr. Nase says in his book on page 182 under the heading MISCONCEPTION #3: ROSACEA DOES NOT AFFECT PEOPLE UNTIL THEY ARE IN THEIR 40's OR 50'S: " This is an extremely common misconception. Most general medical articles report that rosacea is a disorder of the middle-aged. This is Absolutely Wrong! It is Very common for teenagers and young adults to have classic cea. This disorder Usually starts to rear its ugly head in the late teens and early 20's. " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 Ok, I've heard this twice now in the last day or so. What is the difference between flushing/blushing predisposition + acne vulgaris vs having cea? Isnt cea just the predisposition to flushing/blushing that eventually if left untreated long enough will lead to other problems such as papules/telengiectasia/swelling etc? I don't see a difference. Dr. Nase says in his book on page 182 under the heading MISCONCEPTION #3: ROSACEA DOES NOT AFFECT PEOPLE UNTIL THEY ARE IN THEIR 40's OR 50'S: " This is an extremely common misconception. Most general medical articles report that rosacea is a disorder of the middle-aged. This is Absolutely Wrong! It is Very common for teenagers and young adults to have classic cea. This disorder Usually starts to rear its ugly head in the late teens and early 20's. " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 I was diagnosed with rosacea at 25....I think its much more common to develop it at an earlier age (such as teens and 20's) then most " experts " claim. Donna Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 I was diagnosed with rosacea at 25....I think its much more common to develop it at an earlier age (such as teens and 20's) then most " experts " claim. Donna Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 Yes, I started having R symptoms (mostly flushing) when I turned 30. And I've heard of cases as young as late teens. --- Adam filter@...> wrote: > Ok, I've heard this twice now in the last day or so. > What is the difference > between flushing/blushing predisposition + acne > vulgaris vs having cea? > Isnt cea just the predisposition to > flushing/blushing that eventually if > left untreated long enough will lead to other > problems such as > papules/telengiectasia/swelling etc? I don't see a > difference. > > Dr. Nase says in his book on page 182 under the > heading MISCONCEPTION #3: > ROSACEA DOES NOT AFFECT PEOPLE UNTIL THEY ARE IN > THEIR 40's OR 50'S: > > " This is an extremely common misconception. Most > general medical articles > report that rosacea is a disorder of the > middle-aged. This is Absolutely > Wrong! It is Very common for teenagers and young > adults to have classic > cea. This disorder Usually starts to rear its > ugly head in the late > teens and early 20's. " > > > > > > -- > Please read the list highlights before posting to > the whole group (http://rosacea.ii.net/toc.html). > Your post will be delayed if you don't give a > meaningful subject or trim your reply text. You must > change the subject when replying to a digest ! > > See http://www.drnase.com for info on his recently > published book. > > To leave the list send an email to > rosacea-support-unsubscribe > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 Yes, I started having R symptoms (mostly flushing) when I turned 30. And I've heard of cases as young as late teens. --- Adam filter@...> wrote: > Ok, I've heard this twice now in the last day or so. > What is the difference > between flushing/blushing predisposition + acne > vulgaris vs having cea? > Isnt cea just the predisposition to > flushing/blushing that eventually if > left untreated long enough will lead to other > problems such as > papules/telengiectasia/swelling etc? I don't see a > difference. > > Dr. Nase says in his book on page 182 under the > heading MISCONCEPTION #3: > ROSACEA DOES NOT AFFECT PEOPLE UNTIL THEY ARE IN > THEIR 40's OR 50'S: > > " This is an extremely common misconception. Most > general medical articles > report that rosacea is a disorder of the > middle-aged. This is Absolutely > Wrong! It is Very common for teenagers and young > adults to have classic > cea. This disorder Usually starts to rear its > ugly head in the late > teens and early 20's. " > > > > > > -- > Please read the list highlights before posting to > the whole group (http://rosacea.ii.net/toc.html). > Your post will be delayed if you don't give a > meaningful subject or trim your reply text. You must > change the subject when replying to a digest ! > > See http://www.drnase.com for info on his recently > published book. > > To leave the list send an email to > rosacea-support-unsubscribe > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 Yes, I started having R symptoms (mostly flushing) when I turned 30. And I've heard of cases as young as late teens. --- Adam filter@...> wrote: > Ok, I've heard this twice now in the last day or so. > What is the difference > between flushing/blushing predisposition + acne > vulgaris vs having cea? > Isnt cea just the predisposition to > flushing/blushing that eventually if > left untreated long enough will lead to other > problems such as > papules/telengiectasia/swelling etc? I don't see a > difference. > > Dr. Nase says in his book on page 182 under the > heading MISCONCEPTION #3: > ROSACEA DOES NOT AFFECT PEOPLE UNTIL THEY ARE IN > THEIR 40's OR 50'S: > > " This is an extremely common misconception. Most > general medical articles > report that rosacea is a disorder of the > middle-aged. This is Absolutely > Wrong! It is Very common for teenagers and young > adults to have classic > cea. This disorder Usually starts to rear its > ugly head in the late > teens and early 20's. " > > > > > > -- > Please read the list highlights before posting to > the whole group (http://rosacea.ii.net/toc.html). > Your post will be delayed if you don't give a > meaningful subject or trim your reply text. You must > change the subject when replying to a digest ! > > See http://www.drnase.com for info on his recently > published book. > > To leave the list send an email to > rosacea-support-unsubscribe > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 I had full-on cea during my late teens. I'm now 26. I ran into a horrible derm who said once I was too young to have cea. Narrow- minded derms are among the worst. > > , acne rosacea in a 20 year old is possible but very rare -- > far, far more common is acne vulgaris. Also far more common is > chronic flushing/blushing that doesn't have a disorder associated > with it, is just a characteristic of the person, perhaps an inherited > tendency or trait. > > Both acne and easy blushing/flushing occur so commonly in the young > that there's no compelling reason to link them together. Having all > the symptoms of a condition doesn't mean you have that condition, not > by a long shot. > > Plus, if there's any question on a diagnosis, the better medical > management would favor the conditon that is more amenable to > treatment (in your case, acne vulgaris), then to jump immediately to > the condition that has no great treatment -- especially when the > first is so common in the patient population, and the second is so > rare. Does that logic make sense to you? > > Clindagel is a topical antibiotic, like Metrogel commonly prescribed > for rosacea, just a different antibiotic (clindamycin rather than > metronidazole). Why are you sure it will irritate you -- have you had > bad experiences with topical clindamycin in the past? Topical > antibiotics are anti-inflammatory, but only clindamycin will kill off > the bacteria that commonly causes acne vulgaris. (cea isn't > thought to be caused by bacteria). > > I know nothing about photoderm treatments. Why is he recommending > them for you? > > Marjorie > > Marjorie Lazoff, MD > > > > Hello y'all: > > > > I just went to the top rated dermatologist in Nashville and > he > > said that at my age(20) rosacea is almost impossible to have and > that > > what I have is some acne and a flushing/blushing predisposition > that > > can be helped by Zyrtec. He prescribed me the Zyrtec and Clindagel > for > > the acne. I'm worried. So many people say that people my age can > get > > it, and I do have all the characteristic symptoms of rosacea....is > this > > another clueless derm? He also advised getting photoderm at his > clinic, > > likely at a 550 wavelength. I'm sure the clindagel will irritate > > me...I'm confused. Any advice would be appreciated. > > > > - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 I had full-on cea during my late teens. I'm now 26. I ran into a horrible derm who said once I was too young to have cea. Narrow- minded derms are among the worst. > > , acne rosacea in a 20 year old is possible but very rare -- > far, far more common is acne vulgaris. Also far more common is > chronic flushing/blushing that doesn't have a disorder associated > with it, is just a characteristic of the person, perhaps an inherited > tendency or trait. > > Both acne and easy blushing/flushing occur so commonly in the young > that there's no compelling reason to link them together. Having all > the symptoms of a condition doesn't mean you have that condition, not > by a long shot. > > Plus, if there's any question on a diagnosis, the better medical > management would favor the conditon that is more amenable to > treatment (in your case, acne vulgaris), then to jump immediately to > the condition that has no great treatment -- especially when the > first is so common in the patient population, and the second is so > rare. Does that logic make sense to you? > > Clindagel is a topical antibiotic, like Metrogel commonly prescribed > for rosacea, just a different antibiotic (clindamycin rather than > metronidazole). Why are you sure it will irritate you -- have you had > bad experiences with topical clindamycin in the past? Topical > antibiotics are anti-inflammatory, but only clindamycin will kill off > the bacteria that commonly causes acne vulgaris. (cea isn't > thought to be caused by bacteria). > > I know nothing about photoderm treatments. Why is he recommending > them for you? > > Marjorie > > Marjorie Lazoff, MD > > > > Hello y'all: > > > > I just went to the top rated dermatologist in Nashville and > he > > said that at my age(20) rosacea is almost impossible to have and > that > > what I have is some acne and a flushing/blushing predisposition > that > > can be helped by Zyrtec. He prescribed me the Zyrtec and Clindagel > for > > the acne. I'm worried. So many people say that people my age can > get > > it, and I do have all the characteristic symptoms of rosacea....is > this > > another clueless derm? He also advised getting photoderm at his > clinic, > > likely at a 550 wavelength. I'm sure the clindagel will irritate > > me...I'm confused. Any advice would be appreciated. > > > > - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 I had full-on cea during my late teens. I'm now 26. I ran into a horrible derm who said once I was too young to have cea. Narrow- minded derms are among the worst. > > , acne rosacea in a 20 year old is possible but very rare -- > far, far more common is acne vulgaris. Also far more common is > chronic flushing/blushing that doesn't have a disorder associated > with it, is just a characteristic of the person, perhaps an inherited > tendency or trait. > > Both acne and easy blushing/flushing occur so commonly in the young > that there's no compelling reason to link them together. Having all > the symptoms of a condition doesn't mean you have that condition, not > by a long shot. > > Plus, if there's any question on a diagnosis, the better medical > management would favor the conditon that is more amenable to > treatment (in your case, acne vulgaris), then to jump immediately to > the condition that has no great treatment -- especially when the > first is so common in the patient population, and the second is so > rare. Does that logic make sense to you? > > Clindagel is a topical antibiotic, like Metrogel commonly prescribed > for rosacea, just a different antibiotic (clindamycin rather than > metronidazole). Why are you sure it will irritate you -- have you had > bad experiences with topical clindamycin in the past? Topical > antibiotics are anti-inflammatory, but only clindamycin will kill off > the bacteria that commonly causes acne vulgaris. (cea isn't > thought to be caused by bacteria). > > I know nothing about photoderm treatments. Why is he recommending > them for you? > > Marjorie > > Marjorie Lazoff, MD > > > > Hello y'all: > > > > I just went to the top rated dermatologist in Nashville and > he > > said that at my age(20) rosacea is almost impossible to have and > that > > what I have is some acne and a flushing/blushing predisposition > that > > can be helped by Zyrtec. He prescribed me the Zyrtec and Clindagel > for > > the acne. I'm worried. So many people say that people my age can > get > > it, and I do have all the characteristic symptoms of rosacea....is > this > > another clueless derm? He also advised getting photoderm at his > clinic, > > likely at a 550 wavelength. I'm sure the clindagel will irritate > > me...I'm confused. Any advice would be appreciated. > > > > - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 > Ok, I've heard this twice now in the last day or so. What is the difference > between flushing/blushing predisposition + acne vulgaris vs having cea? > Isnt cea just the predisposition to flushing/blushing that eventually if > left untreated long enough will lead to other problems such as > papules/telengiectasia/swelling etc? I don't see a difference. There's a big difference, Adam. Here's how I see it: the predisposition to develop rosacea is called pre-rosacea, which isn't a condition but only an increased disposition to developing the condition of rosacea. That is, we can say that if a person flushes easily, they are at increased risk for developing rosacea in later life. But at that stage it's not appropriate to diagnose them as rosacean. That's because rosacea is not just easy flushing -- easy flushing is not a condition, it's normal. Most young people who flush easily will either outgrow it, or just flush as they always do for the rest of their lives. But in a sizable number of people who flush easily, the recovery from flushing becomes prolonged, it becomes easier and easier to trigger a flush, and in some eye problems develop even before any more obvious skin changes...all are indications that pre-rosace is turning into rosacea (assuming other disorders have been ruled out). No one knows why. How do we treat pre-rosacea to prevent it from developing into rosacea? There's no way I know. But rosaceans can possibly slow down the progression of the early stages to the later, more cosmetically disfiguring stages, with good skin care and attention to triggering events. cea is a clinical diagnosis, which means there's no test to perform, it's all based on signs/symptoms. Classically, rosacea manifests in one or a combination of four ways: inflammation (papules with surrounding erythema), vascular abnormalities (prolonged flushing, spiders), edema (physma), and ocular manifestations. Interesting, that the ocular rosacea can occur while the skin is still in pre-rosacea, but there's a lot that's not clear about this condition. One of the biggest mysteries is the connection between easy flushing and the signs/symptoms of rosacea. There are plenty of theories, but no one theory seems to explain everything about the condition. > Dr. Nase says in his book on page 182 under the heading MISCONCEPTION #3: > ROSACEA DOES NOT AFFECT PEOPLE UNTIL THEY ARE IN THEIR 40's OR 50'S: > > " This is an extremely common misconception. Most general medical articles > report that rosacea is a disorder of the middle-aged. This is Absolutely > Wrong! It is Very common for teenagers and young adults to have classic > cea. This disorder Usually starts to rear its ugly head in the late > teens and early 20's. " I can't know what Dr. Nase is referring to. What evidence does he offer to support those statments? I can't know if he's confusing pre- rosacea with rosacea, which is what the last sentence seems to allude to. But I don't know. To say that rosacea during the teenage years is rare doesn't mean it's impossible, it just means it's rare. That it's far more common for teenagers to suffer from acne vulgaris doesn't mean every teenager suffers from acne vulgaris. And many teenagers blush/flush easily, some will outgrow the tendency, others will continue to flush easily through life but nothing more -- but, a sizable group will progress to signs/symptoms of rosacea. This is key: just because someone blushes/flushes easily does NOT mean they have rosacea or are absolutely destined to develop rosacea. Nor does it mean that everyone with rosacea has a history of easy blushing/flushing. cea is just not that straightforward. Hope that helps. How are things going with the U of Rochester referral? Marjorie Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 > Ok, I've heard this twice now in the last day or so. What is the difference > between flushing/blushing predisposition + acne vulgaris vs having cea? > Isnt cea just the predisposition to flushing/blushing that eventually if > left untreated long enough will lead to other problems such as > papules/telengiectasia/swelling etc? I don't see a difference. There's a big difference, Adam. Here's how I see it: the predisposition to develop rosacea is called pre-rosacea, which isn't a condition but only an increased disposition to developing the condition of rosacea. That is, we can say that if a person flushes easily, they are at increased risk for developing rosacea in later life. But at that stage it's not appropriate to diagnose them as rosacean. That's because rosacea is not just easy flushing -- easy flushing is not a condition, it's normal. Most young people who flush easily will either outgrow it, or just flush as they always do for the rest of their lives. But in a sizable number of people who flush easily, the recovery from flushing becomes prolonged, it becomes easier and easier to trigger a flush, and in some eye problems develop even before any more obvious skin changes...all are indications that pre-rosace is turning into rosacea (assuming other disorders have been ruled out). No one knows why. How do we treat pre-rosacea to prevent it from developing into rosacea? There's no way I know. But rosaceans can possibly slow down the progression of the early stages to the later, more cosmetically disfiguring stages, with good skin care and attention to triggering events. cea is a clinical diagnosis, which means there's no test to perform, it's all based on signs/symptoms. Classically, rosacea manifests in one or a combination of four ways: inflammation (papules with surrounding erythema), vascular abnormalities (prolonged flushing, spiders), edema (physma), and ocular manifestations. Interesting, that the ocular rosacea can occur while the skin is still in pre-rosacea, but there's a lot that's not clear about this condition. One of the biggest mysteries is the connection between easy flushing and the signs/symptoms of rosacea. There are plenty of theories, but no one theory seems to explain everything about the condition. > Dr. Nase says in his book on page 182 under the heading MISCONCEPTION #3: > ROSACEA DOES NOT AFFECT PEOPLE UNTIL THEY ARE IN THEIR 40's OR 50'S: > > " This is an extremely common misconception. Most general medical articles > report that rosacea is a disorder of the middle-aged. This is Absolutely > Wrong! It is Very common for teenagers and young adults to have classic > cea. This disorder Usually starts to rear its ugly head in the late > teens and early 20's. " I can't know what Dr. Nase is referring to. What evidence does he offer to support those statments? I can't know if he's confusing pre- rosacea with rosacea, which is what the last sentence seems to allude to. But I don't know. To say that rosacea during the teenage years is rare doesn't mean it's impossible, it just means it's rare. That it's far more common for teenagers to suffer from acne vulgaris doesn't mean every teenager suffers from acne vulgaris. And many teenagers blush/flush easily, some will outgrow the tendency, others will continue to flush easily through life but nothing more -- but, a sizable group will progress to signs/symptoms of rosacea. This is key: just because someone blushes/flushes easily does NOT mean they have rosacea or are absolutely destined to develop rosacea. Nor does it mean that everyone with rosacea has a history of easy blushing/flushing. cea is just not that straightforward. Hope that helps. How are things going with the U of Rochester referral? Marjorie Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 10, 2002 Report Share Posted April 10, 2002 > Ok, I've heard this twice now in the last day or so. What is the difference > between flushing/blushing predisposition + acne vulgaris vs having cea? > Isnt cea just the predisposition to flushing/blushing that eventually if > left untreated long enough will lead to other problems such as > papules/telengiectasia/swelling etc? I don't see a difference. There's a big difference, Adam. Here's how I see it: the predisposition to develop rosacea is called pre-rosacea, which isn't a condition but only an increased disposition to developing the condition of rosacea. That is, we can say that if a person flushes easily, they are at increased risk for developing rosacea in later life. But at that stage it's not appropriate to diagnose them as rosacean. That's because rosacea is not just easy flushing -- easy flushing is not a condition, it's normal. Most young people who flush easily will either outgrow it, or just flush as they always do for the rest of their lives. But in a sizable number of people who flush easily, the recovery from flushing becomes prolonged, it becomes easier and easier to trigger a flush, and in some eye problems develop even before any more obvious skin changes...all are indications that pre-rosace is turning into rosacea (assuming other disorders have been ruled out). No one knows why. How do we treat pre-rosacea to prevent it from developing into rosacea? There's no way I know. But rosaceans can possibly slow down the progression of the early stages to the later, more cosmetically disfiguring stages, with good skin care and attention to triggering events. cea is a clinical diagnosis, which means there's no test to perform, it's all based on signs/symptoms. Classically, rosacea manifests in one or a combination of four ways: inflammation (papules with surrounding erythema), vascular abnormalities (prolonged flushing, spiders), edema (physma), and ocular manifestations. Interesting, that the ocular rosacea can occur while the skin is still in pre-rosacea, but there's a lot that's not clear about this condition. One of the biggest mysteries is the connection between easy flushing and the signs/symptoms of rosacea. There are plenty of theories, but no one theory seems to explain everything about the condition. > Dr. Nase says in his book on page 182 under the heading MISCONCEPTION #3: > ROSACEA DOES NOT AFFECT PEOPLE UNTIL THEY ARE IN THEIR 40's OR 50'S: > > " This is an extremely common misconception. Most general medical articles > report that rosacea is a disorder of the middle-aged. This is Absolutely > Wrong! It is Very common for teenagers and young adults to have classic > cea. This disorder Usually starts to rear its ugly head in the late > teens and early 20's. " I can't know what Dr. Nase is referring to. What evidence does he offer to support those statments? I can't know if he's confusing pre- rosacea with rosacea, which is what the last sentence seems to allude to. But I don't know. To say that rosacea during the teenage years is rare doesn't mean it's impossible, it just means it's rare. That it's far more common for teenagers to suffer from acne vulgaris doesn't mean every teenager suffers from acne vulgaris. And many teenagers blush/flush easily, some will outgrow the tendency, others will continue to flush easily through life but nothing more -- but, a sizable group will progress to signs/symptoms of rosacea. This is key: just because someone blushes/flushes easily does NOT mean they have rosacea or are absolutely destined to develop rosacea. Nor does it mean that everyone with rosacea has a history of easy blushing/flushing. cea is just not that straightforward. Hope that helps. How are things going with the U of Rochester referral? Marjorie Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 11, 2002 Report Share Posted April 11, 2002 Hmm, thats sorta depressing... all those bouts with Retin-A etc for my 4-5 teenage zits probably helped pass me through the normal flushing/blushing w/possibility-of-outgrowing-it stage into what I have now:( Even more unfortunately, the U of R referral went down the toilet. I called the derm department at Strong Memorial Hospital and they cant see me until late July. Also, the rather rude lady who answered the phone said I wouldn't be able to see a resident or anything, and made me feel like a retard for even asking, according to her there are 5 doctors there to see, thats it, and they're all booked until mid-summer Which brings me back to step 0. I'm wondering about calling a Naturopathic doctor and asking their take on the whole fungus/candidiasis-type thing. (I found one N.D. in the yellow pages) I asked my GP, he said he didn't know enough about the stuff to tell me one way or the other. Its REALLY depressing that over a year later, with all the hard work and determination I have put into trying to figure this out, I don't even have a diagnosis yet! And I'm tired of my dermatologist's approach of " I don't really know what condition this is, so try this steroid, take this harsh medicine, and when you have a bad reaction, give my receptionist a call and i'll make sure to get you in several months later in a prolonged attempt to undo the damage by using new steroids and other harsh medicines " Anyway I made a mistake, the passage I quoted is on page 148, I don't know how on earth I turned that into 182. I'm not sure if he was mistaking cea for Pre-cea, but if you are interested, his sources in this section are the following articles: Plewig, G. " cea: epidemiology and pathogenesis " J Cutan Med Surg 2 Suppl 4: S4-10, 1998. Donshik, P.C., " Inflammatory and papulosquamous disorders of the skin and eye " Dermatol Clin 10: 533-547, 1992. Shear, N.H. " Needs Survey of Canadian cea Patients " J Cutan Med Surg 3: 178-181, 1999. National cea Society " cea Review " Summer 1997. Drake, L. Wiemer, D.R. " Rhinophyma. " Clin Plast Surg 14: 357-365, 1987. Brinnel, H. " cea: disturbed defense against brain overheating. " Arch Dermatol Res 281: 66-72, 1989. (<-- Interesting title, I'm surprised something with this name was published in 1989!!) Klaber, R " The Pathogenesis of cea: a review with special reference to emotional factors " . Br J Dermatol Syp 51: 5011939 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 11, 2002 Report Share Posted April 11, 2002 Hmm, thats sorta depressing... all those bouts with Retin-A etc for my 4-5 teenage zits probably helped pass me through the normal flushing/blushing w/possibility-of-outgrowing-it stage into what I have now:( Even more unfortunately, the U of R referral went down the toilet. I called the derm department at Strong Memorial Hospital and they cant see me until late July. Also, the rather rude lady who answered the phone said I wouldn't be able to see a resident or anything, and made me feel like a retard for even asking, according to her there are 5 doctors there to see, thats it, and they're all booked until mid-summer Which brings me back to step 0. I'm wondering about calling a Naturopathic doctor and asking their take on the whole fungus/candidiasis-type thing. (I found one N.D. in the yellow pages) I asked my GP, he said he didn't know enough about the stuff to tell me one way or the other. Its REALLY depressing that over a year later, with all the hard work and determination I have put into trying to figure this out, I don't even have a diagnosis yet! And I'm tired of my dermatologist's approach of " I don't really know what condition this is, so try this steroid, take this harsh medicine, and when you have a bad reaction, give my receptionist a call and i'll make sure to get you in several months later in a prolonged attempt to undo the damage by using new steroids and other harsh medicines " Anyway I made a mistake, the passage I quoted is on page 148, I don't know how on earth I turned that into 182. I'm not sure if he was mistaking cea for Pre-cea, but if you are interested, his sources in this section are the following articles: Plewig, G. " cea: epidemiology and pathogenesis " J Cutan Med Surg 2 Suppl 4: S4-10, 1998. Donshik, P.C., " Inflammatory and papulosquamous disorders of the skin and eye " Dermatol Clin 10: 533-547, 1992. Shear, N.H. " Needs Survey of Canadian cea Patients " J Cutan Med Surg 3: 178-181, 1999. National cea Society " cea Review " Summer 1997. Drake, L. Wiemer, D.R. " Rhinophyma. " Clin Plast Surg 14: 357-365, 1987. Brinnel, H. " cea: disturbed defense against brain overheating. " Arch Dermatol Res 281: 66-72, 1989. (<-- Interesting title, I'm surprised something with this name was published in 1989!!) Klaber, R " The Pathogenesis of cea: a review with special reference to emotional factors " . Br J Dermatol Syp 51: 5011939 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 11, 2002 Report Share Posted April 11, 2002 Hmm, thats sorta depressing... all those bouts with Retin-A etc for my 4-5 teenage zits probably helped pass me through the normal flushing/blushing w/possibility-of-outgrowing-it stage into what I have now:( Even more unfortunately, the U of R referral went down the toilet. I called the derm department at Strong Memorial Hospital and they cant see me until late July. Also, the rather rude lady who answered the phone said I wouldn't be able to see a resident or anything, and made me feel like a retard for even asking, according to her there are 5 doctors there to see, thats it, and they're all booked until mid-summer Which brings me back to step 0. I'm wondering about calling a Naturopathic doctor and asking their take on the whole fungus/candidiasis-type thing. (I found one N.D. in the yellow pages) I asked my GP, he said he didn't know enough about the stuff to tell me one way or the other. Its REALLY depressing that over a year later, with all the hard work and determination I have put into trying to figure this out, I don't even have a diagnosis yet! And I'm tired of my dermatologist's approach of " I don't really know what condition this is, so try this steroid, take this harsh medicine, and when you have a bad reaction, give my receptionist a call and i'll make sure to get you in several months later in a prolonged attempt to undo the damage by using new steroids and other harsh medicines " Anyway I made a mistake, the passage I quoted is on page 148, I don't know how on earth I turned that into 182. I'm not sure if he was mistaking cea for Pre-cea, but if you are interested, his sources in this section are the following articles: Plewig, G. " cea: epidemiology and pathogenesis " J Cutan Med Surg 2 Suppl 4: S4-10, 1998. Donshik, P.C., " Inflammatory and papulosquamous disorders of the skin and eye " Dermatol Clin 10: 533-547, 1992. Shear, N.H. " Needs Survey of Canadian cea Patients " J Cutan Med Surg 3: 178-181, 1999. National cea Society " cea Review " Summer 1997. Drake, L. Wiemer, D.R. " Rhinophyma. " Clin Plast Surg 14: 357-365, 1987. Brinnel, H. " cea: disturbed defense against brain overheating. " Arch Dermatol Res 281: 66-72, 1989. (<-- Interesting title, I'm surprised something with this name was published in 1989!!) Klaber, R " The Pathogenesis of cea: a review with special reference to emotional factors " . Br J Dermatol Syp 51: 5011939 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 11, 2002 Report Share Posted April 11, 2002 > > > Ok, I've heard this twice now in the last day or so. What is the > difference > > between flushing/blushing predisposition + acne vulgaris vs having > cea? > > Isnt cea just the predisposition to flushing/blushing that > eventually if > > left untreated long enough will lead to other problems such as > > papules/telengiectasia/swelling etc? I don't see a difference. > The difference between flushing/blushing + acne vulgaris and rosacea is location and comededones or not. Practially, treatment wise not much difference. > There's a big difference, Adam. > > Here's how I see it: the predisposition to develop rosacea is called > pre-rosacea, which isn't a condition but only an increased > disposition to developing the condition of rosacea. That is, we can > say that if a person flushes easily, they are at increased risk for > developing rosacea in later life. But at that stage it's not > appropriate to diagnose them as rosacean. That's because rosacea is > not just easy flushing -- easy flushing is not a condition, it's > normal. Most young people who flush easily will either outgrow it, or > just flush as they always do for the rest of their lives. > > But in a sizable number of people who flush easily, the recovery from > flushing becomes prolonged, it becomes easier and easier to trigger a > flush, and in some eye problems develop even before any more obvious > skin changes...all are indications that pre-rosace is turning into > rosacea (assuming other disorders have been ruled out). No one knows > why. > > How do we treat pre-rosacea to prevent it from developing into > rosacea? There's no way I know. But rosaceans can possibly slow down > the progression of the early stages to the later, more cosmetically > disfiguring stages, with good skin care and attention to triggering > events. > Interestingly, you can treat pre-acne with topical retinoids to prevent real acne. Could differin prevent pre rosacea??? > cea is a clinical diagnosis, which means there's no test to > perform, it's all based on signs/symptoms. Classically, rosacea > manifests in one or a combination of four ways: inflammation (papules > with surrounding erythema), vascular abnormalities (prolonged > flushing, spiders), edema (physma), and ocular manifestations. > Interesting, that the ocular rosacea can occur while the skin is > still in pre-rosacea, but there's a lot that's not clear about this > condition. One of the biggest mysteries is the connection between > easy flushing and the signs/symptoms of rosacea. There are plenty of > theories, but no one theory seems to explain everything about the > condition. > > > > Dr. Nase says in his book on page 182 under the heading > MISCONCEPTION #3: > > ROSACEA DOES NOT AFFECT PEOPLE UNTIL THEY ARE IN THEIR 40's OR 50'S: > > > > " This is an extremely common misconception. Most general medical > articles > > report that rosacea is a disorder of the middle-aged. This is > Absolutely > > Wrong! It is Very common for teenagers and young adults to have > classic > > cea. This disorder Usually starts to rear its ugly head in the > late > > teens and early 20's. " > younger ages and rosacea is correlated with type I or II skin, (pale, white folk) (irish types, english types, etc.) and sun exposure, lower lattitudes, high altitudes, etc, and harsh skin products. > I can't know what Dr. Nase is referring to. What evidence does he > offer to support those statments? I can't know if he's confusing pre- > rosacea with rosacea, which is what the last sentence seems to allude > to. But I don't know. > > To say that rosacea during the teenage years is rare doesn't mean > it's impossible, it just means it's rare. That it's far more common > for teenagers to suffer from acne vulgaris doesn't mean every > teenager suffers from acne vulgaris. > > And many teenagers blush/flush easily, some will outgrow the > tendency, others will continue to flush easily through life but > nothing more -- but, a sizable group will progress to signs/symptoms > of rosacea. This is key: just because someone blushes/flushes easily > does NOT mean they have rosacea or are absolutely destined to develop > rosacea. Nor does it mean that everyone with rosacea has a history of > easy blushing/flushing. cea is just not that straightforward. > > Hope that helps. How are things going with the U of Rochester > referral? > > Marjorie > > Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 11, 2002 Report Share Posted April 11, 2002 > > > Ok, I've heard this twice now in the last day or so. What is the > difference > > between flushing/blushing predisposition + acne vulgaris vs having > cea? > > Isnt cea just the predisposition to flushing/blushing that > eventually if > > left untreated long enough will lead to other problems such as > > papules/telengiectasia/swelling etc? I don't see a difference. > The difference between flushing/blushing + acne vulgaris and rosacea is location and comededones or not. Practially, treatment wise not much difference. > There's a big difference, Adam. > > Here's how I see it: the predisposition to develop rosacea is called > pre-rosacea, which isn't a condition but only an increased > disposition to developing the condition of rosacea. That is, we can > say that if a person flushes easily, they are at increased risk for > developing rosacea in later life. But at that stage it's not > appropriate to diagnose them as rosacean. That's because rosacea is > not just easy flushing -- easy flushing is not a condition, it's > normal. Most young people who flush easily will either outgrow it, or > just flush as they always do for the rest of their lives. > > But in a sizable number of people who flush easily, the recovery from > flushing becomes prolonged, it becomes easier and easier to trigger a > flush, and in some eye problems develop even before any more obvious > skin changes...all are indications that pre-rosace is turning into > rosacea (assuming other disorders have been ruled out). No one knows > why. > > How do we treat pre-rosacea to prevent it from developing into > rosacea? There's no way I know. But rosaceans can possibly slow down > the progression of the early stages to the later, more cosmetically > disfiguring stages, with good skin care and attention to triggering > events. > Interestingly, you can treat pre-acne with topical retinoids to prevent real acne. Could differin prevent pre rosacea??? > cea is a clinical diagnosis, which means there's no test to > perform, it's all based on signs/symptoms. Classically, rosacea > manifests in one or a combination of four ways: inflammation (papules > with surrounding erythema), vascular abnormalities (prolonged > flushing, spiders), edema (physma), and ocular manifestations. > Interesting, that the ocular rosacea can occur while the skin is > still in pre-rosacea, but there's a lot that's not clear about this > condition. One of the biggest mysteries is the connection between > easy flushing and the signs/symptoms of rosacea. There are plenty of > theories, but no one theory seems to explain everything about the > condition. > > > > Dr. Nase says in his book on page 182 under the heading > MISCONCEPTION #3: > > ROSACEA DOES NOT AFFECT PEOPLE UNTIL THEY ARE IN THEIR 40's OR 50'S: > > > > " This is an extremely common misconception. Most general medical > articles > > report that rosacea is a disorder of the middle-aged. This is > Absolutely > > Wrong! It is Very common for teenagers and young adults to have > classic > > cea. This disorder Usually starts to rear its ugly head in the > late > > teens and early 20's. " > younger ages and rosacea is correlated with type I or II skin, (pale, white folk) (irish types, english types, etc.) and sun exposure, lower lattitudes, high altitudes, etc, and harsh skin products. > I can't know what Dr. Nase is referring to. What evidence does he > offer to support those statments? I can't know if he's confusing pre- > rosacea with rosacea, which is what the last sentence seems to allude > to. But I don't know. > > To say that rosacea during the teenage years is rare doesn't mean > it's impossible, it just means it's rare. That it's far more common > for teenagers to suffer from acne vulgaris doesn't mean every > teenager suffers from acne vulgaris. > > And many teenagers blush/flush easily, some will outgrow the > tendency, others will continue to flush easily through life but > nothing more -- but, a sizable group will progress to signs/symptoms > of rosacea. This is key: just because someone blushes/flushes easily > does NOT mean they have rosacea or are absolutely destined to develop > rosacea. Nor does it mean that everyone with rosacea has a history of > easy blushing/flushing. cea is just not that straightforward. > > Hope that helps. How are things going with the U of Rochester > referral? > > Marjorie > > Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
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