Re: cea and topical retinoids.

[Guest guest]

Yes, you are " the one who calls himself a doctor. " <g>

Ian, what's the reference for the article you talked about?

Marjorie

Marjorie Lazoff, MD

>

> Hi group.

> This is the first time i post but i have had private contact with

> some of you,Hello Dr Majorie, she knows me as the one who calls

> himself a doctor.

> My name is Ian and i am acctually a Doctor in medicine, i am

willing

> to help as much as i can so feel free to ask and i will get back to

> you as soon as possible,

> I will like to say something about Matijas articule because it

seems

> ironic but is a matter of fact, is well known that retinoic acid is

> not a good choice for people with sensitive skin, Not many years

ago

> if a Dr was thinking in retinoic acid as a choice for rosacea the

> medical comunity would of think of a joke or maybe a mistake

because

> the rosacea is by some considered as some type of acne or adult

acne

> other investigations say that they look alike and sometimes

coesxist

> but they are totally diferent diseases if you think about it who is

> who to decide or determine if nobody knows the cause of rosacea, i

> believe that is multifactorial begining like all diseases with a

> genetic charge, in a personal point of view i think there might be

> even diferent causes or types of rosacea and maybe that is why some

> people responds well to some drugs and others not respond or

respond

> in a paradoxicall or oposite way, and theories there is the

> neurovascular, the demodex mites, the altered temperture regulation

> by the hypotalamus,The H pylori as the responsable, the gluten an

> inmune mediated etc at least we have ideas, although sometimes it

> feels like we are confused and choosing a dark, wrong direccion in

> the plans of investigation because although i am not American there

> are some 13 millions of rosaceans only in United States even the

> expresident has rosacea plus 2 million of Canadians, Australians

and

> many in Europe and nobody knows what is going on many times i feel

> frustrated when i read a Book or an articule wich comfirms that

> rosacea is perfectly controled with Metrogel, Dont get me wrong

there

> are doctors that have being of great help like Dr Nase sadly he

have

> to had it to understand the impact of rosacea.

> Sorry i am loosing the purpose of these post, in recient

> investigations retinoic acid at 0.5% or tretinoin at 0.025 at

bedtime

> combined with the anibiotic clindamicine in the morning has being a

> what i call crazy good choice, why crazy because retinoids are well

> known as pro angiogenics, vasodilators and irritants all that is a

no

> no for rosaceans the irony is that after 6 months of clinical

trials

> and at diferent concentrations retinoic acid improved the

> papulopustular component of rosacea but it had a better impact in

> decreasing the redness, and the telangiectasia, inflamation in

> general and also improved rosacea with post-inflamatory lessions or

> pigmented areas also caused by solar damaged this is because

> retinoids interfiere with the melanosomes that carry melanocites to

> the dermis and epidermis, In a personal experience i had being

using

> isotretinoin the same substance as accutane but in a cream base

wich

> is less irritating than tretinoin and sometimes i like to combine

it

> with topical ketoconazol or an antibiotic like clindamicine or

> erytromicine results are good but again in my personal experience.

> With rosacea we never know what to expect lets play by it rules

lets

> try unexpectable treatments with unexpectable results lets stop and

> think why continue with something that is not working, i learned

that

> living with this condition makes you choose between becoming a

victim

> of some kind of bad karma or become wisely crazy meaning to be able

> to laugh at yourself just to reduce the pain and the stress

accepting

> the fact that there is a problem like many others in life that took

> you to modify your expectations but never the meaning that you gave

> to your life once, i guess that if i dont take it crazy i will be

> the one ending up crazy, i am not saying it shouldnt be taken

> seriously and with smart, secure treatments i have heard of rosacea

> being treated with zofran wich i dont understand besides the price

> the drug blocks serotonin and serotonin is a vasoregulator many

times

> responsable for depression and migrain headaches wich is basically

a

> cycle of vasodilation and vasoconstriccion also asociated with

> rosacea.

> I want to tell you all that we share and understand the same pain

> that maybe we dont know how are we going to feel some day but for

> shure there are things that are going to make us feel better, i say

> lets keep the eyes shining, we are part of the world and things

> sometimes are harder for us,sometimes we are judged by people of

> complaining, of being wrong,victims, how many times i end up

lifting

> shadows of broken dreams, insecure of what i am doing, not sleeping

> wondering if my life has sense, but i am shure we are not cowards,

we

> fight, we are warriors sometimes defeated,sad,hopeless all of that

> are part of all fighter but we still believe, we look for a meaning

> and search for the cause because we ask and some day we will know.

> Take care, sorry but english is not my language hope you understand.

> Dr Ian Alarcon.

[Guest guest]

Yes, you are " the one who calls himself a doctor. " <g>

Ian, what's the reference for the article you talked about?

Marjorie

Marjorie Lazoff, MD

>

> Hi group.

> This is the first time i post but i have had private contact with

> some of you,Hello Dr Majorie, she knows me as the one who calls

> himself a doctor.

> My name is Ian and i am acctually a Doctor in medicine, i am

willing

> to help as much as i can so feel free to ask and i will get back to

> you as soon as possible,

> I will like to say something about Matijas articule because it

seems

> ironic but is a matter of fact, is well known that retinoic acid is

> not a good choice for people with sensitive skin, Not many years

ago

> if a Dr was thinking in retinoic acid as a choice for rosacea the

> medical comunity would of think of a joke or maybe a mistake

because

> the rosacea is by some considered as some type of acne or adult

acne

> other investigations say that they look alike and sometimes

coesxist

> but they are totally diferent diseases if you think about it who is

> who to decide or determine if nobody knows the cause of rosacea, i

> believe that is multifactorial begining like all diseases with a

> genetic charge, in a personal point of view i think there might be

> even diferent causes or types of rosacea and maybe that is why some

> people responds well to some drugs and others not respond or

respond

> in a paradoxicall or oposite way, and theories there is the

> neurovascular, the demodex mites, the altered temperture regulation

> by the hypotalamus,The H pylori as the responsable, the gluten an

> inmune mediated etc at least we have ideas, although sometimes it

> feels like we are confused and choosing a dark, wrong direccion in

> the plans of investigation because although i am not American there

> are some 13 millions of rosaceans only in United States even the

> expresident has rosacea plus 2 million of Canadians, Australians

and

> many in Europe and nobody knows what is going on many times i feel

> frustrated when i read a Book or an articule wich comfirms that

> rosacea is perfectly controled with Metrogel, Dont get me wrong

there

> are doctors that have being of great help like Dr Nase sadly he

have

> to had it to understand the impact of rosacea.

> Sorry i am loosing the purpose of these post, in recient

> investigations retinoic acid at 0.5% or tretinoin at 0.025 at

bedtime

> combined with the anibiotic clindamicine in the morning has being a

> what i call crazy good choice, why crazy because retinoids are well

> known as pro angiogenics, vasodilators and irritants all that is a

no

> no for rosaceans the irony is that after 6 months of clinical

trials

> and at diferent concentrations retinoic acid improved the

> papulopustular component of rosacea but it had a better impact in

> decreasing the redness, and the telangiectasia, inflamation in

> general and also improved rosacea with post-inflamatory lessions or

> pigmented areas also caused by solar damaged this is because

> retinoids interfiere with the melanosomes that carry melanocites to

> the dermis and epidermis, In a personal experience i had being

using

> isotretinoin the same substance as accutane but in a cream base

wich

> is less irritating than tretinoin and sometimes i like to combine

it

> with topical ketoconazol or an antibiotic like clindamicine or

> erytromicine results are good but again in my personal experience.

> With rosacea we never know what to expect lets play by it rules

lets

> try unexpectable treatments with unexpectable results lets stop and

> think why continue with something that is not working, i learned

that

> living with this condition makes you choose between becoming a

victim

> of some kind of bad karma or become wisely crazy meaning to be able

> to laugh at yourself just to reduce the pain and the stress

accepting

> the fact that there is a problem like many others in life that took

> you to modify your expectations but never the meaning that you gave

> to your life once, i guess that if i dont take it crazy i will be

> the one ending up crazy, i am not saying it shouldnt be taken

> seriously and with smart, secure treatments i have heard of rosacea

> being treated with zofran wich i dont understand besides the price

> the drug blocks serotonin and serotonin is a vasoregulator many

times

> responsable for depression and migrain headaches wich is basically

a

> cycle of vasodilation and vasoconstriccion also asociated with

> rosacea.

> I want to tell you all that we share and understand the same pain

> that maybe we dont know how are we going to feel some day but for

> shure there are things that are going to make us feel better, i say

> lets keep the eyes shining, we are part of the world and things

> sometimes are harder for us,sometimes we are judged by people of

> complaining, of being wrong,victims, how many times i end up

lifting

> shadows of broken dreams, insecure of what i am doing, not sleeping

> wondering if my life has sense, but i am shure we are not cowards,

we

> fight, we are warriors sometimes defeated,sad,hopeless all of that

> are part of all fighter but we still believe, we look for a meaning

> and search for the cause because we ask and some day we will know.

> Take care, sorry but english is not my language hope you understand.

> Dr Ian Alarcon.

[Guest guest]

This might be the one he is taking about (see summary below). there

are obvious design flaws in the study (unblinded, no mention of

placebo control etc), but hope springs eternal. Retinaldehyde is a

form of vit a between retinol and retinoic acid (tretinoin). It

apparantly has no irritant qualities because it converts only as

needed in the deeper layers of skin to the active form which

supposedly then imparts the well known anti-aging collegen boosting

effects of retin-a/ renova/ tretinoin.

there is also a study relating to retinaldehyde use in leiu of renova

post-laser resurfacing due to lack of irritation and reduced redness.

------ abstract 1, retinaldehyde and rosacea -------------------

A topical preparation of retinaldehyde (a prescription form of

vitamin A) may be effective in mild rosacea (an inflammatory form of

acne). In an un-blinded trial, women with rosacea used a

retinaldehyde cream (0.05%) once daily for 6 months. 7 Inflammation

was improved in approximately 75% of participants after 5 months.

Blood vessel abnormalities responded in 46% of cases after 6 months,

but the improvement did not reach statistical significance, due to

the small size of the study. Retinaldehyde cream is available by

prescription only and should be used only under the supervision of a

doctor.

Vienne MP, Ochando N, Borrel MT, et al. Retinaldehyde alleviates

rosacea. Dermatology 1999;199 Suppl 1:53–6.

-------------abstract 2, retinaldehyde post-laser resurfacing ---

OP122. Treatment before and after laser skin resurfacing: comparison

of retinaldehyde and retinoic acid

E. M. Sachsenberg-Studer, MD (1) - V. Mengeaud, MD (2) - P. Dupuy, MD

(2) - R. Kaufmann, MD (1)

(1) J.-W. Goethe University, furt, Germany; (2) Pierre Fabre

Research Institute, Toulouse, France

Toulouse - France

Background: For the treatment before and after Laser Skin

Resurfacing, retinoic acid, the active metabolite of vitamin A, is

worldwide the primary used agent. However, many patients do not

support this treatment because of cutaneous irritation, and some

authors suggest that pre-and post-treatment with retinoic acid

contributes to the prolonged erythema after laser treatment which

often persists for months.1. Retinaldehyde, a direct precursor of

retinoic acid, has been proven to be less irritating than retinoic

acid and to have similar biological activities.2

Objective: We performed a monocentric, comparative, randomized,

double-blind, intra-individual (left/right) study to compare the

efficacy and tolerance of retinaldehyde and retinoic acid in pre- and

post-laser skin resurfacing treatment.

Methods: 9 patients were recruted undergoing laser skin resurfacing

for bilateral acne scars. They were prepared by using retinaldehyde

and retinoic acid on randomly assigned hemiface for 2 weeks before

laser. Skin resurfacing was done with Erb:YAG laser (wavelenght 2940

nm, pulselengh 350us) with an energy of 5 J/cm². One (6 patients)

respectively 3 weeks (3 patients) after laser, patients reapplied the

2 retinoids on the same hemifacial sites as before during 3

respectively 5 weeks. Evaluation of local tolerance (erythema,

scaling, pruritus, burning) and chromametry assessment were done once

a week in the pre- and post-treatment phase. Biopsies of the pre-

auricular area were performed at the beginning and end of the study.

Actually, they are being evaluated for epidermal thickness and

differentiation as well as for quality and quantity of dermal

collagene formation.

Results: Post-laser treatment could be started already one week after

laser treatment. Clinical evaluation and chromametry assessment

yielded a higher incidence of erythema, scaling, pruritus and burning

as well as a prolonged erythema after laser skin resurfacing under a

treatment of retinoic acid compared to retinaldehyde. The difference

of erythema intensity between both hemifaces at the end of the study

was statistically at the inferior limit of significancy (p=0.0940).

All patients except 1 prefered a treatment with retinaldehyde to

retinoic acid because of its better cutaneous tolerance. Evaluations

of the biopsies are actually being performed.

Conclusion: A pre-and post-laser treatment with retinaldehyde is

clinically better tolerated than with retinoic acid and contributes

to a more rapid decline of post laser erythema. Its influence on

wound healing compared to retinoic acid, is actually being evaluated.

References:

1. Ruiz-Esparza J, Gomez JMB, Dela Torre OLG, L. Erythema after

laser Skin resurfacing. Dermatol Surg 1998;24:31-4.

2. Saurat J-H, Didierjean L, Masgrau E, Piletta PA, Jaconi S,

Châtellard-Gruaz D, Gumowski-Sunek D, Masouyé I, Salomon D,

Siegenthaler G. Topical retinaldehyde on human skin: Biologic effects

and tolerance. J Invest Dermatol 1994;103:770-4.

patrick.dupuy@...

-----------------------

> >

> > Hi group.

> > This is the first time i post but i have had private contact with

> > some of you,Hello Dr Majorie, she knows me as the one who calls

> > himself a doctor.

> > My name is Ian and i am acctually a Doctor in medicine, i am

> willing

> > to help as much as i can so feel free to ask and i will get back

to

> > you as soon as possible,

> > I will like to say something about Matijas articule because it

> seems

> > ironic but is a matter of fact, is well known that retinoic acid

is

> > not a good choice for people with sensitive skin, Not many years

> ago

> > if a Dr was thinking in retinoic acid as a choice for rosacea the

> > medical comunity would of think of a joke or maybe a mistake

> because

> > the rosacea is by some considered as some type of acne or adult

> acne

> > other investigations say that they look alike and sometimes

> coesxist

> > but they are totally diferent diseases if you think about it who

is

> > who to decide or determine if nobody knows the cause of rosacea,

i

> > believe that is multifactorial begining like all diseases with a

> > genetic charge, in a personal point of view i think there might

be

> > even diferent causes or types of rosacea and maybe that is why

some

> > people responds well to some drugs and others not respond or

> respond

> > in a paradoxicall or oposite way, and theories there is the

> > neurovascular, the demodex mites, the altered temperture

regulation

> > by the hypotalamus,The H pylori as the responsable, the gluten an

> > inmune mediated etc at least we have ideas, although sometimes it

> > feels like we are confused and choosing a dark, wrong direccion

in

> > the plans of investigation because although i am not American

there

> > are some 13 millions of rosaceans only in United States even the

> > expresident has rosacea plus 2 million of Canadians, Australians

> and

> > many in Europe and nobody knows what is going on many times i

feel

> > frustrated when i read a Book or an articule wich comfirms that

> > rosacea is perfectly controled with Metrogel, Dont get me wrong

> there

> > are doctors that have being of great help like Dr Nase sadly he

> have

> > to had it to understand the impact of rosacea.

> > Sorry i am loosing the purpose of these post, in recient

> > investigations retinoic acid at 0.5% or tretinoin at 0.025 at

> bedtime

> > combined with the anibiotic clindamicine in the morning has being

a

> > what i call crazy good choice, why crazy because retinoids are

well

> > known as pro angiogenics, vasodilators and irritants all that is

a

> no

> > no for rosaceans the irony is that after 6 months of clinical

> trials

> > and at diferent concentrations retinoic acid improved the

> > papulopustular component of rosacea but it had a better impact in

> > decreasing the redness, and the telangiectasia, inflamation in

> > general and also improved rosacea with post-inflamatory lessions

or

> > pigmented areas also caused by solar damaged this is because

> > retinoids interfiere with the melanosomes that carry melanocites

to

> > the dermis and epidermis, In a personal experience i had being

> using

> > isotretinoin the same substance as accutane but in a cream base

> wich

> > is less irritating than tretinoin and sometimes i like to combine

> it

> > with topical ketoconazol or an antibiotic like clindamicine or

> > erytromicine results are good but again in my personal experience.

> > With rosacea we never know what to expect lets play by it rules

> lets

> > try unexpectable treatments with unexpectable results lets stop

and

> > think why continue with something that is not working, i learned

> that

> > living with this condition makes you choose between becoming a

> victim

> > of some kind of bad karma or become wisely crazy meaning to be

able

> > to laugh at yourself just to reduce the pain and the stress

> accepting

> > the fact that there is a problem like many others in life that

took

> > you to modify your expectations but never the meaning that you

gave

> > to your life once, i guess that if i dont take it crazy i will

be

> > the one ending up crazy, i am not saying it shouldnt be taken

> > seriously and with smart, secure treatments i have heard of

rosacea

> > being treated with zofran wich i dont understand besides the

price

> > the drug blocks serotonin and serotonin is a vasoregulator many

> times

> > responsable for depression and migrain headaches wich is

basically

> a

> > cycle of vasodilation and vasoconstriccion also asociated with

> > rosacea.

> > I want to tell you all that we share and understand the same pain

> > that maybe we dont know how are we going to feel some day but for

> > shure there are things that are going to make us feel better, i

say

> > lets keep the eyes shining, we are part of the world and things

> > sometimes are harder for us,sometimes we are judged by people of

> > complaining, of being wrong,victims, how many times i end up

> lifting

> > shadows of broken dreams, insecure of what i am doing, not

sleeping

> > wondering if my life has sense, but i am shure we are not

cowards,

> we

> > fight, we are warriors sometimes defeated,sad,hopeless all of

that

> > are part of all fighter but we still believe, we look for a

meaning

> > and search for the cause because we ask and some day we will know.

> > Take care, sorry but english is not my language hope you

understand.

> > Dr Ian Alarcon.

[Guest guest]

This might be the one he is taking about (see summary below). there

are obvious design flaws in the study (unblinded, no mention of

placebo control etc), but hope springs eternal. Retinaldehyde is a

form of vit a between retinol and retinoic acid (tretinoin). It

apparantly has no irritant qualities because it converts only as

needed in the deeper layers of skin to the active form which

supposedly then imparts the well known anti-aging collegen boosting

effects of retin-a/ renova/ tretinoin.

there is also a study relating to retinaldehyde use in leiu of renova

post-laser resurfacing due to lack of irritation and reduced redness.

------ abstract 1, retinaldehyde and rosacea -------------------

A topical preparation of retinaldehyde (a prescription form of

vitamin A) may be effective in mild rosacea (an inflammatory form of

acne). In an un-blinded trial, women with rosacea used a

retinaldehyde cream (0.05%) once daily for 6 months. 7 Inflammation

was improved in approximately 75% of participants after 5 months.

Blood vessel abnormalities responded in 46% of cases after 6 months,

but the improvement did not reach statistical significance, due to

the small size of the study. Retinaldehyde cream is available by

prescription only and should be used only under the supervision of a

doctor.

Vienne MP, Ochando N, Borrel MT, et al. Retinaldehyde alleviates

rosacea. Dermatology 1999;199 Suppl 1:53–6.

-------------abstract 2, retinaldehyde post-laser resurfacing ---

OP122. Treatment before and after laser skin resurfacing: comparison

of retinaldehyde and retinoic acid

E. M. Sachsenberg-Studer, MD (1) - V. Mengeaud, MD (2) - P. Dupuy, MD

(2) - R. Kaufmann, MD (1)

(1) J.-W. Goethe University, furt, Germany; (2) Pierre Fabre

Research Institute, Toulouse, France

Toulouse - France

Background: For the treatment before and after Laser Skin

Resurfacing, retinoic acid, the active metabolite of vitamin A, is

worldwide the primary used agent. However, many patients do not

support this treatment because of cutaneous irritation, and some

authors suggest that pre-and post-treatment with retinoic acid

contributes to the prolonged erythema after laser treatment which

often persists for months.1. Retinaldehyde, a direct precursor of

retinoic acid, has been proven to be less irritating than retinoic

acid and to have similar biological activities.2

Objective: We performed a monocentric, comparative, randomized,

double-blind, intra-individual (left/right) study to compare the

efficacy and tolerance of retinaldehyde and retinoic acid in pre- and

post-laser skin resurfacing treatment.

Methods: 9 patients were recruted undergoing laser skin resurfacing

for bilateral acne scars. They were prepared by using retinaldehyde

and retinoic acid on randomly assigned hemiface for 2 weeks before

laser. Skin resurfacing was done with Erb:YAG laser (wavelenght 2940

nm, pulselengh 350us) with an energy of 5 J/cm². One (6 patients)

respectively 3 weeks (3 patients) after laser, patients reapplied the

2 retinoids on the same hemifacial sites as before during 3

respectively 5 weeks. Evaluation of local tolerance (erythema,

scaling, pruritus, burning) and chromametry assessment were done once

a week in the pre- and post-treatment phase. Biopsies of the pre-

auricular area were performed at the beginning and end of the study.

Actually, they are being evaluated for epidermal thickness and

differentiation as well as for quality and quantity of dermal

collagene formation.

Results: Post-laser treatment could be started already one week after

laser treatment. Clinical evaluation and chromametry assessment

yielded a higher incidence of erythema, scaling, pruritus and burning

as well as a prolonged erythema after laser skin resurfacing under a

treatment of retinoic acid compared to retinaldehyde. The difference

of erythema intensity between both hemifaces at the end of the study

was statistically at the inferior limit of significancy (p=0.0940).

All patients except 1 prefered a treatment with retinaldehyde to

retinoic acid because of its better cutaneous tolerance. Evaluations

of the biopsies are actually being performed.

Conclusion: A pre-and post-laser treatment with retinaldehyde is

clinically better tolerated than with retinoic acid and contributes

to a more rapid decline of post laser erythema. Its influence on

wound healing compared to retinoic acid, is actually being evaluated.

References:

1. Ruiz-Esparza J, Gomez JMB, Dela Torre OLG, L. Erythema after

laser Skin resurfacing. Dermatol Surg 1998;24:31-4.

2. Saurat J-H, Didierjean L, Masgrau E, Piletta PA, Jaconi S,

Châtellard-Gruaz D, Gumowski-Sunek D, Masouyé I, Salomon D,

Siegenthaler G. Topical retinaldehyde on human skin: Biologic effects

and tolerance. J Invest Dermatol 1994;103:770-4.

patrick.dupuy@...

-----------------------

> >

> > Hi group.

> > This is the first time i post but i have had private contact with

> > some of you,Hello Dr Majorie, she knows me as the one who calls

> > himself a doctor.

> > My name is Ian and i am acctually a Doctor in medicine, i am

> willing

> > to help as much as i can so feel free to ask and i will get back

to

> > you as soon as possible,

> > I will like to say something about Matijas articule because it

> seems

> > ironic but is a matter of fact, is well known that retinoic acid

is

> > not a good choice for people with sensitive skin, Not many years

> ago

> > if a Dr was thinking in retinoic acid as a choice for rosacea the

> > medical comunity would of think of a joke or maybe a mistake

> because

> > the rosacea is by some considered as some type of acne or adult

> acne

> > other investigations say that they look alike and sometimes

> coesxist

> > but they are totally diferent diseases if you think about it who

is

> > who to decide or determine if nobody knows the cause of rosacea,

i

> > believe that is multifactorial begining like all diseases with a

> > genetic charge, in a personal point of view i think there might

be

> > even diferent causes or types of rosacea and maybe that is why

some

> > people responds well to some drugs and others not respond or

> respond

> > in a paradoxicall or oposite way, and theories there is the

> > neurovascular, the demodex mites, the altered temperture

regulation

> > by the hypotalamus,The H pylori as the responsable, the gluten an

> > inmune mediated etc at least we have ideas, although sometimes it

> > feels like we are confused and choosing a dark, wrong direccion

in

> > the plans of investigation because although i am not American

there

> > are some 13 millions of rosaceans only in United States even the

> > expresident has rosacea plus 2 million of Canadians, Australians

> and

> > many in Europe and nobody knows what is going on many times i

feel

> > frustrated when i read a Book or an articule wich comfirms that

> > rosacea is perfectly controled with Metrogel, Dont get me wrong

> there

> > are doctors that have being of great help like Dr Nase sadly he

> have

> > to had it to understand the impact of rosacea.

> > Sorry i am loosing the purpose of these post, in recient

> > investigations retinoic acid at 0.5% or tretinoin at 0.025 at

> bedtime

> > combined with the anibiotic clindamicine in the morning has being

a

> > what i call crazy good choice, why crazy because retinoids are

well

> > known as pro angiogenics, vasodilators and irritants all that is

a

> no

> > no for rosaceans the irony is that after 6 months of clinical

> trials

> > and at diferent concentrations retinoic acid improved the

> > papulopustular component of rosacea but it had a better impact in

> > decreasing the redness, and the telangiectasia, inflamation in

> > general and also improved rosacea with post-inflamatory lessions

or

> > pigmented areas also caused by solar damaged this is because

> > retinoids interfiere with the melanosomes that carry melanocites

to

> > the dermis and epidermis, In a personal experience i had being

> using

> > isotretinoin the same substance as accutane but in a cream base

> wich

> > is less irritating than tretinoin and sometimes i like to combine

> it

> > with topical ketoconazol or an antibiotic like clindamicine or

> > erytromicine results are good but again in my personal experience.

> > With rosacea we never know what to expect lets play by it rules

> lets

> > try unexpectable treatments with unexpectable results lets stop

and

> > think why continue with something that is not working, i learned

> that

> > living with this condition makes you choose between becoming a

> victim

> > of some kind of bad karma or become wisely crazy meaning to be

able

> > to laugh at yourself just to reduce the pain and the stress

> accepting

> > the fact that there is a problem like many others in life that

took

> > you to modify your expectations but never the meaning that you

gave

> > to your life once, i guess that if i dont take it crazy i will

be

> > the one ending up crazy, i am not saying it shouldnt be taken

> > seriously and with smart, secure treatments i have heard of

rosacea

> > being treated with zofran wich i dont understand besides the

price

> > the drug blocks serotonin and serotonin is a vasoregulator many

> times

> > responsable for depression and migrain headaches wich is

basically

> a

> > cycle of vasodilation and vasoconstriccion also asociated with

> > rosacea.

> > I want to tell you all that we share and understand the same pain

> > that maybe we dont know how are we going to feel some day but for

> > shure there are things that are going to make us feel better, i

say

> > lets keep the eyes shining, we are part of the world and things

> > sometimes are harder for us,sometimes we are judged by people of

> > complaining, of being wrong,victims, how many times i end up

> lifting

> > shadows of broken dreams, insecure of what i am doing, not

sleeping

> > wondering if my life has sense, but i am shure we are not

cowards,

> we

> > fight, we are warriors sometimes defeated,sad,hopeless all of

that

> > are part of all fighter but we still believe, we look for a

meaning

> > and search for the cause because we ask and some day we will know.

> > Take care, sorry but english is not my language hope you

understand.

> > Dr Ian Alarcon.