THE ROSACEA -ACNE CONNECTION

The picture of rosacea can never be complete without undersdtanding the connection between acne and rosacea. The two conditions can occur together or separately.

Adult Acne co-exists with Rosacea in approximately 82% of sufferers. Adult acne, sometimes referred to as "Acne Rosacea", involves the presence of acne pimples. Acne rosacea is definitely food-related and stress-related. Stress and fatigue cause increased production of hormones by the adrenal gland with increased levels of androgens. These hormones worsens acne. And in women adult acne usually gets worse a week before the menstrual period as the natural estrogen in the body is reduced and as the estrogen increases during the menses; the menstrual period ends as the estrogen reaches the normal level. Acne rosacea often evolves from an irritated acne skin that has been abused with aggressive prolonged acne treatment. Acne rosacea usually develops in the 30's to 40's and the treatment is more delicate as often what improves the acne further stresses the rosacea. Please note that acne pimples with pus resulting from bacteria are 'not' rosacea papules which do not have pus but a raised "red" lesion that usually does not change in any way for weeks or months.

Many of the acne treatments and anti-wrinkle products that have been used in the past have lead to rosacea and seborrheic dermatitis while the acne continues to be a problem. And likewise, the range of rosacea treatments have often resulted in little rosacea improvement and may even cause more symptoms thus dermatologist state that "rosacea is a chronic progressive skin disease". Most dermatologists have been baffled by rosacea and its treatment, and call rosacea an "enigma". Others state the treatment of rosacea is one of the least understood skin diseases. As the traditional treatments fail, alternative therapies have gained respect in the treatment of rosacea of which 82% of rosacea patients also have acne, and 35% have seborrheic dermatitis which makes for a delicate skin treatment condition when a person has two skin disorders, and even more so when a person has rosacea, seborrheic dermatitis, and acne. Treatment can also be achieved naturally without using harsh chemicals.

The Signs And Symptoms of Ocular Rosacea

To understand the overall picture of rosacea, one must consider the ocular aspect of rosacea and it's impact on the rosacea sufferer.

Ocular Rosacea is an inflammatory eye condition often associated with acne rosacea. Ocular rosacea can cause a persistent burning or gritty feeling in the eyes. For others, ocular rosacea manifests itself as inflamed and swollen eyelids with small inflamed bumps, eyelashes that may fall out, compounded by bloodshot eyes (Dr. Thiboutot). The ophthalmic signs of ocular rosacea can vary widely, including blepharitis, conjunctivitis, iritis, iridocyclitis, hypopyoniritis, and even keratitis. (These conditions will be described in detail below.) The term ophthalmic or ocular rosacea covers all these signs. The most frequent signs, which may never progress to a more severe condition, are chronically inflamed margins of the eyelids with scales and crusts, quite similar to seborrheic dermatitis, with which ocular rosacea is often confused. Pain and photophobia (abnormal sensitivity to light) may be present. The ocular complications are independent of the severity of facial rosacea (Drs. Gerd Plewig & Albert M. Kligman).

It is reported that 50 to 60% of all rosacea sufferers also have some sort of symptoms with their eyes which is known as ocular rosacea. In one study (Starr, McDonald 1969) it was found that ocular rosacea symptoms occurred in 58% of patients.

Sometimes (perhaps 20% of the time) ocular rosacea problems occur prior to the typical skin related rosacea symptoms though it is more usual (about 53% of the time) for the skin symptoms to appear first. (Borrie, 1953).

Ocular rosacea patients generally have chronically "bloodshot" eyes, dry eyes, and blepharitis (inflammation and debris of the eyelid margins). In severe ocular rosacea, there may be corneal ulceration (infection) which, if untreated, may even lead to perforation of the eye. This can be a potentially blinding complication.

The Acidic/Alkaline Picture of Rosacea

Rosacea partially results from an overly acidic body and skin. The pH scale (potential of hydrogen) ranges from 0 to 14 with 7 being neutral. As you rethink your past rosacea history, you will see that ‘all’ the rosacea triggers come from ‘acidic items’ regardless of whether they are foods, drinks, stress, out of breath due to not enough oxygen (alkaline) and not able to exhaust enough carbon dioxide (acidic). If we hold our breath for 30 seconds or 60 seconds, we will all notice that our face turns pink or red. The cause is a build up of carbon dioxide which is an ‘acidic’ gas and we have a shortage of oxygen. Very similarly, when we exercise for a short period, we have a build up of ‘lactic acid’ which is a body waste which is obviously acidic.

Those with rosacea need to be very concerned about the build up of acids in our blood stream due to the foods and beverages that we consume. We all know of our triggers such as alcohol, coffee, pizza, candy/cookies, various medications, etc. which all have a pH below 7.0 or is termed acidic. Our objective therefore should be to balance, buffer or neutralize the acids with alkaline.

Water is alkaline with a pH of about 7.3, and likewise more alkaline foods such as more “fresh vegetables and fruits are needed which are alkaline (higher pH than 7.0). Acidic foods and drinks are the problem with a pH of below 7.0 such as coffee at 2.2 and beer averaging 2.0 to 2.5, wines at 3.0, whiskeys/gin/vodka at 4.0 (2 ounces mixed with six ounces of water at 7.3 averages about 6.5 pH or so which is a good drink. The opposite is true when mixed with coke as Soft Drinks have a pH of about 2-2.5 pH. So try hard to minimize the above drinks and delete them entirely if possible while increasing your alkaline foods.

Selecting the best foods to add pH (primarily fruits and vegetables) by the use of greens to your Rosacea Flushing Bank Account to prevent overdraw or going into red or flushing. To improve your total body and skin condition, eat and drink 90% of the alkaline foods with 10% meats while avoiding breads, pastas, sugars, desserts, etc.

This acidic/alkaline scale is logarithmic; meaning that each number is ten times stronger than the preceding number. For example, a pH of 2 is ten times more acidic than a pH of 3 and one hundred times more acidic than a pH of 4. So you will now be able to more easily understand why a rosacea sufferer needs to minimize the acidic foods and drinks as it takes so many more alkaline foods and drinks to compensate.

The body has several different ways to ensure that the pH balance stays in the normal range of 7.35 to 7.45. These are referred to as buffer systems. Through normal day to day activity in the body, acids are formed as waste products that need to be neutralized, alkalized, or buffered and eliminated. Some of the acids are released with CO2 from exhaling; others are excreted via the kidneys. With acidic foods and drinks, there is always more carbon dioxide (acidic) while alkaline foods produce much more oxygen (think of your high school classes of the tree, grass, and plants giving off oxygen). These systems work together in the healthy human body to keep the pH level within normal ranges.

Sometimes with extreme intake of acidic foods and drinks, the normal system can not compensate and the body becomes even more stressed resulting in more stress hormones which are also acidic in nature causing more of a blush/flush. Likewise, simple illnesses such as influenza, minor surgery, or emotional and mental stress continue to lower the pH of the body and with more resulting skin blushing and flushing. Almost all medications are acidic except anti-acid medications such as Zantac, Milk of Magnesium, etc.

You can make sure that your water and many foods are alkaline by purchasing pH paper to measure the pH of the water, drink or foods. Your urine should be in the 6.6, 6.8, and up to a 7.0 pH range most often as the culmination of the body process. As you can imagine if you drink and eat many acidic foods, the result will be deterioration of the skin, body organs & bones.

The adrenal cortex secretes cortisol, a natural body hormone of about 10 mg of cortisol daily, with peak cortisol levels occurring early in the morning and therefore the rosacea flushing and rosacea papules along with seborrheic dermatitis face will look best in early mornings after this natural anti-inflammatory drug. The hormone that will report back to the original brain centers together with other body organs to tell it to stop the whole cycle. But since cortisol is a potent hormone, the prolonged secretion of it will lead to health problems such as the break down of cardiovascular system, digestive system, musculoskeletal system with resulting osteoporosis and arthritis - rheumatism, and the immune system. "Rosacea is more than a red face."

Also, when any organism, system or body does not have a chance for recovery, it will lead to both catecholamine and cortisol depletion. The entire concept is "not to keep" the body in a 'fight or flight' system with stress, stimulation, or the use of 'acidic' food/drinks which you will learn more about on the page entitled "Flushing: Types, Patterns & Systems". The pH of foods, drinks and stress hormones affects "rosacea, the entire body and brain of the rosacea sufferer" and sometimes affects the family and co-workers and there ability to function proficiently.

A Clearer Picture of "Before and After" Treatment Photos

If you’ve ever removed red eye from a digital photo, you know how much fun imaging software can be. With
practice – and the help of a program such as Photoshop – you can even take your ex-boyfriend right out of the picture. Which has to make one wonder: are before-and-after
photos the real deal?
Toronto-based plastic surgeon Dr. Mitchell Brown explains that it’s not difficult to manipulate pictures digitally. While conducting research on the variables affecting nipple symmetry, he said he took one photo of a breast. “Using my imaging software, I was able to come up with almost 40 realistic variations by changing the size, shape, colour and placement.”
There are several ways to protect the integrity of an image – such as embedding a digital watermark, storing the image with WORM (Write Once Read Many) software, or incorporating an icon attesting to its authenticity. Even with these deterrents, it’s easy to alter a photo. For this reason, Brown says such organizations as the American Society of Aesthetic Plastic Surgery (ASAPS) expects its members to adhere to a code of ethics. In other words, not to alter before-and-after photos.
Dr. Michael Kreidstein, another Toronto-area plastic surgeon, says that The College of Physicians & Surgeons of Ontario doesn’t support the use of before-and-after photos in advertising. “Photos are so powerful, we respond without thinking,” he says. “Ideally, an ad should carry the disclaimer: “This is an example of the surgeon’s work, but it is not necessarily representative.”
Often, a problem with photos is the surgeon’s failure to disclose all the procedures a patient has had. “A practitioner might be illustrating how well a particular cream works, but deliberately leave out the fact that the patient has also had a facelift,” says Kreidstein. “Marks, wrinkles, lines and blemishes can easily be removed by imaging software too.”
Lighting can also affect pictures. “In a before photo of acne, pockmarks can be accentuated by lighting the patient from above,” he says. “Then, by changing the light source to the front in the after photo, results will look more impressive because the shadows are less defined.”
Brown says that “photographing the body at a 45° angle provides the most flattering perspective, but not necessarily the most accurate one.” To get a good idea of the surgery results, you should be looking at photos taken from more than one angle – so you can see all sides of the patient.
Clothing plays another major factor. “The way clothing is arranged can also give the illusion of a better result,” adds Brown. “With an abdominoplasty or liposuction, undergarments should be in the same position, not pulled up or down to exaggerate the result.”
Of course, what doctor wouldn’t want to choose the most dramatic images to portray his work? According to Kreidstein, photo selection bias is more common than photo manipulation. “Seeing a few pictures of really good results can be comforting to patients, but they must consider whether or not they’re only looking at the best results.” Brown agrees, “It’s only human nature to want to show your best work, but what I try and do is to show the typical results that I get nine times out of 10.”
Both surgeons stress that patients shouldn’t be too worried about altered photos. “I am convinced most of my colleagues are ethical,” states Brown, “but it is a potential issue and patients can educate themselves by knowing just what to look for.”




What to look for in before-and-after photos
1) Size Both pictures should be taken from the same distance and cropped identically.

2) Angle Pictures taken at a 45° angle may be more flattering.

3) Lighting Shadows and soft-focus lighting are common clues to deceptive photos.

4) Clothing With body surgery, the patient should be wearing the same clothing, styled in the same way. Posture should be identical – slumping exaggerates any body problems.

5) Makeup If a patient is wearing makeup in the after photo, she should be wearing makeup in the before picture too.

Finally, ask to see many photos. The more you see, the better idea you’ll have of average results and what’s too good to be true.

Editorial source:

A General Picture of Rosacea

A general picture of rosacea can encompass different stages. It varies from a pre-rosacea stage that is characterized by frequent bouts of transient facial flushing/blushing, which dissipates quickly, to an advanced stage as manifested by rhynophyma, a bulbous enlargement of the nose. The intermediate stage of rosacea is characterized by facial redness (with prominent dilated blood vessels) and swelling that may persist for weeks or months and become permanent on the nose and cheeks. During bouts of bad flares, patients may experience pulsating facial pain and much discomfort that lasts for days, disrupting their normal lifestyles. Inflammatory outbreaks of papules and pustules are a frequent occurrence at this stage. A most distressing symptom is their intolerance to topical preparations. Their skin becomes red, stings and burns upon application of certain products, particularly acne preparations, cleansers, sunscreens and cosmetics. Rosacea may also affect the eyes with symptoms including irritation, dryness, crusting, tearing, foreign body sensation, swelling of eyelids with loss of eyelashes, appearance of inflammatory papules, conjunctivitis and light sensitivity. It is not uncommon to have ocular rosacea undiagnosed or misdiagnosed.

From:www.lindasy.com/rosacea.html

The Rosacea Picture May be Clearer Now

Misplaced faith leads rosaceans to a picture of misplaced trust:[Update July 2005] In the last year, some in the rosacea community have lost faith in Geoffrey as a leader in rosacea. I want to believe that the last year doesn't mean that we have lost our hopes and dreams that came with Geoffrey ; but sadly my hopes appear to be poorly placed, comments David Pascoe.

The Picture of Health or the Picture of Rosacea?

Those rosy cheeks may look like the picture of health when you're a child but as an adult rosy cheeks may be an indicator of a more complex picture such as rosacea.
The rosacea picture can be a combination of serval stages of rosacea. The pre-rosacea stage pictures frequent episodes of flushing which tend to fade quickly.
Rosacea's intermediate stage is pictured by facial redness, possible dialted blood vessels and swelling that may persist for days to months at a time.The more advanced rosacea picture would be identified by rhynophyma, a bulbous enlargement of the nose.

Words Define the Rosacea Picture

A picture of rosacea affected skin may tell the story but words explain what it all means.Putting the pictures into words; the terminology of rosacea, acne, adult acne, acne rosacea, ocular rosacea and dermatitis helps you to communicate effectively and fully understand your rosacea treatment and medication options. The Rosacea-Ltd glossary defines commonly used rosacea terms, including names of products and medications used in the treatment of rosacea and skin conditions that co-exist with rosacea, such as acne, eczema, lupus, and psoriasis.