This just published abstract is suggesting that it appears to be safe to consume alcohol while taking accutane.

Whilst the Accutane Prescribing Information does not prohibit the consumption of alcohol, it does suggest that alcohol may add to any issues with triglycerides induced by accutane. So it is probably wise to moderate alcohol consumption, despite this study using several patients with `considerable weekly alcohol intake’. Accutane is thought to cause depression in some people, and adding a depressant like alcohol to this combination could be risky.

Interesting that the study found a steep enough drop off in the studied teratogenics after 1 month post treatment to suggest that pregnancy would be safe. The Accutane Prescribing Information also suggests that you should not donate blood for 1 month following ceasing treatment.

This is just one study of course. When you read the list of potential side effects you can’t but think you still need to follow a doctor’s advice carefully. I’d be inclined to read the prescribing information closely and heed my doctor’s advice before taking this study’s findings too far.

One final word of warning, although there is no substantive link between alcohol and rosacea, alcohol can cause strong flushing symptoms. As most rosacea sufferers will tell you, reducing obvious flushing triggers, where possible, is worthwhile pursuing.

The metabolism and pharmacokinetics of isotretinoin in patients with acne and rosacea are not influenced by ethanol, Br J Dermatol. 2009 May 21, Grønhøj Larsen F, Jakobsen P, Grønhøj Larsen C, Heidenheim M, Held E, Nielsen-Kudsk F.

Background: Isotretinoin is effective in the treatment of severe acne and rosacea. Both parent drug and its main metabolite 4-oxo-isotretinoin are potentially teratogenic compounds and contain a carboxylic acid moiety. In the presence of ethanol, naturally occurring as well as synthetic retinoids also containing a carboxylic acid moiety are capable of undergoing an ethyl esterification with the metabolic formation of more lipophilic compounds with a much longer terminal half-life.

Objectives: To determine if isotretinoin (13-cis-RA), its main metabolite 4-oxo-isotretinoin (4-oxo-13-cis-RA), and other possible metabolites in the presence or absence of ethanol are converted to their corresponding ethyl derivatives in patients with severe acne or rosacea after multiple isotretinoin dosing. In addition, pharmacokinetic parameters of the parent drug and its 4-oxo metabolite were determined.

Patients/methods: Eleven patients with severe acne or rosacea were treated with isotretinoin daily for 3 months and investigated pharmacokinetically during 24 h after 1 month of treatment and for up to 28 days after discontinuation of therapy. A possible influence of ethanol was evaluated using a simple self-administered questionnaire and by measuring serum ethanol levels during treatment. The concentrations of isotretinoin, 4-oxo-isotretinoin and possible ethylated and nonethylated metabolites were measured by reverse-phase high-performance liquid chromatography.

Results: Although seven of 11 patients had a considerable weekly alcohol intake, no endogenous synthesis of ethyl derivatives of isotretinoin, the main 4-oxo metabolite or the all-trans compounds was chromatographically detectable in any of the patients’ plasma samples during the treatment period. Multiple dose pharmacokinetic data for the parent drug and its main metabolite were comparable to previous studies.

Conclusions: The metabolism and pharmacokinetics of isotretinoin and its main metabolites are not influenced by ethanol during long-term isotretinoin treatment. After ceasing long-term isotretinoin therapy the recommended period of 1 month for using anticonceptive measures in fertile women seems adequate.

Related Articles

• rosacea and low-dose accutane
• long term extra low dose accutane
• accutane and pregnancy
• rhinophyma myths: alcohol and cancer 
• Alcohol & Rosacea

Recently the manufacturers of Finacea, Intendis, and Coria Laboratories, have begun promoting a new combination package it is calling Finacea plus. This package encourages rosacea sufferers to combine a tube of Finacea with CeraVe Hydrating Cleanser and/or CeraVe Moisturizing Lotion. In theory this sounds like a good idea. Many rosacea sufferers have discovered that a gentle cleansing and moisturizing combination is a key part of their rosacea beating rosacea.

Official Web Site Comments

According to the official CeraVe web site, CeraVe is suitable for rosacea sufferers; “If you are taking a prescription medication for a skin condition, CeraVe Skin Care products are designed to enhance a medication’s therapeutic effect. That’s why many dermatologists recommend CeraVe Skin Care products as part of their therapeutic regimen. The gentle and moisturizing ingredients in CeraVe Skin Care products can also help offset the drying effects of certain prescription medications used to treat conditions such as eczema, psoriasis, acne, and rosacea.”

So the manufacturers are convinced, then.

Medical Opinions

From Rosacea: No laughing matter, Dr. Bikowski stresses skin care to make sure the outer layer, called the stratum corneum, is healthy. "That stops water from leaving, the skin from drying out, and stops things like microbes from getting in, also irritants and allergens." He advises the use of the over-the-counter cleanser, moisturizer lotion and/or moisturizer cream marketed under the name CeraVe. …

"There is nothing over the counter that is of any medical value for treating rosacea except for the skin products [CeraVe]," he said.

Hmmm, Dr. Bikowski sounds convinced too.

Paula Begoun seems to be generally happy with the CeraVe range;

“Hydrating Cleanser deserves serious consideration by anyone with normal to dry skin that’s also sensitive, including those dealing with rosacea. It is an exceptionally gentle, soothing cleanser that contains several ingredients that mimic the structure and function of healthy skin …”

“Moisturizing Lotion is the lotion version of the Moisturizing Cream, and other than having a lighter texture and smoother dry-down, the same formulary comments apply. The blend of glycerin, ceramides, cholesterol, and hyaluronic acid will help normal to dry skin look and feel very good …”

How To Use

Instructions that accompany Finacea Plus recommend that rosacea patients wash their skin with lukewarm water and CeraVe Hydrating Cleanser. This should be followed by an application of Finacea. Finally, it recommends applying CeraVe Moisturizing Lotion to the entire face.

What is the special offer ?

Well perhaps the package is slightly less than exciting. The prescription for Finacea Plus offers patients a $10 coupon towards the prescription cost of Finacea and a $2 coupon toward the purchase of either CeraVe Moisturizing Lotion or CeraVe Hydrating Cleanser. A fairly modest discount scheme indeed.

User Reviews

For more information on Finacea itself, see the Rosacea Support Group page containing Finacea User Reviews.

Here are some comments from rosacea sufferers who have tried the CeraVe range of products;

Artist said: I had also started using Finacea, a topical medication for rosacea, while still using the Cerave (the last few days using it.) I distinctly remember that the Finacea was extremely irritating to my skin, as if my face were on FIRE, when combined with the Cerave. Cerave is known to release moisture throughout the day due to microbeads or some such technology. It also contains ceramides, so maybe that has something to do with it. Who knows. I think this kept re-activating the finacea or just did not combine well with it. I then switched from Cerave moisturizer to Vanicream Lite Lotion

Carol, Brooklyn, Ohio said: (They) mentioned CeraVe Hydrating Cleanser. I tried it and i hope coria labs never stop making it! In three days, my face looks like it did so long ago. I am in love with my skin on my face! I knew from the first night i used it. It was not greasy, it washed off very quick, no residue, no redness, no drying, no itching! I love it!!!!!! I have not had to use my acid mantle or clindamycin for the last three days! love it love it please please please do not stop making CeraVe hydrating cleanser.

DmanChicago said: This relatively unknown brand of cleanser has proven to be the best for my skin. I have moderate Rosacea-mainly the redness, bumps, pimples, and at times even cysts. I’m 47, I have tried literally every product out there and this is my pick. It is completely non-irritating, doesn’t dry my skin, and simply works to clean without the greasy feeling of Cetaphil.

Mikel said: Cerave Lotion is the only lotion I can use on my face, other than DML Lotion. Cerave is far more effective but DML works on the principle of less is more. I cant use the Cerave Cleanser though as my pores get clogged. Go Figure! I use the lotion as the cream is a bit heavy for my combo skin.

MelissaW said: I have a similar reaction to the Cerave cleanser interestingly enough. I find it breaks me out a bit. However I use both the Cerave lotion and cream successfully (so far) and find it very soothing and calming for my rosacea. I have dry skin though so that is probably why I can use the cream without any issues re clogging my pores.

CrabbyCathy said: Hold on to your socks, everyone. I think I have found a moisturizer I love, that beats my beloved Canvas Base Cream! In a matter of days, it has returned moisture to my skin, or at least helped my skin heal so that it can retain it’s own moisture, as nature intended. No more dry, itchy, stinging skin. I guess ceramides do work! I apply a dab to damp skin, concentrating on my cheeks, and dab the little bit left on my fingers onto my t-zone, where I don’t need as much.

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Final Comment

OK, the discount offer is pretty modest, but do you think you’d like to try any of the CeraVe products ? Are the something you will want to keep as part of your daily regime ?

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It is good to see more published research backing topical cyclosporine (Restasis, Allergan) as a treatment for ocular rosacea. Restasis (cyclosporine ophthalmic emulsion 0.05%) has been shown to increase tear production and improve the quality of naturally produced tears and is the first approved therapeutic agent for the treatment of chronic dry eye.

Official Use of Restasis

The FDA has approved Restasis as a treatment to increase tear production in patients whose tear production is presumed to be suppressed due to ocular inflammation associated with chronic dry eye. Note that increased tear production was not seen in patients currently taking topical anti-inflammatory drugs or using punctal plugs. Restasis is not appropriate for immediate relief for an uncomfortable irritated eye as it may take up to 6 months for maximum improvement. (source The Eye Digest)

Other Evidence

An article from 2006 in Ophthalmology Management Topical cyclosporine proves to be effective in treating rosacea whetted our appetite for this interesting new treatment.

The anti-inflammatory mechanisms of cyclosporine are highly appropriate for the treatment of ocular rosacea, as the condition has been shown to have an inflammatory etiology. Barton and associates conducted a study comparing tear fluid concentrations of interleukin-1alpha (IL-1alpha) and tumor necrosis factor-alpha (TNF-alpha) in ocular rosacea with those in control subjects. Tear turnover was lower in patients with rosacea than in controls, and Schirmer scores were also statistically lower in patients with rosacea than in controls.

After 6 months of use, topical cyclosporine was shown to decrease inflammatory cytokines in the conjunctival epithelium of dry eye patients with increased tear production.

…

Given the excellent side effect profile of topical cyclosporine and its lack of systemic absorption, ophthalmologists should consider utilizing topical cyclosporine in the treatment of patients with ocular rosacea.

Expert Opinion

The Rosacea Support Group asked Dr. Eric Jones, MD, the Medical Director of Devers Eye Institute in Portland, Oregon a related question about Restasis and ocular rosacea.

Q: Do you agree with the view that Restasis won’t help ocular rosacea or dry eye triggered by Accutane?

A: The drug rep was in for Restasis the other day and I asked her about it. We looked it up here and didn’t find any studies that checked on Restasis and ocular rosacea together. It’s a great question because, you know people with ocular rosacea have decreased tear production and, if Restasis can help that, I don’t see why it wouldn’t work.

Recent Abstract

Below is the abstract from the recently published paper, from the same author as the above article, but now appearing in a peer reviewed journal. The above link to Ophthalmology Management leads to a full article, which can be consulted for more details if you don’t have access to the full text of the journal article.

Efficacy of topical cyclosporine for the treatment of ocular rosacea, Adv Ther. 2009 Jun 23, Schechter BA, Katz RS, Friedman LS, Florida Eye Microsurgical Institute.

INTRODUCTION: This study was designed to compare the efficacy of cyclosporine ophthalmic emulsion 0.05% with an artificial tear solution for the treatment of rosacea-associated eyelid and corneal pathology.

METHODS: Double-masked, randomized, 3-month clinical trial of 37 patients with rosacea-associated eyelid and corneal changes (defined as lid margin telangiectasia, meibomian gland inspissation, and/or fullness of the lid margin). All findings were standardized and compared to photographs for grading.

RESULTS: There was a statistically significant increase in Schirmer (with anesthesia) scores of 2.7+/-2.2 mm after 3 months of treatment in the topical cyclosporine group (P<0.001), compared with a mean decrease of -1.4+/-4.6 mm (P=0.271) in the artificial tears group. The mean tear break-up time score significantly improved in the topical cyclosporine group (mean increase of 3.56+/-1.5 seconds, P<0.001), but worsened in the control group, although this change was not significantly significant (mean decrease of -0.04+/-1.6 seconds, P=0.929). The topical cyclosporine group exhibited a significantly greater mean reduction in corneal staining scores (-1.3+/-0.53) compared with the control group (-0.2+/-0.83; between groups P<0.001). The topical cyclosporine group had a greater improvement in Ocular Surface Disease Index scores than those using artificial tears (P=0.022). Limitations of the study included an older, predominantly Caucasian patient population and short trial length.

CONCLUSIONS: Topical cyclosporine 0.05% is more effective than artificial tears for the treatment of rosacea-associated lid and corneal changes.

Related Articles

• Official web site: Restasis
• cyclosporine (restasis) shows promise for ocular rosacea
• Ocular Rosacea: Dr. Eric Jones, MD
• trial: treating ocular rosacea with Cyclosporine (Restasis)

If you have trouble swallowing tablets, here is an official FDA sanctioned tip. Open the tablet and sprinkle the delayed release pellets on to a spoonful of applesauce. This is a good option for anyone who finds swallowing the capsule difficult.

This advice is only given for the 100mg and 75mg delayed release formulations of doryx which contain specially coated pellets of doxycycline hyclate. A clinical trial confirmed that the absorption of doxycycline is comparable when the table is taken whole or sprinkled on applesauce, both with and without water.

From Daily Med, Current Medical Information, Doryx (doxycycline hyclate) Tablet, Delayed Release

DORYX Tablets contain specially coated pellets of doxycycline hyclate, a broad-spectrum antibiotic synthetically derived from oxytetracycline, in a delayed-release formulation for oral administration.

Sprinkling the Tablet on Applesauce

Doryx Tablets may also be administered by carefully breaking up the tablet and sprinkling the tablet contents (delayed release pellets) on a spoonful of applesauce. The delayed release pellets must not be crushed or damaged when breaking up the tablet. Any loss of pellets in the transfer would prevent using the dose. The applesauce/Doryx mixture should be swallowed immediately without chewing and may be followed by a glass of water if desired. The applesauce should not be hot, and it should be soft enough to be swallowed without chewing. In the event that a prepared dose of applesauce/Doryx tablet cannot be taken immediately, the mixture should be discarded and not stored for later use.

The FDA has also issued instructions on how to prepare 100mg tablets of doxycycline (in an emergency), for children and adults who cannot swallow pills. See Mixing Doxycycline Hyclate 100mg Tables with Food. This method crushes a tablet into 4 teaspoons of water and then combines this with 3 teaspoons of milk, or chocolate milk or chocolate pudding or apple juice + sugar.

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Natural Remedies for Rosacea?

The roles of complementary and alternative medications in the management of rosacea have yet to be established, so it’s hard to offer any “natural” remedies for the condition. Cucumber was mentioned as early as 1649 as a treatment for facial redness in a text on herbal remedies by Nicholas Culpepper, an English botanist and physician, but cucumber has not been studied scientifically. Some rosacea sufferers, especially those prone to frequent flushing, report benefit from relaxation and stress management techniques.

Self-care and dietary measures may also aid in the management of rosacea, but there are different forms of the disease, and each may require different treatments.

It is great to see more and more articles on rosacea in a publication like the New York Times. It is also encouraging that they have access to the best minds in rosacea research and treatment. Having said that, it is a bit discouraging to find an unsatisfying answer to such an important question. Surely there are good natural treatments out there somewhere ?

We do know that in this year’s AAD meeting in SFO, one presenter Dr. Downie suggested that natural ingredients do have a role in the treatment of rosacea. Dr. Downie suggested feverfew, green tea and licorice as worth investigating.

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Do you have a favourite over the counter treatment for your rosacea ? Depending on your health insurance and access to doctors and pharmacies, prescription treatments are out of the reach of many rosacea sufferers. So what can you try as a rosacea treatment that is easy to source, cheap and available without a prescription ? Is there anything ?

Please help your fellow rosacea sufferers with your best discoveries of treatments that you can get without a prescription or without visiting a doctor.

Here are some suggestions that I have collected that seem to be popular with members of the rosacea support group;

Prosacea

Prosacea is a topical gel, available over the counter at stores like Walgreens. It is also available on the internet at cvs.com. It contains 10% sulphur. The jury is still out, but reading prosacea user reviews, it looks to me like we should include prosacea as a bona fide rosacea treatment.

Rosacea-LTD

Rosacea-LTD is a topical treatment made of various compressed salts. It worked well for me to reduce papules and pustules and it is available only over the internet (which I guess counts as over the counter). This treatment is not cheap like many of the other suggestions in this listing, but I thought it definitely should be included as an over the counter treatment. For more information have a read of Rosacea-LTD User Reviews

Disclosure: rosacea-ltd is a site sponsor of rosacea-support.org

Aspirin

There has been some introductory research suggesting that a daily low dose of aspirin may help with rosacea swelling and flushing. For some it may lead to more flushing, but as an easily available and cheap over the counter treatment, aspirin may be worth a try.

Rosacea Swelling Relief Regime

Dr. Linda Sy has suggested in her rosacea swelling relief regimen, that there are some OTC meds that are easier (than prescription drugs) on the system such as: aspirin (blocks prostaglandin synthetase), antihistamines – ex. Chlor-trimeton which blocks H1 receptors; Cimetidine (Tagamet) which blocks H2 receptors. Pyridoxine (vit.B-6) has also been found to be helpful as a prophylaxis. She has sugested the following over the counter regime;

at Bedtime;

• 1 baby aspirin
• 1 Chlor-Trimeton (an antihistamine)
• 1 Tums (to offset the gastro effects of the aspirin)

and in the AM;

• a B complex vitamin with 50mg of B-6, but without Niacin (niacinamide is ok).
• 1 Tagamet

during a flush;

• apply a cool (not cold) compress to the face
• do deep breathing 10 times slowly.

Flaxseed Oil

Studies have shown that flaxseed oil may help improve acne and for some other Omega 3 sources like Fish Oil may offer additional benefits.

When Dr. Eric Jones was asked about the possibility of any nutritional link to ocular rosacea symptoms he responded “that here are studies with just dry eye, where flaxseed oil and omega 3s are quite effective. Foodwise, everyone is individual. There have been some surveys, and everyone was different. Some said spicy foods, others said hot drinks, alcohol, cold drinks. People have to find their individual triggers, I think.”

Nasalcrom

As an alternative to the steroid based nasal sprays, something like Rynacrom or Nasalcrom may help with allergic rhinitis and relieve other allergic symptoms. Certainly if you think your rosacea symptoms are allergy related this is worth trying. Even if it only relieves other chronic symptoms is might help you get your head around the other symptoms that occupy your thinking.

Afrin / Oxymetazoline

It is early days yet, but some preliminary research and some rosacea sufferers are reporting reductions in redness from using topicals such as Afrin. Rosacea sufferers are cautioned against applying Afrin directly to their skin as it is actually for allergic rhinitis so contains ingredients which may be irritating to rosacea sufferers.

Keep an eye out for updates related to Oxymetazoline based treatments like Afrin. See this forum posting Afrin cure ? for some more information. There are many over the counter products that contain oxymetazoline.

Cleansers and Moisturizers

OK officially cleansers and moisturizers aren’t rosacea treatments. This is a bit of a step backwards for rosacea sufferers. Once you understand that a gentle cleansing and moisturising regime is a good basis for beating rosacea, you are already off to a good start.

Make your own Cleanser

We know from a recent rosacea news article that colloidal oatmeal (Avena sativa) has interesting cleansing, moisturizing, buffering, soothing, protecting and anti-inflammatory properties.

Want to try something natural, perhaps something that you know exactly what it contains because you have made it yourself ? Some of the highlights from the Homemade Mixes community forum include simple natural sunscreens, licorice treatments, a honey cleanser and more.

Colloidal Oatmeal

Officially `Colloidal’ oatmeal is defined as a product made from grinding and processing whole oat grain with strict requirements on the particle size and fat content. In the past rosacea support group members have made their own cleansing masks with oatmeal and water. An extra bonus is that it can sop up flakes associated with seborrheic dermatitis.

Jojoba Oil

I have found that a small amount of jojoba oil blends in really well on wet skin and gives an excellent moisturized feel to my skin. Jojoba oil is cheap and easy to find in health food stores. We do know that jojoba oil has anti-inflammatory properties so it could be an ideal over the counter product.

A final warning

Please do be careful with products that you can get over the counter. Just because something is available without a prescription doesn’t mean it is even safe for rosacea skin. For example some OTC products might secretly (or quietly) contain steroids. As we now know, over the counter steroids can cause steroid induced rosacea.

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Go for It !

OK, so I have made my list, please give some more suggestions below in the comments.

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“Earlier this year, we announced that four important and popular rosacea products that had been unavailable for many months would thereafter, by special arrangement with the originator, be manufactured and distributed by the Rosacea Care Company. We are pleased to tell you that the first of these, the much-loved Vita-Oil, will be released and ready to ship this coming Thursday, June 25. On-line purchases can be made in advance of that date by visiting our website: rosaceacare.com.

We would remind you that this is exactly the same Vita-Oil that has helped so many rosaceans over the years. The formula is identical, and it is being manufactured by the same laboratory. As with previous packaging, an eye dropper and instruction sheet will be enclosed with every order. The price is $28 US.

We would also take this opportunity to announce that original Tinted ZincO will be available sometime in July. The exact release date will soon be posted on our website and on this Support Group page. We thank everyone for their patience and their enthusiasm for these products.”

disclosure: RosaceaCare is a site sponsor of rosacea-support.org

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The following graph, sourced from Collagenex (who sell Oracea), shows the blood plasma concentration of doxycycline after taking Oracea compared to 50mg once a day of generic doxycycline. The horizontal axis stretches out to 24 hours post dosage. The vertical axis is in nano-grams per milli-litre (ng/mL).

The horizontal grey line is labelled anti-microbial threshold is listed here as a concentration of 1000 nano grams/mL (i.e. 1.0µg/mL). This value of 1 microgram per millilitre is considered to be the concentration at which doxycycline is able to affect bacteria i.e. have an anti-bacterial effect.

The two inverted curves show the amount of doxycycline that is present in the blood over a 24 hour period. The top grey curve is for 50mg of generic doxycycline and the bottom green curve is for Oracea.

I read this graph to suggest that Oracea is able to maintain a sustained release of the active ingredient doxycycline without venturing into anti-microbial territory. The advantage of a delayed release product is that Oracea can offer the `area under the concentration-by-time curve’ delivery, but at sub-antimicrobial dosage over 24 hours.

That is, Oracea can deliver a dosage of doxycycline that can give measurable results, but keep the concentration of doxycycline in your blood low enough to reduce potential problems associated with antibiotics.

(click image for larger view)

*16 healthy adult subjects, per arm; mean weight 75 kg

† Measured at 7 days

Data on file, CollaGenex Pharmaceuticals, Inc.

What is happening here ?

We do know that antibiotics have non-antibiotic properties. Recent research has found biologic actions affecting inflammation, proteolysis, angiogenesis, apoptosis, metal chelation, ionophoresis, and bone metabolism. Thus a whole new range of clinical applications are being investigated. So it does appear that taking a low dose, or even a sub-antibiotic dose of antibiotics can have real clinical benefits.

A Cheaper Alternative ?

As Oracea is a new prescription product it can be quite expensive, especially if you don’t have comprehensive insurance coverage. One possible alternative you could discuss with your doctor is 50mg a day of generic doxycycline. Whilst this dosage won’t have exactly the same profile in your blood, the benefits and side effects are likely to be  close. See your doctor for a better opinion.

I doubt whether we will ever see a trial to prove that the benefits and side effects of Oracea and 50mg of doxycycline are comparable. Therefore it seems unlikely that one can say either way whether the above graph shows an important distinction between the two treatments.

Does it really matter that 50mg a day of doxycycline ventures above the anti-microbial threshold for a couple of hours a day, or that the overall dosage delivered is around twice for the generic ? These are questions that can’t be answered at this stage.

As with all systemic treatments, both Oracea and a low dose of doxycycline can cause unwanted side effects so the supervision of your doctor is important.

Related Articles

• Oracea to replace Periostat, new rosacea treatment launched
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Calcium dobesilate (2,5-dihydroxybenzene sulfonate) is a vasoactive drug with presumed effects on endothelial integrity, capillary permeability and blood viscosity. It is often recommended for venous disorders, and also prescribed for diabetic retinopathy and other microvascular disorders.

rosacea and doxium (calcium dobesilate)

Just wanted to let others know that Dr. Cuevas accepted me as a participant in his clinical trial of the 2.5% Calcium dobesiliate cream. I had to arrange and pay for international shipping and managed to get the product into Canada (the product was described as a skin cream for customs purposes).

I have been using the skin cream for 2 weeks in the morning and evening. Redness has visibly decreased. My skin feels smooth and soft where there were small bumps previously. Spontaneous breakouts have also stopped. The study above was conducted over 4 weeks.

Anyone interested in participating in the clinical trial can submit photographs to Dr. Pedro Cuevas at:

pedro.cuevas@hrc.es

Dr. Pedro Cuevas
Servicio de Histología
Departamento de Investigación
Hospital Ramón y Cajal
Ctra. de Colmenar, km. 9.100
28034-Madrid-Spain

Tel. (0034) 913368290

Obviously rosacea sufferers have to be quite keen to pay for their own shipping, but it is only through research and trial and error that we will learn. Please do let us know if you too decide to try the calcium dobesilate cream.

This post-treatment therapy is in addition to some other recently published research that patients treated immediately after IPL with a LED device showed that their post-treatment redness subsided faster compared to not also being treated with LED.

We also know that 2% polyphenone in a hydrophilic cream has shown promise as a treatment for the papules and pustules of rosacea.

Topical polyphenolic antioxidants reduce the adverse effects of intense pulsed light therapy, J Cosmet Laser Ther. 2009 May 27:1-4, Freedman BM., Plastic Surgery Associates of Northern Virginia, McLean, Virginia, USA.

Background: Intense pulsed light therapy (IPL) has been associated with erythema and increased lipid peroxidation. Polyphenolic antioxidants have been shown to decrease inflammation and reduce oxidative stress in irradiated skin.

Objective: To determine whether the topical application of polyphenolic antioxidants to IPL-treated skin reduced the adverse effects of IPL exposure.

Methods: In a split-face study, 10 volunteers underwent three full-face IPL treatments (16 J/cm(2), 10ms, 560nm filter) spaced 3 weeks apart. A polyphenolic antioxidant solution was pneumatically applied to the left side of the face, beginning immediately before the first IPL treatment then weekly for six treatments. The lipid peroxide concentration, skin antioxidant level and skin moisture content were obtained before and after the study.

Results: Skin treated with IPL alone contained a significantly higher concentration of lipid peroxides when compared to skin treated with IPL plus polyphenolic antioxidants (p<0.05). Skin treated with IPL alone contained a significantly lower level of polyphenolic antioxidants and had a significantly lower moisture content (p<0.05).

Conclusions: In this study, the concurrent pneumatic topical application of polyphenolic antioxidants reduced lipid peroxidation and skin dehydration in IPL-treated skin. Polyphenolic antioxidants may confer a protective effect on facial skin and enhance the effects of IPL therapy.

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