About Rosacea
What is Rosacea?
Definition by famous dermatologist: Rosacea is a chronic (long term) skin disorder that most often affects the nose, forehead, cheekbones, and chin (Dr. Berasques). Groups of tiny microvessels (arterioles, capillaries, and venules) close to the surface of the skin become dilated, resulting in blotchy red areas with small papules (a small, red solid elevated inflammatory skin lesion without pus, that is minor when the size is of a small measles lesion, moderate when about the size of a pencil eraser, and severe when the papule is the size of a small currency coin or the tip of the little finger) and pustules (pus-filled inflammatory bumps). The redness can come and go, but eventually it may become permanent. Furthermore, the skin tissue can swell and thicken and may be tender and sensitive to the touch. Note: Pustules are NOT pimples. Pimples have a bacterial component to their pathogenesis and are also mainly localized in and around the hair follicles.
The inflammation of rosacea can look a great deal like acne, but blackheads and whiteheads are almost never present. It is a fairly common disorder -- about one in every twenty Americans is afflicted with it (Drs. Faria and Edward). Rosacea usually begins with frequent flushing of the face, particularly the nose and cheeks. This facial flushing is caused by the swelling of the blood vessels under the skin. This "red mask" can serve as a flag for attention. Telangiectasis is easy to recognize, characterized by the visible presence of capillaries, bright red in color. Diffuse redness frequently precedes the appearance of telangiectasis and is a constant flushed appearance. True diffuse redness is quite different from a localized erythema as seen in cases of sunburn, inflammation or over stimulation. With both telangiectasis and diffuse redness, the redness is not transitory and there generally is not an increase in skin temperature, but particularly there are no alterations in the tissue structure or biochemistry as seen in rosacea. The circulatory network of the skin is extensive and the capillaries are the smallest, most delicate vessels. During normal blood circulation the capillaries undergo constant changes. In between beats the pressure is relieved and the vessels constrict back to their normal size. This return to normal size is accomplished by the natural elasticity in the structure of the capillary. If telangiectasis is present, the capillaries' elasticity is deteriorated so they remain slightly dilated. The constant influx of blood perpetuates this slight dilation. The skin gradually becomes congested and eventually the capillaries become visible through the skin's surface. When it comes to telangiectasis, sometimes a person's lifestyle and habits can be the skin's worst enemy. In a fair, delicate skin predisposed to telangiectasis, a steady diet of hot, spicy food, chronic alcohol consumption and eating meals too quickly will promote telangiectasis. And many retinoids used for acne as well as many harsh soaps continue to aggravate the skin. Then there's cigarette smoking, which depletes the skin of vitamin C, essential for the formation of collagen, accelerates the crosslinkage of collagen and the hardening of elastin and furthermore creates a trillion free radicals, which destroy the capillary structure. Smoking, which additionally robs the skin of oxygen, is a potent initiator of telangiectasis. Also, the smoker may have a variety of medical problems such as high blood pressure, and mineral deficiencies, which can cause the appearance of telangiectasis.
Ocular Rosacea: Rosacea can also cause a persistent burning and feeling of grittiness in the eyes or inflamed and swollen eyelids with small inflamed bumps, eyelashes sometimes fall out, compounded by bloodshot eyes. (Dr. Thiboutot). The ophthalmic signs are exceedingly variable, including blepharitis, conjunctivitis, iritis, iridocyclitis, hypopyoniritis, and even keratitis. The term ophthalmic rosacea covers all these signs. The ophthalmic complications are independent of the severity of facial rosacea. Rosacea keratitis has an unfavorable prognosis, and in extreme cases can lead to corneal opacity with blindness. The most frequent sign, which may never progress, is chronically inflamed margins of the eyelids with scales and crusts, quite similar to seborrheic dermatitis, with which it is often confused. Pain and photophobia may be present. It is instructive to ask rosacea patients how their eyes react to bright sunlight. (Drs. Gerd Plewig & Albert M. Kligman). Ocular rosacea is a serious condition that needs to quickly be under control , as the patient could potentially lose vision from in the more severe cases. Any patient with rosacea who has ocular irritation, light sensitivity along with a decrease in visual acuity or obvious inflammation of the lids or conjunctiva should be referred to an ophthalmologist." One of the concerns in ocular rosacea is the possibility of secondary infection, since a dry environment is a good breeding ground for bacteria like staphylococci.
The hereditary, chronic skin disorder of rosacea is aggravated by many factors, including sunlight, physical and mental stress, sinus and allergy conditions, hot liquids, spicy foods, extremes in temperature, alcohol (either topically applied or orally consumed) and stress (Drs. McKoewn, Wilkin, Wilkin, Wilkin). But it is important to note that what aggravates one person's rosacea may have no effect on another person's condition (Dr. Wilkin)
Stages - Plewig and Kligman Classification of Rosacea
Stage I: The erythema may persist for hours and days, hence the old term erythema congestivum. Erythema lasting only a few minutes is not early rosacea. Telangiectases becomes progressively prominent, forming sprays on the nose, nasolabial folds, checks, and glabella. Most of these patients complain of sensitive skin that stings, burns, and itches after application of a variety of cosmetics, especially certain fragrances and sunscreens. Trauma from abrasives and peeling agents readily induces long-lasting erythema, thus the facial skin is unusually vulnerable to chemical and physical stimuli.
Stage II: Inflammatory papules and pustules crop up and persist for weeks. Some papules show a small pustule at the apex, justifying the term papulopustular. The lesions are always follicular in origin, mainly in sebaceous follicles but also in the smaller and more numerous vellus follicles. Comedones do not occur. The deeper inflammatory lesions may heal with scarring, but scars are inconspicuous and tend to be shallow. Facial pores become larger and prominent. If there has been much solar exposure over decades, the stigmata of photodamaged skin becomes superimposed, namely yellowed, leathered skin (elastosis), wrinkles and solar comedones. The papulopustular attacks becomes more and more frequent. Finally, rosacea may extend over the entire face and even spread to the scalp, especially if the patient is balding. Itchy follicular pustules of the scalp are typical. Eventually, the sides of the neck as well as the retroauricular and presternal area may be affected.
Stage IV: A small proportion of patients goes on to develop more serious expressions of the disease, namely large inflammatory nodules, furunculoid infiltrations, and tissue hyperplasia. These derangements occur particularly on the cheeks and nose, less often on the chin, forehead, or ears. The facial contours gradually become coarse, thickened, and irregular. Curiously, patients may not notice these disfigurements. The deranged appearance becomes evident when photographs from previous years are reviewed. Finally, the patient shows diffusely inflamed, thickened, edematous skin with large pores, resembling the peel of an orange. These coarse features are due to extensively inflammatory infiltration, connective tissue hypertrophy, massive fibrosis and elastosis, diffuse sebaceous gland hyperplasia, and extreme enlargement of individual sebaceous glands forming dozens of yellowish unbilicated papules on the cheeks, forehead, temples, and nose. Thickened folds and ridges may create a grotesque appearance mimicking leonine facies of leprosy or leukemia. The ultimate deformity is the phymas, of which rhinophyma is the prototype. (Drs. Plewig & Kligman)
Rosacea, once believed to be a condition almost exclusive to caucasions, rosacea is now increasingly occurring in asians and middle-easterners. Some believe this is due to the influence of western culture and habits - lifestyles if you will - becoming more common in eastern cultures. While cultural changes are inevitable, change is not always progressive unless we have chosen the proper course in our rosacea treatment. Often adjustments are needed in our lifestyles for progressive change as they are often the 'cause' of rosacea as many rosacea patients have continued with the same pattern of lifestyles producing more catecholomines that produces the "alarm" to the skin. Therefore the rosacea patient continues to face the same problems without much change.
Rosacea Ltd™ was designed specifically to improve the appearance of damage sensitive facial redness (erythema) and dilated facial vessels (telangectasia), as well as rosacea-related papules (raised red lesion without pus) and acne pimples (with pus and inflammation due to bacteria). The very sensitive skin of patients with the combination of rosacea, seborrheic dermatitis, acne are very happy with Rosacea Ltd IV. These rosacea patient's past rosacea treatments would irritate one condition while trying to improve another of these three skin conditions that often co-exist together that makes for a most complex rosacea treatment plan.
During the past 11 years, 98% of rosacea patients throughout the world have confirmed that they are extremely impressed with Rosacea Ltd IV and our Bass & Boney Pharmaceuticals, Inc. 120 day 100% refund. Rosacea Ltd IV received it's name by being the third generation of Rosacea Ltd which was developed in April of 2000. As you will notice the appearance and shape of Rosacea Ltd IV allows for a simple easy application to the eye lid for those with ocular rosacea.
Article of the Week:
STAGE FOUR ROSACEA - RHINOPHYMA
Rhinophyma has been observed from ancient times in Greece and Arabia but first named by Hebrea in 1845. The term rhinophyma stems from the Greek words: Rhis (Greek for nose) and phyyma (Greek for growth). A year later in 1846, rhinophyma was first associated with rosacea. Daniel Sennert performed the first known surgery for rhinophyma in 1629.
As more bumps appear, the nose takes on a more swollen, misshapen appearance. Rhinophyma can take on many different forms. In most forms, the nose is chronically red and inflamed. There is also evidence of swelling, and the skin often shows thickened skin with large pores, resembling the peel of an orange (peau d' orange). In some forms, sebaceous gland hypertrophy and hyperplasia (increased growth and number of sebaceous glands) can cause the nose to grow considerably, resulting in a bulbous appearance. It is a more severe form of acne rosacea. The cause is not really known.Rhinophyma has been associated with many causes such as the over-consumption of alcohol. No consistent causative factor has been identified to date. Men are 12 times more likely to have this problem than women.
Symptoms of rhinophyma include an overgrowth of the sebaceous skin glands, vessel and tissue growth in the deeper layers of the skin, and a thickening of the outer layer of the skin. This can make for a very obvious and prominent nose.
Non-surgical treatment for rhinophyma is similar to rosacea care and includes attention to skin hygiene, avoidance of foods that seem to worsen the condition and the use of antibiotics when small infections are present. Rhinophyma is actually a slow growing benign tumor due to hypertrophy of the sebaceous glands of the tip of nose often seen in cases of long-standing rosacea. Rhinophyma appears as a pink, lobulated mass over the nose with superficial vascular dilation; mostly affects men past middle age. Rosacea patient seeks advicenad treatment because of the unsightly appearance of the tumor, or obstruction in breathing and vision due to the large size of the tumor. Treatment consists of paring down the bulk of the tumor with sharp knife or carbondioxide laser and the area allowed to re-epithelialise. Sometimes, tumor is completely excised and the raw area skin-grafted.
Rosacea-Ltd IV can be used by those with rosacea, acne or seborrheic dermatitis skin conditions ranging from mild to severe. To view rosacea pictures of what we would consider more severe cases, consider these images (pictures of a man's face and a woman's face with rosacea). Please remember that these pictures of rosacea sufferers are severe cases.
Click on the "blue links" on the above left to learn more about Rosacea Ltd IV. Rosacea is very often accompanied by acne pimples in over 76% of patients/customers while approximately 35% have seborrheic dermatitis which makes for an even more sensitive skin condition. If you suffer from acne, click on our site at www.acne-ltd.com for Acne-Ltd IV information. If you suffer from eczema, psoriasis, or dermatitis, click on our site at www.dermatitis-ltd.com for Dermatitis-Ltd IV information. All of our products come with a 100%, 120 day guarantee.
Rosacea-Ltd IV has an unconditional 120-day, 100% refund. Simply return unused portion of Rosacea-Ltd & instruction letter.
For our international rosacea customers who need the exchange rate, a helpful web page is:
All U.S. orders are mailed no later than the following business day by U.S. Priority Mail with DELIVERY CONFIRMATION TRACKING and are usually received within 2 to 3 postal days. International orders are mailed U.S. Global Priority Air Mail and are usually received within 4 to 5 postal days in Europe, Japan, Australia and New Zealand. Canadian deliveries usually take 5 to 8 postal days, and deliveries to other countries not mentioned usually take 5 to 12 postal days. If your package has not been received in the appropriate times listed above, please e-mail us and we will "track it" through the United States Postal computer system and notify you of the status of the order.
We welcome your suggestions or comments about Rosacea Ltd IV or our web site. Many of your questions will be answered on one of the other pages of this web site. However, if after reviewing the extensive information on these pages, you are unable to find the answer to your questions concerning Rosacea Ltd IV, please contact us directly at bass.and.boney.inc@mindspring.com. We will answer your questions as soon as possible, usually within one business day.
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