20 December, 2012

The role of Vitamin D in rosacea/facial flushing

As if a red burning face wasn’t enough inconvenience to deal with, a rosacea patient often also has to face the endless seeming stream of possible treatment options and the fact that none of them seem to work for everyone. Especially the facial flushing, burning and general redness can be very difficult to tackle. Luckily there are forums where fellow patients write about their experiences, but it can be a daunting task to weed through the enormous amounts of posts. One conclusion that all members seem to agree on however, is that there isn’t a golden rule treatment wise. Unfortunately.

There isn’t even a common agreement on the cause of rosacea. The papular subtype has most likely a bacterial component to it, but for vascular rosacea this seems less likely. The opinions vary, but I think personally that at least a big % of the vascular cases stem from inflammation in the body. In my own case this is immune related and there is an auto immune response in other parts of the body as well (for me bowel, blood vessels, skin). I talked to a host of pretty specialized dermatologists over the years and none of them believe that demodex mites, who are linked to rosacea, play a dominant role in the rosacea cases that are primarily dominated by facial flushing and redness. Many people that I e-mail with or communicate with through forums, mention that when they take anti inflammatory medication -sometimes for something totally different- their flushing and redness reduce. It comes most likely down to symptom treatment and minimizing symptoms as much as possible.. Although sometimes rosacea can be brought in remission. 
When it comes to anti-inflammatory medication, there are countless herbs, ointments, vitamins, probiotics and natural products that have potential to help rosacea. This thread will be used to examine the role of vitamin D levels in rosacea and whether adding vitamin D3 through pills or special narrowband light devices can improve the inflammation levels and rosacea symptoms.

Vitamin D and rosacea


Everybody needs vitamin D for strong bones. It stimulates the absorption of calcium. Muscles need it to function correctly and nerves use it to transmit messages between the brain and other organs and body parts. The immune system needs vitamin D to combat viruses and bacteria’s, also in the skin. It maintains the body’s immunity against diabetes, various types of cancers, muscle wasting, heart disease, osteoporosis and so on. Vitamin D3 is actually a hormone and there are very few foods that contain this vitamin. It can be made by the body through the absorption of sun by the skin.

A study that was published in the "Journal of Allergy and Clinical Immunology" showed that vitamin D stimulates the production of a peptide in the skin, cathelicidine, that is effective against micro organisms and fights infections. It helps protect the skin therefore. Studies indicate that people with eczema have a lack of cathelicide and in small scale studies it appeared that adding vitamin D sometimes alleviates symptoms. More studies are needed however for a definitive confirmation but the results so far are promising. (Source)

The relationship between vitamin D and rosacea is a more complicated one. Initial studies showed that rosacea patients had in fact elevated levels and abnormal types of cathelicidine in their skin. Based on these findings one would be inclined to say that elevating the vitamin D levels would lead to more cathelicidine and therefore even more symptoms. These researchers believe that rosacea patients are more helped with medication that blocks the production of cathelicidine in the skin (one of the suspected reasons why doxycycline works for quite a lot cases of rosacea).
Note that the cause of rosacea has been proposed as over-production of the cationic cathelicidin peptide LL-37. Let’s focus some more on these cathelicidins.

In 2007, Dr Richard Gallo of the University of California was the one who discovered that peptides known as cathelicidins and the proteolytic enzymes that activate cathelicidins in the skin are abnormal in patients with rosacea. Cathelicidins are antimicrobial peptides and the enzymes in the skin of rosacea sufferers cause them to produce these peptides in an abnormal form. This revelation turned out to be a breakthrough and sent a whole bunch of scientists off in a new direction. Gallo himself has now done follow up research and he thinks that rosacea patients' innate immune systems, overall, are abnormal.
A study in Belgium has made a connection between the regulation of cathelicidins and vitamin D. This is because there is what they call "a previously unknown and unexpected link between innate immunity and the vitamin D system".
Interestingly, one in four Americans are vitamin D deficient and medical researchers believe that low levels of vitamin D are responsible for a whole range of ills, from muscular weakness to autism. 

Ok, I am lost now with these conflicting studies and conclusions.. Will vitamin D help regulate the immune system and therefore normalize the quality and quantity of those cathelicidins in rosaceans or not?!

I found this publication as well:
"New studies show that vitamin D, particularly vitamin D3 can provide relief from skin inflammatory skin ailments such as rosacea.




Many skin conditions can be caused or worsened by the sun, ultraviolet (UV) radiation and oxidative stress. 

Some antioxidants are said to have potential to protect against some skin conditions, including skin aging and skin cancers. UV light can directly cause DNA damage, as well as start a cascade of oxidative stress and related signaling leading to mutation and irreparable damages to the cells. The dermis contains connective tissues of the skin, nerve endings, sweat glands, and hair follicles. The epidermis must be a weather- and water-proof layer to protect the body. Because of the large amount of cells and structures within the skin, and because the skin is the first line of defense, it is not surprising that many different things can go wrong and cause a variety of skin diseases.

In normal, unstressed cells, there is a constant production of reactive oxygen from the mitochondria, which is balanced by the production of antioxidant enzymes in the cell, such as superoxide dismutase (SOD), catalase, and glutathione peroxidase. When a cell comes under stress, this balance is interrupted, and the reactive oxygen species can overwhelm the cells and lead to a change in normal cellular behaviors. Oxidative stress can be caused by different things, including cigarette smoke, extreme temperature change, and exposure to UV radiation. In fact: exposure to UV radiation is one of the most important factors in many skin disorders and diseases, including aging and cancer.

There are three main types of UV radiation; UVA, UVB, and UVC. UVA is the longest wavelength and is thought to be responsible for many skin conditions including skin aging and the onset of skin cancer. UVB, a mid-range wavelength, is thought to contribute mostly to the development of skin cancer, although it has been shown to play a role in aging and other skin damage.
UVC is the shortest wavelength that does not usually penetrate the atmosphere. However, UVC can also play a role in DNA damage. In many cases, the visible signs of skin aging, such as wrinkling, dryness, and discoloration, are caused by or worsened by UV exposure. Additionally, other skin conditions that can result from chronic sun and UV exposure, such as actinic keratosis, have been linked with increasing an individual’s risk of skin cancer, which can also be induced by UV exposure. UV radiation can also cause oxidative stress in skin cells, which is thought to be another contributor to skin disease and skin carcinogenesis.

Several antioxidants, including vitamins C, E, and the green tea polyphenol (−)-epigallocatechin-3-gallate (EGCG), have been shown to have protective effects against skin conditions. A number of studies have shown that resveratrol also possesses promise against certain skin conditions, including skin cancer, in preventive as well as in therapeutic settings.

Try to avoid sun exposure on your face when you have rosacea. You will avoid sun induced worsening of your rosacea, and as a bonus will develop less wrinkles (unless you smoke of course, tsk tsk tsk in that case).




Rosacea, Cathelicidin and Vitamin D

What is the link between vitamin D and rosacea? It can be explained by cathelicidin dysfunction. Normally, our bodies produce antimicrobial peptides or AMPs, which protect our skin against infection. Cathelicidin is an antimicrobial peptide that is found in the skin and it was found that individuals who do not produce or process cathelicidin properly are more likely to have rosacea. One of the ways with which cathelicidin can be regulated is through the intake of vitamin D3 supplements, which was found to regulate cathelicidin in the skin, and therefore treat or manage inflammatory skin diseases such as rosacea. (Source)

So do we have too much cathelicidin or do we just not produce and process them in the correct way? I am clearly not a scientific researcher, because I am lost slightly here..




I asked my dermatologist, an older German man who knows a lot about rosacea, about this. He replied to me:
"Vitamine D is very important for calcium levels, especially in female elderly persons. It has immuno- supressing activities in higher levels, by multiple mechanismus, obviously in ( auto-) immune diseases.

There is no sufficient evidence for rosacea, but one should try it ( more than three months. To be prescribed by your generalist) .

Cathelicidin levels seem to be regulated by genetic processes, and may be disturbed in certain deseases.

The Demodex mite plays a role in pustular rosacea of the elderly ( very old discussion!).

Should not be important for you."
   


Vicky has the same question and wrote on the rosacea forum:
"My internist recommended I take 2000 mg Vit D per day. My D level is low; it is within the normal range but only by one number-the range starts at 33 and my level is 34. I read (but didn't completely understand)some of the Gallo research and it seemed to indicate that Vitamin D increases the cathelicidin production, which is bad for us, right? However, I talked to my derm and he said if the D level is too LOW it can also interfere with cathelicidin expression. He encouraged me to take the Vitamin D." (Source).

Although I still don’t exactly understand the link between vitamin D and those cathelicidins, I am going with the opinion of both my dermatologist and my internist, who has kept stressing for the past 2 years that I should get my vitamin D levels up if I want to alleviate the auto-immune problems and if I want to get my inflammation-, T-cell- and ANA levels in the normal range. Last year I have been taking sun baths daily in the spring and summer. I made sure that I had full body exposure around noon, when the sun is at its strongest (around noon), for half an hour a day. Sun exposure at higher latitudes before 10 am or after 2 pm will, surprisingly, cause burning from UV-A before it will supply adequate vitamin D from UV-B. It means that sunning should ideally occur between the hours we have been told to avoid. Sunning between 10 am and 2 pm during summer months (or winter months in southern latitudes) for 20-120 minutes, depending on skin type and color, will usually form adequate vitamin D before burning occurs. I had my head in the shade and covered with a hat to avoid getting my cheeks burned and even used a small fan to not get overheated and flushed. It is important to not wear any sunscreen. That will block the formation of vitamin D by the sun. I guess it’s only an option for those who don’t burn easily. I noticed that I usually flushed for an hour or so after this session, but then I would get more pale and the next morning I would be less red as well. I developed a proper tan soon and my flushing and redness and inflammation seemed a lot calmer than in winter. So I will continue to do this in the spring and summertime from now on, if only to not fall back to a vitamin level of below 10 (severely low, must be 50 or greater ideally) like last winter. Now, there might be several factors at play here, since almost everybody gets worse in winter, with more extreme temperature changes etc. But I used a vitamin D lamp in winter and I do think I was a bit less bad than in other years. No miracle cure for me however, but I do think it improves matters a bit in my case. When I spent longer than this 30 minutes in the sun I got very overheated and overly flushed.





Here is a good and very informative article by a specialist about the benefit of sun and vitamin D, how UVA and UVB work exactly and what to watch for when we sunbathe. 

Washing your skin after sun bathing with soap, rinses it of its oils for instance, that are needed to process the UVB into vitamin D by the skin. Here is explained how that works.



Dr. Art Ayers writes an interesting blog about inflammation and anti-inflammatory diets. He wrote about this topic to a rosacea patient:
"Based on my understanding of the rosacea and reports of rosaceans, I would say that diet-based inflammation and the gut changes that result from that diet, are the foundation of rosacea. I would be baffled at antibiotic treatment that was not supported by an anti-inflammatory diet, including probiotics. I would expect that your wife is also deficient in vitamin D. I would recommend that she have her serum vitD checked and adjusted with increasing doses of D3. More serious cases of rosacea exhibit flareups in response to D3 or antibiotics." [..] "Sugar and starch definitely contribute to rosacea. Grain may contribute to common gluten intolerance and be a major source of gut problems that contribute to rosacea.” (source)





I personally found that taking vitamin D3 supplement pills of 1000 units or more made me flush pretty ferociously. And I know from some rosacea friends that they had similar problems. I am always suspicious of possible ingredients that might trigger a response so I usually opt for the organic version with little or no extra ingredients apart from the active ingredient and a vegetable capsule. But despite that, the supplements made me flush a lot, and long term as well. I think it might be related to me getting extra flushed from too much sun exposure as well. Small doses seem the only way forward in my case.

There were similar reports on the forums. Many tried the D3 supplements after Dan reported significant improvement from it, but not everyone had good results. I wonder if the high doses they took might be the reason for this. I will give an evaluation of the outcomes of these threads (one counting more than 130 pages!).
With regards to the vitamin D3 supplement pills I did some reading and found that even people with normal skin mentioned facial flushing! That was very typical indeed. It might have something to do with the way the D3 supplement pills are digested and absorbed by the body.




The vitamin D lamp that I mentioned is a UV narrowband light device and I have been using this for a minute or two every other day during the winter. It is made primarily for the treatment of psoriasis and eczema seems to respond well to it as well at times. The light can burn you, even though it is 'cold' light. It emits very narrow ranged UVB radiation and even one minute of skin exposure stimulates the body to produce vitamin D from the light. I rather have my body make its own vitamin D than to rely on a pill, that has to be absorbed etc etc. When you use the lamp too long, a red rash like a mild sunburn can appear on the exposed skin (usually my arms or legs), so it is key to not overdo it. It might be hard to believe that one single minute is enough, but I discussed it with a laser dermatologist who works with these devices for his psoriasis patients and with the manufacturer of the lamp. The laser derm stressed to not overdo it with the lamp and to start with 30 seconds one both arms (so two times 30 seconds). He mentioned that it is best to expose skin to the lamp that normally tans the easiest or that has the best tan already; that skin will produce far more vitamin D than white, unexposed skin will do.
(However, I read conflicting information about this. Scroll down to the UVB narrowband specification where I marked a *). I try to stick to his suggestions and when I use the lamp 1 minute for my arm and another minute for my leg and another minute for the other leg, I feel I overdo it and although I dont get sunburn reactions, I do feel and look more flushed and red, so you need to find the right balance. But when I use it for one minute every other day, my skin looks calmer than when I don't use the lamp. A friend uses it as well and he developed a proper skin burn (like a sun burn, marked redness and burning) after using the lap for 3 minutes at close range on one part of skin, so be careful. 




And another positive side effect of proper vitamin D
levels is that it is supposed to protect to a degree from cancer. In this link vitamin D is called an anti-angiogenic. It is a well recognized regulator of cell proliferation and differentiation and has the potential to block tumor growth by inhibition of the neoangiogenic process. Sunbathing for hours on end is not a wise idea if you want to protect yourself from getting skin cancer (or wrinkled skin for that matter), but from what I read sunbathing for a short period of time per day, without sunscreen since that blocks UV absorption and therefore vitamin D production -and only when your skin is strong enough to tan by itself and DOESN´T turn red- is not as bad as the cosmetic industries have portrayed it to be the last decades. And I am really careful, since my uncle suffered from advanced and life threatening skin cancer, but the body also needs sufficient vitamin D levels to fight off all other sorts of cancers and to keep a healthy immune system. I also read that every time you develop a proper sunburn, you will multiply your chances of getting skin cancer. So it might also be key to sunbathe for this short amount of time and to be vigilant about not developing any form of sunburn. I am lucky that I tan normally on my body and that only my face burns and gets burned easily.




If you like to try adding vitamin D to your regime, and don't want to expose your (body) skin to direct sunlight or use a UVB lamp or use supplement pills, there is also a synthetic form of vitamin D available in a cream called Calcipotriene. It may also help to control sebum production and, therefore, provide some relief for acne sufferers. Apparently, vitamin A interferes with D, so avoid retinols if you decide to give this therapy a go.

And If you are interested in vitamin D supplements, you should take a look at www.vitaminD3world.com The Canadian Cancer Society now recommends that everyone take vitamin D to prevent cancer. The site has good summaries of the data and offers a new preparation of vitamin D in a micro-pill formulation. The pills have been formulated with cellulose which absorbs water very quickly. This ensures that the pill breaks up very quickly to provide for maximum absorption. The micro pill is tiny and tasteless. Many vitamin D pills on the market have very poor dissolution properties resulting in poor absorption. The site also offers to supply customers with a free supply of 400IU for their children and it also has a good newsletter.





More information on the uvb narrowband 311 nm light device:
Here are some links for the device, and some solid scientific evidence that it really improves vit D levels:
http://www.uvb-311nm.com/en/5-uvb-na...-for-psoriasis
http://www.uvbnarrowband.com/index.p...vb-narrowband/
http://www.cbc.ca/news/background/he...-d-winter.html
http://www.solarcsystems.com/vitamin...erapy-faq.html

The type of uvb narrowband that I have, has a small wavelength that is optimal for vitamin D production by the skin, with less chance of sunburn.(Source)


"UVB Narrow Band is a subset of the UVB Wideband or Broadband spectrum. The UVB band comprises the range of wavelengths between 290 nm and 320 nm while UVB Narrowband is a "narrow band" of wavelengths centered at roughly 311 nm. UVB Narrow Band UVB is fast becoming the defacto standard in UV Phototherapy for Psoriasis, Vitiligo and Eczema UVB Narrow Band causes less sun burning or erythemal effect than other treatments such as UVB Broadband. The chart above shows that the skin's erythemal (sun burning sensitivity) is at its max at around 297 nm and that UVB NB with it's spectra centered around 311-313 nm generates very low erythemal response. This allows the user to have longer treatment times before "seeing" an erythemal response. UVB NB is fast becoming the recommended treatment to replace Broadband UVB and PUVA. Most of Amjo's sales today are UVB Narrow Band units. Clinical studies have shown that the peak therapeutic effectiveness of UVB to be between 295 to 313 nm and that wavelengths below (shorter) than roughly 300 nm are more likely to cause a strong erythemal response or severe burning. UVB Narrow Band is in the 311-313 nm range and causes less burning than shorter wavelengths."



How effective is UVB light for Vitamin D production ?

"If a 100% of a person's skin area can be exposed to UVB light, one single dose of sub-erythema UVB (1 MED) can make the equivalent of 10,000 to 25,000 IU of Vitamin D orally. (Holick) Note that it would NOT be advisable to take 1 MED because that dose is too close to burning, and such a large dose is not necessary if regular exposures are taken; but this does show that getting Vitamin D using UVB light is much more effective than getting Vitamin D through diet or supplements. "Sub-erythema" UVB is the dose just slightly less than the dose needed to cause mild skin burning. Erythema is undesirable because it causes patient discomfort, is a major risk factor for skin cancer, and reaching that state does not produce any additional Vitamin D. By irradiating a larger area of skin, a lower dose per unit area can be taken to create the same amount of Vitamin D, thus maximizing Vitamin D production and minimizing the risk of adverse effects. Or, in other words, the cumulative risk is minimized by spreading it over a larger area. Alternatively, if a small phototherapy device is used, treatments can be taken on different parts of the body on alternate days. If the device produces significant quantities of UVA, this may minimize the formation of a tan, which impairs Vitamin D production and forces longer treatment times. If some areas of the body have received significant amounts of cumulative UVB during a patient's lifetime; such as the face, shoulders, upper back, etc.; it is sensible to NOT further irradiate these areas of the body for Vitamin D production. Conversely, using areas that have received very little cumulative UVB during a patient's lifetime are the best sites to use, such as the buttocks.* All assuming again, that burns are strictly avoided. 


Research that has been done to establish whether the UVB narrowband light does indeed increase vitamin D levels in patients:

From a study entitled “The Effect of Narrowband UV-B Treatment for Psoriasis on Vitamin D Status During Wintertime in Ireland”
To investigate whether the Narrowband UV-B does in fact raise vitamin D levels, researchers followed 60 psoriasis patients during an Irish winter — between October 2008 and February 2009. Half were treated with UVB light therapy three times a week until their psoriasis cleared; the others received no light therapy. Vitamin D levels in the blood were measured along the way. The researchers found that the average patient undergoing UVB light therapy more than doubled their blood levels of vitamin D by the end of the treatment period, which most completed in about 50 days. All of them reached vitamin D sufficient levels, the researchers report in the Archives of Dermatology. As expected, psoriasis also significantly improved with UVB light therapy. Half the patients started out with psoriasis severity scores above 7.1, and by the end of treatment half had scores of 0.5 or below. SOURCE: archderm.ama-assn.org/ Archives of Dermatology, online August 17, 2010.



Another study researched the connection between vitamin D levels and rosacea. In ´The Vitamin D pathway: a new target for control of the skin´s immune response?´, researchers concluded that `Dysfunctional of cathelicidin is relevant in the pathogenesis of several cutaneous diseases including atopic dermatitis where cathelicidin induction is suppressed, rosacea, where cathelicidin peptides are abnormally processed to forms that induce cutaneous inflammation and a vascular response, and psoriasis, where a cathelicidin peptide can convert self-DNA to a potent stimulus of an anti-inflammatory cascade. Recent work has unexpectedly identified vitamin D3 as a major factor involved in the regulation of cathelicin expression. Therapies targeting the vitamin D3 pathway and thereby cathelicidin may provide new treatment modalities in the management of infectious and inflammatory skin diseases. (Source)

Here is information about the link between low vitamin D levels and depression and anxiety.
iDan also made another interesting post about cytokines and depression/inflammation:
And here is a pubmed search on "Vitamin D Pain" as low 25(OH)D levels have been linked to general "musculoskeletal pain", "unusual pain syndrome", "chronic pain", etc:
I personally improve my vitamin D levels only slightly, but there is something called Vitamin D toxicity, so don´t overdo it (mainly an issue when someone uses high dosed supplements).





Patients who saw improvement in their rosacea after introducing extra vitamin D:
Melissa wrote: I have had rosacea for several years and was diagnosed with Vitamin D defeciency last week. I started taking OTC Vitamin D and within the week noticed a reduction in the redness from my rosacea. Thinking it was due to the Vit. D, I did a search and ended up here. I am very hopeful that I will continue to see improvements!! In the meantime, I will keep using my Finacea and Differen! 

Ken wrote: I started taking vitamin D3 in the form of a tiny gel tab from Costco three days ago. I didn't take it for my rosacea, but I noticed that after only one day, my rosacea had substantially improved. I've learned not to get too excited about this sort of thing, but after only three days and three vitamin D3 tabs later, my symptoms are just about gone. I have a pretty bad case of the condition and so consider this nothing short of a miracle. Hooray!

Julie Kay wrote: I've been lax in taking my vitamins the past couple months; D3 being one of them. I finally reordered and am back on my regimen. I take 4,000 units of D3 a day and have (again) for about two weeks. Reading these comments, I realize my cheeks are less red and lightening to a rosy hue! Brilliant. ~jk

Driven wrote: Much more than 2,000 IU/day of D3 and I get very gradually worse. It's so slow that it's almost unnoticeable. However, 1,000-2,000 IU and careful trigger avoidance works wonders. For me, anyway.
And later: I got worse on 1,000 IU, then improved quite a bit after a few weeks. The same happened when I increased to 2,000. I experience the most benefit from 2,000 IU - any more and the bad effects don't go away. I now consider it one of the most important supplements in my arsenal against rosacea.

Melissa W wrote: I have been taking higher doses of vit D3 for a few years now and I think it helps my overall health and my rosacea but these are just anecdotal findings and not hard facts. As with everything in rosacea it is such an individual response and difficult to generalize so all you can do is read what other people's experiences are and then decide if it is worth trialing yourself. I like to keep my blood levels of D in the 60-90 range and find that taking about 5,000 IU's of D3 helps me do that. As with everything medical though please be sure to OK it with your doctor as the RDA of D3 (I think) is 2,000 max. 
And: I haven't had it checked for at least 6 months but it was in the high 60's at that time. my derm asked that I decrease my vitD3 intake from 10,000 IU's so I take about 5,000 (to 7,000) now but my intake does vary as does my outside exposure to the sun. In the summer I am outside all the time and my vit D levels are higher. I am doing well, thanks for asking. Still on Oracea and still have good days and flares but all in all no complaints. 


And: I think Vitamin D3 has a huge central role in our health and so while its deficiency may not be a cause for rosacea it certainly may play an important role as evidenced by Dan's remarkable change and as far as I know Twickle Purple's improvement. Of course there were other factors at play in their health profile so as MediumDog states it is a generalization and should not be extrapolated from one individual to another. However, I believe that almost everyone can benefit by getting their vit D levels up unless they are already in the desired range. If you read the article courtesy of Dan you will see that the desired level is much higher than previously thought. 


Vicky wrote: My internist recommended I take 2000 mg Vit D per day. My D level is low; it is within the normal range but only by one number-the range starts at 33 and my level is 34. I read (but didn't completely understand)some of the Gallo research and it seemed to indicate that Vitamin D increases the cathelicidin production, which is bad for us, right? However, I talked to my derm and he said if the D level is too LOW it can also interfere with cathelicidin expression. He encouraged me to take the Vitamin D.



Strive wrote: I have to say I feel so much better than I did. It's fairly amazing to me how one little vitamin can have so much impact.
Mistica started off with more flushing when she used vitamin D3 supplements but improved later on.  



Patients who saw no improvement or worsening in their rosacea after introducing extra vitamin D:
Kip wrote: I had my vit D level tested and went from 25 to around 38 and noticed no difference in redness. For those taking a supplement, vit D can rise pretty quickly so be sure to test now and then to make sure you don't over supplement.


Tmon 912 wrote: Anybody else notice vitamin D3 making their rosacea worse?


Bloem wrote: D3 made me flush like crazy (within a few days of starting it if I remember correctly). I did not have my levels checked. (and:) . I did try 2 different brands. But it got so bad that I stopped taking them and I'm to scared to try again. Things are sort of under control right now.


V70r wrote: This might interest you. When it comes to vitamin d.... I don't feel like I get flare ups from drinking milk. But if I drink too much milk I might, I have never tried it. But when I take vitamin d3 supplements i really react to it by flaring up. Another thing. I use to work outside in the sun. When I did my rosacea was 100 times better. What does all this mean?? mrsmoof: "I know my rosacea is much better when i am in the sun as well."



MasK wrote: "Some of us like iDan (you can search for his posts) experienced worsening when taking D, then improvements, to the point of total remission. Although some ppl here saw their symptoms worsen, I must say I'm now taking 10 000 IU's (I think you are speaking about international units and not mg) and I don't see much difference, still redness, veins, and flushes. But my gut issues have not been fixed yet. My level of vit D is near 100 and was 10 2 years ago."


Daftpunk wrote: My personal experience has been varied. There was one summer where my face had been flushy for perhaps a few weeks, I started taking 1000 (whatever measurement) vitamin D pills and it cleared it up instantly and it lasted for some time. Right now my face is just getting better after a month of being flushy (it took a mix of oregano oil, peppermint oil, and nicotinamide for a few days and now its looking awesome again.(all oral supps.)) During that month period I tried vitamin D a few times with bad results. Overall, sometimes it helps my redness and sometimes it hurts, it is confusing and tends to make me stick with my bread and butter rosacea supplements. Reading this kind of wants me to try again, might as well, it is healthy after all. 

Roz wrote: No can't say that I have noticed much change in the rosacea with the supplementation. I wish I could say there was an improvement. Yet, I will continue with the supplementation for a variety of reasons based on so much that I have read about the beneficial effects of vit d. And, also based on the fact that if I didn't supplement , my vit d level would be too low.

Findingaway wrote: I did experience increased redness and flushing as I increased my dose by 2000 each week to 10,000IU which has subsided a bit now thank goodness.(kept using the vitamin D).



Lookout wrote: Well I tested my reaction to VitD3 again today....I took 2 400iu tablets.....within 20mins my face started burning and it has taken about 6hrs for that to die down.....I seem to have a severe neg reaction to it for some reason while others are taking 1000-2000ius or more w/o any neg reaction.....I am very confused about this....I know some suggest die off but I only took a very small amount so that doesn't make much sense to me. Also took 2 Advil to help....it didn't work for me at all....burning continued.



Phlika29 wrote: When I was taking it I found that my acne, skin texture and KP improved but like lookout it significantly increased my flushing. When I stopped it so did the flushing. In my mind there appeared a clear correlation between taking the tablets and increased flushing. This was about a year or more and so I will buy some more and give it another go.  




In a thread called The Truth about vitamin D, on the rosacea forum, Quiller writes about vitamin D: 
"Basically, excess vitamin D in the form of 25-D (the storage form) is a bad thing, suppressing the immune system and leading to bacterial infections which suppress the immune system even further:

At the moment, most researchers understand that 1,25-D activates the Vitamin D Receptor. However, they are unaware of the models which demonstrate that 25-D has the opposite effect. Consequently, they do not understand that when people start to supplement with extra vitamin D (which is converted into 25-D) the Vitamin D Receptor begins to turn off, not on.

L-form bacteria begin to live inside the cells of the immune system and in various tissues. These bacteria create proteins that, just like elevated 25-D, are able to bind and block the Vitamin D Receptor. Together, elevated 25-D and bacterial proteins block the ability of the Vitamin D Receptor to turn on the immune system more than either substance alone.
I really don't have any well-formed thoughts about this yet, I just wanted to post it for your consideration. I would also like to know what anyone thinks about the Marshall Protocol.

·     The common denominator in these illnesses is the invasion of white blood cells by tiny cell-wall-deficient bacteria. These bacteria activate the immune cells they penetrate, stimulating production of inflammatory cytokines. Because the bacteria are stimulating the T-helper 1 process of the immune system, the result is called Th1 inflammation.


·     Elevated levels of 1,25-D - the active hormone metabolized from Vitamin D - is a defining characteristic of Th1 inflammation. In healthy people, Vitamin D (25-D) is converted to 1,25-D in the kidneys, where the levels are regulated to match the body's needs. In people with Th1 inflammation, infected white blood cells convert 25-D to 1,25-D independently of the kidneys, causing levels to rise above what the body requires.

Elevated 1,25-D makes it easier for the bacteria to move in and out of cells, protecting them from the immune system. As more bacteria are able to parasitize white blood cells, they in turn produce still more 1,25-D. This vicious cycle largely accounts for the chronic nature of Th1 illnesses. There seems to be a crossover between the list of conditions possibly caused by 1) Cpn 2) the NO/ONOO- cycle and 3) Th1 inflammation: Prof. Marshall's papers describe how numerous Th1 diseases such as sarcoidosis, Lyme disease, chronic fatigue syndrome, fibromyalgia, lupus and rheumatoid arthritis (among others) are caused by Cell Wall Deficient (CWD) bacteria of various species." (source that the writer uses: The Truth About Vitamin D: Fourteen Reasons Why Misunderstanding Endures).

There is a great video lecture explaining the D3 deficiency at the bottom of a link by Dr. Michael Holick.




I responded to this thread recently, regarding vitamin D and rosacea:



"I also find vitamin D a highly contradicting substance :S
Every time I take D supplements (pills, drops, fortified foods) I get massive flushing. But when I sunbathe about an hour or 1,5 hours during midday (only face in the shade), my rosacea calms down enormously. Even people around me can tell and make comments about it. I discussed it with my dermatologist and immunologist and the first said that real sun exposure might be the best way to store vitamin D in the body, as it is the most effective and natural way, your body is exposed to all the right light spectrum rays and pills can indeed cause flushing in fact (I suspect the side products, or the high dose, or the metabolism issues it gives, or it just not being the real natural thing and our bodies not being designed to getting our D's from pharmaceutical pills perhaps?). And the immunologist says that most of his patients with auto immune diseases and inflammation issues in the body have low vitamin D levels. Also his eczema patients for instance. And that in his opinion raising D levels to a normal or higher range will in fact lower overall inflammation.

If you are pale and have a skin that easily develops sun burn, this all might be a problem. I only get sunburn on my face, the rest tans immediately, so I sunbathe wherever possible at noon, when the sun is most powerful, for an hour or so and like I said, whenever the sun is out again I nowadays do so much better than in winter. Winter is pure rosacea hell. In terms of skin cancer risk, I asked the docs about this too and you'll get a different answer from anyone you ask most likely, but what I understood, the risks go up whenever you develop sun burns. But vitamin D has proven to protect you to a degree from other forms of cancer and slowly scientists are starting to acknowledge that low vitamin D levels (almost all north western Europeans are deficient at least 8 months of the year) actually exposes us to more risk of cancer.

If I were you I would just try out what sunbathing (protect face religiously! And NO sun screen as that will block the skin from the rays and will also block the vitamin D production) does for your overall flushing and inflammation, once the sun is out again "




Here are some links to threads where people discuss using vitamin D tablets and getting more or less flushed, or discussing sun exposure versus rosacea:
http://www.rosaceagroup.org/The_Rosacea_Forum/showthread.php?28309-The-vitamin-D-dilemma/page3

 











I am not sure if what Quiller wrote is true, and that storing vitamin D in the body is a bad thing for us. I just wonder if lowering the immune system isn´t actually a GOOD thing. I don´t know about all the other rosaceans, but my immune system is way too active, overly active, causing extra inflammation and every time my immune system is low, like with flu or illness, my rosacea improves. My derm even used immunosuppresive medication for his most severe rosacea patients and it improved their rosacea drastically from wat he told (bummer the side effects are outrageous). I even read a quite surprising article once about a rosacean who had chemo therapy for cancer and her rosacea improved a lot, probably due to the lowered immune system. Then there are a lot of people who mention increased flushing, especially from the D3 supplements. A lot also write that actual (body) sun exposure in the summer seems to improve matters. I am not sure why this happens. I know that I also flushed more from the D3 supplements but that I seem to lower the redness with conservative use of the uvb narrowband light device. I also am less red in summer when I sun bathe regularly, for about 20 to 30 minutes a day. When I sunbathe longer I get more red. Anyway, the verdict is still out there but there seems no harm in trying vitamin D supplements in whatever form for yourself..
Wishing you all a happy Christmas with lots of snow and a healthy New Year! Also a paw from the cats. 





This week I had good and bad days (I hate the red face so much) :(
                                                                                                   
 

 





Update, December 20th 2013

In this article, it is stated that: "Vitamin D influences more than 200 genes. This includes genes related to cancer and autoimmune diseases like multiple sclerosis. Vitamin D affects your DNA through the vitamin D receptors (VDRs), which bind to specific locations of the human genome.
Reuters reports:

    “Vitamin D deficiency is a well-known risk factor for rickets, and some evidence suggests it may increase susceptibility to autoimmune diseases such as multiple sclerosis (MS), rheumatoid arthritis and type 1 diabetes, as well as certain cancers and even dementia.”
Reuter’s information is actually a bit misleading as other scientists have identified a total of nearly 3,000 genes that are upregulated by vitamin D. The particular study referenced above identified 200 genes affected, but it’s not clear if that is in addition to the ones already identified, or if they simply confirmed many of the ones found by others.
One thing’s for sure: Vitamin D is one of the major keys for disease prevention and for optimal health.

The Astonishing Power of Vitamin D to Transform Your Health


In recent years vitamin D has emerged as a star of the “vitamin” world. For example, there are currently over 800 studies showing vitamin D’s effectiveness against cancer. Optimizing your vitamin D levels can literally cut your risk of several cancers by 50 percent!
Further, middle aged and elderly people with high levels of vitamin D could reduce their chances of developing heart disease or diabetes by 43 percent.

How Does Vitamin D Do What it Does?


Vitamin D is actually a “prohormone,” which your body produces from cholesterol. Because it is a prohormone, vitamin D influences your entire body -- receptors that respond to the vitamin have been found in almost every type of human cell, from your brain to your bones.
So what modern science has now realized is that vitamin D does more than just aid in the absorption of calcium and bone formation, it is also involved in multiple repair and maintenance functions, touches thousands of different genes, regulates your immune system, and much, much more.
Just one example of an important gene that vitamin D up-regulates is your ability to fight infections, as well as chronic inflammation. It produces over 200 anti microbial peptides, the most important of which is cathelicidin, a naturally occurring broad-spectrum antibiotic.
This is one of the explanations for why it’s so effective against colds and influenza.
In addition, since vitamin D also modulates (balances) your immune response, it can prevent an overreaction in the form of inflammation, which can lead to a variety of autoimmune disorders, such as Crohn’s disease for example.
When you consider the fact that you only have about 25,000 genes in your body, and vitamin D has been shown to influence nearly 3,000 of them, the bigger picture of its true impact on your health can be easily understood.
It may, in fact, have literally thousands of health benefits!
However, it’s also very clear that unless you have taken specific measures to address it, the odds are overwhelming that you are deficient in this important nutrient.

Are You Vitamin D Deficient?


Vitamin D deficiency is a growing epidemic across the world and is contributing to many chronic debilitating diseases. There are a few reasons for this trend.
First, most people spend far too much time indoors during daytime hours. You may also have also been seriously misled by “expert’” recommendations to avoid all sun exposure, and to slather yourself with sunscreen whenever you do go outside. Please understand that sunscreen will virtually eliminate your body’s ability to produce any vitamin D because it blocks the UVB radiation that causes your skin to produce it naturally.
As a result, in the United States the late winter average vitamin D is only about 15-18 ng/ml, which is considered a very serious deficiency state.
In fact, new studies show that about 85 percent of the U.S. population is vitamin D deficient. This is primarily related to the recent appreciation that your levels of vitamin D should be MUCH higher than previously thought.
Consider the following vitamin D facts:
  • Vitamin D deficiency is epidemic in adults of all ages who have increased skin pigmentation, such as those whose ancestors are from Africa, the Middle East, or India, who always wear sun protection, or who limit their outdoor activities.
  • African Americans and other dark-skinned people and those living in northern latitudes make significantly less vitamin D than other groups.
  • 60 percent of patients with type 2 diabetes have vitamin D deficiency.
  • Studies showed very low levels of vitamin D among children, the elderly, and women.
  • One nationwide study of women revealed that almost half of the African American women of childbearing age might be vitamin-D deficient.
Winter, when sun exposure is at its lowest, is the time of year when you need to be most concerned about the amount of vitamin D you are receiving, as your vitamin D levels can drop by up to 50 percent in the winter.
Of course, if you have the tendency to spend the summer months indoors, out of the sun, or you only go outside with sunscreen on, then you would need to be concerned during the summer months as well.

The Many Health Benefits of Vitamin D


It’s absolutely tragic that dermatologists and sunscreen manufacturers have done such a thorough job of deterring people from the sun -- your optimal source for natural vitamin D.
Their widely dispersed message to avoid the sun as much as possible, combined with an overall cultural trend of spending more time indoors during both work and leisure time, has greatly contributed to the widespread vitamin D deficiency seen today -- which in turn is fueling an astonishingly diverse array of common chronic diseases, including:
Cancer Hypertension Heart disease
Autism Obesity Rheumatoid arthritis
Diabetes 1 and 2 Multiple Sclerosis Crohn’s disease
Cold & Flu Inflammatory Bowel Disease Tuberculosis
Septicemia Signs of aging Dementia
Eczema & Psoriasis Insomnia Hearing loss
Muscle pain Cavities Periodontal disease
Osteoporosis Macular degeneration Reduced C-section risk
Pre eclampsia Seizures Infertility
Asthma Cystic fibrosis Migraines
Depression Alzheimer’s disease Schizophrenia

Vitamin D Against Cancer


A study by Dr. William Grant, Ph.D., internationally recognized research scientist and vitamin D expert, found that about 30 percent of cancer deaths -- which amounts to 2 million worldwide and 200,000 in the United States -- could be prevented each year with higher levels of vitamin D.
Other studies showed that you can decrease your risk of cancer by more than half simply by optimizing your vitamin D levels with sun exposure.
Vitamin D has a protective effect against cancer in several ways, including:
  • Increasing the self-destruction of mutated cells (which, if allowed to replicate, could lead to cancer)
  • Reducing the spread and reproduction of cancer cells
  • Causing cells to become differentiated (cancer cells often lack differentiation)
  • Reducing the growth of new blood vessels from pre-existing ones, which is a step in the transition of dormant tumors turning cancerous

When is the Best Time to Go Out in the Sun, and for How Long?


The optimal time to be in the sun for vitamin D production is as near to solar noon as possible. That would be between roughly 10:00am and 2:00pm.
During this time you need the shortest exposure time to produce vitamin D because UVB rays are most intense at this time. Plus, when the sun goes down toward the horizon, the UVB is filtered out much more than the dangerous UVA.
When you’re out in the sun, be very careful about the length of your exposure. You only need enough exposure to have your skin turn the lightest shade of pink. This may only be a few minutes for some. Exposures any longer than this will not produce any more vitamin D but will accelerate photo aging and increase your risk for non-melanoma skin cancers like basal and squamous cell cancers.
Once you reach this point your body will not make any additional vitamin D and any additional exposure will only cause harm and damage to your skin.
Most people with fair skin will produce the maximum amount of vitamin D in just 10-20 minutes, or, again, when your skin starts turning the lightest shade of pink. Some will need less, others more. The darker your skin, the longer exposure you will need to optimize your vitamin D production. African-Americans need perhaps 20 percent more sun exposure time than whites.
And contrary to popular opinion, your body simply cannot make adequate vitamin D from the sun unless you have more skin area exposed than just your face and hands. In fact, at least 40 percent of your body should be uncovered to optimize your vitamin D production.
Another option is to use a safe tanning bed, again paying attention to not getting burned.

New Way to Protect Against Sunburn


A few months ago I found out that a carotenoid extracted from algae called astaxanthin can be extremely useful in preventing and eliminating sunburn.  Interestingly, this is the antioxidant in krill that prevents it from being damaged.
What current research is showing is that if you are on 2 mg of astaxanthin for a month, it becomes very difficult to get sunburned.
Additionally, it also appears to prevent the development of the most common form or blindness, age-related macular degeneration, as well as cataracts, and most likely protects you from EMF when you are flying or being exposed to diagnostic X-rays.
The key though is that it takes weeks to build up in your tissues, so you  can’t just swallow a few pills prior to your exposure and expect to receive any benefit. Astaxanthin is also fat soluble and needs to be taken with some fat or you simply won’t absorb it.

Vitamin D Supplements: How Much Should You Take?


It is wise to consider oral vitamin D3 supplementation during the winter months, or year-round if you haven’t time or sufficient access to the sun or a safe tanning bed.
However, the Reuter’s article above is years behind the research on their recommended dosage of 1,000 IU’s a day
It’s true, there are no definitive studies on the optimal daily dose of vitamin D, but based on studies on healthy indigenous peoples, many vitamin D experts now agree that most adults, including pregnant women, require about 5,000 IU of vitamin D daily for optimal health – or 35 IU’s of vitamin D per pound of body weight, which is certainly well above the current RDA.
That said, although these recommendations may put you closer to the ballpark of what most people likely need, it is impossible to make a blanket recommendation that will cover everyone’s needs.
The ONLY way to determine how much you might need is by testing your blood level of vitamin D.
This is in fact a very important aspect of optimizing your vitamin D levels that you should not skip over.
Why?
Because while overdosing on vitamin D from sun exposure is highly unlikely as your body has a built-in “failsafe” feedback loop, which will tend to shut down production when your levels are healthy, it IS possible to overdose when taking supplements.

So you need to be careful when using oral vitamin D therapy and make certain you have your blood levels checked. Many of you may choose to ignore this warning, but I am telling you in no uncertain terms that while vitamin D has enormous potential for improving your health, it has significant potential to worsen it, if you use it improperly.

What Vitamin D Level do You Need to Stay Healthy?


The OPTIMAL value of vitamin D that you’re looking for has recently been raised to 50-70 ng/ml, with even higher recommended levels required for more serious disease prevention, as shown in the chart below.   Vitamin D Levels - Hydroxy D
I hope you can see now some of the many benefits of vitamin D, and why it is so critical to make sure you and your family maintain healthy levels at all times.
Please take this opportunity to use one -- or more -- of the options I’ve suggested for getting your daily dose of vitamin D. Optimal vitamin D, however you get it, can literally make the difference between a lifetime of chronic disease and one of vibrant health and vitality.
For even more information about this essential nutrient, please peruse the links below.




And on a side note, the link between autoimmune disease and cancer risk (link):

Autoimmune Diseases Affect Cancer Risk

No. 54 | 10/10/2011 | by Kün / Koh
In a recently published study, scientists of the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) have calculated the interrelations between autoimmune diseases and cancer of the digestive tract. They discovered that many autoimmune diseases increase the cancer risk, while others, such as rheumatism, are associated with a significantly lower bowel cancer risk. These differing impacts on cancer risk may be attributable to the medications administered.

enlarged view In some autoimmune diseases antibodies turn against the body’s own structures | © Roche
An association between autoimmune diseases, in which the immune system attacks the body's own structures, and a higher risk of getting cancer has long been suspected. Kari Hemminki, an epidemiologist at DKFZ, has now studied, jointly with colleagues from Sweden, this interrelation between 33 different types of autoimmune disease and 11 different types of cancer of the whole digestive tract (oral cavity, esophagus, gastrointestinal tract, liver, and pancreas). It turned out that most autoimmune diseases increase the cancer risk in those affected. 




A possible cause of the increase or decrease in cancer risk of patients with autoimmune diseases is medication: Many of these diseases are being treated by immunosuppressive drugs. Thus suppressed, the immune system is no longer capable of efficiently fighting tumor cells. This results in a higher cancer risk. Anti-inflammatory drugs, however, may lower the risk of getting cancer. Thus, it was shown that aspirin agent ASS, which is contained in many antirheumatic drugs, can prevent cancer.

Most people with rosacea don't take immuno suppressive medication and some rosacea pateints have underlying autoimmune diseases and an overtly active immune system. Today, December 20th 2013, news broke that there is a new cancer treatment, where people's  immune system gets activated strongly and this helps so far about 25% of patients. I wonder if patients with an overtly active immune system have less cancer risk therefore.







June 20th 2014

I received a very interesting email:
"First just wanted to say you did a great job with the comprehensive write up on Vit D, and its possible effects on rosacea. I just wanted to give you my experience as I am quite convinced it is relevant to your write up. I am a 32/M. Never had any serious health issues. About 3 or 4 mos ago I developed angular chilitis. It was clear to me what it was so I did research to try to find the cause. Vit D deficiency was my top guess as I don’t eat anything that contains Vit D and my irish skin makes me stay out of the sun as much as possible. So I get tested for Vit D deficiency and I had a level of 6. I have never had rosacea symptoms in my life but would get flush every once and awhile if I worked out hard, but not often. I was given 50k unit megadoses which I was to take for 8 weeks. Less than 1 week in I had CONSTANT flushing. I thought it was awfully strange that it started right after but kind of just hoped it would go away and knew I had to take it because my levels were so low. 2 wks later the flushing clearly started showing all classic signs of rosacea(never had a mark on face before) Rosacea does run in my family thou. There is NO question in my mind the vit D triggered my rosacea symptoms. Theres just no other explanation as to how I would go from having ZERO sign of rosacea, to a rapid development of it, at the EXACT same time I started taking the megadoses. I have also read the study and the HIGH correlation of increased serene protease and cathelicidine in rosacea patients, and the fact that VIT D supplementation increases this production makes it even more unlikely its a coincidence. I also find it too coincidental that the sun is such a huge trigger for rosacea patients, and that I have become ULTRA photosensitive ever since. It is curious that some people improve by taking VIt D, but I think it probably has to do with each individual person and the amount of IU the person is taking. Just wanted to let you know my personal Vit D experience and that its triggering of flushing/rosacea symptoms is undeniable! hope its useful :)"

I replied:
"Thank you! That was an interesting read. Would you mind if I share it in the blog post on Vit. D? Its interesting as you were flush free prior to starting the D injections and it sounds pretty plausible that it immediately responded to it. I never really believed the big hype that was going on a few year ago, when everybody on the rosacea forums swore by vitamin D pills. I mean, I never believed that this vit. D supplementation would be problem free for bad flushers, ultimately. Like you, I get severe flushing from even half a D3 tablet. I notice that when I sunbath, often no longer than 30 minutes, I get very flushed the rest of the day. But, in the long run, I feel I am less red and less inflamened when I built up a bit of a tan. So am still pretty confused about how all this exactly works, apart from the good point you make on the serene protease and cathelicidine. It i clear as day to me that high doses of vit. D supplements or long sun exposure really sets my rosacea off badly, and probably for these chemicals that cause instant vasodilatation. I just fear that being severely low on D as we are, will in the long run cause immune related issues and inflammation. As my prof said, to lower inflammation in auto immune disease they always suggest upping the vit. D to acceptable levels. However, those patients don't typically deal with hypersensitive facial blood vessels.... 
Awful that this seems to have triggered your rosacea. I do believe however that for ppl like us, with the predisposition and the genetic make up for rosacea, it could be a lot of different things that trigger it into full bloom. I always wondered, what if.. if I had never used the cortisone cream? By now I am convinced I would have developed the roacea then anyway, maybe a year or more down the line, from hormonal changes, or stress, or whatever. Maybe this is the case with you too, or maybe vitami D can actually cause rosacea in some? What are your thoughts on this?
Best wishes Nat "

Hi...Yes you may post my comment as long as don’t use my name or email. I think its a legitimate concern people should know about. I agree its a tough position to be in, even if I knew this was a risk. I was def experiencing bone pain, and probably would have been scared into taking it anyways. However, knowing what I know now after researching, I would have never taken such high megadoses. The truth is most doctors don’t have much of a background in vitamins. And even if they do, like most other things, they aren’t going to tell you anything thats not in their little book that deviates from the "standard of care" because these days everyone would sue unfortunately. So basically if you have a symptom, and 50% of the people with that symptom have a certain illness….thats what you have. I always thought docs knew everything but obv I learned thats not true early on. The good ones should keep up on new research and have a hunger to learn everything, the bad are just narcissistic and think they already know everything. Experience is huge imo. You can be the smartest person on earth but nothing can replace experience, and having seen the issue before. But with experience and knowledge also comes narcissism and stubbornness. My vit D levels are finally above 20 so I’m thinking bout stopping and trying to just get more natural sun. I stopped the 50k megadoses after 4 wks but I have been taking 1000-2000IU/day liquid until I got up to 20. Im hoping I didn’t trigger something permanent but who knows. Did you have a decrease in flushing when you stopped the Vit D supplements? It makes sense that its not in our genetics to be taking artificial doses. Pretty sure our ancestors didn’t use that crap ;) Plus the whole idea of vit deficiencies having such an impact on our bodies is relatively new so theres no way they know what some of these megadoses do….esp long term. Thats why I’m so hesitant to take anything new. Its like, you’ve tested it for 5 yrs how do you know what it does to me 20 yrs from now! :) oh ok ill take the company selling its word for it, sounds good :p That study seems seems pretty conclusive to me, I mean every person with rosacea had elevated amounts of sp and c. But I don’t see any more research into it. The wheels in the medical world def turn slow :) 

Thanks, its on there without your name or contact data. Thanks heaps, very good mails. I find that with me the increased flushing and redness wears off, but I think I read vit D is stord in your fat reserve. Yeh it is: http://www.health.harvard.edu/newsweek/vitamin-d-and-your-health.htm
When you take a mega dose, I assume it is stored and it is not a quick matter of time before you flush it out, like that is the case with many other supplements. So the side effects might linger, as the body breaks the reserve down slowly. Hence why I only sunbath a short period of time and try to have a steady and slow stream of vitamin D to the body, but in very low numbers. When I am still more flushed the next days, I don't go in the sun. I am not sure if the body breaks down supplemental vitamin D in the same way as it does natural made vitamin D through sun exposure. The body produces its own vit. D after sun exposure, and when you take pills (or foods like eggs and fish), the body first needs to transform it.
Yeh I know, seen so many derms who only came up with 'Yeh it's rosacea'  and 'all we can prescribe are antibiotics and a cream'.For the flushing subtype 1 they tend to have very little, if any, treatment suggestion. I'm happy so many people have visited Prof Chu over the years, all the feedback I got was very positive, a great derm who does think outside the box and takes all sorts of underlying diseases and problems into consideration and has a range of treatment options, albeit even those are limited at some point Wished there was a cure! But the let down from doctors is indeed extremely demoralizing. You'd think they would help with the pain but there are limitations to what they know and can do about it, and with little profits to be made over a cure, I am afraid that we will have to wait a whole lot longer before anything really progressive is discovered for rosacea, apart from a new pill or cream that will temporarily suppress some symptoms and keeps you hooked for life :(   



Vitamin D and your health: Breaking old rules, raising new hopes

(This article was first printed in the February 2007 issue of the Harvard Men's Health Watch.)
Vitamin D was discovered in 1920, culminating the long search for a way to cure rickets, a painful childhood bone disease. Within a decade, the fortification of foods with vitamin D was under way, and rickets became rare in the United States. But solving the problem of rickets was only the beginning of research into vitamin D. Results suggest that vitamin D may have an important role in many aspects of human health, from bone fractures to prostate cancer, cardiovascular disease, neuromuscular problems, and diabetes.

Breaking the old rules

Vitamin D is one of the 13 vitamins discovered in the early 20th century by doctors studying nutritional deficiency diseases. Ever since, scientists have defined vitamins as organic (carbon-containing) chemicals that must be obtained from dietary sources because they are not produced by the body’s tissues. Vitamins play a crucial role in our body’s metabolism, but only tiny amounts are needed to fill that role.
Although vitamin D is firmly enshrined as one of the four fat-soluble vitamins, it is not technically a vitamin. True, it’s essential for health, and only minuscule amounts are required. But it breaks the other rules for vitamins because it’s produced in the human body, it’s absent from all natural foods except fish and egg yolks, and even when it’s obtained from foods, it must be transformed by the body before it can do any good.
As our habits change, most of us cannot rely on our bodies to produce vitamin D the old-fashioned way. Instead, we increasingly depend on artificially fortified foods and pills to provide this vital nutrient. Coming full circle in the modern world, this substance may actually come to fit the technical definition of a vitamin.

What is vitamin D?

Vitamin D is not one chemical but many. The natural type is produced in the skin from a universally present form of cholesterol, 7-dehydrocholesterol. Sunlight is the key: Its ultraviolet B (UVB) energy converts the precursor to vitamin D3. In contrast, most dietary supplements are manufactured by exposing a plant sterol to ultraviolet energy, thus producing vitamin D2. Because their function is almost identical, D2 and D3 are lumped together under the name vitamin D — but neither will function until the body works its magic (see figure).

How your body makes vitamin D

The sun’s energy turns a chemical in your skin into vitamin D3, which is carried to your liver and then your kidneys to transform it to active vitamin D.
How the body makes vitamin D
The first stop is in the liver, where vitamin D picks up extra oxygen and hydrogen molecules to become 25-hydroxyvitamin D, or 25(OH)D. This is the chemical that doctors should measure to diagnose vitamin D deficiencies. But although 25(OH)D is used for diagnosis, it can’t function until it travels to the kidney. There it acquires a final pair of oxygen and hydrogen molecules to become 1,25 dihydroxyvitamin D; scientists know this active form of the vitamin as 1,25(OH)2D, or calcitriol, but for ordinary folks the name vitamin D is accurate enough.

How it works

Vitamin D’s best-known role is to keep bones healthy by increasing the intestinal absorption of calcium. Without enough vitamin D, the body can only absorb 10% to 15% of dietary calcium, but 30% to 40% absorption is the rule when vitamin reserves are normal. A lack of vitamin D in children causes rickets; in adults, it causes osteomalacia. Both bone diseases are now rare in the United States, but another is on the rise — osteoporosis, the “thin bone” disease that leads to fractures and spinal deformities.
Low levels of vitamin D lead to low bone calcium stores, increasing the risk of fractures. If vitamin D did nothing more than protect bones, it would still be essential. But researchers have begun to accumulate evidence that it may do much more. In fact, many of the body’s tissues contain vitamin D receptors, proteins that bind to vitamin D. In the intestines, the receptors capture vitamin D, enabling efficient calcium absorption. But similar receptors are also present in many other organs, from the prostate to the heart, blood vessels, muscles, and endocrine glands. And work in progress suggests that good things happen when vitamin D binds to these receptors. The main requirement is to have enough vitamin D — but many Americans don’t.

Vitamin D deficiencies

Vitamin D deficiencies were rare when most men rolled up their sleeves to work in sunny fields. But as work shifted from farms to offices, that changed. Because pigmentation can reduce vitamin D production in the skin by over 90%, nonwhite populations are at particular risk. Deficiencies are also common in patients with intestinal disorders that limit absorption of fat and those with kidney or liver diseases that reduce the conversion of vitamin D to its active form, calcitriol (1,25(OH)2D). In addition, certain medications reduce the availability or activity of vitamin D. And even in healthy people, advancing age is linked to an increased risk of vitamin D deficiency.
A number of factors can play a role. Limited exposure to sunlight heads the list. Except during the short summer months, people who live at latitudes above 37 degrees north or below 37 degrees south of the equator don’t get enough UVB energy from the sun to make all the vitamin D they need. The same is true for people who spend most of their time indoors and for those of us who avoid sunshine and use sunscreens to protect our skin from the harmful effects of ultraviolet radiation (see "Suncreens"). It’s an example of an unforeseen consequence of wise behavior, but you can enjoy sun protection and strong bones, too, by taking vitamin supplements.

Sunscreens

Like politicians, doctors often have to compromise; when it comes to sunshine, most pols promise blue skies, while most docs turn out to be the shady guys — or, at least, sunscreen advocates.
Sunlight contains two forms of radiant energy, ultraviolet A (UVA) and ultraviolet B (UVB). UVB provides the energy your skin needs to make vitamin D, but that energy can burn the skin and increase the cell damage that leads to cancer. UVA also contributes to skin damage and premature aging.
To protect yourself, avoid the summer sunshine, especially between 10 a.m. and 2 p.m. Whenever possible, wear a large-brimmed hat and a tightly woven, dark-colored long-sleeve shirt and long pants when you go out in the sun.
But summer garb is usually lightweight and exposes a lot of skin. That’s where a sunscreen comes in. Look for a product with an SPF of at least 15; fair-skinned people would be wise to shoot for 30 or higher. But since SPFs apply only to UVB, look for a “broad spectrum” sunscreen that also protects against UVA; most contain titanium dioxide, zinc oxide, or avobenzone (also known as Parsol 1789). Above all, apply your sunscreen early, often, and liberally.
These many factors explain why vitamin D deficiencies are shockingly common in the United States. Although standards vary, most experts agree that levels of 25(OH)D below 20 ng/ml (nanograms per milliliter) reflect clear-cut vitamin D inadequacy, while levels between 20 and 30 ng/ml are borderline. Using similar criteria, American researchers have reported deficiencies in 42% of African American women aged 15 to 49, in 41% of non-hospitalized patients aged 49 to 83, and in up to 57% of hospitalized patients. And low levels of vitamin D are common even in apparently healthy young adults; in one study, more than a third of people between the ages of 18 and 29 were deficient.
Numbers can never tell the whole story, but in this case, “D-ficiencies” add up to a wide range of health concerns.

Osteoporosis and fractures

It’s a paradox: Skeletal health is the best-known contribution of vitamin D, but it has also become the most controversial. Although doctors agree that vitamin D deficiency increases the risk of osteoporosis and fractures, they disagree about the benefits and optimal dosage of supplements.
Without enough vitamin D, the intestines cannot efficiently absorb calcium. But because blood calcium is critical for neuromuscular and cardiac function, the body does not allow levels to fall. Instead, it pours out parathyroid hormone, which mobilizes calcium from bone. Blood calcium levels remain normal, so your heart and nerves keep working nicely. But your bones bear the brunt: As bone calcium density falls, bones become weak and fracture-prone.
Most studies show that a lack of vitamin D increases the risk of osteoporosis and the likelihood of hip and other nonspinal fractures. But there is considerable disagreement about how much supplements reduce the risk of fractures. Some studies include only women, others both men and women; some include only frail, elderly, or institutionalized subjects, others physically active people; some use vitamin D alone, others a combination of D and varying doses of calcium; and some administer 400 international units (IU) of vitamin D a day, others up to 800 IU a day. Despite this great variability, a major 2005 meta-analysis of 12 randomized clinical trials concluded that daily vitamin D supplements of 700–800 IU could reduce the risk of hip fractures by 26% and of other nonspinal fractures by 23%. In contrast, supplements of 400 IU a day, the conventional dose, had no benefit.
Most authorities agree that high doses of vitamin D supplements appear to protect against fractures and low doses do not. But two trials that found no benefit from 800 IU a day were completed after the 2005 meta-analysis, ensuring that the proper dose will remain a bone of contention.

Prostate cancer

Some men mistakenly dismiss osteoporosis as a women’s worry, but none fail to recognize the importance of prostate cancer.
Vitamin D has an important role in regulating cell growth. Laboratory experiments suggest that it helps prevent the unrestrained cell multiplication that characterizes cancer by reducing cell division, restricting tumor blood supply (angiogenesis), increasing the death of cancer cells (apoptosis), and limiting the spread of cancer cells (metastasis). Like many human tissues, the prostate has an abundant supply of vitamin D receptors. And, like some other tissues, it also contains enzymes that convert biologically inactive 25(OH)D into the active form of the vitamin, 1,25(OH)2D. These enzymes are much more active in normal prostate cells than in prostate cancer cells.
Do the results from these experiments translate into clinically important effects? Possibly. Several lines of evidence are relevant.
First, the calcium connection. In 1998, Harvard’s Health Professionals Follow-up Study of 47,781 men reported that a high consumption of calcium, either from food or supplements, was associated with an increased risk of advanced prostate cancer; the risk was greatest in men taking more than 2,000 mg of calcium a day. Since then, other studies have confirmed a link between very high levels of dietary calcium and increased risk, but they have exonerated modest calcium consumption. The Harvard scientists speculate that the problem is not calcium itself but a relative lack of active vitamin D. That’s because high levels of calcium can reduce the body’s production of the active form of the vitamin.
Second, the sunlight connection. Prostate cancer is more common in North America and northern Europe than in the sunnier climates of Asia, Central America, or Africa. In the United States, the disease is more prevalent in African Americans than Caucasian Americans.
Of course, sunlight is just one of the many differences between these groups of men, and various genetic, dietary, lifestyle, and health care disparities could account for the prostate cancer gap. Indeed, early studies failed to demonstrate a clear association between blood levels of 25(OH)D and prostate cancer. But in 2005, a 13-year Harvard study of 2,399 men reported that those with high blood levels of both forms of vitamin D — 25(OH)D and 1,25(OH)2D — enjoyed a 45% lower risk of developing aggressive prostate cancer than those with below-average levels. And certain genetic variations in the vitamin D receptor appeared to enhance the protective effect of the vitamin.
Can vitamin D reduce your risk of prostate cancer? It’s too early to say — but it’s a possibility that requires additional study.

Other malignancies

The risk of colon cancer, breast cancer, and other malignancies appears to rise in populations at latitudes far from the equator. Sun exposure and vitamin D levels may be part of the explanation. As in the case of prostate cancer, the details vary from study to study. Still, a 2006 review concluded that the overall pattern suggests benefit, especially for colon cancer. A 2006 Harvard study of men calculated that a 10 ng/ml increase in blood levels of 25(OH)D might be linked to a 17% reduction in the risk of developing cancer and a 29% lower chance of dying from the disease. And even more recent research suggests that vitamin D may have a role in reducing the risk of cancer of the pancreas and kidney.
It’s more reason to be hopeful about vitamin D — and more reason to call for additional research. Observational studies and sophisticated calculations are important, but they can be overturned by the results of randomized clinical trials. Indeed, in 2006 a major seven-year trial of 400 IU of vitamin D and 1,000 mg of calcium a day found no protection against colon cancer in women.
Dashed hopes for beta carotene and vitamin E also remind us that caution and patience are the watchwords for supplements — and the conflicting results from randomized trials examining the relationship between vitamin D and fractures remind us that even clinical trials can pose therapeutic “D-lemmas.”

Other diseases

Vitamin D may also have potential benefits in conditions other than osteoporosis and cancer; although they remain speculative, they deserve a look.
Neuromuscular function. Osteoporosis increases the risk of fractures. Falling also breaks bones, and vitamin D can help with both brittle bones and falls. A 2004 meta-analysis of five randomized clinical trials concluded that vitamin D supplements reduce the risk of falling by 22%; most of the participants were women. A 2006 study reported that a daily dose of 700 IU produced a 46% reduction in falls in women but no protection for men. The benefit was greatest in older, less active women; the possible gender difference may be explained by differences in physical activity, muscle size, or diet. Since vitamin D binds to receptors in muscles, the improvements in strength and balance may account for the benefit.
Vitamin D deficiency has been linked to persistent and otherwise unexplained muscle and bone pain, and some patients have been helped by supplements. Several observational studies have linked a high consumption of vitamin D with a reduced risk of multiple sclerosis.
Cardiovascular disease. Vitamin D may play an important role in vascular health. Osteoporosis is associated with an increased risk of coronary artery disease, and low blood levels of vitamin D have been linked to increased coronary artery calcification. Although animal studies suggest that vitamin D has a role in regulating blood pressure, a 2005 Harvard analysis found no link between the consumption of vitamin D and human hypertension. Still, low levels of the vitamin appear related to an increased risk of stroke and congestive heart failure; and a study found that supplements reduce inflammation in patients with congestive heart failure.
Other disorders. Although experiments show that vitamin D can protect animals from diabetes, human studies are less convincing. A study of 83,779 women did not find an overall protective role, but it did suggest that high doses of vitamin D (more than 800 IU a day) and calcium (more than 1,200 mg a day) might reduce the risk of type 2 diabetes by 33%.
Using data from the Framingham Heart Study, researchers found that high levels of vitamin D were associated with a reduced risk of arthritis of the knee. High levels have also been linked to better lung function, a stronger immune system, and an enhanced ability to fight off certain infections, such as tuberculosis. All these potential benefits require additional study, but vitamin D ointments have already been approved to treat psoriasis.

“D” right amount

Until 1997, the recommended dietary allowance (RDA) for vitamin D was 200 IU for all adults. Faced with growing evidence of vitamin D deficiencies in Americans, the RDA for 51- to 70-year-olds was increased to 400 IU, and to 600 IU for people older than 70.
Is more better? New research suggests that it is, and many authorities are recommending 800 or even 1,000 IU a day. Remember, though, that you can get too much of a good thing. Like the other fat-soluble vitamins, vitamin D is stored in the body’s adipose (fat) tissue. That means your body can mobilize its own reserves if your daily intake falters temporarily — but it also means that excessive doses of vitamin D can build up to toxic levels. At those extremes, vitamin D can raise blood calcium to levels that can cause grogginess, constipation, and even death. But it takes massive overdosing to produce toxicity, and doses up to 2,000 IU a day are considered safe.

Delivering D

You can make your vitamin D the old-fashioned way, by exposing your skin to UVB radiation in sunlight. It doesn’t take much, but people living north of the 37-degree-latitude line — roughly the imaginary line between Philadelphia and San Francisco — can’t get enough UVB in winter to do the trick. And many others will find it all too easy to overdose on UVB, increasing their risk of malignant melanomas and other skin cancers, as well as wrinkles and premature skin aging. All in all, most doctors recommend avoiding sunlight (see "Suncreens") and getting vitamin D by mouth.
Diet can help, but it’s very hard to approach the new goals with food alone. Fish and shellfish provide natural vitamin D (oily fish are best), but you’ll have to eat about 5 ounces of salmon, 7 ounces of halibut, 30 ounces of cod, or nearly two 8-ounce cans of tuna to get just 400 IU. An egg yolk will provide about 20 IU, but since it also contains nearly a day’s quota of cholesterol, you can’t very well use eggs to fill your tank with D. Other foods have even less D, which is why manufacturers fortify milk, some yogurt, some orange juice, and many cereals with vitamin D. In general, a serving will provide about 100 IU; that means drinking a quart of fortified milk to get 400 IU.
Most people require supplements to get the vitamin D they need. It’s the main benefit of a daily multivitamin; most provide 400 IU. Remember to read the labels carefully so you won’t get too little or too much. And although cod liver oil is rich in vitamin D, it has too much vitamin A for regular use.

New light on the sunshine vitamin

It used to be simple: just get a “healthy” tan and your body will make all the vitamin D it needs. Desk jobs and sunscreen have changed all that, just as research is underlining the importance of vitamin D and suggesting its possible role in preventing many health problems. That makes vitamin D a dilemma of modern life that has a modern solution: eating fish and drinking some low-fat fortified milk, along with judicious doses of vitamin D supplements.




More information on the effects of using a UVB narrowband to increase vitamin D levels in the body:

It's my understanding that doctors are now suggesting Narrowband UVB phototherapy over Broadband UVB phototherapy for various skin issues, including eczema, because they believe in the long run that the Narrowband will be found to be less dangerous than Broadband. According to Dr. Elizabeth Page, MD, a dermatologist at the Lahey Clinic and an instructor in dermatology at Harvard Medical School in Boston: "Narrowband UVB uses a very small part of the UVB spectrum, which cuts down on exposure to UV radiation." http://www.everydayhealth.com/eczema/light-therapy.aspx 

That sure sounds like a good thing. So it made me wonder if we would still be able to get Vitamin D from the Narrowband UVB. The answer appears to be "Yes". In fact, the below study found that "Narrowband UVB therapy may be a better treatment for vitamin D deficiency than supplementation." However, just like everything, there are caveats. 

All the best!

Janet (NJ) 


UVB Exposure May Boost Low Vitamin D
By Kristina Fiore, Staff Writer, MedPage Today
Published: March 05, 2013
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

MIAMI BEACH -- Narrowband UVB therapy may be a better treatment for vitamin D deficiency than supplementation, Swedish researchers reported here.

In a small, single-center study, patients deficient in vitamin D3 who were given 6 weeks of full-body UVB phototherapy had significantly greater increases in serum vitamin D levels than those who took a supplement during that time (P=0.02), reported Morten Bogh, MD, PhD, of Malmö University Hospital in Sweden, during a poster session at the American Academy of Dermatology meeting.

However, the results do not mean that patients should turn to tanning beds for UV exposure, Bogh warned. Those machines mostly generate UVA radiation, which doesn't stimulate vitamin D production in the body the way UVB does, he said.

"We would not recommend phototherapy as a source of vitamin D to the general population," Bogh said. "Vitamin D deficiency can easily be treated with oral supplementation as shown in this study and several others."

"Nevertheless," he said, "it might be a useful alternative for certain groups of patients, especially those with malabsorption problems or noncompliant patients."

To compare narrowband UVB exposure with supplementation for patients with vitamin D deficiency, as measured by serum 25-(OH)D3 levels of 25 nmol/L or less, Bogh and colleagues enrolled 73 patients between February 2010 and May 2011, skipping the summer months of June through September when patients may have had sufficient exposure to the sun.

Patients were also excluded if they went on holiday to a sunny location during the course of their treatment.

They were randomized to either full-body narrowband UVB radiation three times per week (mean cumulative dose of 9 J/cm2) or to supplementation with 1,600 IU of vitamin D plus 1,000 mg of calcium.

A total of 32 patients completed the full 6 weeks of treatment.

During that time, the researchers found that patients treated with UVB phototherapy had significantly greater improvements in serum vitamin D levels than those taking supplements, rising from 19.2 nmol/L to 75 nmol/L in the phototherapy group compared with an increase from 23.3 nmol/L to 60.6 nmol/L with supplementation.

Bogh concluded that full-body UVB phototherapy thrice weekly is more efficient at raising vitamin D levels than supplementation, but again stressed that it should be reserved for patients with malabsorption problems or noncompliant patients.

Jeffrey Miller, MD, of Penn State University in Hershey, Pa., who moderated the session at which the findings were presented, warned that the tanning industry has promoted tanning beds as a way to build healthy vitamin D levels.

Bogh pointed out that only 1% to 5% of the UV in tanning beds is UVB.

Another audience member agreed that it would be "very dangerous" to misinterpret the findings as a suggestion that indoor tanning could treat vitamin D deficiency. However, future studies could look at using UVB phototherapy that exposes only part of the body to radiation, rather than the whole body.

"It's well known that you get maximum vitamin D with only your arms exposed for 15 minutes a day," she said. "We don't need to irradiate the whole body."

The researchers reported no conflicts of interest.

Primary source: American Academy of Dermatology
Source reference:
Bogh M, et al "Alternative treatments of vitamin D deficiency" AAD 2013.http://www.medpagetoday.com/MeetingCoverage/AAD/37666










February 27th 2015

On a facebook page for rosacea, some people mentioned vitamin D supplements making them flushed:
"I never normally flush.....Been flushing since yesterday......only new thing is vitamin d :( "
Responses:
- I stopped taking vitamin d too!
-It can take up to a month to get out system  I'm sitting with cold cloth on my face just now :(
-I think my rash started when i started taking calcium and vitamin d, never clicked the two might be linked until last month! Still got redness but no rash! Don't know whether its a coincidence or what!
-Yes Vitamin D also makes me flush more :( 























14 comments:

  1. vasomotor rhinitis related facial flushing

    ReplyDelete
  2. Your style is so unique in comparison to other folks I have read
    stuff from. Many thanks for posting when you have the opportunity, Guess
    I'll just book mark this web site.

    ReplyDelete
  3. I like what you publish here. This sort of clever work and exposure! Keep up the terrific work, I've added you
    to my personal blogroll.

    ReplyDelete
  4. Great article. Have admit more than can get on Wikipedia. Thanks

    ReplyDelete
  5. Thanks Primary Games Anywho, I hope it helps people.. Best wishes Scarlet

    ReplyDelete
  6. I have to admit, I do love your blog. I have been reading some of your posts and they are really informative and thorough. Very useful for everyone. Thanks for sharing this. - Ms. George

    ReplyDelete
  7. Thank you Ms. George, what lovely of you to write.

    ReplyDelete
  8. It's been a week since my rosacea dx. I am taking mega vitamins and essential oils. I also do red light therapy. I was said to have low vitamin d level before my stage iv wide spread breast cancer dx. I need the vitamin d intake to control cancer and hopefully it is not the cause of rosacea. I feel I am doomed if I do and doomed if I don't. I would love it if you would give more information on what works best for rosacea; creams etc. There is a lot out there and I have already bought a lot and some seem to make it worse. I am also on antibiotics prescribed by my dermatologist. It is all so overwhelming what to do or not to do. Thanks for this web link. I learned a lot from you. It is an easy read and understandable.

    ReplyDelete
  9. Thanks for that, and I'm so sorry for all your hardships.. Rosacea is tough but cancer... frightening. I am not sure if that diagnosis is already an older one or a recent one but I hope you got the treatment for it to cure you from the cancer. Low vitamin D is linked to cancer onset my immunologist says and I found some research which also pointed to that, but cancer is such a complex multi faceted illness, that I doubt personally that it can be solely linked to low vitamin D levels, but who knows. It seems wise either way to crank your D3 levels up a bit. Some can do that with vitamin pills, others get flushed from them. I use a UV narrow lamp, and shine it a few minutes at a time on my skin (not face! I shield my face from the lamp as it is bright light). That way your body produces its own D3, and as soon as the sun is sufficiently strong here I sunbathe around noon (again; face shielded from the sun), but I don't get sunburn easily so that is a requirement I think.
    I find it hard to advice on moisturizers and creams, because my skin doesn't tolerate much. I made a blog post about them however, I mention jojoba oil in it which I can handle sometimes and some very mild creams from Avène: http://scarletnat.blogspot.fr/2013/07/skin-care-and-foundation-for-hyper.html

    Antibiotics are said to help with rosacea as they lower inflammation levels in the skin. I have not had any luck yet with doxycycline, minocycline, azithromycine, Oracea and the likes, they all made me more red and flushed. But my dermatologist now gave me a 2 month supply for metronidazole (tablets) and that will be our last attempt to improve my rosacea with antibiotics. I haven't had the best experience yet with red light therapy but will try it another round soon.

    I'm sorry for not being of more help, but I mainly know very well what things don't work for my rosacea :) Only a couple things do help me, mostly my anti flushing medication, clonidine, propranolol, Xyzal and mirtazapine.....

    best wishes Nat

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  10. Wow. This is amazingly helpful post.

    ReplyDelete
  11. This comment has been removed by a blog administrator.

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  12. Hi,forgive me for my english(i'm italian),i have written an e-mail about the lamp uvb(scarletrosacea@gmail.com ).
    cuold you kindly give me an answer?

    ReplyDelete
    Replies
    1. Thanks a lot for the answer
      I used the UVB lamp for a month but without positive results now for about two months I am making PROTOCOL COIMBRA taking high doses of vitamin D, but still unfortunately even in this case I managed to get a successful result.
      Now I groped the way of mastocytosis, I bought from the United States and the NasalCrom in September with the arrival of autumn I will commence using it.
      I, for now, only suffer flushes face and blepharitis in the months from September to April.
      Your blog is great and well structured, I read it constantly :)

      Delete
  13. Hi Aldila

    Sorry, it must have ended up in the spam inbox somehow.. I can't find the email back either, what was your question about the UVB lamp? I use it at the moment, all winter, for about 5 minutes at night. Only use it for a minute at one area of skin, then change the lamp position to another piece of skin. When I don't use it for a few days I feel I'm more red and burned up. As soon as there is proper strong sun again out there, I sunbath for about 20-30 minutes a day, body only (never face). Not sure that covers the question you had? Please ask me again otherwise :)

    Best wishes

    ReplyDelete

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