The reports by Gallo and company seem very promising and there has been great coverage of these discoveries... in fact, major newspapers are calling this a cure for rosacea.

In science and medicine, you must understand that physiology and pathophysiological states are extremely complex. We have known for decades that cathelidicins are abnormal in inflammatory skin disorders and do trigger further damage; however, these are always secondary to the underlying vascular cause of rosacea. Not vice versa. Damaged, hyperreactive blood vessels cause these peptides to increase in number and promote further damage... not the opposite. Its the chicken and the egg.

Long before any changes are seen in antimicrobial peptides or epidermal enzymes, rosacea inflammation and vascular dysfuncion has been wreaking havoc with deep dermal inflammation and damage. Long before any changes to cathelidicins. So, obviously these peptides are not at the heart of the disorder and treating them would only bring SOME degree of rosacea clearance, but not address the true underlying cause.

We have seen this for several decades. Someone takes a skin biopsy and says, "A HA, that's the culprit because these levels are far above normal".

1. Remember the big Demodex scare -- 500% to 700% above normal. These are not a major factor though.

2. The big "Rosacea is a Neutrophilic disorder", because physicians found thousands of white blood cells and macrophages located in rosacea skin. Later, this was found to be secondary to vascular dysfunction.

3. The "Immune Status of Rosacea skin" theory as the foundation of its cause was quite popular, but now obsolete. Chronic inflammation causes activation of immune cells. This is natural. If you clear up the immune cells, you are still left with inflammation that stems from blood vessels.

4. The "Psychological Distress is Central to Rosacea Pathology" is now known to be nonsense. The daily torment of rosacea, a chronic and progressive disorder causes depression... we are only human.

This is just a sampling of superficial events, and not underlying causes. If we spend any more money on cathelicidins, we will be out of research dollars AND, more importantly, it takes valuable research away from searching for the biomolecular causes of rosacea. Even if we cure the cathelidicin problem, we will still have full blown rosacea.

Sometimes research and articles like this require critical evaluation and critique so that researchers can refocus on the underlying pinnings of rosacea.

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Best regards,

Geoffrey

Dr. Geoffrey Nase
Ph.D: Micro-Vascular Physiologist
Post-Doctoral Fellowship I: Neuro-Vascular Pathology
Post-Doctoral Fellowship II: Inflammatory Skin Processes
Clinical Research Focus: Rosacea Treatment

Email: drnase1000@hotmail.com
Bibliography: http://drnase.com
Rosacea Treatment: http://rosadyn.com
Rosacea Research: http://drnase.org

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How can I tell whether or not most of my papules and postules are demodex related? What kind of tests does a dermatologist have to do in order to be able to tell? Also, I heard Invermectin takes care of it short term but doesn't have any long term effects. What other ways are there to stop demodex mites bc I feel like they worsen my rosacea.

Chanel 77,

They can perform a simple scrape test or tape test and analyze the demodex under a microscope. They can also do a biopsy, but there is always chance of scarring and increased rosacea redness.

Dr. Nase pointed out oral ivermectin several years back. This seems to have the best effect on demodex and takes care of all its offspring.

Hope that helps.