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Erectile dysfunction (ED), also called "impotence", is one of the most common health problems affecting men. Erectile dysfunction can be a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. Chronic ED affects about 5% of men in their 40s and 15-25% of men by the age of 65. Transient ED and inadequate erection affect as many as 50% of men between the ages of 40 and 70. Causes Erectile dysfunction has many underlying physical and psychological causes. Most men with physical causes usually have an associated psychological component. Underlying conditions of erectile dysfunction include the following: Physical health conditions Problems with the nervous system can affect the transmission of signals from the brain to the blood vessels in the penis. This occurs in conditions including multiple sclerosis, spinal cord injury and Parkinson's disease. The nerves involved in sexual arousal can also be damaged in surgery to the pelvic area, such as removal of the prostate. Vascular diseases account for nearly half of all cases of erectile dysfunction in men older than 50 years. These include atherosclerosis, veno-occlusive disease, peripheral vascular disease, arterial hypertension, history of heart attacks, blood vessel trauma, high cholesterol levels. Systemic diseases associated with erectile dysfunction: Diabetes mellitus is a major cause of erection problems (about 60% of men with diabetes experience erectile dysfunction), scleroderma, kidney failure, liver cirrhosis, hemachromatosis, dyslipidemia, hypertension. Neurologic diseases. Problems with the nervous system can affect the transmission of signals from the brain to the blood vessels in the penis. Diseases that affect the nervous system and are commonly associated with erectile dysfunction include: multiple sclerosis, spinal cord and brain injuries, parkinson's disease, alzheimer's disease, epilepsy, Guillain-Barre syndrome. Respiratory disease associated with erectile dysfunction include: chronic obstructive pulmonary disease, sleep apnea Conditions of the penis: Peyronie's disease (a rare inflammatory condition that causes scarring of erectile tissue), epispadias, priapism, Infections. Traumatic Causes. Trauma or injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to erectile dysfunction by harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa. Bicycle riding for long periods has also been implicated as a cause of erectile dysfunction. Some types of prostate or bladder surgery. Surgery of the colon, prostate, bladder, or rectum may damage the nerves and blood vessels involved in erection. Medications. A great variety of prescription medication are known to cause or contribute to erectile dysfunction: blood pressure medication (especially beta-blockers) heart medication antihistamines antidepressants tranquilizers antipsychotics anticonvulsants appetite suppressants anti-ulcer medications sleeping pills Psychological conditions. Experts believe that psychological factors cause 10 to 20 % of erectile dysfunction cases. Anxiety and guilt are the most common psychological causes of erectile dysfunction. Depression, worry, stress, low self-esteem, and fear of sexual failure all contribute to loss of libido and erectile dysfunction. Substance abuse. Alcoholism. Drinking too much alcohol interferes with the production of the male hormone testosterone, which can reduce libido. Smoking is considered an important risk factor for erectile dysfunction because it is associated with poor blood circulation and its impact on cavernosal function. Hormone Disorders account for fewer than 5% of cases of erectile dysfunction. An imbalance in hormones, such as testosterone, prolactin, or thyroid, can cause erectile dysfunction. Age. Erection problems tend to become more common with age, but it can affect men at any age and at any time in their lives. Physical causes are more common in older men, while psychological causes are more common in younger men. Treatment options Erectile dysfunction is treatable at any age. In around 95% of the cases, a suitable treatment can be found. There are three oral medications approved for the treatment of erectile dysfunction: sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). All three medications belong to a class of drugs called phosphodiesterase (PDE) inhibitors. They block the enzyme phosphodiesterase-5 (PDE-5) and this helps maintain the levels of cyclic guanosine monophosphate (GMP), a chemical produced in the penis during sexual arousal. 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Rosacea is a chronic, lifelong skin condition that affects (most often) the face. The disease is common: approximately 1 in every 20 Americans has rosacea. Women are affected more often in the early stages (flushing and erythrosis), but more men progress to the advanced stages and rhinophyma is seen almost exclusively in men over 40 years of age. Rosacea is characterized by various skin disorders and sufferers must contend with skin flushing, erythrosis (reddish or purplish discoloration of the skin), teleangiectasia (permanent enlargement of small blood vessels), papulopustular rosacea (papules are small, red, raised bumps; pustules are similar but they contain pus) or rhinophyma (enlarged, red, swollen nose) and for many people, some of these signs and symptoms are very common; approximately 94% of people with rosacea have flushing. These attacks last from a few minutes to several hours, and the flushing seen in rosacea is intermittent in nature. The disease, to a greater or lesser degree, is progressive, and the more pronounced skin lesions will usually follow sporadic episodes of flushing. The exact cause of rosacea has not been determined, but here are many theories. Exposure to the sun may be one factor, and exposure to the sun can precipitate acute episodes of flushing. Another possible cause are skin mites, Demodex folliculorum and Demodex brevis. These tiny insects usually live at the base of hair follicles. They are often found on the faces of people with rosacea, and it has been suggested that they may initiate an inflammatory reaction (Inflammation dilates blood vessels and this contributes to the flush, and it may also damage the blood vessels, causing them to be permanently dilated). Infection with the common bacteria, Helicobacter pylori, has also been suggested as a cause. There may also be genetic defects in the vasculature of the skin that causes hem to become easily - and permanently - dilated. The signs and symptoms of rosacea are not dangerous, but they can be uncomfortable, unsightly, and disfiguring. (However, rosacea can affect the eyes. Approximately 3% to 58% of patients with skin changes will have eye problems and rosacea keratitis can lead to blindness). Yet although there is no cure for rosacea, the disease can be managed. Topical medication, oral medications and laser therapy can all be used to control flushing and to remove some of the skin blemishes, swollen blood vessels and discoloration. However, it would be far more preferable to prevent outbreaks of flushing and the development of erythrosis and papulopustular lesions. It is well known that there are certain factors - sunlight, stress, heat - that can trigger rosacea signs and symptoms, and food has been identified as a trigger. What foods have been implicated as causes of rosacea signs and symptoms? The list is long, and there is obviously individual variations in susceptibility: high doses of B6 and B12, chocolate, tomatoes, hot beverages, hot sausage, red pepper, black pepper, vinegar, paprika, white pepper, garlic, wine, hard liquor, beer, cheese, yogurt, sour cream, milk, citrus fruits, eggplants, avocadoes, spinach, raisins, figs, bananas, and marinated meat. Why do these foods exacerbate rosacea? No one knows for sure, and given the fact that the exact cause of rosacea hasn't been clearly determined, that's not surprising. However a look at the pathophysiology of rosacea may provide some clues. The flush that is so common in people with roseacea is caused by dilation of the small blood vessels of the face. Why this occurs is not certain. The blood vessels may be genetically weak, or they may be damaged by years of exposure to the sun. There may also be an increase in the number of blood vessels, or there may be damage to the walls of the blood vessels. Whatever the cause, the blood vessels (which in the face are very close to the surface) dilate. Many of the foods that trigger flushing attacks most likely do so by increasing body temperature, and in order to lose body heat, blood vessels dilate. Others may cause flushing by stimulating the release of histamine. This is a naturally occurring substance that dilates blood vessels and some foods, e.g. beer and citrus fruits may stimulate the release of histamine. penis enlargment fact permanent penis enhancement vimax best penis enlargement surgery penis enlagement cream vimax free exercise tip for penis enlargement penis elargement without pills penis enhancement fact truth about penis enhancement pills truth about penis enlargement

Believe it or not, there is a natural ingredient from Europe that can help change the way your legs feel and the way you feel about the circulation in your legs. Whether we realize it or not, the circulation in our legs can have a huge influence on how we feel and what we do everyday and perhaps even more so every evening. The comfort level of our legs, or better said, their discomfort level at the end of the day can adversely affect our social life and fitness activities - not to mention adversely affecting our sleep. If our legs felt better perhaps we would find it easier to do the things we'd love to do, but find it so difficult to muster the motivation. As if the way our legs can feel at the end of day isn't challenging enough, the changes in the circulation in our legs as we age can seem even more hopeless and discouraging. Now add to that the seeming conspiracy among fashion designers to have us exposing even larger portions of our aging legs and we have a problem that over 80 million Americans with varicose veins understand all too well. (1). Unfortunately, about half of all American women will develop varicose or spider veins at some point in their lives (2). Not only are they unsightly, these leg problems can also cause significant discomfort. Typically, varicose veins are characterized by bulging, blue, sometimes painful and inflamed veins that appear primarily in the calves and thighs. Spider veins, on the other hand, show up as a web of fine lines that can make your legs look like a road map. While age and heredity play a role in the development of varicose and spider veins, weight gain, pregnancy, menopause and the use of hormone replacement therapy can also trigger these vein problems. Making matters worse, chronic inactivity, standing for long periods of time or habitually crossing your legs can make you more prone to injured veins (2). Conventional treatments include surgical stripping, injecting the veins with a chemical irritant or zapping them with lasers. While these approaches can remove existing varicose or spider veins, they will not prevent new ones from developing, since these high-tech treatments do not address the underlying problem of poor circulation. Worse yet, these procedures can also cause infection, scarring, nerve damage and pain (26). If these radical treatments are not an option for you, you'll be happy to hear that there is a natural approach that not only improves the appearance of these ropy, bulging veins, it also fosters leg health to prevent future problems. Veins Explained To understand how varicose veins develop, you need to know a little bit about how blood moves through the body. Essentially, there are two types of major circulatory vessels in the body: the arteries, which channel blood from the heart to the extremities, and the veins, which bring blood from the extremities back to the heart. Of all the veins in your body, leg veins work the hardest to carry blood back to the heart. To accomplish this difficult task, your legs are equipped with specially designed one-way valves that keep the blood moving in the right direction. As efficiently as these valves work, your legs still fight a constant battle against the natural pull of gravity. If the veins can't move the blood efficiently or the one-way valves that prevent the blood from backwashing fail to close properly, blood collects in the legs. This pooling of blood then stretches the vein, causing swelling and injury to the vein's walls (3). Depending on the extent of the enlargement, these veins can show up as either spider or varicose veins. Spider veins are broken capillaries and small veins that appear as jagged red, blue or purple lines on the surface of the skin. While they aren't painful, they can be extremely unattractive. Varicose veins, on the other hand, are thick veins that run deeper beneath the skin. They are far larger and much less attractive than spider veins - and they can make your legs feel fatigued, heavy, achy or even itchy. Varicose veins can also cause burning, throbbing, cramping and restlessness. While these conditions aren't usually dangerous, severe cases can lead to chronic venous insufficiency - a persistent inability of the leg veins to adequately return blood back to the heart (4). Varicose veins are also associated with the development of skin ulcers or a chronic inflammation of a vein - a condition known as phlebitis. Phlebitis is often accompanied by formation of a blood clot, a dangerous situation since the clot can move from the leg vein and travel to the lungs (2). Get a Leg Up with Diosmin Your strategy for battling vein problems naturally is twofold: improving circulation and strengthening the vein walls. The first and simplest measure to improve blood flow is to counteract gravity. Standing or sitting all day makes it harder for blood to move up from the legs and back to the heart. But taking a few minutes to rest with your legs higher than your heart each day allows gravity to help return blood to the heart. Getting in shape can also help relieve varicose and spider veins - and it can even prevent new ones from forming. As we age we lose muscle tone, which adversely affects the health of our legs. Yet adopting a consistent exercise program promotes good circulation and can help to keep our leg muscles, and the blood vessels in our legs, toned. Walking, weight training, low-impact aerobics and swimming strengthen the legs and circulatory system, and help to reduce the throbbing and aching often associated with varicose veins. What you eat can also ease unsightly veins. A low-fat diet filled with fruits, vegetables, beans, legumes and whole grains add key nutrients and fiber to your diet. Eating a fiber-rich diet reduces the chances of constipation which can contribute to varicose veins. Constipation restricts the blood as it returns to the torso through the deep veins in the legs. Straining to have a bowel movement closes off the deep veins in the legs and restricts the flow of blood as it returns to the torso. As the blood backs up, it takes another course through superficial veins, thus the blue streaks in the legs. Eating a fiber-rich diet alleviates and prevents constipation, helping to avoid the damage to the vascular system that can result. In addition to fiber, a diet high in fruits and vegetables also ensures adequate intake of nutrients and phytonutrients, which also help tonify the blood vessels. As a bonus, a healthy diet and exercise program can also jump-start weight loss - an important consideration since carrying too much weight creates extra pressure on your heart and blood vessels, interfering with healthy circulation (2). To strengthen the veins themselves, take a tip from the Europeans. From Austria to France to Italy, women and their doctors have relied on Diosmin for more than 30 years to treat circulatory problems affecting the legs - and with good reason. Diosmin is a unique bioflavonoid derived from citrus fruits and is closely related to other citrus bioflavonoids such as hesperiden, quercetin, and rutin (5). Clinical trials have shown that Diosmin is highly effective in boosting circulation and strengthening the veins in the legs (5). Not only does this improve existing varicose and spider veins, it can also reduce the likelihood of future problems. What makes Diosmin so amazing is its power to specifically target the blood vessels in the legs. Diosmin improves both blood vessel elasticity and microcirculation while relieving pain and inflammation by inhibiting pro-inflammatory prostaglandins and thromboxanes (21,24). Because of its direct action on the integrity of vein walls, Diosmin also reduces the amount of fluid that leaks out of them (21,22). Diosmin's protective benefits do not stop there. Because it is a potent anti-oxidant, Diosmin decreases lipid peroxidation and reduces free radical damage that can undermine vein health (23, 27). In one clinical trial, people who suffered from pain and swelling due to varicose veins experienced significant improvement in their symptoms after taking Diosmin for a few months (6). A review of studies also found that, among more than 5,000 patients with vein disorders, the vast majority not only saw a reduction in their discomfort, they actually saw the swelling in their calves and ankles disappear (7). Across the board, research shows that a daily dose of 500 to 1,000 mg of Diosmin improves the health of leg veins and brings tremendous relief from pain, night cramps and leg heaviness (8,9,10,11). Both short- and long-term use of this highly effective natural ingredient comes without any side effects. It is also so safe that you need not worry about adverse interactions of Diosmin with drugs, foods, lab tests or interactions with diseases or conditions. (5). Help for Hemorrhoids Because Diosmin reduces swelling and bolsters vein health, it can also help people suffering with hemorrhoids - those uncomfortable varicose veins that form in the lower rectum and anus. Along with making it painful to sit, hemorrhoids can itch, bleed or protrude - and almost half of all Americans suffer from them by the time they turn 50 (12). Extensive research conclusively shows that Diosmin can safely alleviate the pain, inflammation and bleeding of hemorrhoids (13,14,15). Best of all, it offers quick relief, often working its magic within a week or two (16). Plus, Diosmin reduces the risk of a relapse (17). Diosmin for Cancer? While no one questions Diosmin's efficacy for treating varicose and spider veins or hemorrhoids, scientists have begun exploring other ways this potent flavonoid may boost health. Their main focus - cancer prevention - especially oral and skin cancers. Researchers haven't conclusively identified the cancer-fighting component in Diosmin, but preliminary experiments show that this flavonoid inhibits the proliferation of cancer cells (18). In two studies pitting Diosmin against other flavonoids like rutin, grapeseed extract and red wine, Spanish investigators found that Diosmin was considerably more effective at reducing the number of metastatic melanoma cells (a potentially deadly type of skin cancer cells that spread through the body) than any of the other flavonoids tested (19,20). Other studies have found that Diosmin puts the brakes on the spread of cancer cells in the mouth (25). Although it could be years before science conclusively proves Diosmin's cancer benefit, this nutrient can't be beat for supporting vein health. Along with taking supplemental Diosmin, there are several simple strategies you can employ to encourage healthy circulation. Eating a high-fiber, anti-oxidant rich diet and getting plenty of exercise can help keep veins in top form. And remember to take a break and put your feet up every now and again. References: 1. American Society for Dermatoloic Surgery. 2. National Women's Health Information Center. U.S. Department of Health & Human Services. 3. American College of Phlebology. 4. Society for Vascular Surgery. 5. Diosmin Monograph. Alternative Medicine Review. 2004;9(3):308-311. 6. Ting AC, et al. Clinical and hemodynamic outcomes in patients with chronic venous insufficiency after oral micronized flavonoids therapy. Vascular Surgery. 2001;35(6):443-447. 7. Ramelet AA. Daflon 500 mg: symptoms and edema clinical update. Angiology. 2005;56 Suppl 1:S25-S32. 8. Bergan JJ. Chronic venous insufficiency and the therapeutic effects of Daflon 500 mg. Angiology. 2005; 56 Suppl 1:S21-S24. 9. Nicolaides AN. From symptoms to leg edema: efficacy of Daflon 500 mg. Angiology. 2003;54 Suppl 1:S33-S44. 10. Smith PC. Daflon 500 mg and venous leg ulcer: new results from a meta-analysis. Angiology. 2005; 56 Suppl 1:S33-S39. 11. Jantet G. Chronic venous insufficiency: worldwide results of the RELIEF study. Reflux assessment and quality of life improvement with micronized Flavonoids. Angiology. 2002;533:245-256. 12. National Institutes of Health. 13. Lyseng-Williamson KA, et al. Micronised purified flavonoids fraction: a review of its use in chronic venous insufficiency, venous ulcers and haemorrhoids. Drugs. 2003;63(1):71-100. 14. Meshikhes AW. Daflon for haemorrhoids: a prospective, multi-centre observational study. Surgeon. 2004;2(6):335-338. 15. Kecmanovic D, et al. PHLEBODIA (diosmine): a role in the management of bleeding nonprolapsed hemorrhoids). Acta Chirurgica Iugoslavica. 2005;52(1):115-116. 16. Diana G, et al. Activity of purified diosmin in the treatment of hemorrhoids. La Clinica Terapeutica. 2000;151(5):341-344. 17. Misra MC, et al. Randomized clinical trial of micronized flavonoids in the early control of bleeding from acute internal haemorrhoids. British Journal of Surgery. 2000;87(12):1732-1733. 18. Browning AM, et al. Flavonoid glycosides inhibit oral cancer cell proliferation - role of cellular uptake and hydrolysis to the aglycones. Journal of Pharmacy and Pharmacology. 2005;57(8):1037-1042. 19. Martinez C, et al. Treatment of metastatic melanoma B16F10 by the flavonoids tangeretin, rutin, and diosmin. Journal of Agricultural and Food Chemistry. 2005;53(17):6791-6797. 20. Martinez C, et al. The effect of the flavonoids dioxmin, grapeseed extract and red wine on the pulmonary metastatic B16F10 melanoma. Histology and Histopathology. 2005;20(4):1121-1129. 21. Ramelet AA. Clinical benefits of Daflon 500 mg in the most severe stages of chronic venous insufficiency. Angiology. 2001;52 Suppl 1:S49-56. 22. Cyrino FZ, et al. Micronization enhances the protective effect of purified flavonoidsfraction against postischaemic microvascular injury in the hamster cheek pouch. Clinical and Experimental Pharmacology & Physiology. 2004;31(3):159-162. 23. Bergan JJ, et al. Therapeutic approach to chronic venous insufficiency and its complications: place of Daflon 500 mg. Angiology. 2001;52 Suppl 1:S43-7. 24. Katsenis K. Micronized purified flavonoids fraction (MPFF): a review of its pharmacological effects, therapeutic efficacy and benefits in the management of chronic venous insufficiency. Current Vascular Pharamcology. 2005;3(1):1-9. 25. Browning AM, et al. Flavonoid glycosides inhibit oral cancer cell proliferation - role of cellular uptake and hydrolysis to the aglycones. Journal of Pharmacy and Pharmacology. 2005;57(8):1037-1042. 26. National Women's Health Information Center. U.S. Department of Health and Human Services, Office on Women's Health. 27. Villa P, et al. Protective effect of diosmetin on in vitro cell membrane damage and oxidative stress in cultured rat hepatocytes. Toxicology. 1992;73:179-189. free penis enhancement enlargement erection penis pills vimax vimax penis enlargement fact vimax penis enlargement surgery cost natural penile enlargement pills plastic surgery penis enlargment homemade pennis enlargement penis enlagement surgery picture truth about penis enlargement

KNOWING ROSACEA Rosacea is a disorder of the blood vessels. It is a common skin disorder. Approximately 48 percent of the world population suffers from Rosacea. However, Rosacea is one of the most misunderstood states of the skin. FAMOUS PERSONS SUFFERING FROM ROSACEA If you are having Rosacea, you are then in the august company of eminent persons. A few of the noted personalities suffering from Rosacea are JP Morgan, WC Fields, Cameron Diaz, Bill Clinton, Prince Harry of England, besides the late princess of Wales and mother of Prince Harry – Diana. ROSACEA SYMPTOMS The common symptom of rosacea is transformation of the skin color into red. The body portions most affected by rosacea are the cheeks, nose and forehead. At times, such redness and flushing of skin can also spread to the ears, scalp, chest or the neck. As Rosacea progresses, the reddish tinge can turn into a permanent condition. There can also be a marked visibility of the small blood vessels particularly at the skin surface, stinging or burning skin sensation, eyes turning gritty and reddish, and pus-filled or simple bumps that appear red. Among these severe symptoms are bulbous noses. The maiden rosacea symptoms are nagging redness which is often wrongly attributed to cleansing, exercising or temperature changes. SIMILAR SKIN DISORDERS Many confuse rosacea with seborrheic dermatitis or/and acne vulgaris. Mentionably, rosacea can co-exist with acne vulgaris and seborrheic dermatitis. THE ROSACEA VULNERABLE SECTION It has been generally noticed that the people with fair skin are the most vulnerable section with reference to rosacea. Therefore, rosacea does have a hereditary strain. Those having a descent from the Celtic or the fair-skinned European stocks are genetically inclined to suffer from rosacea. Notably, both the sexes can fall prey to rosacea. People of all ages can be affected by rosacea. It has also been noticed that people in the age group of 30-50 are easily affected by rosacea. Nonetheless, women in their middle ages are the most vulnerable section of the populace. The reason is, of course, menopause-abetted hot flushes. However, rosacea symptoms are more severe with reference to men. CAUSES OF ROSACEA There is no unanimity among the medical researchers as to the exact rosacea pathogenesis. Nonetheless, there is a concurrence in views insofar as to the cause of rosacea. Rosacea occurs when stimuli repeatedly dilate the blood vessels, and as a result of which the blood vessels get damaged. The damaged blood vessels dilate rather easily. Besides they either remain permanently dilated or stay dilated for a considerably long time. The consequence is redness of the affected portion and its flushing. ROSACEA PAPULES OR INFLAMMATORY PUSTULES The papule or inflammatory pustule can be I the form of a boil, or a pimple, or an eruption for that matter. In rosacea (papulopustular), the mediators (inflammatory ones) as well as immune cells ooze out from the skin bed that is basically micro-vascular by nature. This, in turn, leads to the inflammatory pustule or papule. OTHER CAUSES OF ROSACEA Various conditions can also lead to rosacea. One thing is for sure: strenuous movements cause blushing and flushing. A few of the situations where such flushing or blushing can be formed are as follows: Stress, cold weather, acute sunburn, and extreme heat exposure especially from the sun. Rosacea can also be caused by sudden changes in temperatures while traveling, or in heated rooms especially in winter. FOODS CAN ALSO CAUSE ROSACEA Certain food items that contain very high quantity of histamine have been identified as responsible for the eruption of rosacea symptoms in many people. Similarly, spicy food besides alcoholic substances can definitely trigger off rosacea. MEDICATIONS TOO CAN LEAD TO ROSACEA Several topical irritants and medications may at times cause rosacea. Take for example several drugs people take to hide wrinkles or to deal with acnes. Among these chemicals those particularly responsible for causing rosacea are tretinoin, benzoyl peroxide, isotretinoin, microdermabrasion, and certain chemical peels. Obviously, one should immediately stop the use of any such irritants the moment any rosacea symptoms appear. INDUCED (STEROID) ROSACEA The term ‘steroid induced rosacea’ points to such rosacea symptoms that are caused by steroids, particularly nasal and topical. Notably, these types of steroids are generally prescribed for patients suffering from seborrheic dermatitis. First aid: In such circumstances, immediately consult the physician. Moreover, one should begin the medication discontinuing process over a period of time. Decrease the dosages slowly. Else there may be a flare up of the rosacea symptoms. MITES & BACTERIA CAN CAUSE ROSACEA AS WELL A considerable number of rosacea people have been found to possess the species of mites known as demodex. This is more so the case with those people who have rosacea from steroids. Mentionably, the presence of a large number of these demodex mites can only cause rosacea. But, they cannot by themselves cause the rosacea condition. The demodex mites will have tom act in conjunction with other factors to be able to trigger off the rosacea states. Bacteria, especially the intestinal bacteria, can cause rosacea. These intestinal bacteria reside in our digestive highways. This is a neurological dysfunction. Such rosacea conditions can erupt after the intestinal bacteria activate the plasma kakllikrein-kinin system. THE KAKLLIKREIN-KININ SYSTEM The kakllikrein-kinin system or the kinin-kallikrein system or just the kinin system is a not well delineated structure of blood proteins. The blood proteins have a major role to play in causing pain, coagulation, control of blood pressure and inflammation. Mentionably, the major mediators of the kinin system are bradykinin and kallidin. Both of them act on different cell types. Both are vasodilators DIFFERENT FORMS OF ROSACEA Researchers have identified four forms of rosacea. Each of these subtypes can have its typical symptoms. More importantly, one person can have more then one of the subtypes at the same time. THE ROSACEA SUBTYPES The four rosacea subtypes are Ocular rosacea, Phymatous rosacea, Papulopustular rosacea and Erythematotelangiectatic rosacea. OCULAR ROSACEA Ocular rosacea mainly affects the eyes. The Ocular rosacea symptoms are burning and itching besides sensations as if there are foreign bodies within the eyes. When anyone is affected by ocular rosacea, the eyes and the eyelids turn dry and red. Irritation of the eyes and the eyelids is also very common. PHYMATOUS ROSACEA Phymatous rosacea affects the nose, ears, cheeks, forehead, chin and the eyes. Phymatous rosacea is also linked with the nose enlargement dysfunction called rhinophyma. Another disorder closely connected with phymatous rosacea is the visibility of small blood vessels near the skin surface. Other symptoms of phymatous rosacea are appearance of irregular surfaces on the skin and which may be also accompanied by nodularities. The skin can get thick as well. PAPULOPUSTULAR ROSACEA Many confuse Papulopustular rosacea with acne. However, Papulopustular rosacea remain reddish while acne do not. The common Papulopustular rosacea symptoms are papules (red bumps) filled with pus. Such bumps are called pustules. Papulopustular rosacea papules with or without pustules generally dissolve within five days. People having Papulopustular rosacea usually have permanent redness of their skin. This state is described medically as erythema. Another symptom of Papulopustular rosacea is they tend to flush or blush quite easily. Moreover, the patient can also have burning or itching sensations. ERYTHEMATOTELANGIECTATIC ROSACEA Erythematotelangiectatic rosacea causes the small blood vessels to appear rather prominently near the surface of the skin. This typical state is known as telangiectasias. TREATING ROASAEA There are various treatments for rosacea people. The strategies vary depending on the acuteness and the rosacea subtype that a particular person may be suffering from. Hence, there can be different treatments for different persons suffering from the rosacea symptoms. Hence, the dermatologists opt for the sub-type-directed method to diagnose, analyze and treat rosacea. LASER TREATMENT Laser treatment in dermatology is variously known as Broad spectrum (Intense Pulsed Light), or Single wavelength (Vascular laser). Laser treatment is one of the most popular treatment methods of rosacea. In laser treatment, light is made to infiltrate the epidermis. The light hits the skin’s dermis layer. It targets the dermis capillaries. The oxy-haemoglobin gets heated up after it absorbs the light. The process heats up the capillary walls till 70 degree centigrade. This heat destroys the capillary walls. The damaged walls are then absorbed by the body via its defence mechanism. CO2 LASER TREATMENT Focused thin beams of CO2 laser are manipulated to defocus or cut (as scalpels) the tissues. Then these tissues are vaporized. CO2 lasers are used to get rid of the excessive tissues formed by phymatous rosacea. In this method, our skin directly absorbs the CO2 lasers wavelength. SIMPLE STEPS TO TACKLE ROSACEA (i) Gentle skin cleansing regime Always deal with the skin gently and lovingly. Go for only those cleansers that are non-irritating. (ii) Shielding skin from sun Never venture out in the sun-bated beach sans protection shields. Regularly use sunscreens. Choose such a sunscreen that consists of a physical blocker agent. Such active blockers are titanium dioxide or zinc oxide. (iii) Trigger avoidance It is important to maintain a diary of the foods and the climatic or other factors that generally lead to rosacea. In fact, The National Rosacea Society promotes this habit. This approach also goes a long way in identification and reduction of the triggers. Moreover, trigger avoidance is ideal to control the onset frequency of rosacea. But, all alone it cannot check rosacea. Nonetheless, the mild rosacea attacks can be effectively checked if a patient avoids the factors that triggered off the rosacea symptoms. One can get flushing after consuming red wine or food items having high quantities of histamine. Then, go for antihistamines. Some common antihistamines are loratadine or cetirizine. (iv) Eyelid hygiene Eyelid hygiene is especially recommended for persons complaining of eyelid infections. Practice eyelid hygiene frequently. Here are some easy eyelid hygiene steps. Gently scrub the eyelids daily; You can use baby shampoo in a diluted form; Or, you can also opt for any across-the-counter eyelid cleaner. Apply the cleaner in warm compresses. But, mind you, never should it be hot. Carry on the practice several times in a day. MEDICATIONS (ii) Topical & Oral Antibiotics To get instant relief from the rash, redness, inflammation, pustules and papules, you can go for topical and oral antibiotics. An effective topical antibiotic is metronidazole. Similarly, ideal oral antibiotics are the tetracycline antibiotics. Some examples of tetracycline antibiotics are minocycline, doxycycline, and tetracycline. The oral antibiotics are rather effective in treating ocular rosacea symptoms. Isotretinoin is generally given to patients who complain of persistent pustules or papules. However, there are several side effects of isotretinoin. Therefore, isotretinoin is prescribed only in acute situations. It is also given to treat acute acne. Nevertheless, for patients suffering from phymatous and papulopustular rosacea, low dosages of isotretinoin have been delivering the goods. BETA BLOCKERS OR α-2 AGONIST The commonly used α-2 agonist is clonidine. It is helpful to deal with blushing and flushing. But it has side effects. One can feel drowsy or/and one’s blood pressure may also plummet. So, to neutralize this effect, one can use monoxidine as an alternative. Monoxidine has lesser side effects. But many do not find it as effective as clonidine. Propanolol is an ideal beta blocker. It is akin to α-2 agonists. And, it has been found to be effective in dealing with recurrent social blushing rather than the general rosacea flushing. 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