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Premature ejaculation is embarrassing for the man and no fun for the woman. If you're having a bit of a problem going for the long run, here are 7 tips that will help. Relax Premature ejaculation often results from performance anxiety. Try oral sex, toys, fingers, and passionate kissing to build her passion. If she's sufficiently excited before intercourse she won’t need as much time to reach orgasm. Take care of yourself beforehand Premature ejaculation sometimes occurs because guys are too fired up. The slightest bit of action sets them off a bit too soon. Relieve some pressure by masturbating before the big event. Not right before because getting erect immediately afterwards might be difficult. A few hours before should do the trick. Wear a condom Decreasing sensitivity helps prevent premature ejaculation. One way to make the penis less sensitive is to cover it with a rubber. They're also good for protecting against STDs and unwanted pregnancy, so why not let a rubber help with premature ejaculation, too. Never put on more than one at a time thinking that thicker is better. It’s not. Other desensitizing products Specially-formulated creams containing topical anesthetics can help numb the penis and put premature ejaculation suffers at ease. Be careful though. Don’t accidentally numb your partner without her permission! Once the penis numbs, wash the cream off. Another option is to cover the cream with a condom. Just be sure the cream doesn’t contain ingredients that will cause the condom to weaken or break. Think about something else Careful with this one! If you think of the wrong thing, premature ejaculation may end up being one of several problems. Self-inflicting pain on another body part, memorizing mathematical equations, or creating images of unattractive women have helped some guys, but results do vary. Steer clear of alcohol and drugs Tuning in to your body and feelings can help you control premature ejaculation. When you’re in an altered state of mind, tuning in becomes difficult. Do your homework Several techniques have been developed that help men control the timing of their ejaculations. Mastering techniques such as the “pinch” method, or the “start-stop” method help men identify and focus on the moments that precede the “point of no return.” Don’t give up on sex! These techniques and others have helped many men overcome the embarrassing and frustrating condition called premature ejaculation. penile enlargment tip free exercise tip for penis enhancement penis enlagement patch top penis enlargement pills best penile enlargment pills penis elargement without pills penis enargement surgery vimax penis enlargement technique

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WHICH REMEDY FOR BALDNESS WORKS? With each remedy for baldness I have split up into two categories: "drugs" and "natural". Both remedies for baldness are said to work to a degree. The drugs (creams and pills) have had various clinical trials performed on them, but on the downside they are occasionally susceptible to unwanted side-effects. The natural remedies for baldness most often have had no clinical trials attached, merely word of mouth recommendations, but normally have fewer side-effects (at least less unwanted ones) reported. If you are unsure on which type to try, it is possible to try both (but please get advice from a physician before doing so). ALLOPATHIC REMEDIES FOR BALDNESS Before I start on any allopathic remedies for baldness, I have to explain the current thinking in science behind the causes of losing hair so that the mechanism and effectiveness of the drugs are easily understood. Men convert excess testosterone into a more potent form called DHT by the enzyme 5a reductase. The DHT is highly active on the hair follicle receptors, readily latching to them and restricting blood flow to the hair. This causes the hair to become thin and miniturized creating the "peach fuzz" look. There is apparantly a greater quantity of this enzyme in the scalp of men who are susceptible to male pattern baldness.[1] Women, however, have excess of the enzyme aromatase which converts their testosterone into a form of active estrogen called estradiol. The theory is that after women hit menopause, their levels of natural estrogen lowers letting the testosterone be converted into DHT which makes them more susceptible to losing hair post menopausal. However, that doesn't explain why post andropausal men lose hair when they become older and their testosterone levels die down.[1] Well, that's the theory, so now lets look at each remedy for baldness in turn and determine its effectiveness and availability as of July 2006. Below is a list of each remedy for baldness: Rogaine (Minoxidol) Propecia (Finasteride) ROGAINE Mechanism - unclear. Seems to open potassium availabilty to the hair. Effectiveness - average increase of hair per cm2 was 18.5% after 48 weeks. 1 to 3 months after stopping, hair condition returns to pre-treatment levels. Side-effects - Dizziness has been reported. Local irritation, itching, dryness, and erythema may occur with use of topical minoxidil, most likely caused by the vehicle formulation of alcohol and propylene glycol.[2] Availability - over the counter. Cost - $10 to $15 per bottle (one month). PROPECIA Mechanism - inhibits the 5a reductase enzyme responsible for DHT production. Effectiveness - A third study of 326 men with mild to moderate frontal hair loss found that after 1 year, finasteride treated men had statistically significantly higher hair counts on the frontal scalp. Approximately 50% of treatedmen and 30% of those who took placebo thought the appearance of their hair had improved. Hair regrowth was not reported in older men taking 5 mg finasteride. Side-effects - A decreased libido, erectile dysfunction, or a decreased volume of ejaculate have been reported in less than 2% of patients, which in reality is between 0.5% to 1% when compared with placebo.[2] Availability - was prescription only. Generic version now available. Cost - $69.95 for 3 months NATURAL REMEDIES FOR BALDNESS Most natural remedies for baldness also work by blocking DHT, either by inhibiting the enzyme or blocking the hair follicle receptor, or providing the nutrient for the hair follicle receptor which DHT blocks. There is also an alternative interpretation of the "DHT alone causes hair loss " theory. Some believe that it is too much active estrogen-like substances as well as too much DHT that is to blame for prostate cancer and losing hair, and not enough free testosterone in the body.[3] This sounds contradictory to the allopathic arguement, and concerning estrogen it is. Some naturopaths say that it is all about what blocks the hair follicle receptors. It is these protein receptors which attract nutrients to the hair. DHT and estrogen-like pollutants both block the receptor.[3] Apparently, certain bacteria which thrive on fat, produce estrogen-like substances[4], and there is excess of the aromatase enzyme (which turns testosterone into estrogen) present in fat cells of obese and balding men. Aging, a high fat diet and lack of exercise can create too much estrogen and too little testosterone. Even if testosterone is at normal levels, active estrogen levels can still be way too high.[3] Although this doesn't explain why women with high estrogen levels don't get male pattern baldness. Here is a list of each remedy for baldness and nutrient: Beta Sistosterol (from the herb: Saw Palmetol) Chrysin (from the herb: Passionflower) Vitamin D Vitamin B12 Biotin (vitamin B7) Iron and L-lysine (for women) Folligen (copper peptide) Soy Rooibos tea BETA SISTOSTEROL Mechanism - blocks DHT from the androgen receptors sites found on the hair follicles. Effectiveness - untested. Mixed reviews from people on health forums. Side-effects - None, but side-effects of the herb Saw Palmetol can be male breast enlargement.[2] Availability - over the counter. Cost - 90 Capsules 400mg $7.95. CHRYSIN Mechanism - increases free testosterone by inhibiting the conversion to estrodiol. Effectiveness - shown to be effective at stopping aromatase in the petridish, but not in the body. Not known if it helps with losing hair.[5] Not a proven remedy for baldness. Side-effects - none. Availability - over the counter. Cost - MRM, Chrysin 500, 30 Caps. $14.99. VITAMIN D Mechanism - binds to the many vitamin D receptors in the scalp and hair follicle. Effectiveness - shown to dramatically stimulate hair follicle growth in "nude" mice.[6] Side-effects - none, unless taken over 50 micrograms per day. Availability - over the counter. Cost - 400iu (10 micrograms) 60 capsules $4.99. VITAMIN B12 Mechanism - deficiency causes hair loss.[7] Effectiveness - 40% of Americans are deficient. Not proven to remedy hair loss if taken.[8] Side-effects - None, unless taken over 100 mcg daily. Availability - over the counter. Cost - 1000 mcg, Tablets $7.99. BIOTIN (VITAMIN B7) Mechanism - increases blood flow to the hair follicle.[9] Effectiveness - it can promote hair growth in high doses, although not a proven remedy for baldness. Side-effects - none. Availability - over the counter. Cost - 300mcg tablets $2.99. IRON AND L-LYSINE (for women) Mechanism - deficiencies in both these nutrients have been associated with losing hair in women.[10] Interacts with zinc and copper.[11] Effectiveness - proven effective remedy for baldness for women with losing hair.[10] Side-effects - none unless taken over 250 mg daily (iron). Availability - over the counter. Cost - 100 Tablets $7.29 FOLLIGEN (copper peptide) Mechanism - most effective blocker of the production of both types of 5a reductase enzyme.[12] Effectiveness - low copper and zinc enzyme levels caused hair loss in mice.[13] A topical copper peptide solution created near perfect hair rejuvenation in 6 months in a woman with 10% of her hair at the start.[14] No studies on the remedy for baldness Folligen itself, but some reports of success by women on forums. Side-effects - none. Availability - over the counter. Cost - 2 oz tube, $21.95. 2 months. SOY Mechanism - promotes the production of the good inactive estrogen. Blocks the receptor sites for active estrogen and inhibits 5a reductase.[3] Effectiveness - proven to inhibit the enzyme 5a reductase.[15] Side-effects - none. Availability - over the counter. A food substance, not a remedy for baldness. Cost - ? ROOIBOS TEA Mechanism - unclear. Effectiveness - in a 10% lotion called herbasol, 89% had increased speed of hair growth. 45% saw an increase in hair growth. 78% reported no further hair loss.[2] Side-effects - none. Availability - over the counter. A food substance, not a remedy for baldness except as above. Cost - ? I would personally recommend trying Beta Sistosterol with a powerful multi-vitamin and mineral supplement coupled with the Folligen solution as a good remedy for baldness. -------------------------------------------------------------------------------- [1] Have Scientists Accidentally Discovered the Answer to hair loss? http://www.emaxhealth.com/65/6131.html [2] Treatments for hair loss. http://www.hairlosstalk.com/download/sawaya1.pdf [3] Grow Young and Slim http://www.growyoungandslim.com/articles/Mens_Health_102a.pdf [4] Health Loss Education http://www.stuff4beauty.com/page/hairlosseducation.htm [5] Chrysin: Is It An Effective Aromatase Inhibitor? http://www.vrp.com/art/1208.asp [6] Vitamin D3 analogs stimulate hair growth in nude mice. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12399436&query_hl=41 [7] Diet and Nutrition - vitamin B12. http://www.internethealthlibrary.com/DietandNutrition/VitaminB12.htm [8] Do You Need B-12? http://thyroid.about.com/cs/newsinfo/l/blb12anemia.htm?terms=vitamin+B12+and+Tufts+ [9] Biotin and Hair Growth http://www.add-hair.com/Biotin-hair-loss.htm [10] Nutritional factors and hair loss. http://www.blackwell-synergy.com/links/doi/10.1046/j.1365-2230.2002.01076.x/abs/ [11] Interaction of iron, zinc and copper in the body of animals and humans http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2700243&dopt=Abstract [12] Folligen http://www.folligen.com/ [13] Age-related cochlear hair cell loss is enhanced in mice lacking copper/zinc superoxide dismutase http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10466888&dopt=Abstract [14] Have Scientists Accidentally Discovered the Answer to hair loss? http://www.emaxhealth.com/65/6131.html [15] Regulation of Male Sex Hormone Levels by Soy Isoflavones in Rats http://www.leaonline.com/doi/abs/10.1207/S15327914NC422_9;jsessionid=nFFp1FovOhX-OhcS3V?cookieSet=1&journalCode=nc penis enlarement before and after photo pnis enlargement before and after picture penis girth elargement penis enlargment information cheap vig rx pill penis enhancement secret penis enlargment pic before and after vimax penis enlargement stretcher penile enlargement excercises

Mid life Crisis is not a disease or an event that one can avoid. It afflicts everyone who lives through their middle years. There is no warning as to when it will hit you, but when it does, it likely will come at the worst possible time, but then again, when is a good time for a meltdown? Most likely your time will differ from that of your friends and others close to you like your Husband or Wife, since our Middle years can begin anytime from our mid thirties through one’s fifties and everyone is different. Don’t even think you can avoid mid life Crisis, because you can’t! No amount of money or influence can get you out of this one. How you endure the transformation and to what degree you suffer or not, will vary as widely as those who experience it. You know the cliché, forewarned is forearmed, so knowing what will happen and how to survive the experience in tact, can go a long way. Right! I may have been exaggerating slightly about how ominous Middle aged Crisis can be, because I wanted to grab your attention. However, we have all heard the jokes about middle aged crisis and know that within all jokes, there does contain a grain of truth. The truth here is that some of you will experience a major shift in your lives, while for others the change may be more gentle. Do not doubt that change is on its way. It is inevitable! You may not have say on if or when it will happen, but you do have a say in how you will deal with it. Each and every one of us is equipped with a silver bullet in our personal arsenal to deploy as we see fit. This is something that you may already be using or something that you have yet to take out. It matters not because you never run out of it. It is the most effective weapon we have and that is Attitude! As a Life Coach, we use our attitude and perspective to help our clients deal with many issues in their lives until their own attitude can take over. In fact, we often say that if we only have one tool to use, Perspective would be it. How you view things, and the attitude you take toward life’s ups and downs, (your perspective), has a dramatic effect on how you cope. Are you a glass is half full or half empty person? Do you laugh in the face of danger or do you run and hide in terror? Are you someone who is afraid of change or do you embrace it like me? Do you see problems or opportunities for improvement? Positive and negative personalities are obviously opposites of each other, with the extremes differing in folks all up and down the spectrum of the pole. I can certainly find folks who exemplify the ends of the pole, those with very strong outlooks, but for those who are fence sitters, you now have an opportunity to change your attitude. Only you know how you experience the world around you, but I know that a positive or negative attitude will affect how you experience what I have coined, The Emergence of our True Self. How would you like to go through life? Seeing opportunities or finding problems everywhere? The choice is yours. Look at this time as an amazing opportunity for you to take a peek behind the veil, the cloak of mystery that is you. Avidly seek out the answers to questions that have plagued mankind since the beginning of time. I know that as a child I lay in bed and many times looked up at the sky and wondered, “Why am I here”? “What is my purpose?” “How can I be more than I am?” These are the questions that will now be answered for you. This is your time to finally solve the mystery. View this time as a positive experience. This is your time and it has been given to you so that you can emerge as your True Self. Feel all of it; embrace the experience, even the tough stuff. Remember the butterfly and its struggle to emerge from it’s cocoon. You may struggle through this time but you will emerge a more content person for it. I am positive about this. Middle Aged Crisis, struck this week and it happened to a man we will call Dan. Let’s see how it begins so we know what to look for. Dan is a slightly paunchy, balding middle-aged man in his late 40’s, whose one attempt of rebellious attitude towards his wife, was to go against her thrifty nature and adorn the front end of his mini van with a ‘bra”! One day, Dan left his ‘bra’ behind and came home wearing a shiny new candy apple red corvette instead. It looks like the van was traded in for this gorgeous sexy rolling piece of penis envy. After the ‘big wow’ fell out of your dropped jaw, was your next thought the same as mine “now there’s a guy whose wife is going to kill him”? Where are the kids going to sit? Is Dan a classic case of a man having a mid life crisis?!” Will his ‘search” for himself end here or will Dan take it a step further? It seems that several of the guys in Dan’s office have traded their wives of 3o years for 30 yr.old wives. We don’t know if Dan knows any 30 yr; old women so we will have to wait and see about that. Dan seems to be the poster boy for Middle Aged Men in crisis but what about woman? Are they immune to mid life angst and do men and woman manifest their symptoms in the same way? Joan Rivers and her G-force facelift might be the perfect example of a woman who is still searching for more in her life but can’t get past her mirror. We often joke about woman and their hot flashes, but do they wake up all sweaty and then head out in the morning to buy sexy cars or is there another measure of being unsatisfied they go for? I have a few lady friends who were the very last women in the world I EVER expected to radically deviate from their MOM role. It seemed at 40 something, they woke up one day and traded their beautifully decorated home, mommy and wifely duties for a basement apartment and freedom. Did it mean they loved their children less? Nope, it just meant that they were compelled to find out who they were after being a mom and wife. Yes, a few became what is commonly referred to today as Cougars, woman who prey on younger men, but for the most part, they seemed to be genuinely seeking themselves. Either this was something that was lost, or something they never had in the first place. So is Mid life Crisis a valid condition or an excuse to be selfish and make up for poor choices along the way? Is it a human condition that we will all experience in varying degrees as we pass through their middle ages, or is it reserved for those who share certain personality traits? Is it possible that it is related to female menopause or male Andropause? Do hormones have anything to do with the ‘stress and distress of those in the eye of this storm? Are these people as out of control as they sometimes seem to be? I am not a doctor and do not know the answer to these questions but I do know as a Life Coach and a woman in her middle years, that there seems to be a great many people in this age category who are seeking and searching for something that will fill a part of them that is missing. They have a great desire for something more in their life, but what that MORE is they don’t know. It is a time of personal reflection and for some breaking out of a mold that has held them for many years. Perhaps you know someone who has quit their executive position or walked out on their 30 year marriage. It doesn’t always make sense, this behaviour, but there is common theme. CHANGE! It seems that many are seeking their destiny, and the meaning of life. They want to know what their purpose is and where they fit into the Grand Scheme. They want to know what this thing called LIFE is all about, and they are seeking their soul, their soul mates and questioning long held beliefs. Spirituality is a common theme, and many search for their connection to something larger than the known world and for answers they go to the Unknown world A metamorphosis is taking place and I see it as our third great struggle of life. The first is being born, the second is adolescence and now this time I will coin, The Emergence of Self. The emergence because it is our true self we are seeking. Not the daughter, son, mother, father, doctor, cook or any other label we have put on ourselves, but OUR true SELF , our true soul, the nature of who we really are. It seems this is a time where anything can happen and does. Sometimes those who are most surprised by what happens next are the seekers themselves. As adolescents we go through the change together, it is expected, so resources are in place to help us deal with it. Our families and teachers are there for us, supporting the change. Now in our mid 40’s- 50’s, it seems we face this change alone. No longer are our buddies, families or teachers there to support us. In fact, it may be that those closest to you don’t understand why you are contemplating the things you are. They may argue that you are making a big mistake and you don’t know what you are doing. Even if this is true, and in many cases it is, there doesn’t seem to be anything to do about it except ride it out. Have you ever wondered at the timing of all this? Why is it so important to KNOW right now? Why upset the apple cart at this stage of your life? Perhaps it is so that our time here is not wasted in the larger sense. Many of us as children had a dream or a goal. I think that this first memory may be the truth of who we really are and why we are here. How many of us have stayed true to who we were? I know that there have been many times in my life that duty as a daughter, a mother, and even a wife have taken precedence over who I wanted to be. So maybe this frustration, this time of wanting is really the only way to help us break the chains of ‘good behaviour’ and allows us the time to search for our lost selves or if you believe in the metaphysical then perhaps we are waking up to what brought us here in the first place, our contract or mission. Have you felt that there is a master plan but you haven’t been let in on the details? The there is a great secret, albeit unknown to you, and almost like a cosmic joke, it is at your expense. Why does this transformation take place? Is there a way of escaping it? I think not. It seems to me a natural progression to a higher state of being if we are lucky. It seems we all go through the process, albeit at slightly different ages and degrees of angst. I believe that this is one “Crisis” that is supposed to happen and rather than describe it as a crisis we could rename it as a transformation. We have all have known a “Dan”, a 50 something guy who finally buys his corvette, or his Harley, leaves his wife or leaves his job- any or all of these are fairly common and classic crisis behaviour. As I said earlier, Women are not immune either. We can all envision the Cougar, a woman in her mid to late 40’s who used to be Suzy Homemaker and is now on the prowl for a 2o something guy to make up for her boring life. On the outside, this behaviour seems selfish and I suppose in some ways it is. But remember, this Emergence is about self and change and change never comes easily. There is always a struggle and in this instance, doing what is opposite in nature of what one has always been done may be one of the catalysts to the next step. These folks are in the midst of a chemical and physical transformation. Alchemy is taking place. When all is said and done, they will be different. They are reaching out for their world to make sense and hopefully when all is said and done, they will have found peace. Peace within themselves and peace with their outside world. We know that these folks want more, but and the sexy car, younger mate is not the whole answer because change on the outside does not equate with change on the inside. I feel that this transformation may actually be harder on us than adolescence. When we are young, we have out parents to support us. We walk en mass with our friends to school and we are all going through stuff together. But mid life, we do that one by ourselves and many times, we wreak havoc on the lives of those we love the most. This change, this metamorphosis, cannot likely be stopped, anymore that you can stop breathing, but for some, it comes with great cost. Our bodies change- we don’t child bear anymore. We have wrinkles and grey hairs sprouting from places they aren’t supposed too. Our skin on our hands begin to thin and become translucent, showing the blue of our veins. We fear we are losing our sexuality, our vitality and our ability to be ‘seen’ as one of the players. We fear this invisibility and we fight to be more than we are, because we want to stay in the game. We also know that we are more than we are showing. We wake to an unknown dream or assignment and strive to fulfill our life’s mission, but the guide book is missing. The map is gone and our hands flail in the wind seeking something solid to grip onto. It’s a turbulent time until one day, you wake up and your life begins to make sense again. You start to realize what is important. Who you are and what you are passionate about. You know what you love and whom you love and you have a sense of the greater picture. You know why you are here. You understand your ties to the past and what you bring to the future. The Emergence of Self will happen whether you plan for it or not. At some point in your life mid life, an amazing discovery of self will take place, and I hope that you complete your transformation all the way until you feel at peace within your heart and the world around you. For those of you who are wondering what signs to look for or if you are currently experiencing your transformation, below you can find a list of common features: Typical features of mid-life include: Experiencing healthy dissatisfaction……..yearning for more…..is this it?? What worked before no longer rocks your world. The changing body becomes your guide. You get used to uncertainty You want to give back You become much more than you thought you were. Your values change significantly You are getting a hefty whiff of you own mortality. The emergence of wisdom Mid-life challenges that Coaching can assist with: • Finding your Passion • Removing FEAR from the Change Process • Learning how to acknowledge and accept others • Learning to Communicate at heart level • Reconnect with your SELF • Leaving Guilt Behind • Trusting your instincts • Creating a vision pnis enlargement stretcher vimax penis pills in uk manual pnis enlargement exercise free penis enargement penile enlargment before and after photo prosolutionpills herbal pennis enlargement pills natural penis enargement exercise penile enlargement excercises

ED or erectile dysfunction is one of the major concerns to a happy married life. Erectile dysfunction is also defined as impotence which is also explained as the situations when men are unable to have a proper penile erection though fully aroused. Erectile dysfunction is not only one of the major obstacles when thinking about a successful physical relation but it is one of the major causes which makes a man lose his courage and motivation while performing any other tasks at his home or working place. Impotence is defined as the major element behind disputes in a married life and social life. Not only this it sometimes creates hassles in reproduction also creating blunders to the lives of men and their partners. Impotence or erectile dysfunction occurs because of the absence of nerves between brain and penis which actually act as stimulants at times of intercourse. In the absence of these nerves the blood flow from the brain to penis gets lowered hence allowing low penile erection or early ejaculation at times. Understanding the effects and criticality of impotence in one’s married life medications like tablets and jellies have been introduced into the market. Those who prefer Generic treatments to other branded treatments Generic Viagra is the most reliable and popular treatment available today. Generic Viagra a quicker and reliable source of getting a safer penile erection allowing the partners get a proper satisfaction from their love making. Generic Viagra is available in different dosage forms as 100 mg tablets, soft tablets and jellies depending on the preference of users. Generic Viagra guarantees a quicker and safer result with cheap prices and the flexibility to make love when you want to. It offers the users a quicker result within 30 minutes of its intake and gives a long lasting result up to 4-6 hrs from its consumption allowing the user to attain the maximum out of his intercourse. These wonder pills are very popular with the name of Kamagra which is considered to be the power booster to alls married lives. herbal natural penis enlargement penis enlarement surgery compare penis enlargement pills penile enlargement without pills plastic surgery penis enhancement free pennis enlargement tip vimax cheap penis enlargement pills vimax review penile enlargement excercises

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. It is also ideal to tackle anxiety.