The Epidemic Misconception of “Rosacea”

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You may notice as you browse this site that I always place quotes around the term “Rosacea” whenever I speak of it. The reason is because, in my opinion, there is no other inflammatory facial condition that has been misdiagnosed and mismanaged as frequently. Not surprising is the global pessimism, retirement, and depression surrounding a condition that is fumbled with as the standard of care.


The scary part is that most of these diagnoses and treatment attempts are coming from the most credentialed board certified dermatologists around. When a consensus of real experts are seen as off-point so often, it has to be considered that there is not only a diagnostic inconsistency, but maybe one of a semantic discrepancy…? (i.e. doctors are calling anything that is red rosacea as a “working diagnosis” to introduce treatment attempts. This idea would be reasonable except…, the diagnosis itself often times creates a self-victimizating mindset which can then perpetuate the spiral of hopelessness.)


When I make an adamant stance on this blog, I’d like it to be understood that these expert opinions are being made within the reality that there is no right and wrong in the world of art, and that medicine is certainly not a hard science. The “standards” of westernized medicine have accidentally mislead many people to believe they are speaking in fact rather than outcome statistics. Given that I’ve spoken to thousands of people who are needlessly suffering from “Rosacea” despite treatment at this time, it seems appropriate to both challenge the standard algorithm and to give insight into the treatment of skin that is inflamed, red, flushing, and uncomfortable. As always, these opinions have not been generated from any form of solitary imaginative thinking. Rather, they have been derived from paying extremely close attention, succeeding in the most hopeless clinical situations, and of course, video taping the results.




I will break this important post into two main categories. Those who have been misdiagnosed with “Rosacea” and those who have been accurately diagnosed yet still have failed the standard of care.

1) The Epidemic Misdiagnosis of Rosacea:

If your skin is red, raw, irritated, has broken blood vessels, has sensitivity to light, spicy foods, alcohol, and heat…., you will probably get a diagnosis of Rosacea from many primary care physicians and dermatologist alike. As mentioned above, they may be using this diagnosis as a quick “working diagnosis” to initiate attempts at treatment.
Here’s what physicians and patients are not taking into consideration when making this diagnosis:


-Oily skin alone can cause all these symptoms also.
-Acne prone and inflamed skin from acne can also cause these symptoms.
-Seborrheic Dermatitis causes all these symptoms as well as eye irritation. (there is also an epidemic misdiagnosis of ocular rosacea)

Read this part closely:
-Oily skin causes Seborrheic Dermatitis. (a chronic skin thickening and sensitivity due to oiliness or what is called “seborrhea”)
In a high maintenance patient, Seborrheic Dermatitis will not have the classic scaled and thickened appearance because this patient is constantly removing the flakes every day. Instead, they will present with only red, sensitive, flushed, uncomfortable skin. This presentation is not easy distinguishable on physical exam from rosacea and the misdiagnosis and lifetime treatment failure are driving millions of people crazy.



Here’s a very important sidenote to prevent any new self-vicitimation after hearing the diagnosis of Seborrheic Dermatitis:

All oily-prone and acne-prone patients are also prone to a bit of thickening and seborrheic dermatitis. This diagnosis is simply descriptive and in no way dooms people. It’s tricky, but like acne, is always treatable as proven in the redness videos on the home page. I refer to this type skin as “troubled skin” to avoid the emotional pitfalls of hopelessness that are generated from labels and diagnoses.




2) Those with Classic Rosacea who are still suffering:
If the diagnosis of Rosacea has led you and your doctor to a victory over your facial inflammatory ailment, I’m very glad to hear it. This section of the post is for those who have the classic and obvious diagnosis of rosacea yet still have not achieved inactivation despite going deep into the 20 year old algorithm of topicals like metronidazole, antibiotics like tetracycline, and finally isotretinoin. What is important for this group of sufferers to know is that all inflammatory conditions of the face and body are treatable. Inflammation only propagates for years when improperly treated. Let it be known worldwide that the classic rosacea treatment algorithm has helped millions and failed millions. Do not be baffled or depressed if your rosacea is not responding. It happens all the time. This condition is also completely treatable in this practice. Feel free to send your story and focused photos if you’ve tried “everything” and still need some help with it.




This post is intended to be read by both confused patients and practitioners themselves.


To the passionate doctors of the world,

“Please hesitate before dooming someone with the misdiagnosis of Rosacea. All that is red, sensitive and irritated is not “Rosacea”. Here’s some tips that will prevent the misdiagnosis:

-Tip #1: If a patient has a history of acne, oily skin, blackheads, and sensitivity issues, consider you are working with an acne-prone skin manifestation we call seborrheic dermatitis.

-Tip #2: Many patients with Seborrheic Dermatitis won’t present will scales because they are diligently removing them in a desperate effort to get clean.


Furthermore, when confronted with a real case of classic non-oily rosacea, think twice before ending the management of it after the basic cookbook algorithm is exhausted. These chronic conditions sometimes take more touch than knowledge. We know they don’t really teach the art of medicine in medical school. It’s something that needs to be indulged and cultivated by each and every passionate practitioner.”




The Acne Practice video project represents much more than just an acne solution for those who have become hopeless.

In a world where Acne, Rosacea, Seborrheic Dermatitis, Low Back Pain, and Heartburn are not curable, I’m introducing and illustrating, in high definition, a completely new medical treatment paradigm that is a step forward from the approaches of both traditional Western Medicine and ancient Eastern healing. I will be detailing this new medical paradigm for all chronic ailments in a future post which will break down the history, strengths, weaknesses, and fundamentals of all medicine that is commonly practiced at this time.

I’ll be here,
-Dr. Neal







©2011 “The Epidemic Misconception of “Rosacea” by Dr. Neal Schwartz

One Response to “The Epidemic Misconception of “Rosacea””

  1. Darren Elkins Says:

    Amen!!!!

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