Rosacea

Are you suffering from rosacea at the moment?
If not, please explain why you need this treatment.

Yes

No

Are you currently receiving any treatment or under any medication?
Please provide more information of the medication being used if any.

Yes

No

Can we share this information with your General practitioner?
Providing us with your physician's address means that you allow us to share this information with him/her for updated medical records if need be. It also allows our clinician to access your medical records if there is a need for that. We advice you share this treatment with your doctor for him/her to update your medical records.

Yes

No

Do you have a history of using Finacea Gel to cure rosacea?
If so, how effective was it?

Yes

No

Are on any of the following medication?
Simvastatin or lovastatin are two types of statins. Tolterodine. Mizolastine. Amisulpride. Astemizole. Terfenadine. Domperidone. Cisapride Primozide. Erogtamine and dihydroergotamine are two types of ergotamine. Warfarin.

Yes

No

Do you have a diagnosis of one or more of the following conditions?
Myasthenia gravis is a kind of myasthenia. Porphyria. Irregular heart rhythm is a condition in which the heart beats irregularly. Antibiotic usage has caused diarrhoea.

Yes

No

Do you have a history of using Metrogel Gel to cure rosacea?
If so, how effective was it?

Yes

No

Have you been diagnosed with a blood disorder?

Yes

No

Did you know?
Consumption of Acetazolamide does not serve as substitute for acclimatisation methods unconscious Whenever acclimatisation techniques are applied, it is not always necessary to use Acetazolamide Despite taking Acetazolamide, some people still experience altitude sickness including HACE and HAPE Please reach out if you need help comprehending this

Yes

No

Do you have a history of using Mirvaso Gel to cure rosacea?
If so, how effective was it?

Yes

No

Are you experiencing the following symptoms?
Issues with your circulatory system. Depression. Blood flow to the brain and heart is reduced. Blood flow to the hands, feet, and skin is reduced. Standing up causes a drop in blood pressure . Autoimmune diseases such as Sjögren's syndrome.

Yes

No

Are you aware that Mirvaso should not be used on injured or inflammed skin most especially after laser therapy?

Yes

No

Do you know?
Your urine may appear red after taking Xifaxanta pills? However, this is completely safe. You should wait for at least two hours before taking Xifaxanta if you are using activated charcoal?

Yes

No

Do you have a history of using Rozex to cure rosacea?
If so, how effective was it?

Yes

No

Do you have a history of using Soolantra Cream to cure rosacea?
If so, how effective was it?

Yes

No

If female or transmale, are you currently pregnant, breastfeeding or planning to do so?
Please select your option

Presently Pregnant

Presently Breastfeeding

Planning on getting pregnant

Neither Pregnant nor Breastfeeding

What is your biological gender?
Please select your option

Male

Female

Transmale (Born a female)

Transfemale (Born a male)

Can you relate to any of the following?
You have an underlying medical condition You've been through a major surgical procedure You have allergic reactions You have cardiovascular conditions or might have had suffered a stroke You suffer from a low liver or kidney function

Yes

No

Has a qualified medical practitioner examined you with Rosacea?

Yes

No

For which duration have you suffered with Rosacea?
Please select your option

It just started

A couple of months

At least a year

Several years.

Kindly identify the symptoms you are experiencing
You can select more than one option

Flushing

Redness that doesn't go away

Blood vessels that can be seen

Papules are tiny lumps on the skin (small red bumps)

Pustules are a type of pustule (pus-filled swellings)

Skin that has thickened

Are you experiencing different symptoms other than those stated?

Yes

No

Could you share with us which specific parts of your body are affected by Rosacea?
Please provide all the specific information, it could be your chin, cheeks, face, T-Zone among others.

Kindly submit a photograph of your rosacea.
This will assist in enable timely dispatch of the medication especially if: You do not have a history of using any oral antibiotic treatment such as ERYTHROMYCIN or EFRACEA You have not attempted to use any medication for Rosacea You are yet to have the condition examined The medication is for another treatment other than Rosacea Our medical team will be able to make an informed decision about your treatment with the help of a photograph. Question that is not mandatory

Only .jpg, .jpeg, .png, and .gif formats are allowed.(10MB file size limit)

Do you have a history of using topical corticosteroids on your face such as betamethasone,clobetasone, or hydrocortisone?
If so, please tell us which treatment you utilized and how long you used it.

Yes

No

Are you afflicted with any additional skin problems?

Yes

No

Are you experiencing any of the following signs and symptoms?
Constant vomiting for more than 48 hours? Vomiting so much that your body is unable to hold any liquids down? Green vomit that serves as an indication of bowel blockage? Confusion, a quick heartbeat, sunken eyes, and producing little to no urine? Quickly or unplanned weightloss? high fever, body chills, migranes, or diarrhoea? Do you require assistance?

Yes

No

Do you have any psychological or social issues as a result of your rosacea?
Do you need any assistance?

Yes

No

Do you have a history of using Efracea to cure rosacea?
If so, how effective was it?

Yes

No

Have you tried using a topical rosacea cream, gel, or ointment to treat your rosacea before?
If so, could you inform us of which topical treatments such as Mirvaso Cream, Rozex Gel, Soolantra Cream, and Finacea Gel you used and how effective they were.

Yes

No

Are you on any of the following medication?
Antibiotics. Antihistamines such as stemizole or terfenadine. Cisapride for stomach discomfort. Quinidine for circulatory problems. Pimozide for schizophrenia.

Yes

No

Have you been diagnosed with any of the following medical conditions:
Illness of the liver. Yeast or fungal infection in the mouth or vaginal area. Myasthenia gravis is a kind of myasthenia. Colitis. Irritation or ulceration of the esophagus. Achlorhydria is a parasitic fungus (a condition causing the absence of acid in the stomach). Your stomach or digestive system has been operated on.

Yes

No

Are you aware of the following:
It is never a good idea to self-diagnose and treat urine incontinence. At the very least, you should see your doctor for a checkup once a year. You must follow your doctor's instructions for any treatment. You should only order repeat supplies of medicines that your doctor has prescribed.

Yes

No

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