Moving On ?

From Debunking Dr. Geoffrey Nase
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When we posted our very brief update on May 31, it was in the hope that no more updates would be necessary. After having been silent for so many months, we needed to let the community know how Nase's court case finally ended, and the truth about what had happened on the Forum. Now that the rosacea boards are calmer and more peaceful, it was our hope that we could go back into a state of inactivity.

Unfortunately, before the update even went up, Nase sent us two threatening messages via our attorney. Nase has behaved aggressively towards everyone he has ever suspected of having any involvement with our team, but so far the most viciously defamatory and dishonest material has been against Dr. Soldo and Laura Thomas, who had dared to confront him in court. It is clear that attacks of this nature will now escalate, combined with further attacks over the Rosacea Research Foundation.

Nase's reputation IS the Internet. If people stand in his way, he will do whatever it takes to remove them, and that includes creating fraudulent 'evidence'.

The First Anniversary

A full year has passed since Nase first plunged the rosacea community into chaos by abandoning the RRF, the fund-raising charity he helped found. All of the problems stem from that split, so let us repeat that the split had nothing to do with his later excuses about custody battles, donations, laser insurance payments, or brochures. Although none of the co-directors has ever met, the team had drawn close, and they all went through hell when Nase staged a five-week-long series of near-death dramas. The day after what was supposedly his seventh major operation, the other three directors gently challenged him on whether it could all be true. The next day they were marked down for destruction, and the war had begun.

Up until then, Nase had praised the RRF planning team as tireless workers. Suddenly they were lazy and useless. When he started attacking them on ESFB, there was no mention of any financial problems until one supporter expressed disbelief that so much bitterness could have blown up over slacking: "Ive only seen people get like this when money has been involved." Within minutes, Nase launched his first-ever allegation of theft, and the following day he began calling for people to report his co-directors to the security services. (The money was always safe, and was later put into a National Rosacea Society (NRS) study approved by some of the most prestigious names in rosacea research, including Dr. Jonathan Wilkin, Dr. Richard Odom, Dr. Michael Detmar and Dr. Mark Dahl.)

While the RRF was unravelling, Nase's plans to promote a laser clinic on the West Coast for money fell apart when it came to light that the doctor concerned had a disciplinary record for sexual improprieties with a patient. Nase immediately attacked the woman who had posted this information, but another group of rosaceans defended her and argued that it was right for such information to be aired. Two of them happened to be patients of another laser specialist, Dr. Soldo. Nase emailed them and warned that his "good friend" Soldo would now punish them by cutting off their medical treatment - something that no physician would even contemplate. Dr. Soldo naturally refused to follow Nase's dictates on this issue, and so he and one of his patients, Laura Thomas, were added to the list for destruction. They did not set themselves against Nase; Nase placed them there!

The truth is that there never was a "turf war"; there were no agents and no professional rivalry, just a great tangle of bizarre fantasies on the part of Geoffrey Nase, accompanied by torrents of abusive and threatening phone calls, emails and board posts. Once Nase gets an obsessive idea, it takes on a life of its own, especially when he is egged-on by supporters, most of whom started out genuinely believing his stories, convinced by the faked-up 'proof' he offered.

Enter the Debunkers

It was at this time that the Debunkers drew together. (There were nine, but a tenth joined a few months later.) Some were thrust into it after finding themselves under unrelenting attack, while others joined in sympathy, feeling no one should have their lives made hellish just for speaking the truth. None of us are naturally combative, but we all felt that the madness and Nase's lies had to end. We have never been fueled by hatred or vengeance or monetary motives, just by the knowledge that we had to fight what was happening. If we did not stand up and say, "Enough! This must stop!", no one else would, and the list of victims would surely grow.

When Nase sued to take the Debunking site down, someone had to attend court to challenge his assertions that our site was not telling the truth, and as such had already lost him over a million dollars. Laura Thomas offered to appear in court to oppose the suit, and defend our "truth site". Dr. Soldo agreed to be named alongside her because he was appalled that Nase had phoned and asked him to ditch two of his patients. He also felt that Thomas had been targeted by Nase just because she was his patient. The whole group then hired an attorney to defend us, we all shared the financial cost, and Thomas and Soldo were just the ones who fronted up in public. None of us had any idea what a massive burden that would prove, or how savage and dishonest the blows against us would become. We've debated the merits of all 'coming out' to take some of the heat off Soldo and Thomas, but they have stood firm against giving Nase additional targets.

Nase's future business plans

Nase seems convinced that if he could just force our site off the internet, he could make himself the king - or at least kingpin - of rosacea. Over the past six months or so, he has boasted that his LLC is booming; for example:

- "The consulting business has skyrocketed and I may have to take on a dermatologist part time to help. Things look great all around. ... Im actually expanding and building off of this. Everything could not be better. More hits then ever and more consultations. ... Growth -- may need to hire a dermatologist for a partner to handle demand." (October 08, 2005)

- "I dont even have to open up a forum because my Rosacea Consulting Specialist LLC is amazing. I have at least 4 cases a day now at a Medical PhD pay scale level. But, I am working hard on the new forum." (January 17, 2006)

There have even been claims that he is now so busy that he has had to take on a Personal Assistant, a successor to the famous, perhaps mythical, Amanda. (March 22-23, 2006). Yet no one has ever come forward and reported having used Nase's consulting business.

The super board - ten months ...

On August 7, 2005, Nase announced that his web site designer was hard at work creating a new board for him. A large team of supporters volunteered to help get the site up, then it was announced that two IT professionals (both PhDs) had started work, with a third "IT specialist" added later. On August 23, on ESFB ('Rosacea Forum Completes First Interview ...', reply #42), Nase wrote: "This is already happening. ... Now, I am surrounded once again with my friends and biomedical scientists who can get things done in days, not 6 months." Not days, not 6 months, and now not even in 10 months. There is still no word of an opening date, and no reliable figures on who will participate.

Behind the scenes, talk has it that Nase still has fewer than 200 prospective members. Most people won't pay for information they can obtain freely elsewhere, and the amount of information available in the wider rosacea community has been growing in leaps and bounds. For example, freely available community assets include some excellent background material on the Forum, Rosacea Support's archived posts and new Resource Pages, David Pascoe's monthly Rosacea News bulletins, Andrew Reid's excellent Rosacea Blog and Treatment Database, and the Rosacea Search Engine created by Warren Stuart.

One major attraction of Nase's proposed forum would be access to the specialists and scientists Nase claims would give exclusive reports to members of his board. A key flaw in the plan is that it would be impossible to prevent members from sharing the news with their friends, and most rosaceans would almost certainly rather stay with the current boards, rather than pay for information they can get free as soon as a member of the new group leaks stuff back. For that reason, any subscription board run by Nase would be unlikely to succeed unless all of the free boards could first be shut down.

... And counting

On January 9, Nase told Forum members: "The list for the Rosacea Research and Treatment Forum is now at 6,781 members and 23 physicians and 30 plus medical scientists". Two weeks later, he claimed: "7,102 members now for the forum. Almost a hundred new members in my forum every day now."

Let us take Nase at his word, and let us further assume that despite the phenomenal growth rate reported, his membership total stopped soon after and was capped at 8,000 members. He has refused to reveal the subscription fee to be charged, but a figure of around $125 p.a. has been reliably suggested. That would be an immediate income of $1,000,000 the moment the board opened, and every year thereafter. Add on the extra fees he intends to charge for consultations, for phone calls and letters to patients' physicians and laser specialists, and for helping with insurance forms, and it is clear why Nase genuinely believes that he could be making a million dollars a year from the rosacea community. No wonder he is so determined not to give up on this!

We still think Nase's super forum is unlikely to happen. After boasting for so long that he has well over 7,000 members already signed up, to open a board with only a few members, and with only a couple of doctors, would surely be too great an embarrassment. Although Nase has long since given up hope of rejoining ESFB and Rosacea Support, a return spell on the Forum would give him a chance to recruit more members, as well as patients for his consultancy service. That won't happen unless all of his opponents are driven out - a tricky task, given that the ultimate aim would be the closure of the free board.

Rosacea Researcher?

Nase often claims that he, and he alone, can bring together teams of scientists and physicians and get them all collaborating on rosacea. This is not remotely achievable. Nase is not a "rosacea researcher" as most scientists define the term. As he admitted in the Deposition, he has never conducted a clinical study on rosacea, never received a grant for rosacea research and, in terms of peer-reviewed publications relating to rosacea treatment and pathophysiology, Nase has been involved in just one article. He only turned against the NRS after applying for a research grant and being rejected.

When a study testing the treatment of rosacea by pulsed dye lasers was conducted in 2004, Indiana University School of Medicine provided a respected rosacea expert who knew all about lasers ... Dr Tan, from their Division of Dermatologic Surgery.

Most of Nase's scientific 'finds' come from internet searches, not personal interviews. If he stopped reporting them, the studies and the drugs trials would still continue at exactly the same pace and, if successful, the drugs would come to market in exactly the same way on the same schedule. Giving people absurdly unrealistic release dates, as has happened too often in the past, including with SansRosa, really doesn't help anyone.

The VEGF Contradiction

On his web site, Nase claims that he might set up a Biotechnology Laboratory with Dr. Patrick Bitter Sr. The chief intention would be to work on "one of the most promising near-cures for rosacea -- a Vascular Endothelial Growth Factor Inhibiting Oligonucleotide (blocking the primary genetics behind rosacea redness, flushing and papules)".

"The goal of this treatment would be topical application of gene blockers that would permanently turn off VEGF, a clinically proven 'bad guy' involved in almost every aspect of rosacea development and progression. A second important point to emphasize is that preliminary clinical studies have demonstrated that VEGF is probably the most potent dilator involved in the blushing response. VEGF is premade and stored in granules that once activated are released instantly during the blushing mechansim. Thus the speed of the blush, the intensity of the redness and the duration are intimately controlled by VEGF. With this technology it would only take one treatment and no further maintenance required. No promises yet, but please check back for updates."

So VEGF is "probably the most potent dilator involved in the blushing response" and is "a clinically proven 'bad guy' involved in almost every aspect of rosacea development and progression". VEGF is an agent for angiogenesis, which means more blood vessels -- the last thing any rosacean needs. From most of Nase's previous claims about this growth factor, rosaceans would be entitled to think that VEGF would be dreadful for them.

In his book (pp.318-9), Nase listed a research study on VEGF and rosacea as "one of two excellent studies to have been funded for research, with many others being considered" by the NRS's "top-notch medical advisory board" - the same board he has repeatedly criticized as unknowledgeable about rosacea. Nase predicted that studies following on from this one "may lead to the development of a topical drug that would prevent the release of this substance", and a one-time only application would be the great dream cure.

With VEGF inhibitors high on Nase's list of most promising potential cures for rosacea, it should have raised many eyebrows when he did an abrupt about-face, and suddenly urged everyone on the Forum to try Neocutis Bio-Restorative Skin Cream, (January 9, 2006 'Neocutis -- Nonprescription strength available'). The main active ingredient contains 20 growth factors, including "VEGF and two other blood flow increasing growth factors"! (our emphasis)

Yet only a few posters expressed concern about the potential risks of applying VEGF to their skin. Other group members hurried forward to purchase the cream, dazzled by the incredible praise Nase lavished on it, eg:

"They have 60 patients so far and will be putting more photos up on their website or complete clearance of every subtype within 2 to 5 weeks. Never has a topical come close to these results."

"It is expensive, but I have never seen a topical or oral rosacea medication clear redness and papules better than this product. ... Moderate to severe rosacea before -- 4 to 6 weeks later no trace." (January 11 & 12, 'Interview with Neocutis for Dermatology Times')

Grumbles that the photos on the site were unimpressive brought the unlikely explanation from Nase that the company had given him far better photos showing full clearance, but wouldn't let him show them to anyone else.

When some of the testers reported skin irritation and queried the presence of the VEGF, Nase reassured them, "You need the VEGF to ensure that the other factors take root and grow. You must have it. ... Once you remove VEGF it should normalize -- its not like glycolic peels that have permanent negative reactions." Although he had earlier claimed "complete clearance" within two to six weeks, he now admitted that many would have irritation for up to 60 days, "through two epidermal shedding periods", but insisted that it would be worth fighting through the irritation. Despite that, Neocutis cream was judged a failure.

About turn

Most Forum members remained silent over these twists and turns, but once Nase went back to casting VEGF as the arch-villain, a lone voice piped up to ask some tough questions. (June 10-11, 2006 'is dr nase back?') eg:

"If the Neocutis cream needs VEGF to make the other ingredients (dilators) work and we have to battle it out for up to 60 days before we see possible improvement, then how is it that now a once only topical application of gene blockers to permanently turn off VEGF is all that would be required for clearance of Rosacea?"

The eagerness to trust Nase brought some really ingenious replies to this contradiction. One offered that, while VEGF seemed to help mask rosacea symptoms, stopping it would help get rid of the cause, and suggested that although VEGF was best avoided by rosaceans, it was needed in the Neocutis cream so the other factors could work. Claims that the potent angiogenesis and dilator VEGF was needed to make the other two dilators work would be hilarious if they weren't tragic.

As one non-rosacean recently commented, after reading Nase's Deposition: "I'll tell you one thing that I admire about G. Nase: his ability to gather die-hard fans that refuse to realize what he's about." (June 11, 2006 ESFB thread 'Geoffrey & DenMarc')

When the Neocutis rave posts were at their height, Nase told Forum members that the firm would be making presentations at the San Francisco meeting of the American Academy of Dermatology. "I will be attending that meeting and will be spending the second day and night (dinner) with them to brain storm and figure out more mechanisms of action". (January 11, 'Interview with Neocutis for Dermatology Times') Nase never went to San Francisco, so perhaps his hopes of some kind of arrangement with Neocutis have fallen through.

Two books or Four?

Several people have reported difficulty in trying to purchase copies of Nase's current book. One would-be purchaser was told by Nase late last year that it was being reprinted and a refund would be made to his credit card, but the refund still hasn't arrived. However, we have no idea whether or not Nase is now selling his book again.

A major problem with the sort of highly controversial and rewritten 'research' Nase had been putting on the boards is that, having staked his reputation on the truth of such material, it would be very difficult for him to leave it out of the second book he claims to be working on. Nase is furious when discrepancies in his writing are pointed out, but medical reviewers are a much tougher audience than the average rosacean.

Another problem with Nase's attempt to write a second book about beating rosacea is that those who have met him over the past nine months, or viewed the DVDs of the Deposition, are agreed that he very obviously still has rosacea. It seems well under control, but is clearly present, despite Nase's claims on the Forum (January 14, 2006 thread 'Laser touch up treatments'): "I am personally 6.5 years post and have never had any sort of treatment or touch up and am in 100% remission."

It is difficult for rosaceans to know what to believe when Nase has balked at every request that he post clear, digital photos showing close-ups of his skin, and when all of the photos on his web site are at least 5 years old, even the one labeled "recent", which is captioned October 25, 2004, but was very obviously taken at the same session as one of the photos in his book, published in 2001. If Nase really does travel to England this summer to work with Dr. Peter Crouch on laser techniques and iontophoresis (January 9, 2006, Forum thread 'Large Iontophoresis Patches for Drug Delivery'), ordinary rosaceans should at last have a chance to meet him in the flesh.

One option still open to Nase must be a return to the field he knows best: vascular studies of the heart and of diabetes. Last year, Nase claimed that a leading publishing firm had asked him to write two books on diabetes. If that is so, it might offer him a chance to make his mark in science without having to destroy the rosacea community in the process.