From the Guidelines
The exact cause of rosacea is unknown, but it likely involves a combination of genetic and environmental factors, including abnormal blood vessel function, skin barrier dysfunction, and an overactive immune response, as noted in the 2017 study by the global rosacea consensus (ROSco) panel 1. The pathophysiology of rosacea has yet to be fully determined, but it is believed to involve dysregulation of the innate and adaptive immune system, with increased levels of antimicrobial peptides, neuropeptides, and other factors contributing to the development of the condition 1. Some of the key factors that may contribute to the development of rosacea include:
- Demodex mites, which may trigger inflammation in susceptible individuals
- Ultraviolet radiation exposure, which can activate certain pathways and worsen symptoms
- Hormonal changes and family history, which can influence susceptibility to the condition
- Triggers such as sun exposure, hot or cold temperatures, spicy foods, alcohol, stress, and certain skincare products, which can worsen symptoms. The condition involves chronic inflammation that damages skin tissue and blood vessels, leading to characteristic symptoms like facial redness, visible blood vessels, bumps, and thickening skin. Understanding these contributing factors can help guide treatment approaches that focus on reducing inflammation, avoiding triggers, and repairing the skin barrier, as recommended by the ROSco panel 1.
From the Research
Rosacea Cause
- Rosacea is a chronic inflammatory skin condition associated with four distinct subtypes: erythematotelangiectatic, papulopustular, phymatous, and ocular 2
- The pathogenesis of rosacea is likely multifactorial, involving genetic and environmental contributions 3
- Immunologic alterations and neurovascular dysregulation are thought to have important roles in initiating and strengthening the clinical manifestations of rosacea 4
- Pro-inflammatory pathways involving cathelicidins and inflammasome complexes are central to rosacea pathogenesis 3
- Common rosacea triggers, such as Helicobacter pylori infection and small intestinal bacterial overgrowth, may modulate these pathways in a complex manner 5
- Demodex folliculorum infestation is also considered a possible trigger for rosacea 5
Triggers and Risk Factors
- Flushing is a common symptom of rosacea, and can be triggered by specific factors such as ultraviolet light, temperature extremes, and emotional stress 2
- Avoiding these triggers, using moisturizers to decrease transepidermal water loss, and blocking ultraviolet light can help prevent flushing 2
- Genetic predisposition and associated diseases, such as Helicobacter pylori infection and small intestinal bacterial overgrowth, may also play a role in the development of rosacea 4