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Rosacea: Pathogenesis and Current Treatment


Authors: J. Nemšovská
Authors‘ workplace: Dermatovenerologická klinika LF UK a UNB, Bratislava, prednostka prof. MUDr. Mária Šimaljaková, PhD., MPH, MHA
Published in: Čes-slov Derm, 101, 2026, No. 1, p. 3-11
Category: Reviews (Continuing Medical Education)

Overview

Rosacea is a chronic inflammatory disease predominantly affecting the centrofacial region and the eyes. Rosacea is characterized by recurrent episodes of flushing, persistent erythema, inflammatory papules, pustules, and telangiectasia. Phymatous changes are infrequent. The pathogenesis is multifactorial, involving neurovascular and immune dysregulation as well as genetic and environmental contributions. Several treatment options are available focusing on symptom management. By furthering our understanding of rosacea pathogenesis at the molecular level, we will be better equipped to develop effective and safe therapies to alleviate the burden of disease.

Keywords:

Pathogenesis – treatment – rosacea


Sources

1. BAYLIE, R. L., BRAYDEN, J. E. TRPV channels and vascular function. Acta Physiol (Oxf)., 2011, 203(1), p. 99–116.

2. BECKER, E., BENGS, S., ALURI, S. et al. Doxycykline, metronidazole and isotretinoin: do they modify microRNA/mRNA expression profiles and function in murine T-cells? Sci Rep., 2016, 6, p. 370–382.

3. BUHL, T., SULK, M., NOWAK, P. Molecular and morphological characterization of inflammatory infiltrate in rosacea reveals activation of Th1/Th17 pathways. J Invest Dermatol., 2015, 135(9), p. 2198 –⁠ 2208.

4. CODA, A. B., HATA, T., MILER, J. t al. Cathelicidin, kallikrein 5, and serine protease activity is inhibited during treatment of rosacea with azelaic acid 15% gel. J Am Acad Dermatol., 2013, 69(4), p. 570–577.

5. FORTON, F. M. N. The pathogenic role of demodex mites in rosacea: a potential therapeutic target already in erythemtoteleangiectatic rosacea? Dermatol Ther (Heidelb), 2020, 10(6), p. 1229–1253.

6. GALLO, R. L., GRANSTEIN, R. D., KANG, S. et al. Rosacea comorbidities and future research: the 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol., 2018, 78, p. 167–170.

7. GENG, R. S. Q., BOURKAS, A. N., MUFTI, A. et al. Rosacea: Pathogenesis and Therapeutic Correlates. J Cutan Med Surg., 2024, 28(2), p. 178–189.

8. GETHER, L., OVERGAARD, L. K., EGEBERG, A., THYSSEN, J. P. Incidence and prevalence of rosacea: a systemic review and meta-analysis. Br J Dermatol., 2018, 179, p. 282–289.

9. GOLD, L. S., DEL ROSSO, J. Q., KIRCIK, L. et al. Minocycline 1,5% foam for the topical treatment of moderate to severe papulopustular rosacea: results of 2 phase 3, randomized, clinical trials. J Am Acad Dermatol., 2020, 82(5), p. 1166–1173.

10. HUANG, J., ZHANG, Y., CAITAN, Y. et al. Proteomic profiling reveals distinct inflammatory and neurogenic endotypes in rosacea. JAAD, 2026, 94 (1) –⁠ ehead of print, doi: 10.1016/j.jaad.2025.08.014.

11. CHANG, A. L. S., RABER, I., XU, J. et al. Assessement of the genetic basis of rosacea by genom-wide association study. J Invest Dermatol., 2015, 135(6), p. 1548–1555.

12. IVANIC, M.G., OULEE, A., NORDEN, A. et. al. Neurogenic rosacea treatment: literature review. JDD, 2023, 22(6), p. 556–571.

13. KOZÁROVÁ, A., RAJCIGELOVÁ, T. Terapeutické možnosti rozacey. Dermatol Prax. 2018, 12(4), p. 171 –⁠ 174.

14. NEVORALOVÁ, Z., RULCOVÁ, J., BENÁKOVÁ, N. Obličejové dermatózy. Mladá fronta, a.s., 2016, ISBN 978-80-204-4107-2.

15. OGE, L. K., MUNCIE, H. L., PHILLIPS-SAVOY, A. R. Rosacea: diagnosis and Treatment. Am Fam Physician., 2015, 92(3), p. 187–196.

16. SCHALLER, M., GONSER, L., BELGE, K. et al. Dual anti-inflammatory and anti-parasitic action of topical ivermectin 1% in papulopustular rosacea. J Eur Acad Dermatol Venereol., 2017, 31(11), p. 1907 –⁠ 1911.

17. SLUŠNÁ, M., TÓTHOVÁ, M., DUCHOŇOVÁ, M. Komplexná liečba rozacey. Dermatol Prax. 2020, 16(4), p. 134–140.

18. TWO, A. M., WU, W., GALLO, L. R., HATA, T. R. Rosacea: part II. Topical and systemic therapies in the treatment of rosacea. J Am Acad Dermatol., 2015, 72(5), p. 761–770.

19. van ZUUREN, E. J. Rosacea. N Engl J Med., 2017, 377, p. 1754–1764.

20. van ZUUREN, E. J., ARENTS, B. W. M., van der LINDEN, M. M. D. et al. Rosacea: New Concepts in Classification and Treatment. Am J Clin Dermatol., 2021, 22, p. 457–465.

21. YAMASAKI, K., GALLO, L. R. The molecular pathology of rosacea. J Dermatol Sci., 2009, 55(2), p. 77–81.

22. YOON, S. H., HWANG, I., LEE, E. et al. Antimicrobial peptide LL-37 drives rosacea-like skin inflammation in an NLRP3-dependent manner. J Invest Dermatol., 2021, 141(12), p. 2885–2894.

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Dermatology & STDs Paediatric dermatology & STDs
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