Pathophysiology of rosacea involves a complex interaction between genetics, ultraviolet (UV) light, microorganisms, impaired skin barrier, neuronal and vascular dysfunction, as well as immune system disruption.

The objective of a new study published in the Journal of Cosmetic Dermatology was to describe the etiology ofrosacea – with an emphasis on the role of UV radiation and exposome, and to review the importance of non-pharmacologic strategies focusing on photoprotection.

This was a narrative review of literature that entailed searches from Pubmed between 1990 and 2020.

The findings revealed that several environmental factors, such as – UV light, diverse microorganisms, air pollution, tobacco smoking, nutrition and psychological stress, could act as triggers or worsen rosacea. UV radiation was reported to induce proinflammatory, proangiogenic and profibrotic responses. While the use of sunscreens containing ingredients with emollient, anti-inflammatory and/or vasoregulatory properties was shown to significantly improve symptoms of rosacea.

The results indicated that UV radiation and theexposome play a key role in the development of rosacea. UV light is implicated in all significant aspects of rosacea – skin inflammation, neoangiogenesis, telangiectasia and fibrosis, and may even initiate rosacea. Therefore, sunscreen use is widely recommended.

In inference, it was stated that adequately formulated sunscreens can provide the required level of photoprotection, and may also help in mitigating the barrier dysfunction, neutralizing facial redness (tintedsunscreens) and decreasimg inflammation and vascular dysfunction.

Source: Journal of Cosmetic Dermatology. 2021Feb 24. doi: 10.1111/jocd.14020.