The Rosacea Research Digest from the National Rosacea Society keeps you up to date on recently published basic and clinical research on rosacea, as well as news, reviews, and presentations. It goes out on the last weekday of each month.

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Research

Early investigational agents for the treatment of rosacea: drugs in phase I and II clinical development.

Moran SK, Wong SC, Taylor SL, Feldman SR. Expert Opin Investig Drugs. 2025 Jan-Feb;34(1-2):27-36. Epub 2025 Feb 9. doi:10.1080/13543784.2025.2463093. PMID: 39918332.

Introduction: Rosacea is a multifactorial chronic dermatologic condition with a psychosocial burden for patients. There are topical, systemic, laser, and light treatments FDA-approved, but many patients remain under- or non-responsive to those available, leaving a need for more options. Areas covered: Based on a literature search using databases, PubMed, Embase, Cochrane Library, and Clinicaltrials.gov, using keywords 'rosacea clinical trials,' we discuss treatments undergoing phase I and II clinical trials for rosacea, as well as other early clinical studies. Expert opinion: The evolving understanding of rosacea's multifaceted pathophysiology, including neurovascular dysregulation and immune responses, has led to exploration of novel treatments. Mainstays of treatment are topical and systemic antibiotics, topical vasoconstrictors, pulsed dye laser, and intense pulsed light. However, even with these treatment options, some patients remain unsatisfied with results. Addressing the underlying pathophysiology of rosacea may be more effective than a siloed approach. Therapies on the horizon, such as phosphodiesterase-4 inhibitors, biologics, topical tyrosine kinase inhibitors, neurotoxin, topical probiotics, Dermaceuticals, oral tranexamic acid, oral supplements, and neuropeptide modulators are investigated as targeted interventions. Use of lasers in synergy with topical treatments offers a multipronged personalized approach. While management remains challenging, ongoing research provides promise for additional effective and individualized treatment plans.

Vascular remodeling in rosacea: a study on microcirculatory insights using oral capillaroscopy.

Demirbas A, Demirbas GU, Diremsizoglu E. J Cosmet Dermatol. 2025 Feb;24(2):e70012. doi:10.1111/jocd.70012. PMID: 39918088; PMCID: PMC11803680.

Background: Rosacea is a chronic inflammatory skin condition characterized by facial erythema, telangiectasia, and papules. Although clinical assessment is essential for diagnosis, objective criteria for evaluating severity are lacking. This study aimed to investigate the relationship between rosacea severity, disease duration, and associated microvascular changes through oral mucosal capillaroscopy. Methods: This cross-sectional case-control study included patients with rosacea and healthy controls. Oral capillaroscopy was performed to evaluate capillary morphology, analyzing parameters such as capillary arrangement (regular or irregular), presence of dot vessels, microhemorrhages, glomerular vessels, megacapillaries, tortuous vessels, areas of discoloration, and hyperkeratosis. Results: A total of 100 patients diagnosed with rosacea and 100 healthy controls were included in the study. Oral capillaroscopic findings revealed significantly higher rates of family history of rosacea and tortuous capillaries in the patient group. Patients with microhemorrhages exhibited a longer disease duration. No significant differences in tortuous capillary positivity were found between the papulopustular and erythematotelangiectatic subtypes; however, phymatous rosacea demonstrated no positive findings. Additionally, moderate-severity patients had lower rates of microhemorrhage positivity, whereas the presence of tortuous capillaries increased with severity. Conclusion: Oral mucosal capillaroscopy is a valuable tool for assessing microvascular damage in rosacea and may serve as a diagnostic and prognostic marker for effective management.

Exploring the psychodermatologic burden and associated psychiatric manifestations in rosacea: a systemic review.

Sharifi S, Katamanin O, Jafferany M. Arch Dermatol Res. 2025 Feb 15;317(1):427. doi:10.1007/s00403-025-03982-w. PMID: 39954108.

Rosacea is an inflammatory skin disorder possessing significant mental health implications, including anxiety and depression. Although the disease's link to psychiatric outcomes has been explored, recent data highlights the need for a deeper examination of underlying pathways and overall burden. This systematic review aims to synthesize and evaluate the current literature on the association between rosacea and anxiety and depression, with particular attention to establishing multidisciplinary treatment approaches. A comprehensive review of the PubMed, Embase and Web of Science databases was performed to select peer-reviewed English studies relevant to our topic. Our results reveal that anxiety and depression continue to affect a majority of rosacea patients, with certain demographic variables such as age and gender modulating psychiatric burden. The complex interaction between rosacea and its psychological outcomes is thought to rely on inflammatory mediators, lipid metabolism, and neurotropic factors. Certain treatment options, including carvedilol, paroxetine and Cortexin, may target these core processes and hence, help alleviate psychological sequalae. Bearing these insights in mind, dermatologists should focus on adopting interdisciplinary treatment plans. Future research should prioritize longitudinal designs, diverse populations, and standardized methodologies to deepen our understanding of the relationship between anxiety, depression, and rosacea.