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

Study on the efficacy and safety of supramolecular salicylic acid in the treatment of papulopustular rosacea: results from a multicenter randomized double-blind placebo-controlled superiority study.

Jiang X, Lai W, Gao X, et al. Clin Exp Dermatol. 2025 Jul 24:llaf316. doi:10.1093/ced/llaf316. Epub ahead of print. PMID: 40701547.

Background: Rosacea is a chronic inflammatory skin disorder with a complex etiology involving genetic, immunological, and environmental factors. Despite various treatments, managing papulopustular lesions remains challenging. Salicylic acid, known for its anti-inflammatory properties, has been used in dermatology for decades, but its efficacy in treating rosacea needs further exploration. This study investigated the effectiveness and safety of 30% supramolecular salicylic acid (SSA) in treating papulopustular rosacea. Methods: We conducted a prospective, multicenter, randomized, double-blind, placebo-controlled trial involving 480 patients aged 18 to 60 years with papulopustular rosacea. Participants were randomized 1:1 to receive either 30% SSA or placebo biweekly for six weeks, with follow-up assessments up to week 8. The study assessed primary and secondary efficacy endpoints, including lesion reduction rates, IGA and ISA scores, VISIA red area improvements, and skin barrier functions, as well as safety and tolerability evaluations. Results: The SSA group showed a significant improvement in the primary efficacy endpoint at week 8, with efficacy rates of 51.25% (full-analysis set, FAS) and 59.90% (per-protocol set, PPS), compared to 18.33% (FAS) and 20.50% (PPS) in the placebo group (P<0.0001 for both). Secondary endpoints also favored SSA, demonstrating notable improvements in lesion reduction, IGA and ISA scores, and skin condition. Safety profiles were comparable between the SSA and placebo groups, with no significant difference in adverse event rates. Conclusion: The study's findings highlight the superior efficacy of 30% SSA in improving papulopustular rosacea symptoms compared with that of a placebo, coupled with a favorable safety and tolerability profile. Although the multicenter design and rigorous methodology strengthen the validity of the study, limitations such as short-term follow-up and potential site variability warrant consideration. Further long-term studies are recommended to fully ascertain the therapeutic potential of SSA in rosacea treatment.

The skin microbiome in rosacea: mechanisms, gut-skin interactions, and therapeutic implications.

Asees A, Sadur A, Choudhary S. Cutis. 2025 July;116(1):20-23. doi:10.12788/cutis.1240.

This study aimed to investigate the association between serum metabolomic profiles and the gut microbiota in patients with neurogenic rosacea. We analyzed the serum metabolites and gut microbial composition in 20 patients with neurogenic rosacea and 14 healthy controls. Metabolomic analysis identified 56 differentially abundant metabolites (DAMs), with benzene and substituted derivatives, carboxylic acids and derivatives, and organophosphates being among the most enriched categories. Gut microbiota analysis revealed significant dysbiosis in patients with neurogenic rosacea, characterized by an increased abundance of Lachnospiraceae, Veillonellaceae, and Clostridiaceae, and decreased levels of Prevotellaceae and Bifidobacteriaceae. Spearman's correlation analysis demonstrated significant relationships between specific serum metabolites and gut microbial taxa, including strong positive correlations between 3,4-dihydroxyphenylacetic acid and both Bifidobacterium (r = 0.7307, padj = 9.25e-07) and Lactobacillus (r = 0.6898, padj = 6.39e-06). These findings highlight the complex interactions between metabolic dysregulation and gut microbial imbalances in neurogenic rosacea, suggesting a potential role for the gut-skin axis in its pathophysiology. This study paves the way for future therapeutic strategies targeting both metabolic and microbial dysbiosis to manage neurogenic rosacea.

Targeting vascular and inflammatory crosstalk: cannabigerol as a dual-pathway modulator in rosacea.

Kim S, Lee JH. Int J Mol Sci. 2025 Jul 16;26(14):6840. doi:10.3390/ijms26146840. PMID: 40725084.

Rosacea is a chronic inflammatory skin condition characterized by persistent erythema and abnormal vascular response. Although current treatments focus on symptomatic relief, they often provide only temporary improvement and may be associated with side effects or recurrence. Cannabigerol (CBG), a non-psychoactive cannabinoid, has recently garnered attention for its pharmacological activities, including anti-inflammatory, antioxidant, neuroprotective, and skin barrier-supportive effects. However, its role in modulating pathological responses in rosacea remains unclear. In this study, we investigated the therapeutic potential of topically applied CBG in an LL-37-induced rosacea-like mouse model. Clinical and histological assessments revealed that CBG markedly reduced erythema, epidermal hyperplasia, and mast cell infiltration. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) showed downregulation of Il1b, Il4, Il6, Il13, Il22, Il31, Tlr2, Vegfa, and Mmp9. Immunohistochemistry and Western blot analyses further demonstrated suppression of CD31, vascular endothelial growth factor (VEGF), and Yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ), along with reduced activation of the Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway, including decreased levels of JAK1, STAT3, and phosphorylated STAT3. These findings suggest that topical CBG alleviates rosacea-like skin inflammation by targeting inflammatory and vascular pathways, including JAK/STAT and YAP/TAZ signaling.