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FAQ: What Causes Rosacea?

Although the precise causal mechanisms which produce rosacea remain to be elucidated, in addition to hereditary factors, a great many other factors have been implicated in the development and worsening of the disease.

These factors include :

• systemic heliobacter pylori infection;
  
  
• invisible infestation of skin by demodex mites;
  
  
• sun damage / photoaging;
  
  
• free radicals;
  
  
• fragile or dysfunctional capillaries;
  
  
• allergies (to topical and ingested substances);
  
  
• psychosomatic factors.

Cause #1 — Heliobacter Pylori

Evidence for heliobacter pylori playing a role is controversial. It has been suggested that intestinal bacteria and inflammation sensitize facial neurons, causing capillaries to become dilated, producing redness and leaking pro-inflammatory substances into the facial tissues.

Cause #2 — Demodex Mite Follicular Infestation

Damage to collagen in the dermis (the skin's deepest layer) and to follicles is strongly associated with rosacea. This finding has led some academic dermatologists to suggest that the inflammation seen in rosacea patients is a result of demodex mites and/or bacteria occupying follicles and causing an immune response not found in patients without rosacea.

Stronger evidence exists for rosacea patient's skins' bearing an excess of MMP-9, an enzyme which breaks down the collagen necessary for healthy skin structure and functioning.

Where levels of MMP-9 are greater than the skin's ability to inhibit their action, inflammation and degradation of skin occurs. A similar situation appears to underlie the pathophysiology of ocular rosacea.

Moreover, other studies have shown that poorly regulated levels of MMP-9 are found in rosacea patients both with and without follicular demodex infestation, and that the levels of deleterious MMP-9 are greater in those with demodex than without.

Cause #3 — Irregular Vascular Function

Flushing/blushing and dilated or broken capillaries are associated with all rosacea patients.

The phenomenon of flushing and blushing can be due to a combination of two or more of the following aspects:

• greater superficiality of facial capillaries, increasing the likelihood and frequency of environmental provocation;
  
  
• an increase in blood flow;
  
  
• irregular capillary function, due to immune (humoral) and/or neural factors.

Irregularities in neurotransmitters such as serotonin and histamine may also play a role in the development of visible facial redness (erythema) in rosacea.

Individuals with rosacea have also been found to have excess amounts of certain proteins involved in the skin's immune response against bacteria, viruses and fungi.

High levels of these proteins have been shown to produce all the signs of rosacea: erythema (redness), inflammation (free radical damage), capillary dilation, growth (angiogenesis) and permeability.

In subsequent updates I will detail some of the prime and superior ways in which to manage to manage pre-existing rosacea and prevent frequent exacerbation or permanent worsening or pre-existing rosacea.

If your rosacea is only mild (characterized by only transient flushing/blushing or mild erythema), there is much to be hopeful about, as relatively minor changes to the overall management of your rosacea can produce remission.

Author: Gina Verginis.

Reviewed: Tuesday, May 11, 2010.

Further Information: Risk Factors in Aquiring Rosacea : FAQ: What Causes Rosacea? : Invisible Daylight Exposure Produces Dry Skin in Rosacea : Aetiology of Rosacea : Gastrointestinal Causes of Rosacea : Environmental Factors and Triggers :

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