Citron Essential Oils Alleviate the Mediators Related to Rosacea Pathophysiology in Epidermal Keratinocytes

Recent Advances in the Management of Rosacea through Natural Compounds

Rosacea is a chronic skin disorder that affects more than 5% of the world's population, with the number increasing every year. Moreover, studies show that one-third of those suffering from rosacea report a degree of depression and are less compliant with treatment. Despite being the subject of prolonged studies, the pathogenesis of rosacea remains controversial and elusive. Since most medications used for the management of this pathology have side effects or simply do not yield the necessary results, many patients lose trust in the treatment and drop it altogether. Thus, dermato-cosmetic products with natural ingredients are gaining more and more notoriety in front of synthetic ones, due to the multiple benefits and the reduced number and intensity of side effects. This review is a comprehensive up-to-date report of studies that managed to prove the beneficial effects of different botanicals that may be useful in the short and long-term management of rosacea-affected skin. Based on recent preclinical and clinical studies, this review describes the mechanisms of action of a large array of phytochemicals responsible for alleviating the clinical symptomatology of the disease. This is useful in further aiding and better comprehending the way plant-based products may help in managing this complex condition, paving the way for research in this area of study.

Rosacea: Practical Guidance and Challenges for Clinical Management

Rosacea is a common chronic dermatosis. Clinically, rosacea can present with flushing, erythema, papules, pustules, telangiectasias, phymatous changes, pruritus, burning, and stinging. In 2017, the National Rosacea Society Expert Committee recommended a phenotype-based classification for therapy. In this review, we identify monotherapies and multimodal treatment approaches for the clinical management of rosacea including topical, systemic, laser and light, alternative, and combination therapies.

Effect of COVID-19 and Face Masks on the Condition of Rosacea - A Retrospective Analysis of 87 Patients

Introduction

The pathogenesis of COVID-19 includes systemic immune activation and endothelial dysfunction, which is closely related to the pathogenesis of rosacea. In order to investigate the influence of COVID-19 infection on the condition of rosacea patients, we retrospectively investigated the impact of COVID-19 infection and COVID-19-related masks on rosacea patients.

Methods

We collected the basic information from rosacea patients who had a long-term follow-up at West China Hospital of Sichuan University. Between January 2023 and March 2023, we recruited 87 rosacea patients for this survey.

Results

Our results showed that COVID-19 infection could aggravate the condition of rosacea patients, and the change in the symptoms was not related to fever, temperature, antipyretics use, and vaccination. In addition, we observed a significant association between the type of mask worn by rosacea patients and exacerbation, while the duration of mask usage did not exhibit a similar relationship.

Discussion

Considering the ongoing global utilization of masks due to the COVID-19 pandemic and the possible recurrence of COVID-19 infection, dermatologists should monitor the condition of rosacea patients infected with COVID-19 and adjust the treatment regimens accordingly.

The Effect of Capsaicin on Neuroinflammatory Mediators of Rosacea

Background

Rosacea is a chronic inflammatory skin disease with a pathophysiological mechanism that remains unclear. Recently, dysregulation of the sensory nerve system has been implicated in the development of this condition.

Objective

This study aimed to investigate the effect of capsaicin on neuroinflammatory mediators in rosacea. In addition, this study aimed to evaluate the attenuating effects of capsazepine, a transient receptor potential vanilloid type 1 (TRPV1) antagonist.

Methods

We obtained skin tissue from both rosacea patients and normal individuals for an in vivo study. In addition, normal human epidermal keratinocytes (NHEKs) were cultured, and treated with capsaicin and capsazepine for an in vitro study. Quantitative changes in neuroinflammatory mediators were evaluated by semi-quantitative reverse transcription-polymerase chain reaction (PCR), real-time PCR, enzyme-linked immunosorbent assay, and immunofluorescence staining.

Results

The data showed the increase of TRPV1, TRPV4, cathelicidin (LL37) and tumor necrosis factor-α (TNF-α) in skin tissue by real-time PCR. In addition, the data showed that cathelicidin (LL37), kallikrein-5 (KLK-5), TNF-α, vascular endothelial growth factor (VEGF), interleukin (IL)-1α, IL-1β, IL-8, and protease-activated receptor 2 (PAR2) increased in capsaicin-treated NHEKs. Capsazepine attenuated the expression of TRPV1 and other mediators, except for IL-8, in capsaicin-treated NHEKs.

Conclusion

We confirmed that TRPV1, TRPV4, cathelicidin (LL37) and TNF-α are increased in rosacea skin, and that capsaicin is associated with increase of neuroinflammatory mediators such as LL37, KLK-5, TNF-α, VEGF, IL-1α, IL-1β, IL-8, and PAR2. Modulators or inhibitors of neuroinflammatory mediators including TRPV1 could be potential therapeutic option in the treatment of patients with rosacea.