International Journal of Medical Sciences

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24 March 2018

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Int J Med Sci 2015; 12(5):387-396. doi:10.7150/ijms.10608


Major Pathophysiological Correlations of Rosacea: A Complete Clinical Appraisal

Ravi Chandra Vemuri1✉, Rohit Gundamaraju1, Shamala Devi Sekaran1✉, Rishya Manikam2

1. Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
2. Department of Trauma and Emergency, University Malaya Medical Center, 59100 Kuala Lumpur, Malaysia.


Background: Rosacea is a characteristic cutaneous disorder with a diverse clinical manifestations ranging from facial vascular hyper-reactivity to sebaceous gland hyperplasia. Many theories on pathophysiology of rosacea were proposed over the past decade, however the pathogenicity is poorly understood.

Aim: To review the evidence on different pathophysiological correlations of rosacea.

Methods: A literature search was conducted for studies published between 1990 to March 2014. The inclusion criteria was pathophysiology, randomized controlled trials, controlled trials on rosacea.

Results: Out of 5141 articles, 14 high quality studies met all the selection criteria. Of 14 articles, 5 are randomized control trials (RCTs), 2 are controlled trial, 3 comparative trials, 2 observational trials, 1 prospective and 1 diagnostic trial. The studies were categorized into two groups: the trigger factors and sub-types & symptoms. Of 7 high quality studies, 4 provided strong evidence that immune responses causing disease triggered by external/internal factors such as sunlight, food and chemical agents, 3 trials provided significant evidence of microorganisms as causative agents. The remaining trials did not provide significant evidences on pathophysiology.

Conclusion: Vasculature, chronic inflammatory responses, environmental triggers, food and chemicals ingested and microorganisms either alone or in combination are responsible for rosacea. Many promising drugs are under various phases of clinical trials and interestingly, probiotics could also possibly be used as one of the treatment option.

Keywords: Rosacea, pathophysiology, vasculature, Chronic Inflammation, randomized control trials.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See for full terms and conditions.
How to cite this article:
Vemuri RC, Gundamaraju R, Sekaran SD, Manikam R. Major Pathophysiological Correlations of Rosacea: A Complete Clinical Appraisal. Int J Med Sci 2015; 12(5):387-396. doi:10.7150/ijms.10608. Available from