What is rosacea?

"Fundamentally a vascular disorder"

I have seen many hundreds of rosacea patients enrolled in our experimental efforts over the past ten years. I have not encountered a single one in whom a history of flushing could not be elicited… I, and others, regard rosacea as fundamentally a vascular disorder which ineluctably begins with episodes of flushing, eventuating in the “red” face.

It appears that the secondary symptoms such as facial burning, stinging, papules and pustules, dryness or oiliness, rhinophyma, inflammation and even ocular rosacea stem from the facial flushing and vascular basis of the disease.

"Why don't the drugs or creams my doctor prescribed cure rosacea?"

Dr. Kligman is again highly critical of these studies, often funded by the drug manufacturers, for concentrating on the papular-pustular (almost "acne"-like bumps, even though they aren't acne!) aspect when this is just one by-product of the disease:

I have laboured this point to call attention to the snares inherent in trials based on papulo-pustules counts, when in fact we really want to know whether the drug changes the course of the disease regarding meaning of end-points, the frequency of flushing episodes, the intensity of erythema [redness], eradication of telangiectasias, removal of inflammatory histologic infiltrates, improvement of photodamaged dermal matrix, enhancement of the quality of life and so on. Methodologies already exist using sophisticated methods for visualizing sub-surface changes and modern bioengineering methods to measure accurately these important outcomes, not to mention relief from the psycho-social impediments of this dreadful disorder

Treatments that address the vascular disorder - and hope for future

The only current treatment to address the vascular disorder are in my opinion, vascular laser treatments, which this site focuses on. On our homepage you will find many hundreds of reviews of this type of treatment. It is not a cure and some people do not respond to it, but it has been beneficial for many.

There is also currently a topical drug in development by Collagenex, via their acquisition of SansRosa, that is intended to address the redness and flushing directly. The founder of SansRosa stated in an interview.

“…to nip rosacea in the bud, and get it at that first stage, we are working with a product that is based on vascular dilation modulation so we're going directly after the flushing effect and that's how our product works.”

The SansRosa product is still in the developmental stage, but I believe it is a definite step in the right direction and am excited to track its progress. We have written more about it, since we initially broke the news about its development to the rosacea community: