Vascular Theory

[Guide]

Around the year 2000, the most popular theory on the cause of rosacea was the vascular theory. Since then, other theories seem to have taken over this one. J Bradley Randleman, MD, and C Diane Song, MD in an article, Ocular Rosacea, stated that "...rosacea may be thought of as a disease spectrum with 2 primary etiologic components, vascular and inflammatory. The earliest manifestations of the disease are cutaneous vascular dilatory changes with subsequent increased blood flow in the form of telangiectasias and erythema...." Probably one of the reasons that the vascular theory was so popular back then was when Geoffrey Nase, Ph.D., popularized the theory in his book Beating Rosacea, and stated in his book, "rosacea is primarily a facial vascular disorder in which the affected blood vessels are functionally and structurally abnormal."

In 2004, a leading rosacea expert, Dr. Frank Powell, stated in an article in Cutis, "A leading theory suggests a vascular basis...".

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, "Some researchers believe that rosacea is a disorder where blood vessels dilate too easily, resulting in flushing and redness."

In Postgraduate Medicine, February, 1999, Dr. Millikan wrote, "The cause of rosacea is unknown, but it is commonly thought to be of vascular origin because of a clinical association with flushing, development of telangiectasia and tissue swelling, and ultimately, tissue proliferation and rhinophyma (enlargement of the nose)."

"Flushing and burning sensations in the skin are considered to represent a main clinical feature in rosacea and are regarded as being primarily caused by neurovascular dysregulation. In patients with rosacea, dilatations of the precapillary arterioles lead to flushing and erythema and dilatations of the postcapillary venules result in edema caused by protein leakage and the recruitment of leukocytes." [1] This source refers to this as "Neurovascular Dysregulation."

Now other theories are more popular such as the genetic, inflammatory, immune system dysfunction and others. For a complete list click here. 

End Notes

[1] Int J Mol Sci. 2016 Sep; 17(9): 1562.
Published online 2016 Sep 15. doi:  10.3390/ijms17091562, PMCID: PMC5037831
Rosacea: Molecular Mechanisms and Management of a Chronic Cutaneous Inflammatory Condition
Yu Ri Woo, Ji Hong Lim, Dae Ho Cho, and Hyun Jeong Park, Chris Jackson, Academic Editor