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Nervous System Theory And Rosacea


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"The nervous system may be involved, because exertion, emotions, and weather trigger the disease, in addition to other triggers such as heat, certain types of food, alcoholic beverages, various topical balms and cosmetics, and various drugs. We're clear that blood vessels are dilated but don't know if that comes first or later." [1]

"Patients with rosacea have a significantly increased risk of neurologic disorders such as migraine, depression, complex regional pain syndrome, and glioma. Enhanced expression of matrix metalloproteinase (MMP) is observed in these neurologic disorders as well as in rosacea, which might explain the possible shared pathogenic mechanisms between these conditions." [2]

"Recently, an increased interest has been shown in the potential associations between neurodegenerative diseases and rosacea. For example, a nationwide cohort study from Denmark explored the relationship between rosacea and neurodegenerative diseases such as Parkinson’s disease. MMPs are believed to be associated with the neurodegenerative diseases and an increased expression of MMP-1 and MMP-9 has also been observed in rosacea. In addition, another Danish study found that rosacea was significantly associated with dementia, especially Alzheimer disease. AMPs, MMP, and inflammatory cascades, which have a shared impact on both rosacea and Alzheimer disease, are considered to be involved in the underlying mechanism. Together, these findings suggest that a pathogenic link might therefore exist between rosacea and neurodegenerative diseases." [2]

"We found a significantly higher prevalence and risk of incident migraine especially in female patients with rosacea. These data add to the accumulating evidence for a link between rosacea and the central nervous system." [3]

"Currently, it is clear that the innate immune and the sensory and autonomic nervous systems are overstimulated with dysregulated interactions, leading to a chronic pathological inflammatory state." [4]

"Thus, an activated nervous system in the skin correlates well with the early phase of rosacea, although it is still unclear whether neuronal activation precedes or follows the inflammatory infiltrate. The extent to which the autonomic and/or sensory nervous system is involved in the neuronal dysregulation during rosacea has received considerable attention, as modulation of α-adrenergic receptors or β-adrenergic blockers is helpful in some patients (Craige and Cohen, 2005; Shanler and Ondo, 2007; Gallo et al., 2010)." [5]

"Both augmented innate immune response and neurovascular/neuroimmune dysregulation appear to work in concert in signaling into motion the underlying vasodilation and cascades of inflammation, which produce intermittent flares of diffuse facial erythema." [6]

"According to Morrison (2012) in the study of the autonomic nervous system (using the vegetative index of Kerdo) the prevalence of parasympathetic tone of the autonomic nervous system has been found in Rosacea patients." [7]

"NRS-funded researcher Dr. Martin Steinhoff, director of the Charles Institute of Dermatology at the University College Dublin School of Medicine, and colleagues at the University of California-San Francisco have documented that the nervous system is intimately linked with the vascular system in producing the typical signs and symptoms of rosacea, which suggests that both the flushing and inflammation of rosacea may be part of the same continuum." [8]

Also see this post about Psychology and Rosacea.

End Notes

[1] Rosacea: turning all stones for source of pathology
Publish date: Jun 1, 2004
By: Rebecca Bryant, Dermatology Times, Modern Medicine

[2] 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,

[3] Prevalence and risk of migraine in patients with rosacea: A population-based cohort study.
J Am Acad Dermatol. 2016 Nov 3;
Egeberg A, Ashina M, Gaist D, Gislason GH, Thyssen JP

[4] Clin Cosmet Investig Dermatol. 2015; 8: 159–177.
Published online 2015 Apr 7. doi:  10.2147/CCID.S58940
PMCID: PMC4396587
Update on the management of rosacea
Allison P Weinkle, Vladyslava Doktor, and Jason Emer

[5] J Investig Dermatol Symp Proc. Author manuscript; available in PMC 2013 Jul 8.
Published in final edited form as:
J Investig Dermatol Symp Proc. 2011 Dec; 15(1): 2–11.
doi:  10.1038/jidsymp.2011.7
PMCID: PMC3704130
Clinical, Cellular, and Molecular Aspects in the Pathophysiology of Rosacea
Martin Steinhoff, Jörg Buddenkotte, Jerome Aubert, Mathias Sulk, Pawel Novak, Verena D. Schwab, Christian Mess, Ferda Cevikbas, Michel Rivier, Isabelle Carlavan, Sophie Déret, Carine Rosignoli, Dieter Metze, Thomas A. Luger, and Johannes J. Voegel

[6] J Clin Aesthet Dermatol. 2012 Mar; 5(3): 26–36.
PMCID: PMC3315876
Advances in Understanding and Managing Rosacea: Part 2
The Central Role, Evaluation, and Medical Management of Diffuse and Persistent Facial Erythema of Rosacea
James Q. Del Rosso, DO, FAOCD

[7] Georgian Med News. 2013 Jan;(214):23-8.
[New possibilities in the treatment of early stages of rosacea].
Tsiskarishvili NV1, Katsitadze A, Tsiskarishvili Ts.

[8] Causes of Rosacea: Neurovascular System, NRS

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