Photo Damage

[Guide]

According to the JAAD, May 2010, "UV radiation exposure does not appear to affect the prevalence of PPR." This is one of the few studies ever done on this theory about rosacea. Hopefully more studies will be done in the future. [1] Another report in 2013 says UV exposure may be the cause of "telangiectasias with actinic elastosis." [7] So the evidence isn't nailed down that this theory is the correct one. For years we have reports like the ones below that focus on sun or light damage being a culprit in the cause of rosacea. However, it is important to note that recently more reports on UV radiation exposure may have some link to rosacea.

"A very important background feature is sun damage. Rosacea is always associated with solar elastosis and often with heliodermatosis. Fair-skinned patients with rosacea type I will often give a history of sun sensitivity." [2]

"The general consensus among clinicians is that rosacea is a photoaggravated disorder." [3]

An article in the June 1, 2004 Dermatolgy Times by Rebecca Bryant quotes Michael Detmar, M.D., as saying, "Bacteria are likely involved because what works to some extent as a treatment are antibiotics. Also there appears to be a relationship to photo damage. 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. A new area of research suggests that lymphatic vessels are involved." [4]

One study suggests "that sun exposure has a different influence on each subtype of rosacea." [5]

"The degree of sun exposure had significant correlation with the development and severity of the erythematotelangiectatic subtype (p<0.05), while it had no correlation with the papulopustular, ocular and phymatous subtypes." [5]

One anecdotal report says rosacea was caused by being exposed to sunlight in an office with windows and concluded, "I am happy to say that its been about 3 months that I have been back to my original office without the windows....and the redness on my face is completely gone." [6]

Another reports concluded, "The association of large telangiectasias with actinic elastosis may indicate a causative role of exposure to UV radiation." [7]

Still another report says, "UV-B irradiation and microbial components increase vitamin D3 and TLR2 expression in keratinocytes leading to an increase of cathelicidin production." [8]

However, on the flip side, one report says, "The majority of subjects with atopic eczema, acne vulgaris or seborrheic dermatitis experienced improvement after exposure to sunlight. Individuals with rosacea also experienced improvement more often than impairment from exposure to sunlight." [9]

"Many chronic inflammatory cutaneous diseases, such as rosacea and psoriasis, are known to be associated with dermal remodeling after UV irradiation....the production of ROS and ER stressors after UV radiation provide a logical framework explaining UV radiation as a triggering factor for rosacea." [10]

Actinic Folliculitis (AF) should be ruled out in a differential diagnosis. 
Ruling out Photosensitivity diseases from Rosacea
EM Radiation a Rosacea Trigger?
Florescent Lights and Rosacea

End Notes

[1] Papulopustular rosacea: prevalence and relationship to photodamage.
McAleer MA, Fitzpatrick P, Powell FC.
J Am Acad Dermatol. 2010 Jul;63(1):33-9. Epub 2010 May 11.

[2] Rosacea: classification and treatment.
T Jansen and G Plewig
J R Soc Med. 1997 March; 90(3): 144–150.

[3] Ultraviolet light and rosacea.
Murphy G.
Cutis. 2004 Sep;74(3 Suppl):13-6, 32-4.

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

[5] Ann Dermatol. 2009 Aug;21(3):243-9. doi: 10.5021/ad.2009.21.3.243. Epub 2009 Aug 31.
Clinical evaluation of 168 korean patients with rosacea: the sun exposure correlates with the erythematotelangiectatic subtype.
Bae YI, Yun SJ, Lee JB, Kim SJ, Won YH, Lee SC.
Ann Dermatol. 2009 Aug;21(3):243-9. Epub 2009 Aug 31.

[6] Sara45, The Rosacea Forum, Sept. 17, 2012

[7] Ann Dermatol Venereol. 2013 Jan;140(1):21-9. doi: 10.1016/j.annder.2012.10.592. Epub 2012 Dec 21.
A histological and immunohistological study of vascular and inflammatory changes in rosacea.
Perrigouard C, Peltre B, Cribier B.

[8] Duodecim. 2012;128(22):2327-35.
New insights in the pathogenesis and treatment of rosacea.

Palatsi R, Kelhälä HL, Hägg P.

[9] Photodermatol. 1989 Apr;6(2):80-4.
Epidemiological studies of the influence of sunlight on the skin.

 

[10] 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

 

 

 

 

[Guide]

"The role of the exposome in rosacea must be highlighted: UV light, air pollution, tobacco smoking, nutrition, and psychological stress can trigger or worsen rosacea. Although UV exposure is one of the most commonly reported triggers and UV radiation can play a significant role in the pathogenesis of rosacea, the literature on photoprotection in rosacea is relatively scarce."

"Among these factors, UV radiation is crucial in the pathogenesis of rosacea."

J Cosmet Dermatol. 2021 Nov; 20(11): 3415–3421.
Impact of ultraviolet radiation and exposome on rosacea: Key role of photoprotection in optimizing treatment
Daniel Morgado‐Carrasco, MD, Corinne Granger, MD,  Carles Trullas, MSc,  and Jaime Piquero‐Casals, MD