What Causes Rosacea?

While there are many theories, the underlying cause or causes of rosacea have not been scientifically proven. It is hoped that ongoing research in these areas will lead to improvements in its management and potential prevention or cure.

Many believe that rosacea may be a vascular disorder because of its association with flushing, redness and visible blood vessels. Some physicians have also speculated that flushing may involve the nervous system, since rosacea is often triggered or aggravated when patients are under emotional stress.

One theory about swelling is that increased blood flow during flushing leads to an increase in tissue fluid, which accumulates faster than the lymphatic system can remove it. The swelling in turn may contribute to skin thickening as tissue accumulates.

Beyond vascular factors, the presence of a microscopic mite called Demodex folliculorum has been considered as a potential contributor. This mite is a normal inhabitant of human skin, where it consumes cast-off cells, but has been found to be substantially more numerous in rosacea patients. It is unclear, however, whether this is a cause or a result of rosacea.

The bacterium Helicobacter pylori, which plays a role in duodenal ulcers, has also been implicated in rosacea, perhaps by raising gastrin levels that may stimulate flushing. However, recent studies have shown that H. pylori was no more common in patients with rosacea than in those without.

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