collagenex: rosacea is a chronic inflammatory disease

Collagenex has launched a swish looking consumer and practitioner web site at www.rosaceatoday.com. Collagenex are indirectly using this site to promote their `new’ treatment Oracea as an effective way to treat rosacea. The site is supporting the idea that rosacea is a chronic inflammatory disease.

Many rosacea sufferers are helped by taking systemic antibiotics. This benefit does not lead to the conclusion that rosacea is microbial in origin. Researchers are finding that rosacea symptoms are mitigated by the antibiotic’s ability to interfere with mediators in the inflammatory pathway.

Unfortunately the inflammatory pathways are complex and take some time to understand. One particular page on this on RosaceaToday, `Rosacea is a Chronic Inflammatory Disease‘ has some good text and a helpful digram ;

Sequence of Events

While the evolution of the inflammatory response in rosacea has not been precisely elucidated, investigators suspect a sequence of events similar to the following:

  • Vasodilation of dermal capillaries, possibly mediated by histamine, prostacyclin, prostaglandin E2, nitric oxide, or other vasoactive compounds, causes initial erythema
  • Prolonged dilation weakens capillary walls, allowing neutrophils and proinflammatory cytokines such as TNF-a, IL-1, and IL-6 to leak into the surrounding dermis
  • Extravascular fluid builds up, overwhelming lymphatic vessels, and results in edema
  • Additional neutrophils are recruited by chemotactic factors released from inflamed dermal tissues
  • Activated neutrophils release degradative compounds, including matrix metalloproteinases (collagenases and gelatinases), reactive oxygen species, and nitric oxide—that exacerbate the inflammatory response and lead to tissue damage.

Also see a cute 2:20 video (looking like something from Star Wars) explaining how doxycline may help in relieving the inflammatory response in rosacea. See Doxycycline Method of Action.

Collagenex are also keen to promote the advantages of low-dose antibiotics. By prescribing doses that are low enough to not kill flora or pathogens but still give some anti-inflammatory benefits, any risk of antibiotic resistances is mitigated.

Looking to the future and quoting from Optimized Oral Therapy to Treat Rosacea ;

A Novel Oral Therapy

It may be possible to modify the pharmacokinetics of systemic antibiotics in a way that isolates their anti-inflammatory properties from their antimicrobial properties. By maintaining plasma concentrations within a defined therapeutic window—high enough for anti-inflammatory effect, yet low enough to avoid antibacterial activity—one might be able to achieve inflammatory, but not microbial, suppression.

There is a ton of reading on the net to further explain the concepts presented at a high level at RosaceaToday.

About the Author

About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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5 Reader Comments

  1. Hi
    I hope to try this and still work on the root cause. Some how I have a lack or inefficient working inflammation system.
    My mom died of Amyloidosis and her family all have differing degrees of Rosacea. I have watched my skin change from childhood to early old age, noticing no matter what I do the Rosacea never go’s away. I am very good at using whatever products are available to me to reduce the “congestion” around my pores. This article helps to put into perspective the “congestion” I was at wit’s ‘s end to explain and combat. This will be a way to halt the damage of continuous congestion cycles. My goal is to find out and correct the nutritive elements lacking that initiate the cycling process.
    I think it may started by infant formula instead of breast milk. The fat compounds needed at that time for development may find other avenues of satiation and thus set the body up for continued misdirected nutritional function.
    I am not a scientist, just observations and reading about my condition plus living the condition. I also witnessed my daughter have the same cradle cap reaction, when I had to give up breast-feeding. What ever go’s wrong starts at that point in the body’s ability to process fat and fat based chemical functions.
    The body’s fat storing process and things related to that
    function go’s off and is difficult to adjust again.
    One of my daughters has had great success by eating a gluten free diet. With elimination of sugar. Again
    these are part of the fat storage of our body. I hope someone smarter than me figures it out

  2. Sam says:

    Thanks for sharing some good thoughts, Patricia. I notice this article about the pulsed light treatment is old, yet my derm today didn’t mention it, but did give me a trial run of Oracea. Wonder what’s up with that.

    The word so far is there is no root cause that can be cured for rosacea, but I think your ideas are good about trying those different things; I’m sure they can provide relief if not a cure. I for one agree with your thoughts on how artificial things we’ve added to our environment the past few decades have set us up for these illnesses.

  3. sandy says:

    I have a family history of rosacea (both sides of the family) and not suprisingly’ I’m Irish, both sides. Rosacea has been nicnamed ‘the curse of the celts’ I have had great relief using metrogel. I am a scientist and other than a food allergy, or irritation from alcohol, I really can’t see any food or outside source affecting or initiating rosacea, its just the way you were made, otherwise you wouldn’t see whole families with it like you do. I’m just glad there’s something you can use to try to improve it, because there are a lot of things you could have that there is nothing for it.

  4. sue says:

    I have suffered miserably with the redness, broken blood vessels, huge pustuals and ocular irritation for the last few years. It started immediately after a round of steroids for bronchits. I am fair complected and I remember my uncle and grandfather always had red faces so presume that I too am genetically set up for rosacea. The only thing that has helped lessen the pimples and redness has been Oracea combined with metrogel. The bad thing is as soon as I stop the oracea, everything comes back. I can not imagine taking the oracea for the rest of my life as I am an out doors person and do not like the limitations of taking this or any other prescription. Nothing in my diet has helped or made my systems worse. I have tried everything.
    I do agree that there are far worse illnesses that people deal with everyday, so I am thankful for the Oracea.

  5. M says:

    Hi Rosacea Co-sufferers,

    Too much direct sunlight, makeup, coffee, niacin, red wine, synthetic vitamin A, soy products, spicy food, wind and intense emotion can all encourage my facial skin’s painful inflammatory response.
    In my 15 years of experimenting with Rosacea remedies, a low carb diet, the removal of palmitate A and addition of Omega 3 fish oil have given me the best results. The Omega 3 has been more effective than any of the rosacea remedies offered by the pharmaceutical companies and I’ve tried them all. Also, my husband and I have noticed that since taking the fish oil we do not feel any day-after-working-out aches and pains. This leads me to believe that the Omega 3 oils relieve inflammation, perhaps by balancing our diet and thus preventing the body’s inflammatory response to an imbalanced diet. I wish you all the best luck at finding what works for you.

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