A just published paper has found a statistical link between rosacea and migraines. Specifically, the research has found that female rosacea sufferers over the age of 50 had a `significantly higher prevalence and risk of incident migraine’. So what might we learn about treating both rosacea and migraines from this research? The takeaways from this research are summarised below.
Research from statistics
This sort of research seeks to take information already collected from a large population to make discoveries about possible links between conditions. Any links discovered might direct futher research into the significance of for example, co-existing conditions. Benefits of this sort of research might arise when a new understanding of how a disease progresses, or can be now treated are considered in the light of new information from the co-existing condition.
Egeberg A, Ashina M, Gaist D, Gislason GH, Thyssen JP, J Am Acad Dermatol. 2016 Nov 3.
Background: Rosacea features increased neurovascular reactivity; migraine is a complex neurologic disorder characterized by recurrent episodes of headache associated with nausea and increased sensitivity to light and sound.
Objective: We evaluated the prevalence and risk of new-onset migraine in patients with rosacea.
Methods: All Danish individuals 18 years of age or older were linked in nationwide registers. Adjusted hazard ratios (HRs) were estimated by Cox regression.
Results: In the total cohort (n = 4,361,688), there were 49,475 patients with rosacea. Baseline prevalence of migraine was 7.3% and 12.1% in the reference population and in patients with rosacea, respectively.
The fully adjusted HR of migraine was 1.31 (95% confidence interval 1.23-1.39) for patients with rosacea.
Patients with phymatous rosacea (n = 594) had no increased risk of migraine (adjusted HR 0.45; 95% confidence interval 0.11-1.80), whereas patients with ocular rosacea (n = 6977) had a 69% increased risk (adjusted HR 1.69; 95% confidence interval 1.43-1.99).
Notably, the risk was higher among patients age 50 years or older than in younger individuals, and the risk was only significant among women.
Limitations: We were unable to distinguish between migraine subtypes.
Conclusion: 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.
So What is happening?
Although these sorts of papers do good research and find results worth publishing sometimes we are left wondering what is it all about?
The basis for the co-occurrence of migraine and rosacea is unknown; however, vascular abnormality is central to the etiopathogenesis of both disorders.
Patients with erythematotelangiectatic rosacea often report episodes with prolonged flushing of affected facial skin, and studies have shown increased tissue expression of vascular endothelial growth factor and vasoactive intestinal growth factor receptors in patients with rosacea.
Are there any possible clues relating to the link?
Flushing and disease exacerbation in rosacea is often caused by particular triggers such as stress, exposure to sunlight, hot or cold temperature, strenuous exercise, spicy foods, and hot drinks.
Several triggers for migraine share an overlap with rosacea triggers including stress and alcohol.
Future studies in patients with both rosacea and migraine are required to establish whether these triggers co-occur in the same individual.
However, we emphasize that the pathogenic link between rosacea and migraine remains unclear, and additional studies are needed to elucidate the underlying cause for the observed association.
It is worth also remembering that these sorts of statistical studies have specific limitations.
Observational studies cannot determine causality.
OK so you have reached the bottom of this article, what should you take away from this paper ? Glad you asked 🙂
With the above caveats in mind, we conclude that we found a significantly higher prevalence and risk of new-onset migraine in female patients with rosacea, compared with the general population.
The risk was highest among older individuals, and in particular among individuals with ocular rosacea. These data add to the accumulating evidence for a link between rosacea and the central nervous system.
Have you tried a treatment that is normally used for migraine and noticed any improvement in your rosacea? Please let us know in the comments below.
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