Rosacea is a chronic skin disease primarily characterized by redness. Some forms of rosacea also cause the development of papules and pustules on the skin's surface, similar to acne. This is then referred to as acne-rosacea. Retinoids are a class of molecules effective in combating acne. But what about in the case of rosacea? Let's explore this question together.
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- Retinoids and Rosacea: Good or Bad Idea?
Retinoids and Rosacea: Good or Bad Idea?
- Rosacea-Acne: What are we talking about?
- Retinoids: Effective Against Rosacea?
- Retinoids and Rosacea: Precautions to be Taken
- Sources
Rosacea-Acne: What are we talking about?
Rosacea is a chronic skin disease, characterized by periods of flare-ups and remission. It initially manifests itself through redness , heat sensations but also a significant dilation of the facial blood vessels, making them more visible, especially on lighter skin tones. In some cases, rosacea can progress to skin lesions , with the emergence of papulo-pustules on the skin surface.
The symptoms of this form of rosacea are quite similar to those of acne, hence it is sometimes referred to as acne-rosacea. The development of papulopustular rosacea is linked to the excessive presence of skin mites in the sebaceous glands, the Demodex. The cause of their excessive presence could be due to an immunological disorder that would lead to the formation of a permanent edema promoting an excessive proliferation of these parasites. Given the similar clinical manifestations of papulopustular rosacea and acne, one might wonder if the use of retinoids, recommended for acne, could be relevant for individuals suffering from rosacea.
Retinoids: Effective Against Rosacea?
The retinoids are a family of molecules that include vitamin A, its metabolites, and its derivatives (both natural and synthetic). Among the forms permitted in cosmetics, we notably find retinol, retinoid esters, and retinal. Generally recommended for mature skin, retinoids are also very useful for people suffering from acne. Indeed, these molecules have a keratolytic effect , allowing them to eliminate dead cells accumulated on the skin's surface. This action notably helps to unclog pores and prevent the appearance of future comedones.
Several studies have focused on the effects of retinoids on rosacea, and more specifically on acne-rosacea. It has been demonstrated that these molecules, when applied topically, promote the remodeling of connective tissue and the downregulation of TLR2 receptor expression (Toll-like receptor 2). This membrane receptor plays a significant role in bacterial recognition and in the production of interleukin-6 (IL-6), a pro-inflammatory cytokine. Clinical studies have reported that retinoids, due to their mechanism of action, offer a reduction in erythema, papules, and pustules, as well as telangiectasias, the small vessels that appear on the surface of skin affected by rosacea due to their permanent dilation.
Note : Although retinoids present in cosmetics can help control the symptoms of rosacea, it's important to keep in mind that they cannot replace a treatment prescribed by a dermatologist.
Retinoids and Rosacea: Precautions to be Taken.
The topical application of retinoids can lead to adverse effects on the skin. The most common are dry skin, photosensitivity and irritation. That's why it's recommended for those using them to always apply a moisturizer afterwards and to use sun protection during the day. Moreover, retinoids should not be applied around the eye area due to the sensitivity of this region. We also advise you to introduce retinoids gradually into your routine. It's good to start by applying a retinoid-based product every other day, or even every three days at the beginning. If your skin tolerates it well, you can increase the frequency up to once a day.
Finally, even with topical application, the use of retinoids is contraindicated for pregnant women or those planning a pregnancy. Although the risk of these molecules entering the bloodstream is low with topical use, the teratogenic effects of retinoids should not be overlooked. Indeed, they can cause malformations of the central nervous system of the fetus or cardiac malformations.
Sources
HATA T. R. & others. Topical and systemic therapies in the treatment of rosacea. American Academy of Dermatology (2014).
FELDMAN S. R. & al. Rosacea Management. Skin Appendage Disorders (2016).
ALI F. & et al. Rosacea. British Journal of Hospital Medicine.(2021).
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