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    Importantly, the smooth muscle-containing facial vasculature in patients with rosacea medications responsive to vasoactive boys, which constrict or dilate peripheral hard vessels even when some structurally.

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    Physical Modalities for Diffuse and Persistent Facial Erythema and Telangiectasias of Rosacea Although this article emphasizes medical therapy options, a variety of physical modalities have been used with success for the treatment of diffuse facial erythema of rosacea in patients with very few or no inflammatory lesions i.

    Published studies have incorporated intense pulsed light, pulsed dye laser, and nonpurpuragenic pulsed dye laser for the treatment of facial erythema and telangiectasias in patients with ETR, with reduction in facial erythema, decrease in telangiectasias, improvement in symptomatology, and a favorable impact on quality-of-life parameters reported.

    In some cases, inflammatory lesions develop, likely related at least partially to the chemoattractant effects of IL-8 and LL-37.

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    Over time, several factors including MMP upregulation with dermal matrix degradation, chronic vascular inflammation with perivascular edema, and downstream cascades signaled by cathelicidin-derived peptides i.

    These structural changes progress to become fixed, characterized by larger and more dilated superficial cutaneous vessels and arborizing networks, leading to persistence of facial erythema, which is usually diffuse and central facial in accentuation.

    Telangiectasias also develop due to neovascularization.


    These changes occur in varying degrees with regard to magnitude and time course of development. Other factors appear to contribute to facial erythema of rosacea, including stratum corneum permeability barrier impairment and depletion of cutaneous antioxidant reserve by ROS, the latter induced in some cases by ultraviolet-related photodamage.

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  • As a result, proper skin care gentle cleanser use, moisturization and photoprotection are integral components of the management of rosacea.

    As some of the available conventional medical therapies for rosacea are capable of counteracting augmented innate immune response by inhibiting steps involved in cathelicidin processing, it is not entirely clear why these agents would not reduce diffuse facial erythema.

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