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Moving Rosacea Research Forward

Moving Rosacea Research Forward

While a number of new therapeutic agents have been approved to treat the signs of rosacea, much needed research is underway to better understand its pathogenesis.

An estimated 16 million Americans have rosacea,1 though it is thought to be widely underreported and underdiagnosed, especially in racial-ethnic minority groups.2 There is a critical need to better understand the pathogenesis of the disease in order to lead to more targeted therapies. To move rosacea research forward, the National Rosacea Society (NRS) awarded two grants and extended a third in its research grants program for 2020. This year’s recipients are Drs Raja Sivamani, Michelle Trautwein, and Tissa Hata.

Dr Sivamani is an associate professor of clinical dermatology at the University of California, Davis. He received an extension of his 2017 grant to continue studying the role of the lipidome in ocular and papulopustular rosacea. In particular, this research looks at the alterations in skin and eyelid oils of individuals with rosacea, including if deficiencies in the lipidome can contribute to the formation of papules, pustules, eye dryness, and irritation.

A new grant of $15,000 was awarded to Dr Trautwein, an assistant curator and researcher at the Institute for Biodiversity Science and Sustainability at the California Academy of Sciences in San Francisco. Her research will focus on the genetic sequencing of Demodex mites and will be the first study to map the complete genetic makeup of the microorganism. Research previously funded through the NRS grants program highlighted the potential role of Demodex mites in rosacea, noting that an associated bacteria, Bacillus oleronius, stimulated the inflammatory response in a majority of the study sample of patients with papulopustular rosacea.3 Dr Trautwein’s study will also look to identify other associated bacteria that may be responsible for rosacea signs and symptoms.

In another microorganism-centered study, Dr Hata, clinical professor of dermatology at the University of California, San Diego, received a grant of $15,000 to study the normalization of the microbiome in patients with rosacea. Her research seeks to identify the difference in microbiome activity, including Cutibactrium acnes and Staphylococcus epidermidis, of patients with rosacea with untreated skin vs those who have been successfully treated and have healthy skin. A deficiency in C acnes has been shown to correlate with increased rosacea severity,4,5 while S epidermidis has been shown to have an increased presence in the microbiome of patients with moderate and severe rosacea.4,6

Throughout its 20-year history, the NRS research grants program has awarded more than $1.6 million to support 73 studies. The grants are funded through donations by persons with rosacea and others who want to see improvements in the care and management of the condition. Grant proposals are reviewed and selected for funding by the NRS Medical Advisory Board, and priority for funding is placed on studies related to pathogenesis and progression, mechanisms of action, cell biology, and genetic factors. Previously completed research funded by the NRS have been published in leading peer reviewed publications such as British Journal of Dermatology,3 JAMA Dermatology,7 and Journal of the American Academy of Dermatology.8 The NRS offers reports on completed research on its website (

Researchers should visit for more information regarding the NRS’s grants and how to submit a proposal for 2021.

1. Cices A, Alexis AF. Patient-focused solutions in rosacea management: treatment challenges in special patient groups. J Drugs Dermatol. 2019;18(7):608-612.

2. Alexis AF, Callendar VD, Baldwin HE, Desai SR, Rendon MI, Taylor SC. Global epidemiology and clinical spectrum of rosacea, highlighting skin of color: review and clinical practice experience. J Am Acad Dermatol. 2019;80(6):1722-1729.E7. doi:10.1016/j.jaad.2018.08.049

3. Lacey N, Delaney S, Kavanagh K, Powell FC. Mite-related bacterial antigens stimulate inflammatory cells in rosacea. Br J Dermatol. 2007;157(3):474-481. doi:10.1111/j.1365-2133.2007.08028.x

4. Woo YR, Lee SH, Cho SH, Lee JD, Kim HS. Characterization and analysis of the skin microbiota in rosacea: impact of systemic antibiotics. J Clin Med. 2020;9(1):185. doi:10.3390/jcm9010185

5. Rainer BM, Thompson KG, Antonescu C, et al. Characterization and analysis of the skin microbiota in rosacea: a case-control study. Am J Clin Dermatol. 2020;21(1):139-147. doi:10.1007/s40257-019-00471-5

6. Whitfeld M, Gunasingam N, Leo LJ, Shirato K, Perada V. Staphylococcus epidermidis: a possible role in the pustules of rosacea. J Am Acad Dermatol. 2011;64(1):49-52. doi:10.1016/j.jaad.2009.12.036

7. Aldrich N, Gerstenblith M, Fu P, et al. Genetic vs environmental factors that correlate with rosacea: a cohort-based survey of twins. JAMA Dermatol. 2015;151(11):1213-1219. doi:10.1001/jamadermatol.2015.2230

8. Dahl MV, Ross AJ, Schlievert PM. Temperature regulates bacterial protein production: possible role in rosacea. J Am Acad Dermatol. 2004;50(2):266-272. doi:10.1016/j.jaad.2003.05.005

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