Therapeutic progress in rosacea: targeting the neuro-vascular-immune triad
In brief
Neuromodulators and anti-CGRP agents show promise for rosacea treatment
New therapies that target nerve signaling-such as GABA-derivatives, antidepressants, anti-calcitonin gene-related peptide drugs, vagus-nerve stimulation, magnetic brain stimulation, botulinum toxin and beta-blockers-have demonstrated clinical benefit in early studies of moderate to severe rosacea. However, evidence comes from small trials without clear dosing or duration guidance, and larger randomized studies are needed before these options can be routinely recommended.
- Journal
- Frontiers in immunology (Q1)
- Published
- 22 June 2026
- Study design
- Narrative review / expert opinion
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Xingyin Yang, Wanqing Yang, Nuoran Chen, Dansheng Li, Yang Xu
- PMID
- 42440475
- DOI
- 10.3389/fimmu.2026.1876564
Why clinicians should know about it
- Picked for Dermatology (top studies of the week, 19 July 2026): Therapeutic progress in rosacea targeting neuro‑vascular‑immune triad
Abstract
Rosacea is a chronic inflammatory dermatological condition predominantly affecting the facial region. Clinically, rosacea is characterized by paroxysmal flushing, persistent erythema, telangiectasia, papules, pustules, and ocular symptoms. Severe rosacea cases are frequently complicated by anxiety, depression, and sleep disturbances, imposing a heavy psychosocial burden and markedly impairing the quality of life of the patients. Abnormal activation of the neuro-vascular-immune triad has been reported as a crucial pathological mechanism of rosacea. Moreover, dysregulation within the central nervous system might exacerbate disease progression by modulating peripheral nerve activity and neuroendocrine homeostasis. In this review, we summarize the latest advancements in rosacea treatments targeting the neuro-vascular-immune triad, including γ-aminobutyric acid derivatives, antidepressants, anti-calcitonin gene-related peptide agents, physical neuromodulation (transcutaneous auricular vagus nerve and repetitive transcranial magnetic stimulations), botulinum toxin type A, and β-blockers. We provide a comprehensive analysis of their molecular mechanisms, clinical efficacy, and current limitations. While such therapies could specifically regulate different stages of the pathway, their evidence lacks large-scale randomized controlled trials and clarity regarding optimal dosing regimens and treatment durations. Future studies should strengthen basic investigations and clinical translation, explore combined therapeutic strategies, as well as develop personalized therapeutic strategies for the long-term effective control of rosacea.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.