Rosacea in Dark Skin

  • Uwe WollinaEmail author
  • Adebola Ogunbiyi
  • Shyam B. Verma
  • Karalikkattil T. Ashique


Rosacea is a common chronic inflammatory facial dermatosis, which mainly affects adults of Caucasian origin and among them mostly individuals with fair skin, as expressed by the term “blessing of the Celts” [1]. The ethnic background influences the prevalence and the frequency of the clinical subtypes of rosacea, possibly also any subjective symptoms and comorbidities. There is an impact of geographical and social factors as well. In contrast to Western countries, rosacea research in populations with dark skin is rudimental. However, despite all differences, the response of the disease to treatment is not dependent on patients’s skin type.


  1. 1.
    Wollina U. Classical clinical presentation of rosacea. In: Zouboulis CC, Katsambas AD, Kligman AM, editors. Pathogenesis and treatment of acne and rosacea. Berlin: Springer; 2014. p. 653–9.Google Scholar
  2. 2.
    Al-Dabagh A, Davis SA, McMichael AJ et al. Rosacea in skin of color: not a rare diagnosis. Dermatol Online J. 2014;20(10).Google Scholar
  3. 3.
    Rueda LJ, Motta A, Pabón JG, et al. Epidemiology of rosacea in Colombia. Int J Dermatol. 2017;56:510–3.CrossRefPubMedGoogle Scholar
  4. 4.
    Li J, Li M, Chen Q, et al. Quality of life among patients with rosacea: an investigation of patients in China using two structured questionnaires. J Eur Acad Dermatol Venereol. 2016;30:e98–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Doe PT, Asiedu A, Acheampong JW, et al. Skin diseases in Ghana and the UK. Int J Dermatol. 2001;40:323–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Koffi-Aka V, Kouassi AA, D'Horpock FA, et al. Rhinophyma in a black African. Rev Laryngol Otol Rhinol (Bord). 2002;123:109–10.Google Scholar
  7. 7.
    Al Balbeesi AO, Halawani MR. Unusual features of rosacea in saudi females with dark skin. Ochsner J. 2014;14:321–7.PubMedCentralPubMedGoogle Scholar
  8. 8.
    Khaled A, Hammami H, Zeglaoui F, et al. Rosacea: 244 Tunisian cases. Tunis Med. 2010;88:597–601.PubMedGoogle Scholar
  9. 9.
    Rathi SK, Kumrah L. Topical corticosteroid-induced rosacea-like dermatitis: a clinical study of 110 cases. Indian J Dermatol Venereol Leprol. 2011;77:42–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Steinhoff M, Schauber J, Leyden JJ. New insights into rosacea pathophysiology: a review of recent findings. J Am Acad Dermatol. 2013;69:S15–26.CrossRefPubMedGoogle Scholar
  11. 11.
    Two AM, Hata TR, Nakatsuji T, et al. Reduction in serine protease activity correlates with improved rosacea severity in a small, randomized pilot study of a topical serine protease inhibitor. J Invest Dermatol. 2014;134:1143–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Fischer J, Meyer-Hoffert U. Regulation of kallikrein-related peptidases in the skin—from physiology to diseases to therapeutic options. Thromb Haemost. 2013;110:442–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Li N, Yamasaki K, Saito R, et al. Alarmin function of cathelicidin antimicrobial peptide LL37 through IL-36γ induction in human epidermal keratinocytes. J Immunol. 2014;193:5140–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Yamasaki K, Gallo RL. Rosacea as a disease of cathelicidins and skin innate immunity. J Investig Dermatol Symp Proc. 2011;15:12–5.Google Scholar
  15. 15.
    Wollina U. Rhinophyma—unusual expression of simple-type keratins and S100A in sebocytes and abundance of VIP receptor-positive dermal cells. Histol Histopathol. 1996;11:111–5.PubMedGoogle Scholar
  16. 16.
    Fimmel S, Abdel-Naser MB, Kutzner H, et al. New aspects of the pathogenesis of rosacea. Drug Discovery Today Dis Mech. 2008;5:e103–11.CrossRefGoogle Scholar
  17. 17.
    Dajnoki Z, Béke G, Kapitány A, et al. Sebaceous gland rich skin is characterized by TSLP expression and distinct immune surveillance which is disturbed in rosacea. J Invest Dermatol. 2017;137:1114–25.CrossRefPubMedGoogle Scholar
  18. 18.
    Sulk M, Seeliger S, Aubert J, et al. Distribution and expression of non-neuronal transient receptor potential (TRPV) ion channels in rosacea. J Invest Dermatol. 2012;132:1253–62.CrossRefPubMedGoogle Scholar
  19. 19.
    Zhao YE, Peng Y, Wang XL, et al. Facial dermatosis associated with Demodex: a case-control study. J Zhejiang Univ Sci B. 2011;12:1008–15.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Hua TC, Chung PI, Chen YJ, et al. Cardiovascular comorbidities in patients with rosacea: a nationwide case-control study from Taiwan. J Am Acad Dermatol. 2015;73:249–54.CrossRefPubMedGoogle Scholar
  21. 21.
    Tebbe B, Geilen CC, Orfanos CE. Nachweis von Helicobacter pylori bei Dermatosen. Klinischer Zufallsbefund oder pathologenetische Assoziation? Hautarzt. 1996;47:587–90.CrossRefPubMedGoogle Scholar
  22. 22.
    El-Khalawany M, Mahmoud A, Mosbeh AS, et al. Role of Helicobacter pylori in common rosacea subtypes: a genotypic comparative study of Egyptian patients. J Dermatol. 2012;39:989–95.CrossRefPubMedGoogle Scholar
  23. 23.
    Chen W, Plewig G. Are Demodex mites principal, conspirator, accomplice, witness or bystander in the cause of rosacea? Am J Clin Dermatol. 2015;16:67–72.CrossRefPubMedGoogle Scholar
  24. 24.
    Wilkin J, Dahl M, Detmar M, et al. Standard classification of rosacea: report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol. 2002;46:584–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Egeberg A, Hansen PR, Gislason GH, et al. Exploring the association between rosacea and Parkinson disease: a Danish nationwide cohort study. JAMA Neurol. 2016;73:529–34.CrossRefPubMedGoogle Scholar
  26. 26.
    Egeberg A, Hansen PR, Gislason GH, et al. Patients with rosacea have increased risk of dementia. Ann Neurol. 2016;79:921–8.CrossRefPubMedGoogle Scholar
  27. 27.
    Del Rosso JQ. Advances in understanding and managing rosacea: part 1: connecting the dots between pathophysiological mechanisms and common clinical features of rosacea with emphasis on vascular changes and facial erythema. J Clin Aesthet Dermatol. 2012;5:16–25.PubMedCentralPubMedGoogle Scholar
  28. 28.
    Bhargava R, Chandra M, Bansal U, et al. A randomized controlled trial of omega 3 fatty acids in rosacea patients with dry eye symptoms. Curr Eye Res. 2016;41:1274–80.CrossRefPubMedGoogle Scholar
  29. 29.
    Al Arfaj K, Al Zamil W. Spontaneous corneal perforation in ocular rosacea. Middle East Afr J Ophthalmol. 2010;17:186–8.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Bae YI, Yun SJ, Lee JB, et al. Clinical evaluation of 168 Korean patients with rosacea: the sun exposure correlates with the erythematotelangiectatic subtype. Ann Dermatol. 2009;21:243–9.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Lee WJ, Lee YJ, Lee MH, et al. Prognosis of 234 rosacea patients according to clinical subtype: the significance of central facial erythema in the prognosis of rosacea. J Dermatol. 2016;43:526–31.CrossRefPubMedGoogle Scholar
  32. 32.
    Furukawa M, Kanetou K, Hamada T. Rhinophyma in Japan. Int J Dermatol. 1994;33:35–7.CrossRefPubMedGoogle Scholar
  33. 33.
    Lee WJ, Lee YJ, Won CH, et al. Clinical evaluation of 30 patients with localized nasal rosacea. J Dermatol. 2016;43:200–2.CrossRefPubMedGoogle Scholar
  34. 34.
    Zouboulis CC, Schaller M, Gollnick HPM. Antimicrobial treatment of rosacea. In: Ólafsson JH, Hay RJ, editors. Antibiotic and antifungal therapies in dermatology. Berlin: Springer; 2016. p. 41–56.CrossRefGoogle Scholar
  35. 35.
    Wu J. Treatment of rosacea with herbal ingredients. J Drugs Dermatol. 2006;5:29–32.PubMedGoogle Scholar
  36. 36.
    Alexis AF, Webster G, Preston NJ, et al. Effectiveness and safety of once-daily doxycycline capsules as monotherapy in patients with rosacea: an analysis by Fitzpatrick skin type. J Drugs Dermatol. 2012;11:1219–22.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Uwe Wollina
    • 1
    Email author
  • Adebola Ogunbiyi
    • 2
  • Shyam B. Verma
    • 3
  • Karalikkattil T. Ashique
    • 4
  1. 1.Department of Dermatology and AllergologyHospital Dresden-Friedrichstadt, Teaching Hospital of the Technical University of DresdenDresdenGermany
  2. 2.Department of MedicineUniversity of IbadanIbadanNigeria
  3. 3.Nirvana Skin ClinicVadodaraIndia
  4. 4.Kims Alshifa HospitalMalappuramIndia

Personalised recommendations