New Insights into the Mutual Promotion of Rosacea, Anxiety, and Depression from Neuroendocrine Immune Aspects

Abstract

Rosacea is a common chronic inflammatory skin disease with a complex etiology and undefined pathogenesis, and there is still a lack of targeted clinical treatment. Patients with rosacea are at a higher risk of anxiety and depression compared to the healthy population. Compared to skin conditions such as acne and psoriasis, rosacea has been much less studied in relation to multiple-etiology psychiatric disorders such as anxiety and depression. In contrast to the mainstream belief that the causal association between rosacea and psychiatric disorders is that rosacea increases the psychological burden of patients and thus triggers psychiatric disorders simply by altering their facial appearance, this review outlines the possible common mechanisms between rosacea and anxiety and depression disorders, starting from the pathophysiological mechanisms of transient receptor potential family cation channels, HPA axis, and Th1/Th17 cell polarization. It envisages the possibility of the neuroendocrine-immune interplay between rosacea and anxiety and depression, and new ideas on the complex causal relationship between rosacea and psychiatric disorders, offering more orientations to open up new therapeutic approaches for rosacea.

Evaluation of Dermatological and Neurological Aspects of the Relationship between Rosacea and Headaches

“…In the current study, it was found that a majority of patients with headaches developed their headaches after being diagnosed with rosacea. A shared vascular change between rosacea and certain headache types, along with neurogenic modulation, might play a role [ 21 , 22 ]. The variability in headache types among different rosacea predominant subtypes further suggests a complex interplay, where specific inflammatory and pathophysiological features of each subtype differentially impact neurological outcomes.…”

Therapeutic Potential of Minor Cannabinoids in Dermatological Diseases—A Synthetic Review

“…An important aspect is the influence of cannabinoids, plant or synthetic compounds, which interact with cannabinoid receptors in the skin to regulate neuroendocrine processes. Cannabinoid receptors, mainly CB 1 and CB 2 , present in skin cells and the nervous system, form the foundations of the interaction between the endocannabinoid system and skin neuroendocrinology [ 29 , 30 , 31 ]. In the context of neuroendocrinology, cannabinoids can influence hormone secretion by interacting with cell receptors or indirectly, by influencing stress responses.…”

“…Environmental factors such as UV radiation and pollutants expedite this process, disrupting cutaneous neuroendocrine systems. Topical application of neurohormonal substances, like melatonin, secosteroids and cannabinoids may mitigate skin aging effects through targeted interaction with receptors and enzymes [ 26 , 27 , 28 , 29 ].…”