Revisiting Rosacea Through the Skin-Gut-Brain Axis: A Neuroimmune Perspective

Area of Science:

• Dermatology
• Neuroscience
• Gastroenterology

Background:

• Rosacea is recognized as a complex inflammatory disorder.
• The skin-gut-brain axis integrates gut microbiota, neuroimmune signaling, and stress mechanisms in rosacea.
• Current understanding often views rosacea as a peripheral or dermatological condition.

Purpose of the Study:

• To reframe rosacea as a neuroimmune disorder with active central nervous system regulation.
• To synthesize evidence linking gastrointestinal factors to skin inflammation via the skin-gut-brain axis.
• To highlight brain-centered mechanisms in rosacea pathogenesis.

Main Methods:

• Narrative hypothesis-driven overview.
• Synthesis of mechanistically relevant evidence.
• Emphasis on neurovascular and trigeminal pathways.

Main Results:

• Evidence links gastrointestinal inflammation and microbial imbalance to neurogenic inflammation and skin immune responses.
• Central mechanisms like central sensitization and autonomic dysregulation are integral to the rosacea skin-gut-brain axis.
• Rosacea serves as a model for studying neuroimmune dysregulation across interconnected systems.

Conclusions:

• Rosacea is proposed as a neuroimmune disorder involving the skin-gut-brain axis.
• Central nervous system mechanisms play a key regulatory role.
• Future research should focus on autonomic regulation, patient stratification, and personalized therapies.