Tetracycline Actions Relevant to Rosacea Treatment

Until today, the pathogenesis of rosacea is not known in detail.
Yet in recent years evidence has been accumulating that rosacea
with its common symptoms such as inflammatory lesions, erythema,
telangiectasia, phymatous changes, and ocular symptoms is of
inflammatory nature. Tetracycline derivatives like doxycycline
successfully used in the treatment of skin diseases like acne and
rosacea seem to inhibit different inflammatory pathways involved in
the pathogenesis by various modes of action. Although data for skin
diseases are relatively scanty, the following modes of action of
tetracyclines seem to be most relevant for an effective treatment
of acne and rosacea: inhibition of matrix metalloproteinases,
downmodulation of cytokines, inhibition of cell movement and
proliferation, inhibition of granuloma formation, inhibition of
reactive oxygen species, nitric oxide, and angiogenesis, whereas
inhibition of phospholipase A2 seems to be of lower importance. The
role of the saprophytic mite Demodex folliculorum remains to be
clarified. Additional studies are necessary to further elucidate
how tetracyclines work in rosacea treatment. Copyright (C) 2009 S.
Karger AG, Basel