It seems this is the direction of current research although we are
probably far from identifying the suggested single genes. The
implications as to cause are that if you have no family history or
have an unusual case, more investigation into underlying or
contributing factors should be considered. The implications as to
future treatments are not just vascular lasers but more control of
the mentioned mediators.

Semin Cutan Med Surg 2001 Sep;20(3):199-206

Rosacea: current thoughts on origin.

Bamford JT.

Department of Family Practice and Community Health, University of
Minnesota-Duluth Medical School, MN, USA. Jbamford@...

Rosacea is a clinical pattern beginning and evolving in the
genetically susceptible individual in response to a host of
exposures. It produces a variety of clinical presentations, which
vary over time and with age. Recently, many specific mediators of
rosacea development have been described. A primary genetic cause for
rosacea is suggested as single genes often control such mediators:
enzymes, neuroendocrine transmitters, and cytokines are found in
pathways to rosacea signs and symptoms. Currently, neither a specific
cause nor a laboratory indicator of rosacea has been suggested.
However, broadening interest in rosacea portends future increase in
knowledge.

PMID: 11594675 [PubMed - in process]

I think concepts from this article also capture some of what Dr. Nase
argues in his extraordinary book (http://www.drnase.com).

Presse Med 1988 Dec 17;17(45):2393-8

[Rosacea.] Grosshans E.

Clinique dermatologique de la Faculte de Medecine, Strasbourg.

Rosacea should no longer be considered a follicular skin disease. It
is a vascular disease of the face characterized by a significant
evolution towards local complications such as telangiectasias,
papular and aseptic pustular lesions, lupoid granulomas, chronic
facial oedema and seboglandular hyperplasia. The basic abnormality
seems to be a microcirculatory disturbance of the function of the
facial angular veins directly involved in the brain-cooling vascular
mechanism. The first clinic hallmark of this dysfunction is the
occurrence of flushing, which may be spontaneous or induced by
alcohol, intake of hot food, emotional stress and sudden variations
in temperature. Tetracycline, metronidazole and isotretinoin are very
useful for therapy but they only influence the cutaneous and ocular
complications and do not act upon the basic vascular trouble. Current
therapeutic research is directed towards drugs having an alpha-
sympathomimetic activity and inhibiting the endogenous opioid
mediators of flushing such as naloxone or clonidine.

Publication Types:
Clinical Trial

PMID: 2974982 [PubMed - indexed for MEDLINE]

Innovative understanding and treatments will emerge in the treatment
of seemingly related and unrelated conditions.