Review Uncovers Shared Neurovascular and Neuroinflammatory Pathways Linking Rosacea and Migraines via CGRP, SP, and PACAP

Traditionally, rosacea, a chronic inflammatory skin condition, and migraine, a debilitating neurological disorder, have been considered distinct. However, emerging evidence points to a significant overlap, particularly through shared neurovascular and neuroinflammatory pathways. Current standard-of-care treatments for each condition often fail to address this potential comorbidity, leaving a gap in integrated therapeutic strategies. Understanding these common underlying mechanisms, especially the role of specific neuropeptides, is crucial for developing more holistic and effective treatments for both conditions.

This literature review systematically explored existing research to identify and synthesize shared mechanisms between rosacea and migraine. The authors analyzed studies focusing on neurovascular and neuroinflammatory pathways, specifically examining the roles of key neuropeptides. These included calcitonin gene-related peptide (CGRP), substance P (SP), and pituitary adenylate cyclase-activating polypeptide (PACAP). The review aimed to highlight their involvement in mediating inflammation and vascular dysregulation common to both disorders, identify current knowledge gaps, and propose directions for future interdisciplinary research.

The review established that rosacea and migraine, despite affecting different organ systems, share significant neurovascular and neuroinflammatory underpinnings. It highlighted the crucial involvement of neuropeptides, including CGRP, SP, and PACAP, in mediating the inflammation and vascular dysregulation common to both conditions. These neuropeptides are implicated in processes such as vasodilation, mast cell degranulation, and neurogenic inflammation, contributing to symptoms in both the skin and brain. The review noted that CGRP in particular plays a central role in migraine pathophysiology and is increasingly recognized for its involvement in rosacea-related flushing and inflammation. > The most significant finding is the recognition of rosacea and migraine as interrelated neurovascular disorders, driven by common molecular players and advocating for integrated therapeutic approaches. Furthermore, the review identified notable gaps, such as limited data on the impact of migraine treatments (e.g., CGRP inhibitors) on rosacea, suggesting a potential therapeutic avenue that remains largely unexplored.