Recent evidence suggests that in rosacea inflammation is associated with the production of reactive oxygen species by inflammatory cells such as neutrophils (Tisma, Basta-Juzbasic, Jaganjac, Brcic, Dobric, Lipozencic, Tatzber, Zarkovic & Poljak-Blazi, 2009). Reactive oxygen species (ROS) themselves do not necessarily have to lead to development of pathological processes; however, in the presence of transition metals, such as copper and iron, they easily generate harmful hydroxyl radicals. Iron has the capacity to accept and donate electrons readily, which makes it physiologically essential as a component of cytochromes and oxygen binding molecules. However, iron is also biochemically dangerous; it can damage tissues by catalysing the conversion of hydrogen peroxide to free radicals that attack cellular membranes, proteins and DNA. Iron overload may amplify the damaging effects of super oxide and peroxide overproduction in a broad spectrum of acute and chronic inflammatory conditions. In a recent study it was hypothesised that increased release of free iron in the skin cells via proteolysis of ferritin and consequent oxidative damage of the skin, possibly induced by UV light or other exogenous stressors such as high temperature and inflammation, might have a pathogenic role in rosacea (Tisma, Basta-Juzbasic, Jaganjac, Brcic, Dobric, Lipozencic, Tatzber, Zarkovic & Poljak-Blazi, 2009). In this study it was found that lower antioxidant potential support the onset of systemic oxidative stress in patients with rosacea.
Tisma, V.S., Basta-Juzbasic, A., Jaganjac, M., Brcic, L., Dobric, I., Lipozencic, J., Tatzber, F., Zarkovic, N. & Poljak-Blazi, M. 2009.Oxidative stress and ferritin expression in the skin of patients with rosacea. Journal of the American Academy Dermatology, 60, 2, 271-276.