As the exact cause of rosacea is still under investigation, researchers are looking at various factors that can play a role in the rosacea disease process. A recent publication(1) looked at the role of iron in rosacea pathology. It has been known that inflammation can be associated with the production of reactive oxygen species (ROS) and metals such as iron have the capacity to transform these reactive oxygen species into harmful radicals (see this article on free radicals – opens in a new window).
These radicals can attack cell membranes, proteins and DNA. An iron overload inside cells can amplify the damaging effects of ROS in chronic inflammation. Most iron is usually bound to a specific protein called ferritin. Ferritin is therefore important to limit the effect of oxidative reactions, by sequestering iron.
Ultraviolet light (and UV-A in particular) is one of the most important contributors to the skin’s oxidative stress. Studies have shown that UVA radiation leads to an immediate release of iron from ferritin. It has been found that skin that is exposed to UV-A light has approximately 3 times more iron content than unexposed skin. Excess iron can also be found in skin affected by certain skin disorders such as psoriasis and atopic eczema (2).
The study I mentioned above, looked at rosacea skin in particular. The study involved 60 rosacea patients and 11 control subjects. Skin biopsies from the face were studied for iron and ferritin content and serum was collected for determination of total peroxide levels (to get an idea of how much oxidative stress each person was under).
It was found that the more severe cases of rosacea had higher levels of ferritin and iron in their skin compared to the control groups. This could possibly also explain why the more advanced cases of rosacea are more sensitive to UV(A) exposure. Additionally, rosacea patients overall were found to have higher peroxide levels in their serum and a lower anti-oxidant potential.
The authors of this study suggested that the higher frequency of rosacea seen in women can be attributed to women having a thinner skin than men and the fact that iron supplementation is more common in women.
Limiting UV exposure and reducing stress in combination with a diet that is high in antioxidants may be helpful in reducing the severity of rosacea sysmptoms.
1. Tisma, VS, Basta-Juzbasic, A, Jaganjac, M et al (2009) Oxidative stress and ferritin expression in the skin of patients with rosacea. J Am Acad Dermatol 60: 270-6.
2. Bissett, DL, Chatterjee, R, Hannon, DP. (1991) Chronic ultraviolet radiation-induced increase in skin iron and the photoprotective effect of topically applied iron chelators. Photochem Photobiol 54:215-23.
What is your experience with iron? Have you ever been on iron supplementation for extended periods and have you seen an effect on rosacea symptoms?