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Study finds significant association between rosacea and malignant melanoma
Last reviewed: 02.07.2025
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A recent study published in the journal Scientific Reports has found that rosacea, a common skin condition typically considered merely a cosmetic problem, may be associated with several related conditions, including melanoma.
The study used a large age- and sex-matched cohort derived from the TriNetX platform (n = 244,888) that included Caucasian, Black, Asian, Alaskan, and Pacific Islander ethnicities.
The study results show that, contrary to previous research, rosacea is significantly associated with an increased risk of visual impairment, metabolic disorders, joint problems and type 2 diabetes (T2D).
Most notably, the Caucasian subgroup showed a significantly increased risk of melanoma, which was not observed in the Asian subgroup. These ethnic differences may explain the inconsistent reports of comorbidities in previous studies.
Despite the notable limitations of the retrospective study design, it justifies the need for further research into the pathology of this common but poorly understood disease.
What is rosacea and why has it remained under the radar of epidemiologists for so long? Rosacea is a chronic skin condition that primarily causes redness and rashes on the cheeks, chin, nose, and forehead of affected individuals. The condition is most common in women aged 30-50, although it can affect people of any age and gender.
Global reports indicate that people of Celtic descent and fair-skinned northern Europeans are more vulnerable to the disease, with prevalence among these ethnic groups estimated to be between 5 and 10%, compared to a global estimate of 1-7%.
Although rosacea was described as early as Geoffrey Chaucer's Canterbury Tales in the late 1300s and possibly as early as 200 BC by Theocritus, it remains poorly understood.
Although numerous causes of the disease have been proposed, including ultraviolet exposure, smoking, alcohol, heat, exercise, psychological stress, and, most commonly, genetics, these causes have never been scientifically proven.
Recent studies have linked Demodex species infections to rosacea manifestations, leading to oral antibiotics becoming the clinical intervention of choice when symptoms occur. However, these interventions only provide temporary relief, and there is currently no long-term cure for the disease.
The present study aimed to retrospectively use data from a large "real-world" database (TriNetX platform) to identify possible correlations between rosacea and several systemic diseases, including malignancies.
The data were obtained from 21,913,235 enrolled TriNetX patients between June and July 2023 and included both demographics (especially age, gender, and ethnicity) and medical records (diagnoses, medications, laboratory observations, and genomic information).
Inclusion criteria for the study included patients diagnosed with International Classification of Diseases and Related Health Problems (ICD-10) code L71 (rosacea) and an equal number of patients without a diagnosis of rosacea, matched for age and sex, included as a control group.
Of 132,388 patients diagnosed with ICD-10 code L71 (rosacea), 122,444 (69.2% women) had age- and sex-matched patients without a diagnosis of rosacea and were included in the present study. Of these, 82% were Caucasian, 3% were black, 1.6% were Asian, 10% were unknown, and the remainder were Alaskan, Indian, Hawaiian, or Pacific Islander.
"While the risk of being diagnosed with vascular disease was 0.185 in patients without rosacea, this risk increased to 0.336 in patients with rosacea [OR 2.234 (2.192, 2.276)]."
In contrast to previous reports, rosacea was found to be associated with a significant increase in the risks of heart disease (OR = 1.649), type 2 diabetes (T2D; OR = 1.618), metabolic diseases (OR = 3.165), and eye or joint diseases (OR = 4.164-4.801).
Of greatest concern are the comorbidities most strongly associated with rosacea, including cutaneous neoplasms (including malignant melanoma; OR = 6.031).
"In a subgroup analysis of rosacea patients with cutaneous neoplasms, we were able to identify not only an increased risk of non-melanoma skin cancer [C44; OR 5.550 (5.345, 5.763)] but also malignant melanoma (C43) [OR 4.468 (4.144, 4.818)]. Given the sharply increased risk of malignant melanoma in our rosacea population, we performed a Kaplan–Meier survival analysis for this subgroup of patients. The probability of survival at the end of the time window was 92.51% and 97.71% for the cohort with and without rosacea, respectively. With an HR of 3.286 (95% CI 3.101, 3.481), mortality was higher in patients with malignant melanoma if they also had rosacea (p = 0.059)."
Overall, this study is the first to convincingly link rosacea to a variety of comorbidities, some of which (melanomas and heart disease) are life-threatening.
Despite the notable limitations of using only retrospective data and ICD-10 codes, the study highlights the importance of rosacea and the need for further research into this deceptively harmless disease.