Findings from a retrospective cohort study indicate that cosmetics and topical medications were the most common culprits causing allergic sensitization in patients with rosacea. These findings were published in ACTAS Dermo-Sifiliográficas.

Data from all patients (n=200) who underwent patch testing and were diagnosed with rosacea at the Allergy Clinic of Hospital General Universitario de Valencia in Spain from 1991 through 2019 were analyzed in this study. The patients underwent Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea (GEIDAC) testing (100%) and testing using the preservative series (28.5%), cosmetic series (7.5%), and photopatch testing (2.5%). The most common types of allergic irritants were evaluated.

Among all patients who underwent skin patch testing during the study period (N=9521), 2.1% were diagnosed with rosacea. The patients with rosacea were 81% women, mean age 44.7 years, and 29% had a personal or family history of atopy.

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The patients were allergic to metals (43.6%), primarily nickel sulfate (28.7%), medications (17.1%), preservatives (13.2%), fragrances (8.8%), and dyes (7.2%).

The most common source of sensitization among patients with a positive result was cosmetics (76.6%), particularly moisturizers, perfumes, hair dyes, and nail polish. The next most common sensitization source were medications (23.3%), primarily corticosteroids and topical antifungal agents.

The study authors concluded, “We highlight the high prevalence of allergic contact dermatitis in patients with rosacea, thus supporting the use of patch tests in this population. […] The study of skin allergy could prove useful in patients with rosacea in terms of secondary prevention through allergen avoidance, although it can also play a role in primary prevention. […] Furthermore, informing patients with rosacea about the possibility of repeat open application testing or cosmetic use testing before regular application of products could help to optimize clinical management.”


Magdaleno-Tapial J, López-Martí C, García-Legaz-Martínez M, et al. Contact allergy in patients with rosacea. Actas Dermosifiliogr. 2022;113(6):550-554. doi:10.1016/

This article originally appeared on Dermatology Advisor