Exploring the Risk Factors of Rosacea Exacerbation Associated with COVID-19 Infection or Vaccination: A Cross-sectional Study

Authors

  • Xidie Yin Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Yiting Zhao Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Liyuan Zhou Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Xiaojing Liu Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Yu Yan Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Zhi Cao Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Shu Zhan Shen Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Qihang Chang Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Yajing Cao Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Xiuli Wang Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
  • Peiru Wang Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China

DOI:

https://doi.org/10.2340/actadv.v105.43615

Keywords:

COVID-19, COVID-19 vaccination, Rosacea, neurogenic inflammation

Abstract

COVID-19 can affect the skin, with rosacea flare-ups reported after infection or vaccination. This study compared rosacea patients with and without post-COVID-19 exacerbation to identify contributing factors. A customized electronic questionnaire was administered to rosacea patients, gathering COVID-19 infection/vaccination status, demographics, and rosacea features. Participants were classified by post-COVID-19 rosacea exacerbation vs none. Multivariable logistic regression identified risk factors. Finally, a total of 104 patients were analysed; 15.4% experienced rosacea exacerbation after COVID-19 vaccination and 28.8% after infection. Comorbidities such as metabolic diseases or allergic diseases were associated with a higher risk of rosacea exacerbation after vaccination or infection (OR = 11.083, 95% CI: 1.136–108.135). Burning and stinging symptoms predicted higher exacerbation risk after vaccination (OR = 8.978, 95% CI 1.968–40.969). Papulopustular rosacea was associated with lower risk (OR = 0.276, 95% CI: 0.066–1.160). Higher body mass index (BMI) was associated with lower exacerbation risk after vaccination (OR = 0.646, 95% CI 0.450–0.928) and infection (OR = 0.731, 95% CI: 0.572–0.933). Frequent rosacea episodes increased exacerbation risk after infection (OR = 8.288, 95% CI: 2.044–33.608). In conclusion, lower BMI was associated with higher risk of rosacea exacerbation after COVID-19 vaccination or infection. Patients with burning and stinging symptoms or a non-papulopustular subtype were more likely to experience exacerbation after vaccination.

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References

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Published

2025-09-04

How to Cite

Yin, X., Zhao, Y., Zhou, L., Liu, X., Yan, Y., Cao, Z., … Wang, P. (2025). Exploring the Risk Factors of Rosacea Exacerbation Associated with COVID-19 Infection or Vaccination: A Cross-sectional Study. Acta Dermato-Venereologica, 105, adv43615. https://doi.org/10.2340/actadv.v105.43615

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Vol. 105 (2025)

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Copyright (c) 2025 Xidie Yin, Yiting Zhao, Liyuan Zhou, Xiaojing Liu, Yu Yan, Zhi Cao, Shu Zhan Shen, Qihang Chang, Yajing Cao, Xiuli Wang, Peiru Wang

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