Rosacea May Increase Migraine Risk

Patients with rosacea, especially women, were found to have a significantly higher prevalence and risk for incident migraine, according to the results of a study published recently in the Journal of the American Academy of Dermatology. In the study, the prevalence for new onset migraine was 12.1% overall.

“We found an increased risk of new-onset migraine in patients with rosacea compared with the general population, in particular among patients with ocular rosacea,” wrote researchers led by Alexander Egeberg, MD, PhD, from the department of dermatology and allergy at Herlev and Gentofte Hospital, University of Copenhagen. “These data add to the accumulating evidence for a link between rosacea and the central nervous system.”

According to the study, previous research has linked rosacea with other neurologic conditions such as Parkinson disease and multiple sclerosis. To date, research looking at associations between rosacea and migraine has been unclear.

In this study, Egeberg and colleagues evaluated the prevalence and risk of new-onset migraine in patients with rosacea by looking at data from more than 4 million patients taken from nationwide Danish registries. They identified 49,475 patients with rosacea.

The overall population of patients had a baseline prevalence for migraine of 7.3% compared with 12.1% for patients with rosacea. Patients with rosacea had a 31% increased risk for migraine compared with the general population (adjusted hazard ratio [HR]=1.31; 95% CI, 1.23-1.39).

“The basis for the co-occurrence of migraine and rosacea is unknown; however, vascular abnormality is central to the etiopathogenesis of both disorders,” the researchers wrote. “Patients with erythematotelangiectatic rosacea often report episodes with prolonged flushing of affected facial skin, and studies have shown increased tissue expression of vascular endothelial growth factor and vasoactive intestinal growth factor receptors in patients with rosacea.”

Looking at subgroups, the researchers found that 594 patients with phymatous rosacea had no increased risk for migraine (adjusted HR=0.45; 95% CI, 0.11-1.80). In contrast, the 6,977 patients with ocular rosacea had a 69% increased risk for migraine (adjusted HR=1.69; 95% CI, 1.43-1.99).

When the patients were stratified by age, those patients aged 50 or older had the highest risk for migraine (adjusted HR=1.38; 95% CI, 1.24-1.53; P<0.001). Additionally, whereas men had no significantly increased risk for migraine, women had a 24% increased risk (adjusted HR=1.24; 95% CI, 1.17-1.32; P<0.001).

The researchers acknowledged the limitations of their study, including that causality cannot be determined in observational studies. In addition, the design of the study did not distinguish between subtypes of migraine.

“Several triggers for migraine share an overlap with rosacea triggers including stress and alcohol,” the researchers wrote. “Future studies in patients with both rosacea and migraine are required to establish whether these triggers co-occur in the same individual.”

Egeberg A, et al. Prevalence and risk of migraine in patients with rosacea: a population-based cohort study. J Am Acad Dermatol. Epub 2016 Nov 3.