Supplementary Material for: Plant Extracts in Rosacea Management-a narrative review

ABSTRACT
Rosacea is a prevalent, chronic inflammatory skin disorder increasingly affecting middle-aged individuals worldwide. Characterized by facial erythema, flushing, papules, pustules, and telangiectasia, rosacea arises from complex, dysregulated immune responses with chronic inflammation and vascular instability. Given its multifactorial nature, treatment approaches focus on managing symptoms and often require a multidisciplinary strategy that integrates targeted skincare, topical and systemic therapies, and physical modalities to address the condition’s diverse clinical manifestations, subtypes, and severity effectively. Validated conventional treatments, like metronidazole and azelaic acid, offer symptom relief to varying extents; however, many patients find these therapies insufficient, leading to a growing interest in alternative therapies. Dermocosmetic products containing natural ingredients, particularly botanicals, are gaining in popularity, driven not only by their reported anti-inflammatory properties and perceived favorable tolerability, but also because they often appear to align with the personal values and beliefs of many individuals, and offer a more holistic approach to care. Emerging clinical evidence suggests that plant-based ingredients may help alleviate rosacea symptoms by modulating inflammation, regulating keratinization, and supporting vascular health, thereby promoting skin restoration, vessel stability, and reduced sensitivity. This review provides an up-to-date summary of advancements in the use of botanical ingredients for the management of rosacea. By exploring both well-studied botanicals and emerging plant extracts, this review highlights the growing role of natural adjunctive treatments in rosacea care.