Rosacea is a chronic, inflammatory skin condition with distinct clinical subtypes. Subtype 1 (Erythematotelangiectatic Rosacea, or ETR) is characterized by persistent facial redness, flushing, and visible blood vessels. Subtype 2 (Papulopustular Rosacea, or PPR) includes inflammatory papules and pustules in addition to persistent erythema.

Advances in understanding the pathophysiology of rosacea—including immune dysregulation, neurogenic inflammation, and angiogenesis—have paved the way for targeted, synergistic treatments. This article explores how Enerpeel Mandelic Acid (Enerpeel MA) and the Rosagate Professional range work independently and in harmony to address the multifaceted challenges of subtype 1 and 2 rosacea.

Understanding Rosacea Pathways

Key Pathways in Subtype 1 Rosacea (ETR)

  • Vascular hyperreactivity
  • Neurogenic inflammation via TRPV1 receptors
  • Angiogenesis driven by VEGF
  • Barrier dysfunction and photodamage

Key Pathways in Subtype 2 Rosacea (PPR)

  • Dysregulated innate immunity
  • Overexpression of KLK5 and KLK7 serine proteases
  • Overactivation of cathelicidin LL-37
  • Neutrophilic inflammation
  1. Enerpeel MA: Deep-Targeting Clinical Procedure for Subtype 1

Enerpeel MA composition: (only Mandelic based peel licensed for vascular rosacea)

  • 20% Mandelic acid (surface exfoliation)
  • 20% Mandelate in an Enerpeel carrier (deep dermal delivery)
  • 5% MSM (Methylsulfonylmethane)

Mechanisms of action:

  • Mandelic Acid: Reduces stratum corneum by ~1/3, enhancing barrier and texture.
  • Mandelate: Converted within dermis into mandelic acid, promoting vasoconstriction and vascular stability.
  • MSM: Anti-inflammatory; downregulates IL-1α, TNF-α, VEGF to reduce excessive angiogenesis and redness.

Enerpeel Carrier Technology ensures accurate delivery of actives to skin layers with minimal irritation. Particularly suited for ETR where vascular dysregulation and inflammation are dominant.

2. Rosagate Professional Kit: Multi-Targeted In-Clinic Therapy – adds to control of vascular symptoms but also targets underlying triggers of papulopustular symptoms

Three-step protocol:

  1. PS-R Cleansing Wipe: Gently prepares reactive skin.
  2. Functional Emulsion (RO-Peptide 23, MSM, 4-T-Butylcyclohexanol):
    • Inhibits KLK5/KLK7
    • Normalizes LL-37 Cathelicidin
    • Reduces papule and pustule formation.
    • Targets VEGF over expression
    • Targets Substance P and neurogenic erythema
    • Recues histamine impact of vasodilation and erythema
  3. Invisible Gel Mask: Seals and soothes with leave-on actives which sit within the stratum corneum and are absorbed over time into the living skin.

Clinical Results:

  • Up to 47.7% reduction in erythema (depth, duration and frequency)
  • 59.8% improvement in hydration
  • Benefits last 10 weeks post-treatment with no further application (this is without at home products)
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  • Rosagate Homecare: Daily Defence & Recovery

Rosagate 24hr Cream

  • Actives: Silymarin, MSM, 4-T-Butylcyclohexanol, Polyglutamic Acid
  • Benefits:
    • Reduction in IL-1 alpha, TNF-alpha – targets flushes
    • VEGF inhibition – to continue to reduce excess angiogenesis
    • Skin barrier support – boosts lipid component and promotes recovery of skin barrier and intercellular lipids
    • Hydration film from polyglutamic acid
    • Targets neurogenic inflammatory flushes, burning and stinging

Rosagate SPF 50+ contains Magnolol, MSM, Butylcyclohexanol, Polyglutamic acid

  • In addition to Day and Night Cream (use in conjunction)
  • Protection Spectrum: UVB, UVA, visible light, IR
  • Technology:
    • Synchroblock© prevents zinc filter absorption, ideal for sensitive skin
    • Magnolol: Anti-inflammatory polyphenol synergises with MSM
    • Includes non-absorbed plant-derived (phyto) chemical filters

Rosagate Invisible Gel Mask

  • For clinic & home (3-7 nights/week)
  • Action: Repairs skin, calms burning/stinging, restores hydration and barrier integrity and targets papules and pustules
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Key Ingredient Summary

IngredientAction
RO-Peptide 23Inhibits KLK5/7, normalizes LL-37, reduces neutrophilic inflammation
MSMAntioxidant, inhibits VEGF, TNF-α, IL-1α; improves skin barrier
4-T-ButylcyclohexanolTRPV1 antagonist; reduces neurogenic inflammation
MagnololAnti-inflammatory, photoprotective
Polyglutamic acidRestores skin barrier, restores intercellular lipids, increases external trigger tolerance to flushing triggers.
SilymarinAntioxidant, reduces UV-induced erythema and inflammation

A Synergistic Protocol for Comprehensive Rosacea Control

Therapeutic layers:

  • Enerpeel MA: Clinical intervention for acute vascular/inflammatory triggers (Subtype 1)
  • Rosagate Professional: Immune and neurogenic modulation (Subtype 1 & 2)
  • Rosagate Homecare: Ongoing barrier support, anti-inflammatory maintenance, flare prevention, Papular pustular control, neurogenic symptom relief

Clinical Advantages:

  • Multiphase action: acute, chronic, and post-trigger
  • Enhanced Trigger Tolerance Threshold (TTT)
  • Reduction in flare frequency, intensity, and duration
  • Fortified barrier and improved resilience to UV and environmental stress

Conclusion

Rosacea management requires more than symptom suppression—it needs pathway-specific intervention. The integrated protocol of Enerpeel MA, Rosagate Professional, and Rosagate Homecare represents a scientific, non-invasive, and clinically validated solution to both Subtype 1 and 2 rosacea. Combining anti-inflammatory, barrier-repairing, and flare-reducing actions, it empowers clinicians and patients alike to regain control over this complex condition and restore skin health long term. The two clinical treatments can be delivered separately or within the same session. Enerpeel MA first and then Rosagate Professional