Plant Adaptogens for Rosacea: Augmenting Prescription Therapy With Skin Care

Zoe Diana Draelos, MD, FAAD, a research and clinical dermatologist at Dermatology Consulting Services in High Point, North Carolina, a clinical faculty member in the department of dermatology at Duke University School of Medicine in Durham, and Dermatology Times editor in chief emeritus, recently co-authored a multicenter trial evaluating a plant adaptogen serum in patients with mild to moderate centrofacial erythema associated with rosacea.¹ In an interview, she explained the mechanisms behind adaptogens and why they may enhance outcomes for patients already on prescription rosacea treatment.

What Plant Adaptogens Are and How They Work

Adaptogens are botanical materials derived from plants growing in high-UV environments; they have evolved to protect themselves from oxidative damage. In the skin, they work by scavenging oxygen radicals produced by UV radiation, pollution, cigarette smoke, poor sleep, and metabolic stress. Draelos described the product studied as using PATH (Plant Adaptogens Targeting Homeostasis) technology, a formulation approach designed to select complementary botanicals supporting the organism's ability to resist oxidative insults.

"Homeostasis means the organism is in equilibrium or balance, and it's able to sustain oxidative insults from ultraviolet radiation, cigarette smoke, pollution, poor sleep, metabolic challenges," Draelos said. "The PATH technology is a way of selecting complementary botanical materials designed to improve the ability of the organism to sustain oxidative insults—basically result in inflammation."

She noted inflammation is the final common pathway for aging, a process she referred to as "inflamaging," and described PATH adaptogens as specifically targeting this mechanism.

Augmenting Prescription Therapy Through Barrier Repair and Inflammation Reduction

The trial enrolled 2 groups: patients managing rosacea with OTC products alone and patients already using prescription therapy with breakthrough erythema. Both groups demonstrated decreased redness with the addition of the adaptogen serum. Draelos explained the mechanism operates on 2 levels: barrier function and antioxidant activity.

"What the plant material can do is augment inflammation by attacking oxygen radicals, so while we use anti-inflammatory antibiotics in rosacea, we can couple those with skincare products," Draelos said. "The skin care product improves barrier function, reducing inflammation, and then the antioxidant capabilities of botanicals within the moisturizing vehicle can further reduce inflammation."

She noted prescription rosacea products, including topical metronidazole and tetracycline derivatives, are themselves anti-inflammatory but are typically penetration-enhanced for drug delivery, meaning they do not support barrier repair. Pairing them with a moisturizing skincare product can create an artificial barrier while active ingredients promote barrier regeneration.

The Role of Skin Care in a Complete Rosacea Regimen

Draelos framed the study findings in terms of a practical clinical message for dermatologists.

"Prescription therapy is highly complementary to over-the-counter skin care," she said. "Optimal treatment involves everything: cleansers, moisturizers, sunscreens, and then prescription therapy."

She emphasized dermatologists should consider both prescription and skincare recommendations simultaneously, rather than treating them as separate decisions.

Reference

1. Draelos ZD, Watchmaker J, Nelson DB. A multicenter trial evaluating the safety and efficacy of a serum containing plant adaptogens in patients with mild-to-moderate, persistent centrofacial erythema associated with rosacea. J Clin Aesthet Dermatol. 2026;19(3):32-37