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Treat Rosacea with a Focus on Gut Health and Nutrition
written by Keri Berardinelli, Holistic Nutritionist, Licensed Aesthetician and Detox Therapist
April 23, 2020
Rosacea is a skin condition that is treated medically, as well as, aesthetically, in many medical offices, spas and beauty salons alike. Estheticians will approach this condition with topical preparations only, as there have been many skin care lines dedicated to the Rosacea skin condition, all promoting soothing and healing actives on the skin’s surface in the form of professional in-spa treatments and home-care products. This type of approach, within the beauty industry, is rarely effective for the long-term. This is because the condition runs much deeper than a sole, topical skin issue, as its origin stems from a systemic imbalance that requires attention to the body as a whole, rather than just to its parts. It’s been stated that all disease starts in the gut and now science recognizes the gut’s role in the manifestation of skin disorders, such as Rosacea.
What is Rosacea?
What exactly is Rosacea? Rosacea is a skin condition that typically manifests in Caucasian skin types that is initially characterized by flushing of the skin. The skin’s flushing eventually advances to a constant state of erythema (reddening), skin dehydration, with skin barrier breakdown, telangiectasia (distention of the skin’s capillaries causing threadlike, red lines often situated on the cheeks and chin), along with the presence of papules and pustules. Currently, standard medical treatment for Rosacea is the prescription of anti-inflammatory antibiotics, prescription topical creams, laser treatments, and in extreme cases, surgery. Although the use of antibiotics may show benefit for the short term, there are issues in relying on antibiotic treatment for the long-term, as antibiotics further disrupt the gut’s delicate microbiome, creating a cycle of flare-ups. Antibiotics have also been associated with bacterial resistance, in which case, the antibiotic proves to be ineffective and the use of stronger antibiotics are then resorted to, which can potentially create a lot of havoc and irritation within the gastrointestinal tract. These short-comings in standard care have led scientists to investigate the true nature of the disorder with much of the studies leaning towards the role of gut function and balance.
Rosacea and Gut Disorders
Studies show that Rosacea patients tend to have gastrointestinal dysfunctions such as: IBD (Irritable Bowel Disease), IBS (Irritable Bowel Syndrome) and/or constipation. “Epidemiologic studies suggest that patients with Rosacea have a higher prevalence of gastrointestinal disease”. “One epidemiologic study reported the improvement of Rosacea following successful treatment of SIBO”, or “Small Intestinal Bacterial Overgrowth” , a bacterial infestation of the small intestine where microbes that are typically found in the colon are colonizing in the proximal portion of the small intestine, creating many gastrointestinal symptoms, like that of IBS symptoms, such as gas, bloating, abdominal distention and pain. In addition, SIBO has been linked to decreased gut motility, which will ultimately result in a challenge with bowel elimination, a condition that will only exacerbate any skin condition. The question lies, “what does the skin and gut have in common and how are they connected?
The Gut/Skin Axis
Both the skin and the gut are largely vascularized and innervated organs that communicate via the central nervous system. Additionally, both organs are colonized by a great number of microbes that have the ability to communicate with our inside and outside environments. “Though not fully explored, the mechanisms by which the intestinal microbiota exert their influence on skin homeostasis appear to be related to the modulatory effect of gut commensals on systemic immunity”. ; e.g.: the microbes on the skin’s surface, are able to modulate the gut’s function due to the manufacturing of Vitamin D3, via sunlight exposure, interacting with the skin’s stored cholesterol for absorption; hence, the skin affects the gut and the gut affects the skin. These complexities that connect the skin with the gut, and vice versa, science is now terming as “the gut-skin axis”. Although not fully and broadly recognized, it is a field that is gaining further interest and study.
Dietary intervention plans that display promising results for the Rosacea skin condition is the Mediterranean Diet. The Mediterranean Diet is a dietary plan that is high in whole foods such as fruits, vegetables and whole grains, with moderate amounts of fish and poultry. Olive oil is used abundantly. The Mediterranean Diet is known as the anti-inflammatory diet and is naturally high in fiber, promoting the release of anti-inflammatory cytokines, via the microbiome, and increasing gut motility [by increasing fiber via the diet] to increase gut transit time, improving bowel elimination.
Dietary intervention through the use of supplements has also been studied for effectiveness. A study on omega-3 fatty acids showed marked improvement taking 325 mg of EPA and 175 mg of DHA for a duration of 90 days . Supplementation with probiotics is another avenue of promising exploration, as there was a study highlighting the bacterial strain, Lactobacillus Paracasei, a strain that, when taken for a minimum of two months, decreased skin sensitivity and reduced TEWL (Trans-epidermal Water Loss), strengthening the skin’s outer barrier and immune response. .
In conclusion, Rosacea is a skin condition that reflects a systemic imbalance of the body that includes the gastrointestinal tract and the gut’s microbiome. Supporting this connection through effective dietary intervention shows significant improvement to this condition, without the use, or misuse, of antibiotics or other drugs. Rosacea can be a debilitating skin disease, in which it has a great impact on one’s confidence level and just like acne, Rosacea can be detrimental mentally and physically. Having the power to put the disease into remission, via lifestyle modifications, proves to be empowering and inspirational to the support of organic living.
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1. Emma Weiss, Rajani Katta “Diet and Rosacea: the role of dietary change in the management of rosacea”; Dermatology Practical & Conceptual: October 2017 (31-37); doi:10.5826/dpc.0704a08
2. Catherine A. O’Neil, Giovanni Monteleone, John T. McLaughlin “The Gut-Skin Axis in Health and Disease: A paradigm with therapeutic implications: August 2016; doi.org/10.1002/
3. Iman Salem, Amy Ramser, Nancy Isham, Mahmoud A. Ghannoum “The Gut Microbiome as a Major Regulator of the Gut-Skin Axis” Frontiers in Microbiology; July 2018; doi: 10.3389/fmicb.2018.01459