Rosacea is the most misdiagnosed skin condition. We see so many clients that have been given treatment, advice, and products that are not indicated and have in fact worsened their condition. At HUSK Naturopathy we refer to GPs that specialise in skin conditions, and we refer for specialised pathology testing so our treatments are targeted, individualised and make a difference. We also work exclusively with Corneotherapists, who are experts in skin analysis, and who use only the most therapeutic, effective and bespoke skin products.
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The following blog is written by Ijlal, during Rosacea Awareness Month, 2022.
Rosacea is a chronic inflammatory, non-contagious skin condition. The condition primarily affects the central focus of the face (cheeks, nose and in some cases the eyes). Often described as a “permanent flush”, it may also present with other known symptoms such as,
Rosacea can also be classified into four sub-types:
Subtype 1: Erythematotelangiectatic rosacea (sensitivity, redness, flushing)
Subtype 2: Papulopustular rosacea (red papules, pus-filled pimples, alongside facial redness)
Subtype 3: Phymatous rosacea (skin thickening, bumpy on nose)
Subtype 4: Ocular rosacea (eye &/or eyelid inflammation, sometimes no skin symptoms are noticeable)
It is important to note that symptoms can fluctuate depending on the individual and the listed subtypes are just a guide to support treatment.
Due to the physical and visual nature of rosacea, sufferers can experience frustration, embarrassment and low self-esteem. Husk Naturopathy prioritises finding the root cause and an individualised approach to each client. With thorough treatment, patients can have improvements in symptoms and management of rosacea.
Rosacea is a multifactorial skin condition, and the exact causation remains unknown. Research has highlighted certain factors possibly contributing to rosacea.
Diet and Food Sensitivities
Some foods and drinks may exacerbate rosacea. These may include, spicy food, aged food high in histamine (e.g. processed meats, wine, aged cheese), alcohol, cinnamaldehyde containing foods (e.g. cinnamon, citrus, chocolate, tomatoes). These foods are known to increase vasodilation, which may aggravate rosacea symptoms.
Impaired Digestive Health
The role of the gut microbiome is considered a significant factor in skin health. Gut microbiota plays a role in regulating inflammatory responses in the body, therefore intestinal dysbiosis can activate neurogenic inflammation resulting in skin inflammation. Studies suggest specific microbiome alterations (dysbiotic strains in microbiota) have a link with rosacea patients and rosacea progression. Rosacea patients may experience gut-associated conditions, such as h.pylori infection, small intestinal bacterial overgrowth [SIBO], Crohn’s disease, celiac disease, ulcerative colitis, gastritis and gastroesophageal reflux disease [GERD]. The connection between digestive conditions suggests a strong correlation between the gut microbiome and rosacea.
Skin Microbiome
The gut microbiota has shown ability to impact skin function and health, via immune system modulation (regulating inflammation) and/or the intestinal barrier. Studies have shown that chemicals can be released via gut bacteria, entering the bloodstream and reaching the skin. One study found that free phenol and p-cresol chemicals can enter the bloodstream and contribute to skin symptoms. Rosacea patients are believed to have an over-growth of skin microorganisms called Demodex folliculorum, contributing to skin hypersensitivity.
Intestinal Permeability
Studies have demonstrated the link between skin conditions and intestinal permeability. The gastrointestinal epithelium works as a protection against external pathogens from entering the blood stream via the gut microbiota and the gastrointestinal lining as physical barriers. Intestinal permeability can contribute to pathogens and other substances entering the bloodstream, leading to inflammation which can reach the skin.
Some other factors may include:
Inaccurately, there can be the common misconception that darker skin tones do not present with rosacea. Misdiagnosis, lack of awareness and underreporting of rosacea in skin of colour are barriers to accurate management and effective treatments. A lack of education, information and research into the way rosacea presents in darker skin tones is also hindering accurate diagnosis and support.
How rosacea may present in skin of colour,
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AUSCFM. (2020). A Concise Guide to Rosacea: A Functional Medicine Approach. Functional Medicine.
Black Skin Directory. (2020). Rosacea in Skin of Colour.
Cooper, J. (2019). Natural Rosacea Treatment. Advanced Functional Medicine: A Revolution in Healthcare.
Easthope, A. (2022). A Functional Medicine Approach to Rosacea. Rupa Health.
Miyazaki K, Masuoka N, Kano M, Iizuka R. (2014). Bifidobacterium fermented milk and galacto-oligosaccharides lead to improved skin health by decreasing phenols production by gut microbiota. Beneficial Microbes, 1;5(2), 121-128. doi: 10.3920/BM2012.0066
Reynolds, S. (2018). Natural Medicine Approaches for Rosacea. Fx Medicine.
Sarkar, R. (2020). Rosacea in skin of colour: A comprehensive review. Indian Journal of Dermatology, Venereology and Leprology (IJDVL), 86(6), 611-621. doi: 10.4103/ijdvl.IJDVL_769_19.
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