Rosacea is a chronic inflammatory skin condition characterized by facial redness, flushing, and the presence of small pimples. While there can be many causes for Rosacea, a large body of clinical research shows a surprising link with the gut. This condition actually starts in the gut and for some people with Rosacea is known as Small Intestinal Bacterial Overgrowth or SIBO for short.(*)
If you are like many people with rosacea, you have tried Metronidazole, Diflucan, various topical antibiotics, medicated gels and creams applied to the face, yet these stubborn red pimples and redness, refuse to go away.
If this has been your experience, It might be time to dig a bit deeper. Rosacea linked to the health of your gut??, sounds intriguing right? Well keep reading. Small Intestine Bacterial Overgrowth (SIBO) is a condition characterized by an abnormal increase in the number and/or types of bacteria in the small intestine. Normally, the small intestine contains a very small population of bacteria, as the majority of the gut’s microbes live in the large intestine. However, in SIBO, bacteria from the large intestine migrate upwards into the small intestine and proliferate. Once they find their way into the small intestines, these bacteria can cause all kinds of digestive symptoms as well as skin problem like Rosacea.
Understanding Bacterial Overgrowth and its Link to Rosacea:
bacterial overgrowth or gut dysbiosis, refers to an imbalance in the community of microorganisms residing in our digestive tract. These microbes, including bacteria, viruses, fungi, and other organisms, play a vital role in our overall health and well-being. When the delicate balance of our gut microbiota is disrupted, it can lead to inflammation, immune dysfunction, and other health issues, including rosacea.
1.Antibiotic use: Gut dysbiosis can occur from many things and if you have Rosacea, you may have noticed that it started shortly after antibiotics taking antibiotics. Antibiotics disrupt the natural balance of bacteria in the gut, as these medications can kill off both harmful and beneficial bacteria.
2. Poor diet: another common cause of gut dysbiosis leading to Rosacea is a poor diet. A diet high in processed foods, sugar, gluten, Corn, soy, dairy, high protein, high fat, low fiber diet can contribute to an imbalance in the gut microbiota. This can lead to overgrowth of certain harmful bacteria and a decrease in beneficial bacteria.
3. Chronic stress: Did your Rosacea start up after a bout of high stress? Many of my patients, have reported that after a stressful event, they began to experience digestive problems, and a few months later, they began to experience all kinds of skin issues including rosacea. High levels of stress cause an elevation of a hormone known as Cortisol. Cortisol impacts every aspect of digestion. Cortisol impact the gut-brain axis, it alters the composition of the gut microbiota. Cortisol has been shown to alter the kinds of bacteria that make up the microbiome, high cortisol decreases the flow of oxygen and blood to the stomach. Stress-Cortisol-GutHealth-unhealthy skin is an important connection.
4. Infections: Within our gut we have specialized immune system cells that help protect us from infection. These immune system cells (B-cells) produce something called Secretory IgA. When Secretory IgA levels are depressed, opportunistic pathogens such as bacterial, viral, or parasitic infections of the gastrointestinal tract, can disrupt the balance of the gut microbiota and lead to dysbiosis, this in turn can snowball into Rosacea.
5. Environmental factors: Exposure to environmental toxins, pollutants, bacterial LPS toxins (*), and chemicals can negatively affect the gut microbiota and contribute to dysbiosis.
6. Aging: If we never gave much thought to supporting our gut health in our youth, as we age, we can eventually expect to see a loss of gut diversity and stability of the gut microbiome. When this diversity is affected long enough, the end result can lead to overgrowth of bacteria in the small intestines and eventually Rosacea.
These factors, either individually or in combination, can contribute to an imbalance in the gut microbiota, leading to intestinal dysbiosis. If you suffer with Rosacea or any other problem with your skin, looking into problems related to the gut may be the answer for your skin condition. If you do have problems in the gut, then it is important to address these underlying causes and promote a healthy gut environment to restore microbial balance and improve overall health.
The Gut-Skin Axis:
The concept of the gut-skin axis highlights the bidirectional relationship between gut health and skin health. The gut serves as a barrier between the outside world and our internal systems, and disruptions in gut function can have repercussions on the skin. In the case of rosacea, gut dysbiosis can trigger systemic inflammation, leading to skin inflammation and the appearance of rosacea symptoms.
Bacterial Overgrowth and Rosacea:
Gut health can not be overstated when it comes to Rosacea. Bacterial overgrowth refers to an excessive proliferation of specific bacterial species in the gut. This overgrowth can disrupt the delicate balance of the gut microbiota and contribute to gut dysbiosis. Studies have shown that individuals with rosacea may have elevated levels of certain bacteria. While various types of bacteria can be involved in SIBO, the following are commonly associated with the condition:
1. Escherichia coli: Certain strains of Escherichia coli, a common bacterium found in the gut, have been found to overgrow in the small intestine of individuals with SIBO.
2. Streptococcus species: Several species of Streptococcus, such as Streptococcus pneumoniae and Streptococcus viridans, have been detected in individuals with SIBO.
3. Klebsiella pneumoniae: This bacterium is normally found in the large intestine but can proliferate in the small intestine in the case of SIBO.
4. Enterococcus species: Various species of Enterococcus, including Enterococcus faecalis and Enterococcus faecium, can contribute to SIBO.
5. Staphylococcus species: Staphylococcus aureus and other Staphylococcus species have been found to overgrow in the small intestine of individuals with SIBO.
6. Helicobacter pylori- These bacteria produce substances that can trigger inflammation and contribute to the development or worsening of rosacea symptoms.
Inflammation and Rosacea:
Chronic inflammation is a hallmark of rosacea. The disturbed gut microbiota resulting from gut dysbiosis and bacterial overgrowth can stimulate the release of pro-inflammatory molecules in the gut. These molecules can travel throughout the body, including the skin, contributing to local inflammation, redness, flushing, and the presence of small pimples
What You Should Remember About this article
While the relationship between gut health and rosacea is complex and requires further research, it is clear that gut dysbiosis and small intestinal bacterial overgrowth can influence the severity of this skin condition. By promoting gut healing through strategies such as probiotics, prebiotics, anti-inflammatory diets, and stress management, individuals with rosacea may experience a reduction in symptoms and an improvement in overall well-being. As always, it is essential to consult with a healthcare professional for personalized advice tailored to your specific needs. If you suspect you have SIBO or want to assess your risk, take the SIBO Quiz here