Learn commonly overlooked root causes of rosacea and a get a holistic plan to overcome it naturally!
Note from Dena: This guest post was co-written with Sarah Fennewald, Dietetic Intern, as part of a research partnership between Back To The Book Nutrition and post-graduate nutrition students from the University of Houston.
Most people associate rosacea with redness or acne on the face, but its sufferers know it’s much more than that. Rosacea affects 16 million Americans and is linked to poor gut health, allergies, asthma, hormone imbalance, dementia, anxiety, and depression. (1-3, 9, 10)
Traditional dermatologists recommend topical creams, oral antibiotics, and medications to help manage skin related symptoms, but underlying causes of rosacea often aren’t addressed. Sadly, most individuals with rosacea are told this is something that they must live with forever.
Thankfully, that’s not necessarily true!
A holistic approach to rosacea can help sufferers identify and overcome the deeper root health issues, alleviating symptoms from the inside out, reducing risk for associated conditions, and dramatically improving quality of life!
Rosacea Subtypes and Symptoms
First, some background on Rosacea. Rosacea is a chronic inflammatory skin condition that causes intermittent redness on the checks, chin, nose, or forehead. There are 4 subtypes. Subtype 1 is most common, but an individual may have more than one subtype at the same time or it may evolve from one subtype to another over time.
- Subtype 1- Erythematotelangiectatic Rosacea: flushing, persistent redness, and visible blood vessels (“spider veins”)
- Subtype 2- Papulopustular Rosacea (previously called acne rosacea): persistent redness, bumps and pimples that may come and go
- Subtype 3- Phymatous Rosacea: skin thickening, enlargement of the nose
- Subtype 4- Ocular Rosacea: effects the eyes including dry eye, tearing and burning, swollen eyelids, and potential loss of vision
In addition to the subtype-specific symptoms listed above, rosacea always includes at least one of the following primary symptoms. (3,4)
Most Common Rosacea Symptoms
- Persistent Redness
- Bumps and Pimples
- Visible Blood Vessels (“spider veins”)
What Really Causes Rosacea?
According to the traditional medical community, the cause of rosacea is unknown and there is no cure for the condition. In contrast, functional/holistic practitioners take the skin symptoms into account, but also use them as signals to uncover deeper issues going on beneath the surface.
As with most health conditions, there are multiple underlying factors in rosacea rather than just one cause. Here are some of the most common ones, according to the latest research.
Poor Gut Health
Nearly half of patients with rosacea also have Small Intestinal Bacterial Overgrowth (SIBO), and 90% of rosacea patients experience significant or complete resolution of their symptoms once their SIBO is treated. (7)
Rosacea is clearly an inflammatory condition. And when the skin appears inflamed, it is often a sign that there is inflammation elsewhere in the body (6). It’s important to determine the source of the inflammation – whether stress, poor gut health, excess body fat, illness, autoimmunity, nutrient deficiencies, or a combination of these and other factors.
Impaired Nerve Function
Rosacea patients have higher levels of Substance P, a neurotransmitter and potent vasodilator produced in the gut, brain, and skin. Altered gut microbiota increase substance P production in both the gut and the skin, which may explain why Substance P levels rise during a rosacea flare. Again, this points back to the role of gut health in rosacea. (5,8)
While the skin issues may not be a root cause of rosacea, certain environmental factors can exacerbate symptoms for already-damaged skin.
- Spicy of hot foods and drinks
- Sun and wind exposure
- Conventional make up and skin care products
How to Overcome Rosacea Naturally
Fix your gut
We’ve already established a clear link between rosacea and gut health, so it goes without saying that identifying and addressing SIBO or other gut overgrowths, infections, or pathogens, is a top priority.
I’ve helped a number of clients identify and overcome SIBO and other gut issues with comprehensive stool testing along with natural supplements and personalized diet recommendations through my Holistic Nutrition Coaching services, and I’d love to help you too!
In addition to improving gut health, here are some excellent ways to reduce inflammation in the body:
- Manage stress – remember both negative and positive “stressors” can elicit a stress response from the body
- Improve sleep to maximize rest and repair functions, and soothe inflammation.
- Exercise…but not too much! Over exercising can actually increase inflammation rather than reduce it.
- Eat a colorful, plant-rich diet with plenty of anti-inflammatory omega-3 fatty acids from wild caught seafood and pastured raised meats. Minimize added sugars and processed foods, especially those with processed oils (canola, safflower, etc.)
- Laugh, play, and pray more!
Remove Skin Triggers
If you have rosacea, it’s important to minimize exposure to your personal skin triggers. Triggers are different for each individual so keep a daily symptom diary to determine what yours are, then avoid those foods or activities.
Switching over to natural make up and skin care products is also a great idea. Here are some of my favorite natural skin and body products!
Approach Medications Cautiously
I’m certainly not anti-medication, but it’s a good goal to save them for when they’re truly needed and will help the most. I’d urge you to ask some questions before taking medications.
- Will this medication address root causes or just help manage symptoms?
- How long will I need the medication?
- What are the side effects?
- What are the long term impacts of this medication on my gut and other areas of my health?
- Are there more natural alternatives to this medication?
- Are there diet and lifestyle measures I should try first?
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About the co-author: Sarah Fennewald completed her B.S. in Dietetics at Fontbonne University in St. Louis, Missouri and co-wrote this post as a Dietetic Intern at the University of Houston. Sarah’s goal is to use her nutrition knowledge to empower individuals to make real life changes that will improve their quality of life.
Disclaimer: Information on this site is intended only for informational purposes and is not a substitute for medical advice. Always consult with a trusted healthcare provider before implementing significant dietary change. Read additional disclaimer info here.
- Egeberg, A., Hansen, P. R., Gislason, G. H., & Thyssen, J. P. (2016). Patients with rosacea have increased risk of depression and anxiety disorders: a Danish nationwide cohort study. Dermatology, 232(2), 208-
- Rainer, Barbara M. et al. (2015). Rosacea is associated with chronic systemic diseases in a skin severity–dependent manner: Results of a case-control study. Journal of the American Academy of Dermatology , 73(4), 604 – 608.
- National Rosacea Society. (2017). All about rosacea. Retrieved from https://www.rosacea.org/patients/allaboutrosacea.php
- National Rosacea Society. (2017). Acne or rosacea? A cause of mistaken identity. Retrieved from https://www.rosacea.org/weblog/acne-or-rosacea-case-mistaken-identity
- Woo, Y. R., Lim, J. H., Cho, D. H., & Park, H. J. (2016). Rosacea: molecular mechanisms and management of a chronic cutaneous inflammatory condition. International Journal of Molecular Sciences, 17(9), 1562.
- Melnik, B. C. (2014). Endoplasmic reticulum stress: key promoter of rosacea pathogenesis. Experimental dermatology, 23(12), 868-873.
- Parodi, A., Paolino, S., Greco, A., Drago, F., Mansi, C., Rebora, A., … & Savarino, V. (2008). Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication. Clinical Gastroenterology and Hepatology, 6(7), 759-764.
- Kresser, C. (2012). The gut-skin connection: How altered gut function affects the skin. Retrieved from https://chriskresser.com/the-gut-skin-connection-how-altered-gut-function-affects-the-skin/
- Egeberg, A., Hansen, P. R., Gislason, G. H., & Thyssen, J. P. (2016). Exploring the association between rosacea and Parkinson disease: a Danish nationwide cohort study. JAMA neurology, 73(5), 529-534.
- Egeberg, A., Hansen, P. R., Gislason, G. H., & Thyssen, J. P. (2016). Patients with rosacea have increased risk of dementia. Annals of neurology, 79(6), 921-928.