Is Rosacea Connected to Your Gut Health?

While it may not seem like your skin would have a relationship with your digestive system, we know now that what goes on in the gut is often reflected in the skin. (1)

Those with bacterial overgrowth in the small intestine are more likely to have rosacea.

A reader of the Body Ecology newsletter recently responded to a Body Ecology article about small intestinal bacterial overgrowth (SIBO)—her question was about rosacea.

Denise M. asks:

Hello, I was just diagnosed with Rosacea (skin disorder with papules and redness on my nose and cheeks with some broken blood vessels). I am 54. In my research it says not to use any fermented products if you have this condition. Thoughts? I eat 75% raw, some cooked vegetables, little to no meat, no packaged or processed foods, no dairy, nuts and seeds. I am allergic to coconut. What can you recommend? 

The Rosacea-Gut Connection

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Those with small intestinal bacterial overgrowth are more likely to have rosacea. Researchers discovered that skin inflammation associated with rosacea has been linked with gut inflammation.

The gastrointestinal tract is surrounded by lymph tissue, where we find roughly 70–80% of the immune system. The latest research on skin disorders, including rosacea, tells us that the skin has its own ecosystem. Like the gut, the skin is populated by microbes that directly interact with the body’s immune system. (2)

It may come as no surprise, then, to learn that those with bacterial overgrowth in the small intestine are more likely to have rosacea.

In fact, in 2004 researchers at the University of Warwick found that increasing the gut transit time (or how fast food moves through the digestive tract) of one patient led to a complete remission of symptoms associated with rosacea. (3) This tells us that SIBO—when food stagnates and makes the gut leaky and inflamed—is linked to skin that is inflamed.

Researchers at the University of California, San Diego, explain that we influence the skin’s ecosystem with:

  • Lifestyle
  • Emotions
  • Community
  • Diet
  • Drugs, like antibiotics and steroids

Dysbiosis—or a wounded ecosystem—can lead to skin disorders. When the body is unable to restore balance to this ecosystem, we see chronic issues like rosacea.

The Value of Starter Cultures

The scientific literature on rosacea shows that it is often found in those who have been diagnosed with SIBO. This suggests that rosacea might have something to do with an imbalance in the gut—especially when rosacea clears up as SIBO is addressed. (4)

Fermented foods are packed full of nutrients. But when it comes to SIBO, we want to look at two qualities:

  1. Fermented foods are raw and full of enzymes.
  2. Fermented foods carry good microbes into the digestive tract.

An overgrowth of bacteria in the small intestine tells us that food, microbes, or both are not moving through the small intestine. (5)

Once food exits the stomach, the body continues to digest food in the small intestine. But if the small intestine is missing the correct enzymes to break down food, or if it is already overgrown with microbes, we see this activity slow down. The result is small intestinal bacterial overgrowth, which can be detected with a breath test.

Some healthcare practitioners may suggest that those with rosacea avoid fermented foods under the misguided notion that fermented foods encourage bacterial overgrowth. 

The reality is that all fermented foods contain probiotics, or microbes that are beneficial to our health. These probiotics naturally:

  • Fight infection
  • Address leaky gut
  • Control bacterial overgrowth

However, fermented foods that are wild ferments may have some pathogenic or opportunistic strains of microbes that are not good for our health. These microbes may make SIBO worse.

For those of us who are healthy, wild ferments pose no risk. Yet for those of us who struggle with a health disorder like SIBO, the body may not be able to handle the burden that wild fermented foods place on the immune system. This is when a starter culture is necessary.

Fermented foods made with a starter culture are therapeutic because they are cultured with specific probiotic strains known to support gut health.

When you use a starter culture to make fermented foods, you get all the benefits of probiotics—without the negative response that may be associated with wild ferments.

What To Remember Most About This Article:

The health of your skin is directly related to the health of your gut. If you have been diagnosed with a skin disorder like rosacea, your doctor may have told you to avoid fermented foods to alleviate symptoms of inflammation. This could not be further from the truth.

Researchers have discovered that small intestinal bacterial overgrowth (SIBO) increases the likelihood of developing rosacea. In short, when the gut is leaky and inflamed, skin is also inflamed. The delicate ecosystem of the skin is influenced by lifestyle, emotions, community, diet, and medication. A wounded inner ecosystem in the gut can further affect the ecosystem of the skin and overall skin health.

If the small intestine is missing essential enzymes to break down food, small intestinal bacterial overgrowth may occur. Fermented foods can be used to restore skin and gut health with probiotics that fight infection, calm leaky gut, and control bacterial overgrowth.

Rosacea sufferers will do best to use a starter culture when fermenting. A starter culture will provide safe, friendly probiotics in fermented food form, compared to a wild ferment that could contain pathogenic microbes to make SIBO (and rosacea) worse.

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  1. Bowe, W. P., Patel, N. B., & Logan, A. C. (2013). Acne vulgaris, probiotics and the gut-brain-skin axis: from anecdote to translational medicine. Beneficial microbes, 1-15.
  2. Schommer, N. N., & Gallo, R. L. (2013). Structure and function of the human skin microbiome. Trends in microbiology, 21(12), 660-668.
  3. Kendall, S. N. (2004). Remission of rosacea induced by reduction of gut transit time. Clinical and experimental dermatology, 29(3), 297-299.
  4. 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.
  5. Sachdev, A. H., & Pimentel, M. (2013). Gastrointestinal bacterial overgrowth: pathogenesis and clinical significance. Therapeutic advances in chronic disease, 4(5), 223-231.
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