As one of those skin conditions that I am commonly asked about, this is the start of a multiple part blog post on rosacea. I hope it sheds some light on this enigmatic condition, and we’ll be exploring in detail the causes and some treatment options for rosacea. Stay tuned for the next post in this series.
Rosacea is characterized by erythema (redness) of the skin due to inflammation of the capillaries. But, what causes it? Well, as with most skin disorders, there’s no single cause. However, here are some likely culprits:
- Overgrowth of bacteria in small intestine (aka small intestine bacterial overgrowth or SIBO) – How do you know if you have SIBO?
- Test positive for a hydrogen breath test – the antibiotic, rifaximin, was given to rosacea patients testing positive for the hydrogen breath test – over 70% of the patients involved in the study showed complete alleviation of rosacea1. Rosacea patients who did not test positive for the hydrogen breath test showed no improvement in this study by treatment with rifaximin indicating that not all cases of rosacea are attributable to SIBO1.
- Test positive for a methane breath test – the antibiotic, metronidazole, is used to treat rosacea patients testing positive in a methane breath test with greater than 95% of the patients responding to the antibiotic2
- Steroid induced rosacea – triggered by steroids taken for other conditions such as allergies (internally) or topically applied (commonly for seborrheic eczema) – if you experience steroid induced rosacea, you’ll want to talk with your doctor about slowly transitioning off steroids to avoid a flare-up of whatever condition you are using the steroids to control.
- Cathelicidin – an anti-microbial peptide (AMP) present at elevated levels on the skin of rosacea sufferers3 – while cathelicidin is very important to the body, its over-production on the skin is problematic for those with rosacea – Vitamin D upregulates cathelicidin production4. It is possible that Vitamin D’s role in cathelicidin production explains rosacea flare-ups in some patients whose rosacea is triggered by sun exposure and dairy products (since many dairy products are now fortified with Vitamin D).
I feel as though I need to make a quick comment on Vitamin D. I am not a medical doctor, but in my humble opinion, you do not want to try to totally avoid or limit your intake of Vitamin D. There are several new articles showing Vitamin D aids in preventing certain cancers.
At the same time, I wholeheartedly feel as though Vitamin D is one of those compounds that the medical authorities push too much as being good for you. Too much Vitamin D can actually cause calcification of the arteries5 and other interstitial tissues and promotes decalcification of bone when taken in too large a quantity6. So, once again, there’s a fine balancing act on Vitamin D intake (at least in my opinion, again, I’m no doctor, and I have no formal training in clinical medicine, so take my opinion with a grain of salt)6.
1 A. Parodi, et al. Small Intestinal Bacterial Overgrowth in Rosacea: Clinical Effectiveness of Its Eradication. Clinical Gastroenterology and Hepatology. Volume 6, Issue 7 , Pages 759-764, July 2008. http://www.cghjournal.org/article/S1542-3565%2808%2900155-9/abstract
2 Parodi A, Paolino S, Greco A, Drago F, Mansi C, Rebora A, Parodi AU, Savarino V. Small Intestinal Bacterial Overgrowth in Rosacea: Clinical Effectiveness of ItsEradication.Clin Gastroenterol Hepatol. 2008 May 2. & Scientific Programme & EACCME Poster Sessions: Upper GI 12:15 – 01:01 Hall Z. P0584. Oct 21st, 2008. HYDROGEN INSTEAD OF METHANE EXCRETION DURING GLUCOSE BREATH TEST ALLOW US TO PREDICT THE CLINICAL RESPONSE TO ANTIBIOTIC THERAPY WITH RIFAXIMIN IN PATIENTS WITH ROSACEA. A. Parodi, et al. http://uegw08.uegf.org/scienpro/abstract_detail.php?navId=139&ss=1814
3 Gallo, R. Increased serine protease activity and cathelicidin promotes skin inflammation in rosacea. Nature Medicine 13, 975 – 980 (2007). http://www.nature.com/nm/journal/v13/n8/abs/nm1616.html.
4 Gombart, A, et al. Human cathelicidin antimicrobial peptide (CAMP) gene is a direct target of the vitamin D receptor and is strongly up-regulated in myeloid cells by 1,25-dihydroxyvitamin D3. The FASEB Journal. 2005; 19: 1067-1077. http://www.fasebj.org/cgi/content/full/19/9/1067
5 Watson, K, et al. Active serum vitamin D levels are inversely correlated with coronary calcification. Circulation. 1997 Sep 16;96(6):1755-60. http://www.ncbi.nlm.nih.gov/pubmed/9323058
6 http://en.wikipedia.org/wiki/Vitamin_D and http://en.wikipedia.org/wiki/Hypervitaminosis_D#cite_note-20 Yes, I know, Wiki is not a source you want to see here, but these articles provide a comprehensive overview of Vitamin D in a straightforward manner and make you aware of the need to balance this vitamin in your diet. I am not a medical doctor, and the intent of this article is to shed light on rosacea not to articulate my beliefs on Vitamin D supplements.
Talk to your own doctor, shaman, medical advisor, best friend(s), applicable family members (the ones you like and who like you), and/or holistic healer AND research Vitamin D’s effects on the body for yourself before making any decisions regarding Vitamin D in your diet.