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June 20, 2018  |  Login
by James F. Balch, M.D. and Mark Stengler, N.D.

Rosacea is an inflammatory skin disorder in which the nose, the cheeks, the forehead, or the chin are chronically reddened and prone to breaking out in acne-like welts. Unlike acne, however, rosacea never produces blackheads or whiteheads, and it rarely appears during adolescence. Instead, rosacea generally sets in during a person's thirties or forties, beginning with a mild pink blush that doesn't go away. If treated early, the condition may never progress any further or may even recede a bit. But in advanced cases, it can cause permanent thickening and redness, especially on the nose. Although women are more likely to have rosacea than men are, men who do have rosacea tend to have more severe cases.

Anything that dilates blood vessels in the face can lead to a flare-up of rosacea. Specific triggers differ from person to person, but the most common are alcohol, hot liquids, coffee, spicy or fatty foods, extreme temperatures, sun exposure, harsh wind, and stress. It's important to minimize the exposure to triggers, because each time the blood vessels expand, they lose some elasticity. Over time, they become incapable of constricting properly and they remain in a dilated state-hence the redness. A person who already has the early flushing of rosacea will find that triggers make his or her face even redder, or that they lead to pimples that may or may not disappear when the trigger is removed.

Although we understand the elements that make rosacea worse, there is no one underlying cause of this. Skin conditions generally point to some kind of digestive problem, and rosacea is no exception. Many rosacea sufferers have been found to have low levels of stomach acid, which prevents proper digestion of trace minerals and possibly the overgrowth of bacteria that aggravates the skin. Sluggish bowels and constipation may have a similar effect on digestion. And whenever pimples or red spots appear, it's likely that the skin is pushing out toxins that an impaired digestive tract is unable to process.

Leaky gut syndrome, which is characterized by malabsorption, may be an issue for people with rosacea. Also, B-vitamin deficiencies, especially of B12, are common with this condition. Friendly flora that are involved with detoxification and that prevent the overgrowth of infectious bacteria are often depleted. We have also found that rosacea becomes a problem as the result of a hormone imbalance. Premenopausal and menopausal woman often find that rosacea starts to act up until they get their hormones balanced with natural therapies. On the other hand, synthetic hormone replacements and birth control pill use initiate or worsen this condition for some women. Finally, hidden food allergies may cause flushing that is mistaken for rosacea.

Conventional treatment for rosacea involves antibiotics, either oral or topical, which have a minimal effect and which must be taken continuously. While people with severe cases that may lead to disfigurement might want to consider medication, most people will be better off making an effort to avoid their personal triggers and improve their digestion.

Next: What are the Symptoms of Rosacea

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