How to calm Rosacea from the inside out

A woman is touching her face with her hands.

It seems totally unfair that during adulthood you can develop redness and pustules on the face. Rosacea can really undermine someone’s self confidence and it is a skin condition that can cause a significant amount of embarrassment, anxiety and depression. When it comes to dealing with a skin condition like Rosacea, most people immediately think of applying topical treatments and hope for the best. However, if the condition doesn’t improve or gets worse, it may be time to consider addressing it from within and look at your gut health and your nutrition.

Rosacea is a chronic inflammatory skin condition that primarily affects the cheeks and the nose, but you can also get it on the forehead and eyes. It can cause redness, flushing, visible blood vessels and thickening of the skin. In many cases, small bumps and pustules appear in the area of the skin affected. Because of the inflammation, the blotchy skin on the face may also feel overly warm or painful and some people experience a burning or stinging feeling when they splash water on their face or use certain skincare products.

It tends to develop gradually and is most common in people aged 30-60 years old. It can be exacerbated by various factors, including sun exposure, extreme heat or cold, hot or spicy foods, excess alcohol, high stress and certain medications.

Although the exact cause of Rosacea is unknown, it is believed to involve a combination of genetic, environmental, stress and vascular factors. While there is no cure for Rosacea, adopting a holistic approach that includes gentle skincare, lifestyle modifications (such as relaxation techniques), dietary changes and addressing any underlying triggers can help manage Rosacea symptoms and promote healthier skin.

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These are the key things to consider:

Check for H. Pylori infection

Helicobacter Pylori (H. Pylori) is a bacterial infection that is pretty common (about 35% of the population of the UK will be carriers) and for most people it causes no symptoms. It is unpleasant to think about, but it can burrow into the stomach lining due to it’s spiral shape and suppress the levels of hydrochloric acid produced. In one study H. Pylori was found to be present in 81% of Rosacea patients who also had accompanying gastric complaints.

This suppression of stomach acid can lead to poor digestion of proteins and a lower absorption of several essential nutrients required for skin repair, such as zinc and B vitamins. So without enough stomach acid your skin does not get nourished with what it needs to keep it healthy and the inflammation down.

Symptoms of H. Pylori can be similar to other digestive complaints, so if you suspect an H. Pylori infection, it’s important to get tested by your medical doctor and, if you get a positive result, seek appropriate medical treatment which is usually a two week course of antibiotics and proton pump inhibitors.

Address low hydrochloric acid levels

Low stomach acid levels (also known as hypochlorhydria) as well as too alkaline stomach pH, can contribute to skin issues with or without the presence of an H. Pylori infection. Stomach acid is made up of hydrochloric acid and pepsin and it is important to have enough of both for optimal protein digestion as well as the absorption of some key nutrients including iron, vitamin B12, magnesium, calcium and zinc.

This combination of gastric juices needs to be strongly acid with a pH below 3 to kill any unwanted bacteria present in the food that we consume, or else there is greater potential for infections such as salmonella. A pH of 3 or less tend to be the people who have a “cast iron stomach”. If the pH is less acid and raised above pH 4 then is is much more likely for bacterial overgrowth to build up and this in turn can increase the likelihood of an infection in the gut or the skin.

This low acid state is a very common phenomenon that lots of people experience, especially as we get older and ironically can mimic some of the symptoms of too much hydrochloric acid in the stomach including indigestion, reflux, belching and hiccups.

You can easily help to promote an acidic environment in the stomach experiment by consuming naturally acid liquids such as apple cider vinegar and lemon and lime juice and see if these help. Use them in salad dressings or drizzle/squeeze over food or mix into water and drink through a straw. You can also eat bitter foods such as rocket, chicory, endive and ginger into your diet to help stimulate more hydrochloric acid.

If you feel any increased discomfort from taking these foods, then it more likely that you have plenty of hydrochloric acid, and to negate any of this discomfort drink an alkaline liquid such as water with some bicarbonate of soda mixed in.

Promote good gut bacteria

Research has found that most people with long-term inflammatory health conditions including Rosacea also experience some degree of gut problems such as reflux, indigestion, an irritable bowel, bloating, gas or constipation. There are also an important interplay between the gut health, the immune system and the skin called the gut-skin axis. This means that very often the state of the gut health can be reflected in the skin.

As well as the H. Pylori bacterial infection as mentioned above, some people with Rosacea often harbour higher levels of pro-inflammatory bacteria in their gut such as Clostridium difficile, Campylobacter and Enterococcus faecalis and carry less of the beneficial anti-inflammatory bacterial such as Lactobacillus and Bifidobacterium.

You can take positives steps with your diet to help get a better balance of gut bacteria by including a variety of prebiotic-rich foods such as chicory, bananas and artichoke as well as probiotic-rich foods like yoghurt, kefir, sauerkraut and kimchi in your diet. Alternatively, you can consider taking a probiotic supplement (usually sold as strains of natural bacteria or live bacteria due to regulations banning the term ‘probiotic’).

The good gut bacteria feed off the fibre in your diet, so feed them well with a diverse range of plant foods including vegetables, fruits, salads, pulses, nuts, seeds and wholegrains.

Combat yeast overgrowth

Yeast overgrowth which can populate the intestinal tract after taking antibiotics can manifest as a white tongue, vaginal thrush or skin fungal infections. Candida infections are also more prevalent if a woman takes the oral contraceptive pill.

Just as much as with bacteria overgrowth, too many fungal and yeast organisms in the intestines like candida albicans can contribute to a range of skin problems including Rosacea via the gut-skin axis. This is mainly because candida and other fungal infections are pro-inflammatory and invasive. They also can deplete you of zinc which is a key mineral for skin health and repair.

To help reach a better balance of gut flora, again promote the beneficial yeasts via a Mediterranean diet rich in prebiotic foods such as chicory, green bananas and artichoke as well as considering yeast-based probiotics such as Saccharomyces Boulardii.

You an also incorporate natural antifungal herbs like oregano oil, pau d’arco and olive leaf extract into your supplement regimen for a few weeks. Consuming plenty of garlic in the diet is also beneficial as this has natural anti-fungal properties.

The combination of promoting the beneficial yeasts within the intestinal tract and using herbs with anti-fungal properties can help clear out the excess invasive yeast organisms and restore a more balanced gut ecosystem. This in turn dials down overall inflammation and encourages better skin health.

Include omega-3 fatty acids

Omega-3 fatty acids have anti-inflammatory properties, which can be beneficial for both the skin and the gut. These are known as essential fatty acids as we need to consume them regularly from the diet and we do not make them from within. Omega-3 has been dubbed “skin’s best friend” as people who consume plenty of it through their diet often have glowing clear skin.

Unfortunately the modern diet tends to be heavy in the more pro-inflammatory omega-6 fatty acids which are abundant in safflower, sunflower, corn/maize and soya bean oils. It can take 3 months to change the balance of omega-6 to omega-3 in your body, but you should see some nice benefits in the meantime if you start to reduce the omega-6 rich foods and increase the omega-3 rich foods.

Foods rich in omega-3s include fatty fish such as salmon, mackerel, sardines as well as shellfish and other seafood. Other sources are organic whole milk, specialist omega-3 eggs, grass-fed red meat, flaxseeds, chia seeds and walnuts. Alternatively, you can take a high-quality fish oil or marine algae supplement.

Boost zinc intake

Zinc is a mineral that supports skin healing and also plays a vital role in gut health and immune health. It is a key nutrient to help maintain a healthy gut-skin axis and also is one of the main minerals needed to create all your gastric juices including hydrochloric acid. Ensure you’re getting enough zinc by including foods like red meat, dark meat poultry, legumes, nuts and seeds in your diet. If you can stomach them, oysters have loads of zinc. If you struggle to eat enough of these foods, you can also consider taking a zinc supplement for 3 months to see if it makes a diference.

Investigate food intolerances

Food intolerances, particularly to gluten and dairy products, are common triggers for skin conditions like Rosacea. Sometimes it may be wheat rather than gluten, or cows’ milk but not goat or sheep cheese that affects you. So if you want to enjoy a broader diet and not unnecessarily restrict what you eat, it would be prudent to seek out further testing through a practitioner well versed in food sensitivities, so you get to know better which foods help and which ones hinder you.

Another food group to be aware of are the high histamine foods such as tomatoes, avocado and spinach as well as drinks such as wine or orange juice. If your skin flares up from consuming foods or drinks or you get other symptoms of histamine intolerance such as sneezing, itching or feeling hot at night in parallel, then screening for histamine intolerance may be helpful. This testing is usually via a combination of a stool test, a finger-prick blood test or a genetic profile that focuses specifically on histamine genetic SNPs. You can then work out a strategy to help build these foods back in over time through some targeted food supplements.

Eliminating these identified problematic foods from your diet for a few months at the outset can help reduce inflammation and improve your skin’s condition. Over time they can usually be added back in once the gut has had a chance to heal.

Round up

Taking care of your Rosacea involves more than just topical treatments. By nourishing your body from within, you can support healthy skin and overall well-being. Start with looking after your digestion by managing your stomach acid levels and promoting a healthy gut microbiome. Eat a diverse diet with a variety of protein sources so that you aren’t deficient in important minerals such as zinc. Testing for food intolerances may also be an appropriate way to support your body in managing the symptoms of Rosacea.

While these nutritional strategies can be helpful in  alleviating skin conditions like Rosacea, it’s important to remember that everyone’s body is unique. Consulting with a nutritional therapist or naturopath who takes the functional medicine approach is recommended to develop a personalised approach that addresses your specific needs. To book a clinic appointment with one of our NatureDoc team click here.

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  1. Thank you for writing this very helpful blog! I suffer with type 2 rosacea (lots pustules on skin) and it has a huge impact on my overall confidence. Can you recommend some brand of supplements? As there are so many it’s mind boggling. Thank you

    1. Hi Rebecca, that sounds horrible for you. Unfortunately we have been told we are not allowed to recommend products on this web site because scientific evidence is not allowed when selling products! Amazing but true!
      So we suggest 3 options:
      1. Use the contact us link for free advice on simple things
      2. Join the NatureDoc Live! Q&A Forum where you can ask questions and join Lucinda in her monthly zoom sessions.
      3. Arrange a clinic appointment with a practitioner