rosacea blog

Vitamin B6 is one of the many B vitamins and one of the best studied B vitamins. Vitamin B6 was discovered in the 1930ies and is a water-soluble vitamin that exists in many different forms, including pyridoxal, pyridoxine, pyridoxine phosphate, pyridoxamine, pyridoxal phosphate, and pyridoxamine phosphate. The active form of vitamin B6 is pyridoxal phosphate.

Vitamin B6 plays a major role in hundreds of enzymatic reactions in the body, including the synthesis of amino acids, nucleic acids (DNA/RNA), phospholipids (which are part of cell membranes), histamine, certain neurotransmitters (such as serotonin, norepinephrin, GABA), heme (the center part of hemoglobin) and the processing of carbohydrates.

Vitamin B6 is believed to have a major impact on the skin as when vitamin B6 levels are insufficient, inflammation of the skin can develop, in particular seborrheic dermatitis. Vitamin B6 used to be called anti-dermatitis factor and is also one of the main ingredients in topical treatments for seborrheic dermatitis.

Vitamin B6 deficiency
Since vitamin B6 is involved in the production of the “building blocks” for every tissue in the body, tissues that regenerate frequently such as blood and skin, are affected most when vitamin B6 is deficient. Symptoms of a vitamin B6 deficiency include anemia, fatigue and skin conditions such as eczema and (seborrheic) dermatitis.

Vitamin B6 is absorbed from our food in the intestines via passive diffusion. The absorption of B6 vitamins pyridoxal phosphate and pyridoxamine phosphate involves the dephosphorylation catalyzed by intestinal alkaline phosphatase, which is a a membrane-bound enzyme. Vitamin B6 deficiencies are relatively rare, but people with inflammatory bowel conditions (such as Crohn’s disease and celiac disease), people who drink large quantities of alcohol and people taking certain drugs (corticosteroids, anticonvulsants) are at risk for developing a vitamin B6 deficiency.

Because vitamin B6 plays a major role in the healthy functioning of our nervous system and skin, a severe deficiency of B6 can result in seizures, convulsions and inflammatory skin conditions.

Vitamin B6 is also important for the synthesis of vitamin B3 and for the absorption of vitamin B12. Foods that contain high amounts of vitamin B6 are meats, fish (tuna) and vegetables such as spinach, broccolli, Brussels sprouts, cauliflower and more. Cooked and processed food however, have lost most of the active vitamin B6 and for that reason, supplementation with vitamin B6 may be beneficial to your health if you suspect a B6 deficiency. In addition, several studies have reported that vitamin B6 supplementation can be helpful for managing symptoms of autism.

When stress takes over our lives, it can be damaging to our health. Stress not only weakens our immune system, but it also affects our skin’s barrier function. The skin’s barrier function is important for regulating the balance of water and temperature of our skin as well as blocking the entry of microorganisms.

Chronic stress activates the so-called HPA axis, which is the connection between the hypothalamus and pituitary gland in the brain and the adrenal glands on the kidneys. Activation of the HPA axis by stress leads to higher levels of the stress hormones corticotropin-releasing hormone (CRH) and cortisol, which have a profound effect on our health, skin and brain. The HPA axis is kept balanced by neurotransmitters such as serotonin, adrenaline and dopamine. However, if the HPA axis gets chronically stimulated by stress, a major imbalance in neurotransmitters can result and may lead to the development of anxiety and depression.

Research suggests that the breakdown of the skin’s barrier function (or matrix degeneration) in combination with excessive exposure to the sun, forms a central part of rosacea development. A breakdown of the collagen fibers is thought to play a major part in the degeneration of the skin’s matrix. Poor connective tissue support for blood vessels just underneath the skin can therefore result in the pooling of serum, metabolic waste and immune mediators, which over time leads to more flushing, edema, chronic erythema and telangiestacias. The involvement of a matrix breakdown in rosacea is likely, because blood vessels in rosacea are still able to respond to vasoactive substances.

An out-of-balance HPA axis (particularly prominent in depression and anxiety), results in high levels of corticotropin-releasing hormone (CRH). CRH has been shown to increase the permeability of peripheral blood vessels through the stimulation of mast cells, which in turn release immune mediators such as histamine and nitric oxide. Anti-depressant drugs are thought to “calm” an over-active HPA axis by increasing the availability of neurotransmitters such as serotonin, dopamine and adrenaline. Therefore, the use of antidepressants for a prolonged period of time may reduce the severity of rosacea symptoms. Reducing stress levels in our lives could have a significant impact on the progression and stabilization of rosacea symptoms.

Fimmel S. et al. (2008) New aspects of the pathogenesis of rosacea. Drug Discovery Today: Disease Mechanisms 5: 103-111.

More on Stress and Depression

• comment on mental health in the workplace: food for thought by … – a very well written article. unfortunately mental health isn’t openly discussed as much as it should be. maybe one day it will be.

I couldn’t find any scientific publication on the topic of gluten sensitivity and rosacea, but if you do a search online, then you’ll find plenty of information on the topic (mostly in forums and message boards).

As it turns out, many people with rosacea wonder if their rosacea symptoms are caused by a gluten sensitivity. Some have been successful in reducing their rosacea symptoms by following a gluten-free diet. As I and others have written before, there seems to be a digestive component to rosacea.

Gluten is a protein that’s abundant in certain grains, mostly wheat, barley and rye. The gluten itself is a protein made up of two protein parts, gliadin and glutenin. The gliadin part is responsible for the abnormal immune reaction that causes gluten sensitivity and celiac disease. Between 0.5 and 1% of the world’s population suffers from gluten-sensitivity. Gluten sensitivity is not the same as a gluten allergy. The gluten proteins of corn and rice lack the gliadin part and do therefore not cause any sensitivity.

The immune system’s overreaction to wheat’s gluten causes celiac disease, in which the lining of the small intestine becomes chronically inflamed. Symptoms of celiac disease include chronic diarrhea, cramps, bloating, fatigue and malabsorption of essential nutrients, which could result in secondary symptoms such as psychological and neurological problems.

The gluten sensitivity makes it difficult for the body to absorb vitamins, in particular vitamin D. This could explain the possible involvement of vitamin D in rosacea and autism that I described recently. Many children with autism have seen their symptoms improve after staring a gluten-free diet.

Whether a potential gluten sensitivity is involved in the development of rosacea symptoms, it is possible that the inflammation of the intestines contributes to an overall stronger inflammatory response in the facial skin of rosacea patients. While there are many rosacea trigger factors, pizza (loaded with gluten and histamine) is one food that probably should be limited in your diet if you have rosacea.