rosacea blog

Rosacea affects about three times as many women than men. Rhinophyma, seen in late-stage rosacea, is characterized by a bulbous overgrowth of the nose, and occurs in approximately 4% of all rosacea sufferers. It affects about twelve times as many men than women and is usually seen in white males of English or Irish descent. Rhinophyma causes a lot of embarrassment and distress to people who have it.

Traditionally, rhinopyma was thought to be associated with alcoholism, but this turned out not to be the case. Rhinophyma is associated with late-stage rosacea and is characterized by fast growing sebaceous tissue and inflammation. Rhinophyma is worsened by anything that dilates blood vessels.

The fact that rhinophyma affects more men than women, could be explained by the fact that male hormones stimulate sebaceous gland growth and secretion of sebum. The sebum is secreted around hair follicles, where it mixes with common skin bacteria, which secrete the enzyme lipase. The lipase interacts with the sebum to produce free fatty acids which stimulates inflammation. Fast growing tissue forces the skin pores to open up, allowing more bacteria to enter.

Rhinophyma cannot be controlled satisfactory with traditional rosacea medications and topical treatments. The treatment of the early stages of rosacea with topical treatments can delay the onset or the severity of the condition. Rhinophyma can be surgically treated. This has to be arranged through a dermatologist. Tissue can be surgically removed or the rhinophyma can be treated with a laser.

If you’re a fan of Top Chef (Bravo TV), then you may have noticed that many chefs on the show have red faces. Not just this particular season, but I have seen it in many previous seasons. Of course, when you’re a chef, you’re working in a hot environment and usually under constant pressure. These working conditions are naturally conducive to developing rosacea (However, while hot environments naturally cause facial flushing, facial redness alone does not always mean “rosacea”). During my career as a research scientist, I have seen many colleagues with facial redness. As is the case for many job types, working in science has become more stressful every year, with more competition for funding and tighter deadlines.

I was just wondering, is rosacea more prevalent in certain professions (e.g. linked to a certain personality type) or is rosacea just a condition related to stress?

In the past, it was thought that rosacea was part of a certain type of personality, a personality that was thought to have differences in self confidence, emotions, affect, levels of anxiety, self-criticism and self-aggression compared to people without rosacea. However, a study by Karlsson et al. disputed this claim, by showing that rosacea can affect anyone, regardless of personality and that rosacea patients react very similarly to other people in regards to aggression toward self or others, irritability, guilt and detachment.

Most people with rosacea know that chronic stress and certain foods can make rosacea symptoms worse. It wasn’t until 2007 that the pathological mechanism of rosacea was described. A study by Yamasaki et al. found that certain antimicrobial peptides were elevated in rosacea skin and that these antimicrobial peptides were processed differently in rosacea skin leading to a chronic inflammation condition. Of course, stress, high levels of anxiety and histamine, can all further stimulate this proposed pathological pathway. (More details of this pathway in a future post).

So now we know that rosacea has a clearly defined pathological pathway, in which immune system, genetics and stress (chronically activated HPA axis) all play a part in its development. Although we may appear differently than our non-rosacea friends, our appearance has nothing to do with personality. Since the rosacea inflammatory pathway is known, one question remains: can rosacea be cured or does the pathway allow for the development of more effective treatments?

Karlsson, E., Berg, M. and Arnetz, B.B. (2004) Rosacea and personality. Acta Derm Venereol. 84: 76-7.

Yamasaki, K. et al. (2007) Increased serine protease activity and cathelicidin promotes skin inflammation in rosacea. Nat Med 13: 975-80.

Read more about Reverta’s rosacea treatments.

Problems with digestion can be linked to a number of conditions and are frequently caused by microorganisms. Psychological conditions such as depression and anxiety can have gastrointestinal symptoms. GI problems with depression and anxiety are often linked to over-stimulation of the Hypothalamus-Pituitary-Adrenal (HPA) axis.

Digestive problems have been linked to rosacea as early as 1967. In recent years, studies have suggested that a bacterium called Heliobacter pylori could be a marker of digestive problems in patients with rosacea. While some studies report a positive relationship between H. pylori and rosacea, other studies have found no significant difference between the number of H. pylori in the digestive tracts of control subjects and rosacea patients.

H. pylori is a gram negative bacterium that has been thought to cause an increase in the synthesis of reactive oxygen species in the gut such as nitric oxide (NO). NO and pro-inflammatory cytokines play a role in the inflammatory processes underlying the rosacea pathology. However, no increased rate of NO synthesis could be linked to H. pylori.

Studies have also looked at a possible link between H. pylori and other skin conditions, such as psoriasis, and vascular disorders. However, for most of these conditions, eradication of H. pylori failed to show any beneficial effect. For most of these studies, a variety of antibiotics was used to eradicate H. pylori.

My digestive problems started around the same time I was diagnosed with rosacea. I did not think anything about it and thought that my digestive problems were the result of too much stress, anxiety or an allergic reaction to a particular food ingredient. I did find some foods that I reacted to (peanuts, peas, bananas), but I never knew if my digestive problems were really based on any allergies. However, my digestive problems continued and became progressively worse over time. The cramping and other GI problems became so bad, that I saw several doctors for it, including a liver specialist.

The doctors could not find a particular cause of my digestive problems, however when I went to see a doctor with heavy cramping and a high fever, he thought it could be diverticulitis. My diverticulitis was treated with a heavy dose of antibiotics and the cramps and fever disappeared. However, the symptoms of diverticulitis returned periodically and I started to look at alternative treatments.

During my search for alternative treatments of my digestive problems, I came across several scientific papers about a possible association between H. pylori and rosacea and the eradication H. pylori with extracts of mastic gum. Mastic gum is the resinous gum of the Pistacia lentiscus tree and a few studies suggested it was effective against H. pylori. So I took mastic gum for a few months and my diverticulitis completely disappeared (at least the symptoms). Every time I notice any cramps, I take mastic gum capsules for a few days.

While mastic gum does seem to work well for GI problems, I am not sure whether mastic gum has any effect on the redness, inflammation and swelling of the face associated with rosacea. The scientific community is still not sure whether mastic gum can eradicate H. pylori, but based on personal experiences it does seem to help with digestive issues.

Do you think your rosacea is associated with gastrointestinal problems? Let us know..

You may like: Digestive enzymes Supplement.

References

Marks, R., Beard, R.J., Clark, M.L., Kwok, M. and Robertson, W.B. (1967) Gastrointestinal observations in rosacea. Lancet 1: 739-43.

Sharma, V.K., Lynn, A., Kaminski, M., Vasudeva, R. and Howden, C.W. (1998) A study of the prevalence of Helicobacter pylori infection and other markers of upper gastrointestinal tract disease in patients with rosacea. Am J Gastroenterol 93: 220-2.

Utaş, S., Ozbakir, O., Turasan, A. and Utaş, C. (1999) Helicobacter pylori eradication treatment reduces the severity of rosacea. J Am Acad Dermatol 40: 433-5.

Herr, H. and You, C.H. (2000) Relationship between Helicobacter pylori and rosacea: it may be a myth. J Korean Med Sci 15: 551-4.

Gürer, M.A., Erel, A., Erbaş, D., Cağlar, K. and Atahan, C. (2002) The seroprevalence of Helicobacter pylori and nitric oxide in acne rosacea. Int J Dermatol 41: 768-70.

Zandi, S., Shamsadini, S., Zahedi, M.J. and Hyatbaksh, M. (2003) Helicobacter pylori and rosacea. East Mediterr Health J 9: 167-71.

Bebb, J.R., Bailey-Flitter, N., Ala’Aldeen, D. and Atherton, J.C. (2003) Mastic gum has no effect on Helicobacter pylori load in vivo. J Antimicrob Chemother 52: 522-3.

See what Reverta’s rosacea treatments can do for rosacea skin.