Rosaceans are rosacea sufferers

Cause of Rosacea Revisited

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Copyright 2010 by Brady Barrows

If you were around in August 2007, there were headlines such as, Scientists unmask the cause of rosacea, [1] and UCSD Researchers Discover Cause of Rosacea [2] not to mention all the other headlines which created quite a stir in all the online rosacea groups and brought a lot of hope for rosacea sufferers. These articles seemed to conclude that rosacea’s mystery is resolved and within time a treatment would be found to eradicate rosacea. These startling headlines were the result of a paper published by researchers at UCSD associated with Richard L Gallo, et.al, in a study published by  Nature Medicine [3]. This paper concluded:

“These findings confirm the role of cathelicidin in skin inflammatory responses and suggest an explanation for the pathogenesis of rosacea by demonstrating that an exacerbated innate immune response can reproduce elements of this disease.”  More info on cathelicidins.

If you will notice in the above statement that the findings suggest an explanation for the pathogenesis of rosacea. Gallo, et.al, never said they found the cause of rosacea.  The newspapers came to the conclusion that now all the mystery of rosacea is over and we now have the cause nailed down. All we have to do is wait for the treatment. This is not exactly the truth.  While the research of Gallo, et.al, at UCSD is remarkable and insightful, the jury is still out on what causes rosacea. And while the jury is still out, there is more news worth mentioning that may be related to cathelicidin, peptides or antigenic proteins.

According to The Irish Times, Irish Scientists blame bacteria as the cause of rosacea according to a different study. This study is the result of researcher Dr Kevin Kavanagh, a senior lecturer in biology at NUI Maynooth. According to The Irish Times, “Working with the Mater hospital, the researchers previously identified a Bacillus bacterium inside Demodex mites. The bacteria release two proteins that trigger an inflammation in patients with facial rosacea.” [4]

At least one type of bacteria is associated with demodex mites and rosacea. This bacteria is Bacillus oleronius according to an NRS press release [5] which quotes Dr. Kavanagh as saying, “This indicates that the Bacillus bacteria found in the Demodex mite produce an antigen that could be responsible for the tissue inflammation associated with papulopustular rosacea.”  A study released in September 2007 by Dr. Frank Powell, et.al, also concluded, “Antigenic proteins related to a bacterium (B. oleronius), isolated from a D. folliculorum mite, have the potential to stimulate an inflammatory response in patients with papulopustular rosacea.” [6] Another study released in January 2010 also said, “The strong correlation provides a better understanding of comorbidity between Demodex mites and their symbiotic B oleronius in facial rosacea and blepharitis.”  [7]

In the recent past, a couple of noted rosacea online gurus have dismissed the role of demodex in rosacea. One such rosacea guru said, “Rosacea experts all agree that this mite plays no real role in the development of progression of rosacea (except for the odd pustule).”  [8] The other rosacea guru says, “I have always pushed the line that demodex mites have thus far only been proven to be innocent bystanders in rosacea symptoms.” [9] However, the NRS continues to sponsor research into demodex and the RRDi just released a paper by Dr. Kosta Y. Mumcuoglu and Dr. Oleg E. Akilov on demodex’s role in rosacea. [10] In fact, there is probably not many other type research with as many papers on the subject of demodex except for a scarce few. [11]

Another theory on the cause of rosacea is that irritable bowel syndrome is related to rosacea. “Rosacea may be a symptom of an unhealthy gastrointestinal system and healing the entire gastrointestinal system may be the basis for eliminating rosacea. Many people with rosacea also have been diagnosed with Irritable Bowel Syndrome (IBS), Crohn’s Disease or some for of Colitis.”  [12]

This theory also is related to bacteria in the gut and that using antibiotics clears rosacea. An article in the St. Louis Dispatch [13] says that one doctor has been prescribing Xifaxan, an antibiotic for gastric problems and reports clearing of rosacea. Previously to this report a study in Italy published that eradicating the bacteria in the gut had improved rosacea. [14]

Another theory that has come up is that SIBO is related to rosacea. The previously mentioned rosacea online guru had this to say about SIBO and rosacea:

“This sort of abstract just make me shake my head. If you read quickly you will think that this abstract suggests that Small Intestinal Bacterial Overgrowth (SIBO) causes rosacea. What this abstract is saying that is that rosacea sufferers seem to have a higher incidence of SIBO than non rosacea sufferers.” [15] “The link between SIBO and the papules and pustules of rosacea is still a mystery.” [16] For more information on rosacea and SIBO click here.

There is also a continuing controversy as to whether H Pylori is a factor in rosacea and I have written an article on this subject for your interest.

So in conclusion, the jury is still out on what causes rosacea but it appears that the jury hasn’t ruled out demodex quite yet, despite what the rosacea gurus tell you. The headlines may one day come to another ’cause’ of rosacea or highlight the ones discussed above. Whatever happens, keep an open mind, since we still don’t know what causes rosacea. We may be surprised one day to actually read a headline that says truthfully what the cause of rosacea is.

For more information on the cause of rosacea and other theories on this subject click here.

[1] Scientists unmask the cause of rosacea
August 06, 2007|Alison Williams, Los Angeles Times Staff Writer

[2] UCSD Researchers Discover Cause of Rosacea
UCSD News Center

[3] Increased serine protease activity and cathelicidin promotes skin inflammation in rosacea
Kenshi Yamasaki1, Anna Di Nardo1, Antonella Bardan1, Masamoto Murakami2, Takaaki Ohtake3, Alvin Coda1, Robert A Dorschner1, Chrystelle Bonnart4,5, Pascal Descargues4,5, Alain Hovnanian4,5,6, Vera B Morhenn1 & Richard L Gallo1
Nature Medicine 13, 975 – 980 (2007)
Published online: 5 August 2007 | doi:10.1038/nm1616

[4] Study finds cause of rosacea
Claire O’Connell
The Irish Times – Tuesday, July 14, 2009

[5] New Study Shows Role for Bacteria in Development of Rosacea Symptoms
NRS Press Release, May 3, 2004, Suzanne Corr / Barbara Palombo

[6] Mite-related bacterial antigens stimulate inflammatory cells in rosacea.
Lacey N, Delaney S, Kavanagh K, Powell FC.
Department of Biology, National University of Ireland, Maynooth, Co. Kildare, Ireland
Br J Dermatol. 2007 Sep;157(3):474-81

[7] Correlation between Ocular Demodex Infestation and Serum Immunoreactivity to Bacillus Proteins in Patients with Facial Rosacea,
Li J, O’Reilly N, Sheha H, Katz R, Raju VK, Kavanagh K, Tseng SC.
Ophthalmology. 2010 Jan 14,

[8] page 110 quote
Beating Rosacea Vascular, Ocular & Acne Forms
Geoffrey Nase, Ph.D.
Nase Publications 2001

[9] Mar 29, 2007 R-S post by David Pascoe

[10] The Role of Demodex Mites in the Pathogenesis of Rosacea and Blepharitis and Their Control
Kosta Y. Mumcuoglu, Ph.D., Oleg E. Akilov, M.D., Ph.D.
Journal of the Rosacea Research & Development Institure, Vol.1, No.1

[11] For a partial list of Demodex in rosacea and acne click here.

[12] Dr. David Dahlman, a Chiropractic Physician with a degree in Nutrition

[13] New way to treat skin disorder
By Cynthia Billhartz Gregorian, St. Louis Post Dispatch, 04/29/2010

[14] Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication.
Parodi A, Paolino S, Greco A, Drago F, Mansi C, Rebora A, Parodi A, Savarino V.
Department of Internal Medicine, Gastroenterology Unit, University of Genoa, Genoa, Italy.
Clin Gastroenterol Hepatol. 2008 Jul;6(7):759-64

[15] SIBO eradication clears rosacea: are you serious ?
May 7th, 2008, by David Pascoe

[16] Gut Bacteria and Xifaxan get some press coverage
April 30th, 2010, by David Pascoe

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11 Responses to “Cause of Rosacea Revisited”

  1. Inger Gauna
    on Sep 3rd, 2010
    @ 12:09 pm

    Thank you for bringing this site internet, my lifetime is more effective now. :)

  2. Bud Bornemann
    on Sep 3rd, 2010
    @ 1:13 pm

    The old adage, “you are what you eat” cannot be truer than when it comes to common causes of acne. Often individuals who do not consume a healthy diet or whose diet lacks the proper amount of critical vitamins and minerals find that their acne is worse or flares up after bad food. Your body must be healthy before your skin can improve so strive to eat a well balanced diet. If you are experiencing acne problems,look first at the nutrition value of your current diet.

  3. Edgardo Menz
    on Sep 3rd, 2010
    @ 3:43 pm

    i tried skinid proactiv exposedacne they didnt really work i have some pics of my acne to show you how bad it looks. If anyone knows any treatments i should consider please let me know thanks !

  4. Patti Paglialunga
    on Sep 3rd, 2010
    @ 4:29 pm

    Im only 14 and i’ve already got big acne spots on my face, i want to pop them so much but i dont want to look like all those disgusting people with scars on the internet and all the nerds at skool. help me please im worried

  5. Jeanene Lickteig
    on Sep 3rd, 2010
    @ 5:00 pm

    Although acne tends to cause us stress to a certain extent, most people don’t realize that stress may cause acne as well. There are certain types of acne, which really get a lot worse whenever a person is under an extreme amount of stress. Even a slight change in circumstances that causes a person to be anxious may cause this acne to show up. There are also several other skin conditions, such as rosacea, which tend to get better and worse depending on our stress levels. That is why it is important for you to learn how to control your stress if you’re going to learn how to control your acne.

  6. Thad Edin
    on Sep 3rd, 2010
    @ 5:27 pm

    Hey, im 18 been suffering from acne for a long time now.

  7. Juan Dearco
    on Sep 6th, 2010
    @ 1:26 am

    i tried skinid proactiv exposedacne they didnt really work i have some pics of my acne to show you how bad it looks. If anyone knows any treatments i should consider please let me know thanks !

  8. Chu Lontz
    on Sep 6th, 2010
    @ 1:54 am

    It all started 3 years ago when i was 15 years old. I noticed, that there’s too many blackheads and pimples on my face. I started to wash my face more frequently, but it had no use, my acne just got worse. Than my mom bought me some garnier cleanser. I started using this cleanser and it looked like it really works. After one month i understood, that this cleanser doesn’t help me either, it just reduces some redness on my face a little bit. After this i started to search in the internet more information about my problem

  9. michelle
    on Mar 12th, 2011
    @ 1:15 pm

    Acne is not rosacea!!!! If you have severe acne I try accutane. It is amazing but can damage your liver. Take it for the min amount of time.

    Accutane is not cheap but your insurance might cover it. It’s the MOST effective drug I have come across. Your doc won’t want to sign you up though because it might be the harshest -there could be harsher but it’s pretty rough

    Skip the harsh “zit creams”!!!!! Don’t burn your face, a little dab is ok on a zit but I’ve seen some chemical burns that look mush worse than a couple of zits

    witch hazel is a nice toner, Dove has nice soap and oil of olay has a nice moisturizer with SPF (always use spf!!)

    there are others but my point is that you can not scrub zits or black heads away.

    hormones cause zits so if you’re a teanager you’re going to get them. Every other teenager is too busy thinking of their zits/hair/clothing/dance/etc to worry about your few zits. you’ll know this years later

    if you need to pop a zit look it up and do it proper, don’t go crazy in the bathroom mirror.

  10. admin
    on Dec 19th, 2011
    @ 9:52 am

    You are quite correct that stress is a factor or a rosacea trigger. For more info.

  11. admin
    on Dec 19th, 2011
    @ 9:54 am

    Popping zits can not only be painful, but cause infection if not done properly. You need sterile conditions and I recommend seeing your dermatologist about this.

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