You may have heard of the gut microbiome – the community of microbes living in our intestines that play a key role in our health and wellness. When the microbiome gets out of balance (known as dysbiosis) it is thought to contribute to various health issues, including inflammatory bowel disease (IBD) (1), liver disease (2), and even certain types of cancer (3).
Dysbiosis of the microbiome can also impact our skin health and contribute to conditions such as eczema, psoriasis, and acne (4). This means that taking care of your gut health isn’t just about digestion, it’s about supporting the immune system and keeping our skin healthy, and looking good.
What is Rosacea?
Rosacea is a skin condition that causes redness and a rash on the face. It is more common in women, however, men seem to experience more severe symptoms. Rosacea is an inflammatory condition and can present itself in many ways, including flushing, red or purple skin, and pus-filled spots. The condition can show up differently in every person and can be caused by a mix of factors both inside and outside the body.
These include genetics, UV light, heat, immune system imbalances, and changes in the balance of bacteria in the gut (5). Interestingly, and the key point of this blog is, that many people with rosacea also experience digestive issues like bloating and stomach pain. It is suspected that there might be a connection between skin health and the gut microbiome, which could explain these symptoms.
There are many gases found in exhaled breath such as hydrogen and methane that are believed to come from the activity of the gut microbiome, offering an interesting way to explore the connection between gut health and skin issues like rosacea. To dig deeper, a study investigated whether there is a connection between small intestinal bacterial overgrowth (SIBO) and rosacea (6).
This study used breath tests to measure levels of the key gases hydrogen and methane, alongside checking for gut symptoms and examining the skin. The goal was to find out how common SIBO is in people with rosacea and if treating SIBO could improve rosacea symptoms.
Let’s delve into this study…
In this study, 113 people with rosacea and 60 healthy people were included, and they all had their blood, stool, and breath tested. They also had the severity of rosacea assessed and answered questions about their symptoms (stomach pain, bloating, diarrhea, etc). The breath tests specifically measured hydrogen and methane, which are commonly measured to diagnose patients with SIBO.
Some of those who tested positive for SIBO based on the hydrogen and methane in their breath were randomly picked to receive rifaximin – an antibiotic used for the treatment of SIBO. After treatment, patients took another breath test to see if their SIBO was cleared and had their symptoms and rosacea assessed again.
But what were the results?
SIBO is more common in people with rosacea.
52 patients with rosacea were found to also have SIBO, whereas only 3 patients without rosacea had the condition. SIBO was successfully treated in 28 (87.5%) of patients who took rifaximin, and in these people, their gut symptoms were also improved. Of these patients, 26 also found improvements in their rosacea.
The findings from this study suggest a potential connection between imbalances in the gut microbiome and the development of rosacea. People with rosacea were more likely to have SIBO compared to those without rosacea. Treating SIBO improved the skin symptoms associated with rosacea, with many patients maintaining these improvements for several months.
The exact reason for this link is not fully understood, but it is believed that SIBO may cause the gut to become more permeable, meaning the immune system and inflammatory compounds can leave the gut and circulate throughout the body, potentially triggering skin inflammation in people prone to rosacea. In fact, studies have found that people with SIBO often have higher levels of inflammatory compounds in their blood, which could contribute to rosacea (7).
Rifaximin is an antibiotic that stays in the gut and doesn’t affect other areas of the body. This helps ensure that the improvements seen in rosacea symptoms in the patients with SIBO and rosacea who took the medication are likely due to the treatment targeting the gut bacteria rather the the skin.
Breath analysis and OMED Health.
Clinical evidence demonstrating the link between SIBO and rosacea highlights the profound diagnostic power of breath analysis. By measuring hydrogen and methane gases, we can gain immediate, objective insights into the activity of the small intestinal microbiome. Pinpointing these gas levels allows independent clinicians to accurately diagnose underlying overgrowths that may be actively driving the systemic inflammation responsible for chronic skin flare-ups.
That is why the medical-grade OMED Health Breath Analyzer is exclusively integrated into our clinician-led SIBO and IMO breath testing kits. Distributed and managed entirely through independent healthcare professionals, this system allows you to capture precise gas curves from the comfort of home, syncing the data directly to your practitioner’s specialist dashboard.
Using the OMED Health App, you can systematically log your daily skin flare-ups and dietary triggers alongside your physical symptoms. By evaluating these overlapping timelines, your practitioner can look beyond topical skin treatments, accurately identify microbial root causes, and build a highly targeted, data-driven gut recovery plan to support your skin from the inside out.
An Integrated Safety Net for Chronic Inflammation
When a bacterial overgrowth is the hidden driver behind a inflammatory skin condition like rosacea, standard topical creams and gentle lifestyle shifts are rarely enough to break the cycle. If your tracking data reveals a pronounced, stubborn overgrowth that requires pharmaceutical clearance to calm the systemic inflammatory response, our platform features a built-in medical safety net. Your independent specialist can seamlessly escalate your care through our ecosystem, granting you direct access to an OMED Health medical doctor for expert clinical review and targeted antibiotic prescriptions—ensuring you have an end-to-end medical pathway to clearer skin and better digestion.
References.
- Frank DN, St. Amand AL, Feldman RA, Boedeker EC, Harpaz N, Pace NR. Molecular-phylogenetic characterization of microbial community imbalances in human inflammatory bowel diseases. Proc Natl Acad Sci U S A. 2007 Aug 21;104(34):13780–5. DOI: 10.1073/pnas.0706625104
- Zhu L, Baker SS, Gill C, Liu W, Alkhouri R, Baker RD, et al. Characterization of gut microbiomes in nonalcoholic steatohepatitis (NASH) patients: A connection between endogenous alcohol and NASH. Hepatology. 2013;57(2):601–9. DOI: 10.1002/hep.26093
- Louis P, Hold GL, Flint HJ. The gut microbiota, bacterial metabolites and colorectal cancer. Nat Rev Microbiol. 2014 Oct;12(10):661–72. DOI: 10.1038/nrmicro3344
- De Pessemier B, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C. Gut–Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms. 2021 Feb;9(2):353. DOI: 10.3390/microorganisms9020353
- Rainer BM, Kang S, Chien AL. Rosacea: Epidemiology, pathogenesis, and treatment. Dermatoendocrinol. 2017 Jan 1;9(1):e1361574. DOI: 10.1080/19381980.2017.1361574
- Parodi A, Paolino S, Greco A, Drago F, Mansi C, Rebora A, et al. Small Intestinal Bacterial Overgrowth in Rosacea: Clinical Effectiveness of Its Eradication. Clin Gastroenterol Hepatol. 2008 Jul 1;6(7):759–64. DOI: 10.1016/j.cgh.2008.02.054
- Sánchez-Pellicer P, Eguren-Michelena C, García-Gavín J, Llamas-Velasco M, Navarro-Moratalla L, Núñez-Delegido E, et al. Rosacea, microbiome and probiotics: the gut-skin axis. Front Microbiol. 2024 Jan 8;14:1323644. DOI: 10.3389/fmicb.2023.1323644
