Some research also points to rosacea being related to oxidative stress, so rosacea sufferers everywhere are likely to benefit from good nutrition.

SPF on Your Plate: Researcher Connects the Mediterranean Diet With Skin Cancer Prevention

ScienceDaily (Aug. 16, 2010) — We all want that summer glow that comes from a day at the beach, but taking in the rays can have long-term implications for our health. Now Dr. Niva Shapira of Tel Aviv University’s School of Health Professions suggests a way to make fun in the sun safer — and it’s all in our food.

In a study recently published in Nutrition Reviews, Dr. Shapira has shown that a diet rich in antioxidants and omega-3 fatty acids, like the diet eaten in Mediterranean regions where melanoma rates are extremely low, can help protect us from skin cancer.

The sun’s rays damage both the skin and the immune system by penetrating the skin and causing photo-oxidation, she explains, affecting both the cells themselves and the body’s ability to repair any damage. Her prescription is to “go Greek” with foods such as olive oil, fish, yogurt and colorful fruits and vegetables to fight the oxidizing effect of the sun, as well as regular applications of sunscreen and appropriate body coverings such as hats, beach coverups, and other sportswear.

I’m heartened to see this paragraph as well as I think we can easily get sucked in to the `supplements are as good a real food’ idea all too easily.

It might be tempting to load up on dietary supplements instead of changing the diet, but according to Dr. Shapira, supplements are simply not as effective. Foods provide nutrient “synergy,” she says. “In foods, many vitamins and various antioxidants and bioactive ingredients work to support one another and the body’s natural protective mechanisms. Synergies between the nutrients in your food, which make a significant contribution to health, may contrast with the relative isolation of a vitamin supplement.”

A further extract from the referenced Abstract;

Nutritional approach to sun protection: a suggested complement to external strategies

Penetrating photo-oxidative ultraviolet A radiation reduces skin and blood antioxidants and damages cell components, including DNA. Dietary antioxidant vitamins, minerals, and phytochemicals in addition to n-3 polyunsaturated fatty acids, n-9 monounsaturated fatty acids, and low pro-inflammatory n-6 polyunsaturated fatty acids, have demonstrated protective properties. The presence of these elements in the traditional Greek-style Mediterranean diet may have contributed to the low rates of melanoma in the Mediterranean region despite high levels of solar radiation.

Related Articles

• RSPR: Role of Inflammation in Rosacea
• diet and psoriasis: is there a link ?
• how metrogel works II – free oxygen radicals
• could rosacea be caused by diet ?

What are the best known naturopathic treatments for rosacea, and how well have they been shown to work ? Naturopathy is a medical philosophy that tries to improve our health by helping the body’s own ability to recover from illness and injury.

Those who practice naturopathic medicine promote a holistic approach to health and would steer away from synthetic treatments such as antibiotics and metronidazole for example.

If you ever wanted to get to the bottom of the mumbo jumbo that sometimes surrounds naturopathic treatments, then read on.

Herbs

There are now several products on the market to treat rosacea that promote their genesis in natural products. Additionally it may be possible to use some herbs in their natural form. Some of the commercially available products include the Aveeno Ultra Calming range that contains feverfew, and the Eucerin Redness Relief range that contains Licochalcone A, an extract of licorice. One other `naturally based’ topical worth considering is Rosacure which contains MSM and silymarin (Lady Thistle Extract). Although not a herb, colloidal oatmeal containing products from Aveeno are also based on a natural ingredients and my be useful in treating the itch of rosacea.

One herb that stands out (in theory at least) for me is arnica montana. This herb does have a long history of being used to treat swelling and bruising. If this can be extended to include the inflammation of rosacea then arnica might be worth exploring further. One other interesting approach is the Califlora and aloe vera based anti flushing protocol to control angiogenesis between IPL treatments.

It seems to me that products that are sourced from natural ingredients, that also have been tested and developed into commercial products, and are easily available; hold a lot of promise for rosacea sufferers.

Acupuncture

Although acupuncture has been a subject of active research since the late 20th century, accupuncture’s effects are not well understood. It is considered safe when administered by well trained practitioners using sterile needles, but probably like most of these sorts of therapies, needs more research.

See the following acupuncture thread over at the Rosacea Support Community for thoughts from other rosacea sufferers. It seems that acupuncture may be good for overall health, help you relax and might just help you cope with rosacea. Another thread at The Rosacea Forum from a member’s acupuncture trial is also worth reading, although there doesn’t seem to be a conclusion just yet.

Aromatherapy

Aromatherapy uses what are called essential oils and other aromatic compounds to affect one’s mood or health. Note that the `essential’ in essential oils only refers to the oils being concentrated from the plant they were extracted from. Thus the usage of `essential’ here should not be confused with uses of the term such as essential fatty acids for example.

According to wikipedia, the scientific evidence for aromatherapy is weak and could only be considered as mildly encouraging for a limited set of possible uses. Proponents of aromatherapy suggest that there are 2 main ways that the therapy works; firstly by the influence of the aroma on the brain, and secondly by the pharmacological effects of the essential oils.

Unlike acupuncture, aromatherapy is considered a largely Western treatment regime. The delivery of aromatherapy can be via aerial diffusion, inhalation or directly on the body. Many of the potentially interesting essential oils, like lavender oil, eucalyptus oil for eg. may also be useful as a topical treatment in their own right.

As aromatherapy preparations are often concentrated, dilution with a suitable solvent would be advised.

Homeopathy

Does homeopathy rise about the mumbo jumbo sounding statement of `treating like with like’ ?  Can it offer something useful for rosacea sufferers ? While the formal description of homeopathy; “an ill person can be treated using a substance that can produce, in a healthy person, symptoms similar to those of the illness” doesn’t sound too bad, sadly the research has never been able to escape the placebo effect. When you consider that many homeopathic remedies are diluted such that the active ingredient is undetectable in the diluent, it isn’t surprising that any benefits are hard to prove.

What about the Placebo Effect ?

For those not familiar with the placebo effect, it might be worth exploring that further here. When a new medication is trialled, researchers need to prove the efficacy of the medication when compared to placebo. The mind is a powerful influence in any treatment, especially when the patient has an expectation of improving. When trialists expect that they are receiving the active ingredient, but are only receiving the inactive placebo, and do perceive a benefit – this benefit is known as the placebo effect. Thus a blind study is more convincing; where trialists do not know if they are receiving an active ingredient, and the response can be measured objectively.

There are several theories about why the placebo effect exists. A disease may have its own natural cycle, or some people may be predisposed to the power of suggestion.

Despite being hard to prove, homeopathy is one of the most wide spread non conventional treatment approaches alongside Chinese medicine, herbal medicine and osteopathy.

There is a lot of discussion about the merits of homeopathy as treatment regime. One robust criticism of the whole approach that is worth a read Quackwatch: Homeopathy The Ultimate Fake. The author, Stephen Barrett, M.D. asserts that the FDA has not held homeopathic products to the same standards as other drugs and that at best the remedies are just placebos.

Nutrition

We all of course know that what we eat influences our health. Just how much does diet affect our rosacea though ?

Some foods are known to be common rosacea triggers. It can be quite complicated to understand one’s own allergies and food intolerances, especially if there are rosacea flareups related to intake of unknown foods. One good source for further reading is the resource page Dietary Influence.

Beyond some directly traceable intolerance to a particular food, what about a particular style of diet ? Rosacea Diets have been around for several years. Can avoiding processed foods or eating an alkaline diet help your rosacea ? Anecdotal reports suggest that this may be the case.

One paper that looks to be heading an an interesting direction is summarised here; could rosacea be caused by diet ?

Pursuing a whole foods, plant-based diet is also something worth considering when thinking about your general health and longevity. My belief is that we would all benefit from seeking the advice of a dietician for our rosacea and indeed for our general health and wellbeing. With so many chronic diseases having links to diet, it makes good sense to explore good nutrition with a dietician.

Physical Therapies

This sort of therapy includes hydrotherapy, physiotherapy, sports medicine and soft tissue manipulative therapy. While it might be hard to imagine how physical therapies can help rosacea, they may well improve your quality of life. We also know that moderate exercise may help your rosacea.

Psychological Counselling

There has been little direct research between the effects of stress and rosacea. It appears that emotional flushing in rosacea sufferers may be maintained by a combination of both cognitive and physiological factors. What comes first though ? does stress  make rosacea worse, or does rosacea induce its own stress, and feed off itself.

While we wait for more research, those who do suffer from anxiety or depression will likely benefit from meditation, relaxation, and stress management.

Another result from some recent research linking rosacea and flushing found that `The stress and fear of blushing can be mitigated by psychological intervention such as Cognitive Behavioural Therapy and Task Concentration Training.’ These are 2 more options that may be worth exploring to help rosacea sufferers copy with flushing and anxiety.

Over to you.

OK, so I have tried my best to outline the depth of naturopathic treatments and frame them with some relevance to treating rosacea. What successes can you report ? Do these sorts of treatments hold much promise for rosacea sufferers ?

Related Articles

• treating rosacea with herbs
• Rosacea Support Community: A naturopathic physician’s take on treating rosacea
• RSRP: Dietary Influence
• rosacea diet review
• could rosacea be caused by diet ?
• natural anti-inflammatory therapies
• lavender, arnica, aloe vera, tea tree oil, and calendula ; do they work ?

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. The secondary result is that eliminating SIBO clears rosacea. Well that is no surprise ! Antibiotics interrupt the inflammatory pathway that causes the papules and pustules of rosacea. We all know that. This just published abstract doesn’t tell us anything new, although at first glance it might look like it.

What would be interesting to explore further would be what causes the SIBO. Could that cause point back to something triggering papules and pustules ?

If you view the AbstractPlus you will see that SIBO has been linked by the same team to Scleroderma, abnormalities in acromegaly, and IBS.

Small Intestinal Bacterial Overgrowth in Rosacea: Clinical Effectiveness of Its Eradication ,Clin Gastroenterol Hepatol. 2008 May 2, Parodi A, Paolino S, Greco A, Drago F, Mansi C, Rebora A, Parodi AU, Savarino V.

Department of Internal Medicine, Gastroenterology Unit, University of Genoa, Genoa, Italy.

….

CONCLUSIONS: This study demonstrated that rosacea patients have a significantly higher SIBO prevalence than controls. Moreover, eradication of SIBO induced an almost complete regression of their cutaneous lesions and maintained this excellent result for at least 9 months.

Extended Conclusion:

(continues) In fact in 78% of our patients, skin lesions fully cleared an in 17.7% improved greatly 1 month after interrupting rifaximin therapy. Moreover, all rosacea patients who remained unchanged with placebo treatment and were switched to the antibiotic arm showed the same dramatic improvement of their lesions. Last, rosacea was kept in remission in 96% patients followed for at least 9 months, and this remarkable finding contrasts with the frequent relapse observed with th traditional therapies.

..

How SIBO might lead to skin lesions is unclear. However, other associations between SIBO and extraintestinal diseases, such as fibromyalgia and NASH, have an unclear pathogenesis.

…

The clearance of cutaneous lesions in almost all rosacea patients after its eradication strongly suggests that SIBO plays a significant pathogenetic role in rosacea, expecially in its papulopustular component. Although the underlying mechanisms linking SIBO to the cutaneous lesions of rosacea need to be elucidated, we believe that our findings represent paramount progress in the clinical management of those frustrated patients.

Related Articles

• 100mg doxycycline no better than oracea
• Periostat and Oracea
• Subantimicrobial Dose Doxycycline for Acne and Rosacea
• Tetracyclines: their non-antibiotic properties

[Update]: there is a thread over a the forum SIBO diet/treatment, where Artist mentions that Rifaximin doesn’t leave the gut so doesn’t directly have any effect on the skin. This leads to the question of what inflammation has it blocked and what can we prove that this means ?

On a related note Seth Kendall speculates in his paper Remission of rosacea induced by reduction of gut transit time, that

“It is possible that intestinal bacteria are capable of plasma kallikrein–kinin activation and that flushing symptoms and the development of other characteristic features of rosacea result from frequent episodes of neurogenic inflammation caused by bradykinin-induced hypersensitization of facial afferent neurones.”

[Update 2]: I have a scanned copy of this paper. If you would like to read it, please email me – david@rosacea-support.org

A randomized, double-blind study of a nutritional intervention in the treatment of psoriasis, Mandeep Kaur, MBBS, Steven Feldman, MD, PhD, Ann McCarty, MS, PA, Wake Forest University School of Medicine, Winston-Salem, NC, United States

Background: The cellular immune system plays a dominant role in the exacerbation of psoriasis. The digestive system (by virtue of the profile, number, and species of bacteria present at any given time) influences the status of the immune system. Bacterial pathogens influence specific cytokine activity due to the activity of super antigens. Modulation of bacterial gut flora offers a potential target for psoriasis treatment.

Methods: Approximately 40 adult male and female subjects with mild to moderate plaque-type psoriasis will be enrolled. Subjects will be randomized to take a lactobacillus nutritional supplement versus placebo once daily for 8 weeks.

Results: The primary outcome of this study is the change from baseline to week 8 (or end of treatment) in the composite score of the signs of psoriasis (erythema, scaling, plaque thickness) for target lesions. Other outcomes include Investigator’s and Subject’s Global Assessment of Response and change in pruritus score.

Conclusion: This study will be a first step to understanding the use of nutritional intervention in treatment of mild to moderate psoriasis.

Author disclosure: The Department of Dermatology has received support from Ganeden Biotech. Sponsored by the National Psoriasis Foundation.

Poster Discussion Session P2805, American Academy of Dermatology, 64th Annual Meeting, March 3-7 2006, San Francisco.

Supplement to Journal of The American Academy of Dermatology, March 2006, Volume 54, Number 3.

• JAAD Poster Abstracts Online

Related Articles

•  could rosacea be caused by diet ?
• RSRP: Dietary Influence

Implications for the Role of Diet in Acne, Seminars in Cutaneous Medicine and Surgery Volume 24, Issue 2, June 2005, Pages 84-91, Advances in Acne Research, Cordain L.

Within the dermatology community, a general consensus has emerged that diet is unrelated to the etiology of acne. Except for 2 poorly designed studies, now more than 30 years old, there are few objective data to support this notion. In contrast, a large body of evidence now exists showing how diet may directly or indirectly influence the following 5 proximate causes of acne:

1. increased proliferation of basal keratinocytes within the pilosebaceous duct
2. incomplete separation of ductal corneocytes from one another via impairment of apoptosis and subsequent obstruction of the pilosebaceous duct
3. androgen-mediated increases in sebum production
4. colonization of the comedo by Propionibacterium acnes
5. inflammation both within and adjacent to the comedo

This article will provide a review of the currently available literature on the association between diet and acne vulgaris as well as a discussion of the physiologic principles that may underlie this association.

Conclusion and Recommendations

The last diet-acne trial was published in 1971. In the ensuing 34 years, great strides have been made in understanding how diet influences long-term health and well being. Unfortunately, appreciation of this information has generally gone unnoticed in the dermatology community, as witnessed by the 34-year vacuum since the last dietary intervention in acne patients. A substantial body of literature now exists that directly implicates diet as the most likely environmental factor underlying the development of acne. Confirmation of the diet-acne hypothesis will require numerous well controlled dietary interventions examining multiple nutritional factors. As a starting point, future experiments testing the diet– acne hypothesis should employ diets that mimic the nutritional characteristics of diets found in nonwesternized populations known to be free of acne. Although there is no single nonwesternized diet, there are certain universal characteristics that have a theoretical basis for testing. These diets are free of processed foods, cereal grains, dairy products, refined sugars, and refined oils and almost entirely comprise unprocessed fresh, fruits, vegetables, and lean meats, fish, and seafood.

• PubMed Extract
• DOI Link
• Full Article Online

Related Articles

• rosacea diet review
• Resources: Dietary Influence