SIBO Eradication Clears Rosacea (Rifaximin/Xifaxan): are you serious ?

99 Comments over 2 pages ↓

#44898 Hammer on September 28, 2010 at 2:57 AM

Hi again,

Could those of you who tried Riflaximin for 10 days (as indicated by the study) inform me about the dosage details?

The study mentions 1200mg per day for 10 days.

- Is this taken in one dose? Or spread out throught the day?

- With or outside of meals?

- Morning of evening?

Thanks again,

Hammer

#44899 Al on September 28, 2010 at 3:22 AM

Hammer,

I took three pills a day – and don’t recall when I took them. I’ll see if I can find my old prescription – it’ll tell me.

Al

#46472 dil on November 15, 2010 at 8:49 AM

Hi i have suffered from acne rosacea since i was about 16 years old and im 36 years old now …. so nearly half my life.
I have tried various diets ,creams and biotics over the years with little effect.
I live in Australia and would now like to Try Rifaximin but it is not approved here in Australia and was wondering if anyone knew of any reliable /legit websites to order from ?
Has anyone ordered online and recieved the real deal if so what was the website?
I got a script from my dodtor for rifaximin as some websites request a script but i am still worried that i will recieve a fake or not recieve it at all.
Also like someone else stated here in the forum what is the dose ?(1200mg a day for 10 days only? ) , with foods , do you need a repeat course after the 10 day course at all?
any info would be great
thanks….

#46488 Hammer on November 16, 2010 at 5:30 AM

I would also be interested. I am experiencing the same issue….

- Not available in Canada,

- Want to order online but want to me 110% sure of what I am buying,

- Proper dosage and posology?

Thanks again to anyone that can provide information,

Hammer

#46829 John on December 3, 2010 at 10:32 PM

If metronidazole(Flagyl) works by killing gut bacteria that produce methane, why do some rosacea patients improve with topical metronidazole ointment applied to the face??

#46830 Jeff on December 3, 2010 at 10:45 PM

is this true?

#52480 A on March 8, 2011 at 10:38 AM

My experience with rifaximin as an attempted treatment for papulopustular rosacea:

After I discovered the information about the allegedly uplifting results others had seen with this drug – in despair of the disfiguring consequences we are all too familiar with – I spent my last money on a trip to Barcelona, Spain, where rifaximin is produced and sold under the brand name Spiraxin – available for purchase in any pharmacy without prescription from a doctor. I actually took 1200 mg/day for two weeks, not just ten days. When taking my first dose, my rosacea was worse than ever, pretty much. Well, long story short, aften five days I noticed improvement, on day ten I was CLEAR! Since then (three weeks post-treatment), my skin has been so much better, with only the occasional little pustule or papule if I eat unhealthy as a little reminder to struggle with – I now have cleaner skin than most people my age (I`m 19):) SIBO was obviously my problem, and fortunately the bacteria reacted positively to the drug – thank you, life! How long it will take before I experience complete remission is unknown, but I`m at least hoping for a few months – rifaximin does not trigger resistant bacterial colonies in your gut and can be used repeatedly with approximately the same effect over and over again. Just remember to take probiotic supplement between courses. I`ll keep you updated whenever something remarkable happens, enjoying a renewed self-esteem and life quality in the meantime.

So, for others, try it; you have everything to gain and nothing to lose. I love and empathize with you all, stay strong and don`t give up no matter how troubling rosacea can be to how we judge ourselves. We are beautiful xanthochroids regardless.

#53616 D. Beales on March 29, 2011 at 4:02 AM

None of what the medical community does in relation to rosacea seems to make much scientific sense to me. Treatment is empiric, a fancy word for “educated guess.”

I think the reason the medical communty is so stumped about how to treat rosacea is that it is *all* caused by infection, and because it is caused by multiple pathogens and our ability to test for same in cases where infection is not rampant is so limited, we are left with the scattershot approach of trying antibiotic after antibiotic until something works.

Carbohydrates n the diet are correlated to bacterial overgrowth. Strict carbohydrate limitation may help, but some experts think it only has success *after* whatever pathogen has been brought under control.

Some diets I’m aware of that accomplish this are the Paleolithic Diet, and the Specific Carbohydrate Diet. Both are medically controversial.

I am discouraged that no one followed up on their progress over the long-term.

#53635 Hammer on March 29, 2011 at 7:07 AM

Maybe once a year or so, my face is dramatically more clear.

Whatever caused this to happen, has made me realize that my face and body can heal very quickly, when the different factors are in place.

This being said, I completed a full 7 day (168 hours) water fast (no food no cheating, only spring water).

If rosacea is related to diet, then I should of seen a better skin, which unfortunately did not materialize.

I attempted strict zero carb (only skinless chicken and boiled eggs) for a week…nothing.

Gluten free for 6 months…nothing.

Large quantities of digestive enzymes and hydrochloric acid…nothing.

Exaggerated amounts of Essential fatty acids…nothing.

Whatever causes my face to heal once a year, I would like to find out.
Difficult to trace…

I controlled and experimented for stress, which doesnt seem to be the answer either…

All of my blood chemistry, urine, stool, hair, and saliva tests are excellent.

Except for this:

- Very low cholesterol (even if dietary intake is high)
- Very low body temperature (thyroid is ok, tested 3 times)

……….

Hammer

#53639 Hammer on March 29, 2011 at 8:30 AM

Sorry, also forgot to add:

Low blood sugar

#53649 Al on March 29, 2011 at 10:34 AM

And Sexual Abstinence. Tried that for 24 hours and showed no marked improvement.

#53650 Al on March 29, 2011 at 10:37 AM

So, D. Beales – here is an update. I am still clear. Not 100% mind you, as I have one persistent little spot off to one side . . . . but better than I had ever hoped for. I may invest another couple of weeks to see if this one spot persists, then will try Riflaximin again and see if that wraps ‘er up.

#53676 D. Beales on March 29, 2011 at 7:57 PM

Al, are you saying you took rifaximin & it cleared you almost entirely? Now you’re considering attemtping a second course of it? Thanks for the follow-up. I am in great need of it. As my husband recently tested positive in a hydrogen breath test and has GI ulceration, it’s my theory that we are both infected with the same bug but are manifesting it differently. I am going to propose that we *both* go on rifaximin, and possibly my son as well, so we don’t continually pass it back and forth. It they haven’t even been able to fully understand SIBO, I’m fairly certain they also know little about its transmissibility.

Hammer, I have meibomian gland disease, whch is strongly associated with rosacea. Are you aware that “low cholesterol” (if by way of that you mean your HDL cholesterol is in the higher range) may actually be a problem? I will try to explain in layman’s terms…

There is new evidence that the body can produce a “defective” kind of HDL chlesterol, i.e. HDL is not the “good” cholesterol, as medical science has assumed for decades. Recently, meibomian gland disease has been identified in one study to be a possible marker for HDL-related disease and cardiovascular risk.

My theory, but this is only a theory and the evidence to support it is indirect at best, is that infection drives cholesterol dysfunction, which is why diet and exercise don’t control it in some people.

Here are some articles to think about. I have dozens of articles on a related theme around periodontal disease, which has been linked not only to rosacea, but heart disease, diabetes, and cancer, for for this purpose I’ll provide 3 related to the paragraph above.

The problem seems to be that no one is looking at the big picture, which IMO is infection. Just because we cannot identify it in laboratory analysis doesn’t mean it isn’t there. It means out testing methods are inadequate. For example, when I recently had a serious flare of periodoontal disease, a CRP and CBC came back completely normal. Anectdotal, I realize, but I’m a researcher and a scientist, and what that tells me is that our tersting methods are not sufficiently sensitive.

1. Am J Ophthalmol. 2010 Sep;150(3):371-375.e1. Epub 2010 Jul 8.

Association of dyslipidemia in moderate to severe meibomian gland dysfunction.

Dao AH, Spindle JD, Harp BA, Jacob A, Chuang AZ, Yee RW.

University of Texas Medical School at Houston, Department of Ophthalmology and
Visual Sciences, Houston, TX 77030, USA.

PURPOSE: To determine whether meibomian gland disease, a major contributor to dry
eye syndrome, is associated with dyslipidemia.
DESIGN: Retrospective case-control study.
METHODS: setting: Clinical practice. patient or study population: Sixty-six
patients from January 2008 to July 2009 with moderate to severe meibomian gland
disease whose serum lipid levels were obtained. We excluded patients who were
already taking lipid-altering substances and patients with rheumatologic disease.
We analyzed several parameters in prevalence of dyslipidemia (total cholesterol >
200 mg/dL, low-density lipoprotein [LDL] > 130 mg/dL, high-density lipoprotein
[HDL] 150 mg/dL) in MGD patients and compared
these patients to the general population as reported by data from the National
Health and Nutrition Examination Survey (NHANES). main outcome measure: The
prevalence of dyslipidemia (elevated total cholesterol, elevated LDL, decreased
HDL, or elevated triglycerides) in patients with moderate to severe MGD.
RESULTS: Patients with moderate to severe MGD had a higher incidence of
dyslipidemia with respect to elevated total cholesterol (>200 mg/dL), 67.4% to
45.1% (P = .0012) when compared to population controls. There was a smaller
number of MGD patients with low HDL (HDL 150 mg/dL), 15.2%, when compared to controls, 33.1%
(P = .0049).
CONCLUSIONS: Patients with moderate to severe MGD have a higher incidence of
dyslipidemia with respect to elevated total cholesterol than the general
population. Surprisingly, the component of total cholesterol that contributed
most to this increase in total cholesterol came from elevated serum HDL levels.
To our knowledge, elevated HDL has not been associated with any pathologic state.
Patients with MGD had a statistically significant lower incidence of
hypoalphalipoproteinemia (low HDL) than the general population. Patients with MGD
also had a lower incidence of hypertriglyceridemia than the general population.

PMID: 20619393 [PubMed - indexed for MEDLINE]

2. N Engl J Med. 2011 Jan 13;364(2):127-35.

Cholesterol efflux capacity, high-density lipoprotein function, and
atherosclerosis.

Khera AV, Cuchel M, de la Llera-Moya M, Rodrigues A, Burke MF, Jafri K, French
BC, Phillips JA, Mucksavage ML, Wilensky RL, Mohler ER, Rothblat GH, Rader DJ.

Cardiovascular Institute, University of Pennsylvania, Philadelphia, USA.

Comment in:
N Engl J Med. 2011 Jan 13;364(2):170-1.

BACKGROUND: High-density lipoprotein (HDL) may provide cardiovascular protection
by promoting reverse cholesterol transport from macrophages. We hypothesized that
the capacity of HDL to accept cholesterol from macrophages would serve as a
predictor of atherosclerotic burden.
METHODS: We measured cholesterol efflux capacity in 203 healthy volunteers who
underwent assessment of carotid artery intima-media thickness, 442 patients with
angiographically confirmed coronary artery disease, and 351 patients without such
angiographically confirmed disease. We quantified efflux capacity by using a
validated ex vivo system that involved incubation of macrophages with
apolipoprotein B-depleted serum from the study participants.
RESULTS: The levels of HDL cholesterol and apolipoprotein A-I were significant
determinants of cholesterol efflux capacity but accounted for less than 40% of
the observed variation. An inverse relationship was noted between efflux capacity
and carotid intima-media thickness both before and after adjustment for the HDL
cholesterol level. Furthermore, efflux capacity was a strong inverse predictor of
coronary disease status (adjusted odds ratio for coronary disease per 1-SD
increase in efflux capacity, 0.70; 95% confidence interval [CI], 0.59 to 0.83;
P<0.001). This relationship was attenuated, but remained significant, after
additional adjustment for the HDL cholesterol level (odds ratio per 1-SD
increase, 0.75; 95% CI, 0.63 to 0.90; P=0.002) or apolipoprotein A-I level (odds
ratio per 1-SD increase, 0.74; 95% CI, 0.61 to 0.89; P=0.002). Additional studies
showed enhanced efflux capacity in patients with the metabolic syndrome and low
HDL cholesterol levels who were treated with pioglitazone, but not in patients
with hypercholesterolemia who were treated with statins.
CONCLUSIONS: Cholesterol efflux capacity from macrophages, a metric of HDL
function, has a strong inverse association with both carotid intima-media
thickness and the likelihood of angiographic coronary artery disease,
independently of the HDL cholesterol level. (Funded by the National Heart, Lung,
and Blood Institute and others.).

PMCID: PMC3030449 [Available on 2011/7/1]
PMID: 21226578 [PubMed - indexed for MEDLINE]

3. N Engl J Med. 2011 Jan 13;364(2):170-1.

HDL and cardiovascular-disease risk–time for a new approach?

Heinecke J.

Comment on:
N Engl J Med. 2011 Jan 13;364(2):127-35.

PMID: 21226584 [PubMed - indexed for MEDLINE]

#53677 D. Beales on March 29, 2011 at 8:10 PM

I should also add that I too, like Hammer, have attempted many unsuccessful treatments, including:

*Dr. Tseng’s demodex mite protocol (tea tree oil applied according to his published article in British Journal of Derm)
*apple cider vinegar (could not keep it down)
*sodium bicarbonate (could not keep it down)
*HCL tablets
*carbohydrate restriction
*topically applied borax/hydrogen peroxide solution (helped the acne, not the redness, meibomian gland disease)
*salicylate wash (also helped the acne but did nothing else)
*immunosuppressive therapy
*low-dose doxycycline
*low-dose minocycline
*clavenulate-amoxicillin
*azithromycin

Nothing has helped.

#53682 Hammer on March 30, 2011 at 1:29 AM

Thank you for the information D. Beales.

I’ve been trying to research the significance and implications of low cholesterol levels.
Reading on the subject…Alot of conflicting information.

The book: Ignore the awkward by Dr. Ravnskov, relates with your evidence on abnormal cholesterol levels and infection as a factor.

Here’s the average of 4 of my blood samples in the last 2 years (early 30s – male):

Total: 2.89 mmol/L
Tri: 0.66
HDL: 0.92
LDL: 1.76

*** Are there any guidelines or places you can advise I research or educate myself further?

The rosacea-bacterial overgrowth-infection link appears to be the answer. I can assure all that, at this point, I am not deficient or missing in any nutrients…

Therefore if not diet, or lifestyle based (I experimented with different factors)….bacteria would seem like a better hypothesis.

My experiments with very high intakes of fresh garlic along with other anti-microbial herbs yielded little results. But perhaps a stronger antibiotic (taken with probiotics) could be a solution.

I prefer to avoid taking antibiotics, and since Riflaximin appears to work only when a particular bacteria is detected, how or where can an individual take a breath test to determine if the bacteria in question is present?

Hammer
(in Canada)

#53683 D. Beales on March 30, 2011 at 1:54 AM

I don’t know of any one source that would give you what you’re looking for, Hammer. The medical community itself appears to just recently be recognizing the infection/cholesterol link, and it is *very* controversial as to whether cholesterol comes first and bacteria grow because they’re attractd to it, or vice versa. The only way you might get at this is to search http://www.pubmed.gov using the terms you’re specifically interested in, but be prepared to read information at a very high level of understanding, and full text articles are not usually free.

You should ask your doctor about hydrogen/methane breath tests. Show him/her articles relating SIBO to rosacea. They are also controversial, and the evidence within them is not considered to be strong.

#53898 mrtlbbry on April 6, 2011 at 5:25 PM

Hi,

I’m very interested in the potential link between SIBO and Rosacea. I was recently diagnosed with rosacea and have had terrible p+p’s for around a year now. I am 31 years old and never had problems with my skin before – even as a teenager.

It took a while for a definitive diagnosis (misdiagnosed as acne and even a skin infection) and I have been prescribed both Erythromycin and Metronidazole topical treatment since diagnosis with little improvement. Flare ups are more regular but less severe.

Like many I was interested in the SIBO link. I am especially curious as two recent blood tests have show that I have significantly raised Bilirubin (studies suggest raised serum bilirubin reliably predicted presence of SIBO). My GP is scratching her head as to what is causing the raised level and we’re awaiting advice from the local Gastro dept.

@A (who purchased Rifaximin (Spiraxin) in Barcelona and have good results).

I have a few of questions about your purchase.

1. Did you buy your full dose from one pharmacy or did they have a limit on how many packets you bought?

2. What was the pack size and cost of each pack? My research has shown Spiraxin is available in 12x200mg packs but you may have more accurate info.

3. Are you still ‘clear’?

thanks

#54100 deborah on April 14, 2011 at 5:03 AM

Hammer: OMG i have low cholesterol, low body temp and sometimes low blood sugar, and rosacea. weird. i can tell you that my rosacea was in a remissive state when I Attacked my candida yeast or SIBO as they call it here; bad bacteria is what I refer to it as. I began rosacea symptoms in my early 30′s having no idea what it was and then one day i was waiting for a dental appt and read a magazine and there it was on a page. So i went to a dermatologist and he said i will put u on tetracycline for life! So knowing how bad antibiotics can be long term I said i would try for a month and do a checkup – he convinced me to try one more month and my face was perfect, but I would not continue so i went off of them and proceeded to gain weight and become depressed and had no idea why. After a few years i found out that the antibiotic killed my “good” bateria and that I had an outrageous overblown yeast problem. So now (then) I am 210 pounds, and determined to get my life back. I bought a program online which killed the yeast (wholeapproach.com) Caproyl (coconut oil), physlium husk and bentonite. I also cut out most carbs – any white foods like flour potatoes rice etc and ate a few whole grains and lots of fruits and veggies, very little dairy and no meat (i am a vegetarian). So after two weeks of that I began to feel a little better and had some energy and started walking everyday, 10 min, then 15, then 30 and when i was doing 45 a day I had gone from a size 16 to a size 8, i started to ride a bike, a mile then 2 etc. and at about two months at 15 miles a day I was wearing sz 4 and 127 pounds; it took 9 months total and I looked and felt great and no rosacea! My skin was starting to tan a little and no pustules or very much redness at all. I did use sun screen before going outside (in Florida) and all in all I was doing very well. I kept the weight off for over a year and unfortunately was HBC while riding my bike and i have been on and off my diet and excersize program every since. It took me about a year to recover and i shot up to 165#. Now I am looking to get back into it, I can tell the yeast is back; sweet cravings, weight gain and depression. It is a hard uphil battle I can tell you, but it is doable. So for the record i beleive that there is a direct link to the sibo and rosacea. Another anecdotal thing to consider is that this diet is often called the celtic curse and what did the Irish eat for decades? potatoes! carbs in fact – so it is very possible that it effected their gut bateria and perhaps made a predisposition. Anyway I would love to try this antibiotic to kick start my program but i don’t have the money to go to a doctor for the prescription. Anyone know a way around it? thanks and good luck to everyone!

#54269 Al on April 16, 2011 at 1:56 PM

Well, my single red spot has grown into a regular pustule and now has several friends and family on my chin. Just like before. So, back to the doc and just started a new course of Riflaximin ( Xifaxin actually ) today. They come in 200 mg pills so I am taking three in morning, three at night for a daily dose of 1200 MG for two weeks. Going to go for carpet bombing and hope for total obliteration this time. Once done, I may try Probiotics like Flora Q and see how long I stay symptom free. Any probiotic suggestions?

BTW – Had my Cholesterol checked again ( I’m always high but have no other issues – my BP and pulse are low, weight is lowish, no history of heart disease, I exercise and eat very, very well etc . . . ) and my lipoprotein profile reads like a horror-book. 330 total, HDL = 60, LDL = 254 and a ratio of 5.5. Go figure.

Anyways – we’ll see what happens in the days ahead.

#54383 Emily on April 18, 2011 at 7:52 AM

I’m not nearly as knowledgeable about the rest of you as far as rosacea and mine is mild, but I wanted to throw this out: I have celiac disease, an auto immune disease which causes villous atrophy in the small intestine, and thus, poor vitamin absorption, malnourishment, and other digestive problems. Often, celiacs (and those with IBS and Crohn’s and other GI disease) have SIBO, and I did, diagnosed on hydrogen breath test.

My understanding is not that I have a contagious ‘bug’, but that there is bacterial growth in the small intestine that shouldn’t be there, given the failure of my small intestine to work properly. SIBO causes celiac-like symptoms of malabsorption and villous atrophy, so it may be that the roscea isn’t liked to diet, per se, or cured by the Xifaxin which doesn’t leave the small intestine, but overall health. In other words, when I fixed my gut completely, my skin cleared. As a result of celiac and SIBO, I was a mess but had to treat both (with the gluten free diet and Xifaxin, after the GF diet didn’t get rid of my symptoms). Hydrochloric acid seem to work in brief spurts before SIBO, but it clearly doesn’t treat the infection. (Which makes sense, given how intractable gut infections are).

I took Xifaxin for 2 weeks (1200 mg per day) and like the rest of you, my skin cleared up immediately. Those of you who write about this may want to consider whether you have gut problems that give rise to some sort of malnourishment/failure to absorb nutrients from your food that allows your skin to become inflamed. I’m pretty sure it’s worked like that for me.

Anyway, I wanted to throw those things out there because I’ve been shocked at the extent to which all these things have, in my experience, been related.

#59476 Nancy on June 11, 2011 at 11:23 PM

I’ve been suffering from rosacea for the past six years and am being treated at a well respected hospital in San francisco, ca. My derm. Just prescribed xifanan 550 mg., 2x/day, and pretherin cream to kill skin mites. It’s only day 3 and I’m literally watching and waiting to see if I will have improvements with these new treatments. My face felt cool and soft after the first treatment with the cream but I have to do a second treatment 7 days later (tonight) and then observe to see if I get any more acne rosacea. I’m skeptical since my rosacea is difficult to control, but I’m hopeful.

#60057 Kathleen on June 23, 2011 at 10:03 AM

Oh my gosh, the Dr’s have been of little help for me. This site is a God send. Have been on prilosec for 5 and a half years due to reflux from a hiatal hernia, was increased to twice a day for 3-4 mos last year due to voice problems ( LPR ). Developed allergies a year ago, much much worse, the past 6 mos, have dropped 12-14 pounds without trying since I can eat so few foods without reacting. GI said no connection between allergies and gut, suggested a probiotic or Neomycin, probiotic caused bloating, did not take the Neomycin for many reasons. GI thought I might have SIBO due to prilosec. Last year face/neck so red ! One dermatologist said nothing about rosacea, one last week said I had it and to use topical cream. This is all fitting together at long last. Have seen 2 acupunturists, a Holistic Nurse Practitioner, a Homeopath, 2 GI’s, 2 Dermatologists, in addition to primary care. It is sad that I have to do put the pieces together myself. Have spent hours and hours researching and just today decided to google rosacea again and was amazed at the connection with CIBO. Thanks for all the great explanations. Have a GI appt in a couple weeks, allergy next week—all she wants me to do it take meds, cannot tolerate zrytec or allegra, claritin does nothing. Went to a dietician who was no help at all. Am interested in histamine producing foods since I can only eat chicken, turkey, oatmeal, quinoa, cabbage, lentils, broccoli without reacting. Anyone else having food challenges ? Thanks again. I am a retired nurse so pretty familiar with navigating the system but the lack of help in this case is very sad.

#60657 rich on June 28, 2011 at 8:27 PM

hey guys, i live in australia. does anyone know how i would go about getting a hydrogen breath test and get hold of some rifaximin. my gp knows nothing about either. cheers

#60665 Hammer on June 28, 2011 at 9:20 PM

Sorry, I dont.
(Im in Canada and dont know how to get either here neither).

#60997 MARY on July 3, 2011 at 7:46 AM

my rosacea appeared at 78 yrs of age. I am fair skin but any sunscreen seems to irriate. So far I haven’t had any luck with trying elimanting various things in my diet.I saw article on rifaximin and tried it for 10 days. My insurance wouldn’t approve it so had to pay $240 myself. My redness, etc. seemed to improve for one month after two 200 mgs tablets of rifaximin for 10 days. Now, however, my redness, etc. is back. I wish I knew more about chances of help from repeating rifaximin as am on a fixed budget. Thanks
Mary

#61036 Al on July 5, 2011 at 12:44 AM

Mary,

Here it is, July 1st and on April 16th this year I took three Rifaximin in the morning, three at night for a daily dose of 1200 MG for two weeks. I also took NEWCHAPTER Organics Probiotic All-Flora pills ( 2 per day ) since then.

I am 100% clear, no redness, no pustules and very, very pleased.

I am hoping that this is the end of a long story for me. I strongly recommend that anyone try this simple approach if you possibly can.

Good luck all.

#61675 harry on July 11, 2011 at 5:07 PM

Hi, $240 for 10 day course of 2 tablets of 200 MG/day is very very expensive. You can get it for 1/3rd of the price in Malaysia or Thailand or Sri Lanka. For a 2 week period of 1200 MG per day (3 times x 400 MG tablet / per day), it would only cost you 100 USD. Pity that you guys have to shell out so much. If anyone is in need of the tablets, please let me know.

#61709 rich on July 14, 2011 at 6:48 AM

harry, can you post it to australia?

#61763 Troy on July 17, 2011 at 8:06 AM

Rich, apparently http://www.CDD.com.au can prescribe it, they are in Five Dock Sydney. Hydrogen breath tests can be done at Stream In Box Hill, Vic, at Warringal hospital Heidelberg, Vic or at CDD in Sydney also.

#62679 Francisco on August 4, 2011 at 12:28 AM

I’m have suffered from acne rosacea since i was about 16 years old and im 42 years old now, I have 4 days trying rifaximin 200mg (in Venezuela called Normix) my gastroenterologist recommended dose of 800mg daily, 400 mg at breakfast and dinner. I’m still awaiting a response from my dermatologist. comment on my experience later. Thank you.

#64202 Mike on August 31, 2011 at 2:25 AM

I live in the uk but got Rifaximin known as Spiraxin in Spain, sent to me by a friend as I was unable to obtain it in the UK. It was like a miracle!! After about 5 days my skin began to clear and after 10 days I had a perfect nose again!!! A week afterwards I have one bad patch, although not sore as it was before. I shall repeat the treatment as mine was particularly severe before the treatment. I have also noted a marked improvement in my stomach and have not experienced on bout of IBS! It has to be worth a try!!

#64561 Hammer on September 9, 2011 at 3:04 AM

Rifaximin is not available in Canada.

I contacted the manufacturer (Alfawaffermann) in Italy.
They only sell it to distributors.

The antibiotic is sold under different brands:

USA, Germany, Poland –> Xifaxan
Spain –> Spiraxin
Tunisia, Venuzuela, Italy –> Normix
Mexico, Colombia –> Flonorm

I want to give it a try and see what it does for me, however living in Canada makes it more complicated. I could drive to the US, however it is not sold over the counter and therefore requires a prescription.

I am tempted to order online, however I want to be absolutely certain that I am getting the real thing. No generic, nothing else.

Many online pharmacies exist (many appear shady).

Are any of you aware of a legitimate one I could order from?

Alternatively, I would be willing to buy directly from you (and pay extra) in order to make certain I am receiving the legitimate product.

Hammer

#64562 Hammer on September 9, 2011 at 3:06 AM

I forgot another option…

I would also be willing to travel to purchase the antibiotic personally should it be available over the counter…Mexico, Spain, Italy…

If anyone knows if thats the case in either of those countries, I’m there!

Hammer

#64784 Darby on September 11, 2011 at 7:41 AM

I have suffered with acne/rosacea my entire life. I took accutane in my 30′s which cleared me for a while but then rosacea reared it’s ugly head. I am 57. Last December I printed an article about xifaxan and rosacea off and took it with me to my annual gynecologist appointment. He wrote me an RX but for the wrong dosage; 200mg 3xday. I had it filled ($300) my insurance would not cover it. I took the 10 day course and have been clear for 9 months. I am just starting to have a few issues again now. I took the same information to my dermatologist who had never heard of this before. After researching it, she wrote me an RX. (insurance still won’t cover it)We are going to do the lower dose since I responded so well to it before. She also advised me that the NIH is going to do a clinical trial of xifaxan and rosacea. Good news for all of us!! I did take probiotics on and off but was not sure if you should take them for a long period of time. I use Florastor. If anyone has more information on how long to take the probiotics, I would appreciate you sharing it.

#64804 Hammer on September 12, 2011 at 12:04 AM

Hi Darby,

Probiotics make my symptoms much worse.

Anyone willing to send me Rifaxin (Im in Canada, none here), I am willing to pay for the antibiotic + your troubles.

Hammer

#64951 Pete H on September 17, 2011 at 12:37 AM

Hi all…

I am 76. I have had nose area rosacea since age 41. Tetracycline, and then doxycycline in recent years, always beat it into remission with zero side affects. Lately I have used a topical foam product by Onset Therapeutics called Clarifoam EF. It is sodium sulfacetamide and sulfur based. It works very well.

This site is really really great for rosacea sufferers. I am convinced that rosacea has many different possible causes and severeties that differ depending on each individual. Thus, the possible remedies differ depending on the individual. The great thing about this site is that it covers the whole waterfront somewhere. So trial and error will most likely narrow down the causes and remedies to one, or several, that work for you.

The one common piece of advice I will volunteer to fellow sufferers is: Become a compulsive hand-washer, keep your fingers away from your nose, and do not touch your face after petting a dog, or, especially, a cat. The bacteria on a cat’s coat would colonize the solar system.

With thanks and best wishes for this site.

Pete H

#65029 Deborah on September 19, 2011 at 8:18 AM

Pete H. well that is interesting what you say about animals. I started with symptoms after getting our two shepherds when i was 30 something. my face broke out into a hundred tiny white heads when i went to the beach one day. I no longer have the dogs, but have had a long hair cat for 16 years and bury my face in his coat often. I had a bad over growth of candida yeast when using tetracycline for two months years ago and have used nothing since. My skin is frequently red and breaks out. I touch my face a lot. I would love to try this antibiotic they speak of but do not have the money nor insurance. Thanks for the tip, guess I can try that.

#67520 Heather on October 28, 2011 at 1:24 AM

I’m 34 and had had symptoms of Rosacea for about 5 years. I tried many approaches: antibiotics and mitrogel cream, Pluse dye laser, low glycemic index diet, herbal and vitamin supplements, etc. I should also mention that I had about an 8 year period of chronic UTIs in which I was on numerous antibiotics, prior to the manifestation of my Rosacea. I had never tried Rifaximin, but after reading the article decided to give it a shot.

We ordered Rifaximin from India–I believe the death penalty is the puinishment for selling fake drugs in India.

I followed the dosing in the protcol, athough I don’t remember how I spaced out the doses. (BTW-I did not get the SIBO breath test beforehand because I couldn’t find a MD who would order it for me.) I would say that my symptoms have not completely resolved, but they are at least 50% improved–I have not had a papule or pustule since taking the Rifaximin. Also, I have not been on any antibiotics since taking the Rifaximin.

One more thing, I took “candigone” after I took the Rifaximin because I thought I might have a yeast infection in my pores.

#79398 Oopsiedaisy on December 20, 2011 at 11:22 AM

I did the course of Rifamixin. Cannot recall the dose or length of time, but basically I printed out the study and my PCP prescribed me exactly what the people in the study were given. I followed it perfectly and saw NO improvement. Also, Rifamixin wasn’t covered by insurance, so I spent several hundred dollars out-of-pocket on this little experiment.

It just goes to show you that not everyone’s Rosacea has the same cause(s)…

#80317 Fern Roy on December 23, 2011 at 11:00 AM

Does most people get tested for SIBO before they start the treatment? MY GP Dr said they do not usually test because it is to expensive and not reliable. If the Dr thinks you have it they just put you on the meds instead. I have had intestinal problems for around 5 yrs since I had colon surgery. I now have Ocular Rosacea, dry eyes, inflamed eyes and eye lids, etc. Will be seen the GI Dr next week and will take the article w/me to see what he says. My system has not been able to tolorate Doxy, erythorcin since my problem leading up to surgery and the surgery. Not sure how hard xfaxan is on the stomach. I do not know how expensive it is here in the US, I do buy some things from Canada but it does not sound like it is any cheaper there. Fern

#80335 Darby on December 23, 2011 at 12:39 PM

Fern, My husband has had a few colon surgeries. His GI doctor put him on a course of xifaxamin when he was having severe diahrea. I don’t recall how long he took it or the exact dosage because he started it when he was hospitalized but I think it was only 3-5 days. (this was over a year ago) At the time, he was also dealing with nausea issues. He had no adverse side effects from the xifaxamin. Our insurance did cover the RX since it was prescribed by a GI doctor for a GI issue. We did pay 3 tier level co pay. The insurance did not cover it for me as it was written by my gynecologist for my face. I called several pharmacies and the cheapest was Costco. The cost is around $600 if your insurance won’t cover it. It may help you with both your rosacea and your GI issues. My husband’s GI doctor had samples he was going to give us but my husband was discharged on the weekend when he was not on duty. Your doctor may have some samples. It wouldn’t hurt to ask!

#80932 Fern Roy on December 25, 2011 at 10:33 AM

Hi Darby;

You did not say if it helped with the GI problem or the face?? I will be seeing my GI Dr on Thursday with the lit in hand to show him. I have had the GI problems since my colon surgery about 4 or 5 yrs. I have Ocluar Rosacea, inflamed eyes and eye lids for around 5 mo. I am hoping to try xifaxamine to see if it will help both. Thanks, Fern

#85062 Ken on January 8, 2012 at 10:13 PM

Just thought I’d provide the group with my own experience using Xifaxan/Rifaximin, which I turned to after trying virtually everything else available.

I am a mid-50′s, fair-skinned US male who has had type-II rosacea since at least his 20′s.

Through most of that time I have also suffered from acne vulgaris, which kept the rosacea from being diagnosed until telangiactases began to appear late in my 30s. I went through a course of accutane in my late 20s for my “regular acne,” which totally ceased being a problem for me only a couple of years ago. (I no longer get blackheads–just the papules and pustules of rosacea. I’d gladly trade one problem for the other, thank you very much.) I also have seborrhea, mainly in the eyebrows, which tends to be worst in the winter. Otherwise, my health is very good–I exercise regularly, eat well, etc.–although fairly minor, non-specific intestinal issues bother me on occasion (low-level nausea, looser than normal stools, etc.) I am probably a bit lactose intolerant, and stay away from milk products most of the time.

As for other rosacea treatments, not one of the typically-prescribed topicals (like metronidazole, azelaic acid, etc.) or oral tetracyclines (like doxycycline) work, period. The only things that do work–but only while taking them–are macrolides like azithromycin, and, of all things antibiotic, amoxicillin. (For me, amoxy works like a charm.)

OK. I took a hydrogen breath test, which I got after sending my GP the 2008 Italian study. It came back mildly positive for SIBO.

My doctor then prescribed Xifaxan 1200 mg/day for 10 days, just as in the study.

Immediately before starting the Xifaxan, I had finished a course of Amoxicillin, so I was clear to start. (After completing a course of Amoxy, the rosacea papules always reappear within a couple of days.)

Well, while taking the Xifaxan, I remained totally clear, until the ninth day of treatment, when one solitary papule appeared near my upper lip.

Unfortunately, that one uninvited guest was soon joined by scores of others for the usual party, all within three days of finishing the scrip. I am now nine days out from completing the treatment, and it is as if I never took it.

I was hoping for at least a few months of respite, but it was simply not to be.

My experience suggests the following, at least to me: given that the body plan of all life forms from planaria to humans is the same (a hollow tube), the skin and the gut are one and the same, just differently placed, and what affects one will likely also affect the other. This may help explain why Rifaximin works on rosacea, regardless of its not being adsorbed into the bloodstream. Rifaximin has anti-inflammatory characteristics, just like other antibiotics. No great surprise then, that it works at least to some extent on the symptoms of the condition.

It’s back to square one for me. Given that the etiology of rosacea is doubtless multifactorial, don’t let my story keep you from trying Rifaximin as a long-term prophylactic, if not a cure. It might work for you. Just don’t be too disappointed if it doesn’t, or doesn’t work beyond the time you take it.

#85093 Pete H on January 9, 2012 at 12:20 AM

Of all the causes and remedies I have read about on this excellent site I am really starting to focus on mites and the toxicity of their fecal deposits under my nose skin as the real engine of my rosacea. Why don’t the mites burrow into other places on my body that are warm and blood engorged? Maybe they live and colonize on my pillow where my nose rests all night long. Maybe there is a natural selection process whereby only mites of a certain physical character are attracted to burrow into my nose skin. I am starting to rub my nose with alcohol before I get into bed thinking that it might discourage them. What is the best topical mite killer? I want to try it.

Pete H

#85096 Ken on January 9, 2012 at 12:35 AM

You asked about the best topical mite killer. Definitely alcohol, but it’s really best if taken internally. I suggest MaCallan cask strength or Glenmorangie.

Seriously, I always thought demodex mites were merely a(nother) symptom, not a cause, and I’ve never tried treating for them.

Causation seems unlikely to me, but stranger things are no doubt true.

#85111 Ken on January 9, 2012 at 1:34 AM

David Pascoe, in his original blog post more than 3 1/2 years ago, asked what inflammation is blocked by Rifaximin.

Looking at the studies, ingesting it apparently increases the levels of the anti-inflammatory cytokine known as interleukin-10. (Whatever the heck that is.)

I have to find my lab coat, polish my glasses and paste on a pointy little beard in order to quote the following, so hold on a minute….

Ahem: “Rifaximin increases the expression of PXR and PXR-regulated genes involved in the metabolism and excretion of xenobiotics and antagonizes the effects of TNFα in intestinal epithelial cells.”

That’s from a December 2010 paper published in Biological Pharmacology, entitled “Pregnane-X-receptor mediates the anti-inflammatory activities of rifaximin on detoxification pathways in intestinal epithelial cells.”

Obviously, the quoted bit means f-all to most, including yours truly.

Nevertheless, the take-away is pretty clear: rifaximin interrupts the inflammatory processes that lead to typical rosacea symptoms. Hence its effectiveness, at least so long as you are taking it, and perhaps for awhile afterwards.

What causes the inflammation in the first place, to ask the big-money question?

Who knows. Probably numerous things, which are different for different people.

Me, I don’t know what I might be doing (if anything) that is causation linked. I think I’ll start by eliminating all the surmised possibles from my diet (including the usual “triggers”) and if the symptoms subside, I’ll start adding things back in, one at a time. (And if it doesn’t subside, at least I’ll know that diet isn’t a likely contributor to the problem.)

So goodbye, wine and spirits. Goodbye, all simple carbs, grains and gluten. Goodbye, hot peppers. Goodbye, hot soup. Been nice knowin’ ya.

#85145 Deborah on January 9, 2012 at 5:44 AM

Hi Ken I think the inflamation is from candida yeast which is promoted by sugar intake and many other things. i believe the antibiotic works because it kills the yeast; there are other ways to do that as well such as changing your diet and using caprilic acid (derived from coconut) a website called wholeapproach.com explains it all. and yes all those things you mentioned except perhas the peppers and hot soup will have to go at least for a while. good luck, i am in the process of killing my yeast once again!

#85150 Ken on January 9, 2012 at 6:09 AM

Sorry, Deborah, but antibiotics kill or prevent or slow the growth of bacteria, not yeasts. They are two different sorts of life entirely, as different, perhaps, as house cats and mushrooms.

Candida (usually, C. albicans) is, as you know, a yeast. Yeasts are fungi, and to kill or control fungi you need an antifungal. Antibiotics do not kill yeast–in fact, they can at least indirectly promote their growth!

In other words, killing all sorts of bacteria, both good and bad, with the use of a broad spectrum antibiotic often “makes room” for the growth of yeasts like C. albicans.

That’s why it is always a good idea to take probiotics when you are taking an antibiotic (if not an antifungal), so that, to the extent you can, you do not enable the overgrowth of other organisms, like C. albicans.

Anyway, yes, it’s a good idea to stay away from sugars and simple carbs that easily break down into sugars. There is way too much of both in the modern diet. I doubt, however, that there is that much of a connection with rosacea, at least in my case, as I limit my intake of sugar and processed foods, and have for years.

#95801 juanita... on April 8, 2012 at 3:00 AM

Hello all,

I have a sister who was recently diagnosed wit rosacea.. she is 17.. dermatologist prescribed metronidazole cream and some antibiotics… I’m really hoping it helps and I was reading and thought where can she get a hydrogen breath test.. and if she took rifaximin would it help?