Treating Intestinal Bacteria with Xifaxan May Improve Rosacea

Some more recent publicity from Internal Medicine News on the possible link between Small Intestinal Bacteria Overgrowth (SIBO) and Rosacea.

In 2008 Rosacea News highlighted a paper that suggested that treating patients with rosacea and SIBO with Rifaximin would improve both their SIBO and rosacea symptoms. That posting has attracted a lot of interest, heading towards 100 comments. Two threads in the online support forums are also growing.

In 2010 an article in the St. Louis-Dispatch also highlighted the work or Dr. Weinstock, a Gastroenterologist, in explaining the success in treating some rosacea patients with Xifaxan (brand name for rifaximin 200mg).

Large Clinical Trial

The recent article, extracted below, mentions that a further large randomized clinical trial is underway. That trial (which looks to be NCT01359228) will study 100 patients in two groups – the active group to receive a dosage of Xifaxan 550mg, 3 times a day for 14 days – and the inactive arm to receive placebo (and then cross over).

This is great news! Rifaximin will get a thorough testing as a general treatment for rosacea symptoms.

Latest Publicity

Treating Intestinal Bacteria May Improve Rosacea


By: HEIDI SPLETE, Internal Medicine News Digital Network


NATIONAL HARBOR, MD. – Treating patients with both rosacea and small intestinal bacterial overgrowth with the drug rifaximin was associated with improved rosacea symptoms in some patients, in a small, preliminary study. The findings were presented at the annual meeting of the American College of Gastroenterology.


A total of 32 rosacea patients were positive for SIBO, and 28 of these (including all ocular rosacea patients) received 1200 mg/day of rifaximin (two 200-mg tablets 3 times daily) for 10 days. Of the treated patients, 46% showed clearance of, or marked improvement in, rosacea symptoms, while another 25% showed moderate improvement.

"All four patients with ocular rosacea and SIBO reported marked improvement in conjunctivitis, sclera erythema, and dry eyes following treatment with rifaximin," Dr. Weinstock noted.


Major Finding: Of 28 adults with both rosacea and small intestinal bacterial overgrowth (SIBO), 46% of those treated with rifaximin for 10 days showed improvement in rosacea symptoms.

Data Source: A prospective study of 32 adults with rosacea and SIBO.

Disclosures: The study was supported by a grant from Salix Pharmaceuticals, maker of rifaximin.

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About the Author

About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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1 Reader Comment

  1. Doug says:

    Wasnt there a study where SIBO should be treated depending on if you had more hydrogen or methane? The SIBO test is a breath test correct? Also, it looks as if they are only testing people with Type 2 Rosacea. UGH! I have Type 1 and am wondering if anyone with Type 1 has been tested for SIBO. If so, did you get treatment and did it help your Rosacea?

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