What role do micro-organisms in play in Rosacea?

Written by on December 10, 2010 in Demodex Mites, research, What Causes Rosacea? with 0 Comments

This abstract promises to tell us everything we need to know about the possible role of micro-organisms in the way that the disease Rosacea starts and develops.

Even though the role of published research is not to provide reading material for the general public, I still look to journal articles to move the science forward.

This paper promises to review the currently available literature relating to how some micro-organisms might play a role in the way that disease rosacea progresses.

I don’t have access to the full text, but following  is some background information that will hopefully prove helpful.

Although not mentioned in the abstract, I would hope that the paper would also discuss the role of Small Intestinal Bacterial Overgrowth in rosacea.

Helicobacter Pylori

Long part of the rosacea folklore, Helicobacter Pylori is a bacteria that lives in the cell lining of the stomach. The link between HP and rosacea is muddied by the fact that the common treatment for h. pylori is also a possible treatment for rosacea in it’s own right. Here is a quote from the NRS:

H. pylori May Not Be a Rosacea Factor

A recent study suggested that treatment of Helicobacter pylori, a bacterium associated with peptic ulcers and other gastric disorders, may benefit the often small portion of rosacea patients who harbor this infection. However, another study has found that H. pylori itself does not appear to be a major factor.

“It should not be surprising that rosacea symptoms may improve during treatment for H. pylori, since antibiotics have long been successfully used to treat rosacea in all patients,” said Dr. Larry Millikan, chairman of dermatology, Tulane University. “Smaller dosages of oral antibiotics are routinely prescribed to bring rosacea under immediate control, along with long-term use of topical antibiotics to maintain remission.”

In a more recent controlled clinical study of 44 rosacea patients with H. pylori infection in the United States, half of the patients were treated for H. pylori and half were not. When examined two months after treatment, there was no statistical difference in rosacea symptoms between the treated and untreated groups.

Demodex Folliculorum

Also a long standing member of the rosacea folklore is the issue of demodex mites.

Always held back as a theory by the fact the demodex is found in both rosacea and non-rosacea skin, and researchers being unable to show whether the mites cause, or just like living in rosacea skin, demodex folliculorum has recently become interesting again.

This new interest has been sparked by a study that showed that a particular type of demodex bacteria was responsible for a greater immune response in rosacea sufferers.

Like all good theories, demodex mites needs more research to prove how strong the link is between their presence and rosacea symptoms.

staphylococcus epidermis

This is one of the organisms that is a normal part of human skin flora, i.e. it is normal to find it living in our skin. Typically it only causes problems for people who are immune compromised.

A 2010 study summarised here: Skin Bacteria Thrives in Rosacea Patients shows that researchers were able to prove that this bacteria was more prevalent in the pustules of rosacea and in the eyelids of people who suffer from facial rosacea lesions.

Would I sound too much like a broken record if I were to say that more research is needed here to prove or disprove this link?

clamydia pnuemonia

According to wikipedia, Chlamydophila pneumoniae is a small bacterium that infects humans and is a major cause of pneumonia.

At least one study has been able to show some link; concluding “preliminary data imply a possible link between C. pneumoniae and acne rosacea as well as suggest a need for further investigation with clinical trials.” Interesting the treatment used in that study, Azithromycin is also effective against H. Pylori.

One place to read more about CpN is RSRP: Chlamydia pneumoniae.


The potential role of microorganisms in the development of rosacea, J Dtsch Dermatol Ges. 2010 Nov 8.

Lazaridou E, Giannopoulou C, Fotiadou C, Vakirlis E, Trigoni A, Ioannides D., First Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece.

Rosacea is a chronic cutaneous disorder characterized by centrofacial persisting erythema, telangiectases, papules, pustules, edema, phymas and ocular involvement. Despite being one of the most common skin disorders, its pathogenesis remains unclear and controversial. Although the disease triggering factors are well recognized, the underlying causes of rosacea have not yet been identified.

Several different postulates about its pathogenesis can be found in the medical literature. Abnormalities of the pilosebaceous unit, as well as genetic, vascular, inflammatory, environmental and microbial factors have been described.

The microorganisms that have been associated include Helicobacter pylori, Demodex folliculorum, Staphylococcus epidermidis, and Chlamydia pneumonia; all the studies have been inconclusive. We review currently available scientific data on the potential pathogenetic role of microorganisms in the development of rosacea.

How neat would it be to say that you belong to the Aristotle University Medical School – sounds impressive hey.

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

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