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Introduction
Acne rosacea can be a frustrating and emotionally challenging skin condition that affects millions of people worldwide, particularly women in their 30s and 40s. While conventional treatments often focus on topical creams, antibiotics, or laser therapy, many people fail to see long-term improvement. This case study presents the journey of a woman who healed her acne rosacea through a functional medicine approach, focusing on gut health and addressing Small Intestinal Bacterial Overgrowth (SIBO) for good.
Case Overview
- Name: Sarah (Name changed for privacy)
- Age: 42
- Symptoms: Persistent facial redness, swelling, and inflamed papules/pustules across the cheeks and nose for over five years. Episodes of stinging and burning sensations. Difficulty with self-esteem due to the condition.
- Conventional Treatments Tried: Topical creams (metronidazole), oral antibiotics, and laser treatments, with minimal improvement. Symptoms would return shortly after stopping treatment.
- Additional Symptoms: Fatigue, bloating after meals, and occasional diarrhea, especially after consuming high-sugar or dairy-based foods.
Sarah had been dealing with acne rosacea for years, following various conventional approaches with limited success. Frustrated by the lack of lasting improvement, she decided to seek the help of a functional medicine practitioner, Dr. Davina, who could explore the root causes of her rosacea beyond surface-level treatments.
Initial Consultation and Assessments
During the initial consultation, the functional medicine practitioner focused on exploring Sarah’s health history and assessing her lifestyle, diet, and other contributing factors. Several key areas of concern emerged:
1. Gut Health: Sarah had been experiencing digestive issues such as bloating, irregular bowel movements, and discomfort after meals for several years. She also reported a frequent sense of fatigue that was disproportionate to her daily activities.
2. Inflammation and Immune Response: Given her chronic skin inflammation and digestive symptoms, the practitioner suspected a systemic source of inflammation—likely tied to gut dysbiosis or a leaky gut.
3. Diet and Triggers: Sarah's diet included processed foods and occasional alcohol consumption, both known triggers for rosacea flares. Additionally, dairy products worsened her digestive issues, which could be linked to food sensitivities.
Dr. Davina recommended a SIBO breath test to investigate whether an overgrowth of bacteria in Sarah’s small intestine was contributing to her skin condition and overall inflammation. This test revealed that Sarah had positive SIBO, confirming that bacterial overgrowth in the small intestine was likely playing a role in her skin and gut issues.
Functional Medicine Approach
With the confirmation of SIBO, the practitioner developed a personalized treatment plan for Sarah, focusing on addressing the root causes of her acne rosacea through a gut-healing protocol and lifestyle changes. Here's the step-by-step breakdown of the functional medicine approach used to heal Sarah’s acne rosacea.
### 1. Targeting SIBO with Antimicrobial Treatment
The primary goal was to eradicate SIBO, as previous research has shown that clearing SIBO can lead to a marked improvement in rosacea symptoms. The functional medicine practitioner prescribed a course of the antibiotic rifaximin, a non-systemic antimicrobial commonly used to treat SIBO.
Additionally, Sarah was given natural antimicrobials to continue the treatment once the antibiotic course was complete. These included:
- Berberine
- Oregano oil
- Allicin (garlic extract)
These supplements were designed to help restore balance in Sarah’s gut and reduce the overgrowth of harmful bacteria.
### 2. Healing the Gut: Leaky Gut Protocol
Since gut permeability (leaky gut) was likely contributing to systemic inflammation, Sarah was placed on a gut-healing protocol to repair the intestinal lining and reduce inflammation. The practitioner focused on removing irritants from her diet and restoring the integrity of the gut lining.
- L-glutamine and zinc carnosine were used to repair the gut lining.
- Collagen peptides were added to support gut health and tissue repair.
- A high-quality probiotic was introduced to re-establish healthy bacteria in her gut and support digestion.
### 3. Anti-Inflammatory Diet
An elimination diet was recommended to remove foods that triggered gut inflammation and potentially worsened her rosacea. Sarah removed the following for a period of 6 weeks:
- Dairy
- Gluten
- Sugar
- Processed foods
- Alcohol
Instead, her diet was rich in:
- Anti-inflammatory foods such as wild-caught fish, leafy greens, and colorful vegetables
- Omega-3 fatty acids from fatty fish and flaxseeds, to help reduce inflammation
- Bone broth and fermented foods like sauerkraut, for gut-healing nutrients
### 4. Supporting Detoxification and Reducing Toxin Load
Since SIBO and gut dysbiosis can lead to the build-up of toxins and lipopolysaccharides (LPS) in the bloodstream, the practitioner recommended supplements to support liver detoxification:
- Milk thistle to help detoxify the liver
- N-acetylcysteine (NAC) and glutathione to support the body’s natural detoxification pathways and reduce oxidative stress
### 5. Stress Management and Lifestyle Changes
Stress is known to be a major trigger for both gut health and skin conditions like rosacea. The practitioner worked with Sarah to implement stress-reducing activities such as:
- Mindful meditation and deep breathing exercises to manage daily stress
- Incorporating gentle exercise like yoga, which also aids digestion and overall well-being
- Establishing a regular sleep routine to support her body’s healing process
### Results and Progress
After just 3 weeks of following the treatment protocol, Sarah began to notice significant improvements in her digestive symptoms. Her bloating decreased, and her bowel movements became more regular. Within three months, she experienced dramatic improvements in her skin:
- The redness and inflammation in her cheeks and nose diminished.
- The papules and pustules associated with her rosacea were almost completely gone.
- Sarah reported feeling more energetic and began waking up feeling refreshed for the first time in years.
- She no longer experienced frequent rosacea flare-ups even after exposure to previous triggers like alcohol or spicy foods.
By the six-month mark, Sarah’s acne rosacea had almost entirely resolved, and she felt empowered by the knowledge that her skin condition was connected to her gut health. Her confidence returned as her skin cleared, and she was able to discontinue all conventional rosacea treatments.
### Conclusion
Sarah’s case illustrates the profound connection between gut health and skin conditions like acne rosacea. By addressing the underlying cause of her rosacea—**SIBO** and gut dysbiosis—and supporting her body with a functional medicine approach, she was able to heal from the inside out. This approach not only cleared her skin but also improved her overall health, energy levels, and quality of life.
If you or someone you know is struggling with acne rosacea and conventional treatments aren't providing lasting results, consider exploring the role of gut health and consulting with a functional medicine practitioner to get to the root of the issue. Healing from the inside may be the key to transforming your skin and overall well-being.
Takeaway: Acne rosacea is more than a skin condition—it is often a reflection of deeper imbalances in the body, particularly in the gut. Through targeted treatments that address SIBO, gut health, and lifestyle changes, long-lasting relief from rosacea is possible (Parodi, A., Paolino, S., Greco, A., Drago, F., Mansi, C., Rebora, A., & Savarino, V., 2008).
Parodi, A., Paolino, S., Greco, A., Drago, F., Mansi, C., Rebora, A., & Savarino, V. (2008). Small intestinal bacterial overgrowth in rosacea: Clinical effectiveness of its eradication. **Clinical Gastroenterology and Hepatology, 6**(7), 759-764. https://doi.org/10.1016/j.cgh.2008.02.054
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