H.pyloriAcne rosacea is a different disease from acne vulgaris (run-of-the-mill acne). However, since symptoms often overlap, I like to keep on top of rosacea research as well. A few years ago I read a truly fascinating study which found that the guts of people with rosacea had a much higher incidence of bacteria colonization with a type of bacteria called H. pylori (helicobacter pylori), the same bacteria that is responsible for the majority of stomach ulcers. Of the people who had this bacteria, 20 of 28 of them appeared to be cured by using a powerful antibiotic to specifically kill the helicobacter pylori bacteria. I got so jazzed from the possibility that perhaps H. pylori could also affect acne vulgaris that I went to the doctor and had him order an H. pylori test for me. The test took hours and involved me blowing into a detector every few minutes. My results: Negative. I didn’t have any H. pylori in my gut.

Another study has since been conducted in Nepal. The researchers found that 17 out of 26 rosacea patients they studied had colonies of H. pylori in their gut.

This evidence is so compelling that rosacea researchers are starting to look at the possibility that rosacea is simply a skin manifestation of an internal disease of the gut.

Might another existing or still undiscovered gut bacteria cause or aggravate acne vulgaris? I would so love to know.


  • Parodi A, et al. “Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication.” Clinical Gastroenterology and Hepatology. 2008; 6(7): 759-64.
  • Ghattarai S, et al. “The study of prevalence of helicobacter pylori in patients with acne rosacea.” Kathmandu University Medical Journal. 2012; 10(40): 49-52.

I mentioned a while ago about the interesting trial in the journal Clinical Gastroenterology and Hepatology in which they studied people with rosacea. They noticed a high prevalence of intestinal bacteria overgrowth in about half of the rosacea patients and effectively cured most of them by administering a strong intestinal antibiotic called rifaximin–exciting news to say the least. I immediately got highly interested in this potential link between the gut and skin. However, I looked around and there have not been any studies like this done on acne patients.

So, I decided to guinea pig myself. Acne and rosacea are not the same disease, but they have similarities, and I figured it couldn’t hurt to get checked myself for intestinal bacteria overgrowth. I went to multiple doctors and finally found one who would refer me to the right GI (gastrointestinal) specialist who agreed to administer gut bacteria tests on me. The first test was a stool test called the Stool H. Pylori Antigen test. Yeah, gross. And the second was a three hour breath test called a Lactulose Hydrogen Breath Test. Both came out negative.

The search continues, but I find the gut/acne connection to be potentially an interesting area of research. If any of you have intestinal issues such as cramping, bloating, gas, etc. and get checked for intestinal bacteria overgrowth including what they call SIBO (Small Intestinal Bacteria Overgrowth) or H. pylori, please let me know. If you take rifaxamin for it, I’d also love to know how your skin reacts afterward.

In doing reserach on rosacea, I came across a fascinating study in 2009 where about half of the people with rosacea were found to have small intestinal bacteria overgrowth (SIBO). Upon administration of rifaximin, an antibiotic that does not penetrate the intestinal wall, thus staying within the intestine and eradicating the SIBO, many of the rosacea sufferers with SIBO were completely cleared. At a nine month follow up they remained clear.


No such study has been performed on people with acne, but hey, who knows! So I’ve asked my doctor to refer me to a testing facility to see if I have SIBO myself, just for fun. It’s a simple breath test, and I’m hoping to find someone in the area who can perform the test. I’ll let you guys know how it goes. I am reseraching as much as I can about intestinal bacteria and skin disease, with acne as a particular focus of course. If you have any references for me, please let me know.

My fabulous research assistant, Miriam, and I have been steeping ourselves in rosacea research for the past couple of weeks. It’s a mysterious topic, but some effective treatments exist. Also, the latest research is showing promise for hopeful rosacea eradication in the future. I distilled down what we learned onto the new rosacea pages, with Joel’s help of course :)

Let me know what you think!