In my opinion, there are many different causes stemming from digestive disturbances that may result in rosacea. Knowing the internal source makes rosacea treatable, in most cases. Rather than resorting to soothing remedies that do not correct the problem or medications that further damage the skin, it is time to address rosacea holistically and more permanently.

THE DEMODEX MITE THEORY
Many rosacea sufferers have the demodex mite, but so do most people. They are a natural part of the human microbiome; they are there by design. The suggestion that the skin reacts to this bug is odd, considering this fact. Additionally, when I imagine the skin responding to an infected follicle, I envision isolated bumps that are somewhat similar to acne. However, the many types of rosacea do not present in this way. Furthermore, look at clients with rosacea in the form of rhinophyma. Is it plausible to assume that the skin is reacting to mites and only on their nose? What about the mites on the rest of their face? Why does the entire face not react and why does alcohol inflame that area? It is questions like these that need to be asked in order to continue the search for the real cause of rosacea.

If something is true, it should be true in almost every case. For example, there are many people who have rosacea on their cheeks or forehead that flares with spicy food or stress. Why does the body decide to react to certain mites and not others? In my opinion, the mite theory creates more questions than answers and simply does not make sense in the face of the facts.

DIGESTIVE DISTURBANCES
The aforementioned SIBO study is the first clue to the real cause of rosacea and digestive disturbances. In fact, rosacea can be isolated to different regions of the gut based on where redness shows up on the skin. This identification should not seem strange since the skin was built from embryonic tissue that connected all of the organs to regions of the skin.

The Tip of the Nose
The tip of the nose shows inflammation of the back of the throat. Sometimes, this inflammation is caused by a bacterial throat infection, but it is usually from hard alcohol hitting the back of the throat. It often takes excessive amounts to reach enough inflammation to show up on the tip of the nose. Rhinophyma is the formation of scar tissue after chronic inflammation.

The Side of the Nose
Rosacea in this area most frequently appears as broken capillaries, but can also present as redness or flaking skin. It is connected to the esophageal sphincter and is damaged most often by acid reflux. This condition can be asymptomatic, but the skin never lies.

Next to the Nose
The stomach can be irritated by a few factors, notably gastritis and H. pylori. The affected area on the skin is about one centimeter wide, but redness can also travel down towards the mouth.

The Mid-Cheek
Rosacea in the mid-cheek occurs about an inch from the nostril and originates from the small intestine. It is often quite red and acneic when the client has SIBO, but the redness can also be associated with ulcers, candida overgrowth, or irritable bowel syndrome.

The Cheekbone, Temples, and Forehead
Rosacea in this area comes from large intestine inflammation that is usually associated with candida overgrowth or irritable bowel syndrome. Redness as a result of large intestine inflammation, can travel up the temple and across the forehead.

Peri Oral Dermatitis
The mouth area reflects the end of the colon and is often associated with constipation. Leaving stool in place for extended periods of time results in toxin reabsorption and inflammation around the mouth. Acne in this area is also common.

STANDARD TREATMENTS
Treating rosacea requires addressing the specific causes identified above. The standard treatment being recommended today includes topical and/or internal antibiotics, steroids, and anti-mite ingredients. The antibiotics, when they work, are only reducing redness by suppressing immune repair activity. It is my belief that this course of action is not beneficial since the redness is a result of the skin trying to heal itself, not attacking itself. Steroids use a similar mechanism as the antibiotics. These approaches cause long-term harm to the skin and body and should be avoided. Since the problem is internal, attention needs to be directed to that area for the best results. The immune system needs to become stronger, not weaker, in order to keep up with repair activity.

FOR HEALING ROSACEA

Treat the Source
Rosacea on the tip of the nose is worthy of a client conversation about alcohol consumption, however, it is not advisable to accuse the client of being an alcoholic. A simple question such as, "How much hard alcohol do you drink?" is a good first step. The professional should explain the mechanism behind the reaction and tell the client to consider drinking wine or, ideally, nothing at all for a while. Wine is not hard on the throat, but it can aggravate other forms of rosacea by stimulating candida overgrowth. It will be difficult to heal the damage if the client does not stop drinking. Remember, there are other factors that cause inflammation of the back of the throat, but they are uncommon.

Two key ingredients that work on a majority of the internal causes of rosacea include trioxolane and scalar wave supplements. Trioxolane, when taken internally, encourages repair of damaged tissue in the throat, esophageal sphincter, and elsewhere. It works by providing a unique oxygen molecule that is used by the body's repair cells. Scalar wave medicine is a new way restore health to restore digestive cells energetically. All cells vibrate at their core, subatomically, and specific scalar waves can correct imbalanced cells. H. pylori can also be corrected with trioxolane and scalar wave supplements and candida overgrowth can be neutralized using scalar waves. There are diets rosacea suffereers can follow and antifungal medicines, like Diflucan, that they can take, but nothing has proven more effective than digesting antifungal scalar wave-enhanced water. Another cause of resacea, acid reflux, is best treated with digestive enzymes. Digestive enzymes help by improving digestion and reducing acid naturally. Many people chose antacids for reflux, but they actually harm the stomach and reduce digestion, causing other issues over time. It is always a good idea to check for food allergies when evaluating irritable bowel syndrome, but the previously mentioned remedies can be very helpful regardless. If constipation is an issue, I believe that scalar wave waters, digestive enzymes, fiber, and water are extremely beneficial. Treating the source can dramatically improve redness without any topical applications while helping the client to feel much better in the process.

Restoring the Barrier
The reason clients with rosacea often have sensitivity to topical ingredients is because their barrier is compromised and the skin is too overwhelmed to handle other requests, like increasing collagen. When the skin is attempting to handle significant repair and/or inflammation, it is often depleted of its resources making it much harder to maintain the epidermal turnover process, which results in an inadequate barrier. An incomplete epidermis allows more product into the skin, thus making the clients sensitive to highly active or inflammatory ingredients. While most professionals think moisturizers are the answer, they actually increase epidermal water loss because of their surfactants. I have found phosphatidylcholine to be very effective at holding in moisture and protecting the skin from environmental pollutants as the skin is calmed to improve skin nutrient availability. Waxes and high-dose silicones will cover barrier weakness, but also block skin detoxification in the process and are, therefore, not advised.

Calming Inflammation
Even though the dermis is inflamed as a result of digestive inflammation, it must still be addressed with the right active ingredients. One of the most powerful topical active ingredients for this reaction is trioxolane, which has a unique, stable oxygen structure that encourages repair and strengthens immune function without pushing the skin beyond its capabilities. Normally, oxygen itself is a mistake because it increases free radical damage, but trioxolane does not turn into a free radical. Many people think oxygen is beneficial for rosacea because they can often see redness diminish with oxygen infusions; unfortunately, this belief is not true. What is actually happening is that the skin's blood vessels shrink (vasoconstrict) in the presence of too much oxygen in an effort to reduce further oxygen delivery from the bloodstream. This reaction can make the skin look less red, even though it is actually suffering greater damage as a result of the free radical cascade. There are many calming ingredients that can be used, like willow herb, chamomile, sea buckthorn, aloe, feverfew, and cucumber.

REVERSING AGING AND DAMAGE
While many people think it is not possible to permanently reverse aging and sun damage, it can be done. The secret is providing the skin with the tools it needs to activate enough repair to overcome ongoing damage and start working on past trauma. This goal is achieved with ingredients like trioxolane, zinc finger technology, liposomal retinaldehyde, liposomal niacinamide, liposomal asiaticoside, AC-11, stem cell- and fibroblast-derived growth factors, and other key ingredients. The main idea is that the professional must work with the skin's immune system and avoid trauma of any kind.

With rosacea, the amount of inflammation and/or repair inhibits the skin's ability to actually reverse aging, but that does not mean it should not be attempted. The process should move from calming and strengthening the immune activity over a month or two to slowly accelerating the amount of the more stimulating repair ingredients. Growth factors and trioxolane are well tolerated in the early phase, but the other actives will require calmer skin. This treatment requires the source of the rosacea to be addressed at the beginning of the process.

In most cases, a person's skin is a reflection of what is happening internally. Being able to map the source and/or location of rosacea makes it much easier to educate clients and provide more targeted, permanent results. The main strategies being utilized today are not really addressing the issues and, in many cases, they are hurting the skin further. Rosacea does not have to be a lifelong condition. Amazing results are possible when skin care professionals work holistically with the skin and body.

Ben Johnson, M.D. is the founder and formulator of Osmosis Skincare. Johnson began his career by starting one of the first medical spa chains in the country, along with founding/formulating Cosmedix. He is an established speaker, educator, and formulator who is well known for his unique approach to skin conditions by thinking outside of the box. Johnson's passion is creating tremendous change in the skin without constantly exfoliating away the protective benefits of the epidermis.