Rosacea: Types, Causes, and Remedies
Does H. Pylori Cause Rosacea?
H. pylori, a type of bacteria known to cause ulcers, may contribute to the development of rosacea. Discover what experts have to say about this theory.
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Everyday Health:What role, if any, does H. pylori play in rosacea development?
Jessica Wu, MD ()The jury is still out on the role of H. pylori bacteria in the development of rosacea. It's difficult to draw solid conclusions from studies that attempt to link H. pylori and rosacea since 50 percent or more of the population carries H. pylori. Some researchers have reported that H. pylori is more prevalent in those with rosacea, and that perhaps the bacteria releases a toxin that contributes to flushing and inflammation. However, the research is conflicting, since other studies show no significant difference in H. pylori infection rates among rosacea vs. non-rosacea subjects. Similarly, some studies have reported that rosacea improves when H. pylori is eradicated with antibiotics, while other studies demonstrate no relationship between the eradication of H. pylori and skin lesions of rosacea. Complicating matters is the fact that metronidazole (Flagyl) is used to treat both H pylori infection and rosacea, so perhaps they both respond to the antibiotic, but may not be related.
Nicholas Perricone, MD ()H. pylori is a pathogenic organism that creates increased levels of systemic inflammation and therefore could lead to exacerbation of the clinical picture.
Elizabeth Tanzi, MD ()In my opinion, H. pylori plays a minimal role at most. I don't screen for it.
Howard Murad, MD ()In the past it was believed that stress was the cause of ulcers but later Helicobacter pylori was linked to the condition. It has also been said that stress could be a cause of rosacea; however, the relationship between H. pylori and rosacea is still undetermined. Some studies say it is linked, and some negate these claims.
Macrene Alexiades-Armenakas, MD ()There is a high rate of Helicobacter pylori in rosacea patients. This same group also tends to have periodontal disease. It is important to ask patients about gastric ulcers and reflux as well as gum disease and to treat those conditions, as this will cure the rosacea.
Jeannette Graf, MD ()Although there have been studies where the majority of patients with rosacea also had H. pylori-positive gastritis, other studies have shown no such link. In addition, in patients with both H. pylori and rosacea, when the H. pylori was eradicated through treatment there was no effect on the rosacea. Therefore, although there has been an association in some studies the evidence points to no direct role.
Neil Sadick, MD ()Very controversial: not enough scientifically based evidence to show that it plays a role in rosacea pathogenesis.
Marta Rendon, MD ()Studies have shown that patients with H. pylori have rosacea, but the exact relationship has not been established as of yet.
H.L. Greenberg, MD ()I'm not familiar with H. pylori playing a role in rosacea; however, if someone has H. pylori they should be treated according to the guidelines their provider recommends.
Sarah Swanson ()Similar to the mite story, a higher rate of H. pylori infection has been reported in patients with rosacea, linking the organism as a possible cause of the skin disease. Additionally, eradication of H. pylori with amoxicillin, metronidazole and bismuth led to an improvement in rosacea symptoms in one study. However, in this study the rate of H. pylori seropositivity between rosacea patients and matched controls were equivalent, and other studies have not confirmed improvement in rosacea symptoms with H. pylori treatment.
Finally, rosacea typically responds to metronidazole therapy, so it is not clear whether the improvement is related to the treatment of H. pylori. Patients with H. pylori have a higher rate of bacterial overgrowth in their intestines. One study has found that bacterial overgrowth in the small intestine of 46 percent of rosacea patients compared to 5 percent of controls and that eradication of bacterial overgrowth improved rosacea. In summary, antibiotics improve rosacea possibly by changing intestinal flora, but the relation between intestinal infection and rosacea is still controversial.
Eric Schweiger, MD ()Several microorganisms have been associated with rosacea including H. pylori. Currently the role of pathogenic microorganisms in the development of rosacea is undetermined and somewhat controversial. Additional studies are needed to clarify the role of H. pylori in rosacea.
Nelson Lee Novick, MD ()The role of H. pylori in the causation of rosacea has been hotly debated over the years, and the jury is still out on the issue. I might consider sending a patient with particularly severe or intractable H. pylori to conventional rosacea therapy to test for the presence of this organism. However, for the most part I have seldom found this necessary and will continue to use conventional rosacea treatment, which I have found successful, until the controversy is resolved.
Darrell W. Gonzales, MD ()To this date there is no overwhelming evidence to support that idea that H. pylori is a contributing factor in rosacea. Although some rosacea patients have demonstrated that they are carriers of H. pylori, no direct relationship has been found. Therefore, the management of rosacea usually does not involve determining if one is a carrier of H. pylori.
William Ting, MD ()The role of H. pylori has yet to be fully delineated in rosacea development, and its contribution is thought to be minor at best.
Dina Strachan, MD ()I believe the association between H. pylori and rosacea that was reported in the 1990s has been refuted and is thought to be a coincidence. The inflammation of rosacea responds to antibiotics. Antibiotics are the treatment for H. pylori.
Brad Abrams, DO ()I don't believe H.Pylori plays any roles in the development of rosacea.
Eric Huang, MD ()Two studies suggested a link between H. pylori and rosacea. One showed a slightly higher prevalence of H. pylori in patients with rosacea than normal controls, and the other demonstrated a high percentage of rosacea patients with H. pylori gastritis. However, other studies have not supported this link. When researchers treated rosacea patients with the same regimen to eradicate H. pylori, patients without the bacterium improved as much as those with the infection, suggesting that the presence or absence of H. pylori was not the cause of rosacea symptoms. Most dermatologists do not believe in any role of H. pylori in rosacea.
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