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    No one really knows the cause of rosacea but there are many theories. "Rosacea is a skin disease with an obscure and complicated pathogenesis." [1]

    The current most popular theory is that rosacea is a disorder of the innate immune system. For over twenty years the vascular theory was held as the most promising. What is interesting is at the heart of the innate immune system theory is that this includes an overproduction of cathelicidin (a killer of microscopic organisms that is at the cellular level found in white blood cells and also found in cells on the skin) which is transported in the vascular system, so we have come full circle. Some consider the nervous system as the root cause of rosacea, and the list goes on with many other theories worth considering (the latest theory is the Trigeminal sensory malfunction theory) but a good place to start your research is our post on Theories Revisited

    End Notes

    [1] Dovepress
    Rosacea and Helicobacter pylori: links and risks
    Elizabeth Lazaridou, Chrysovalantis Korfitis, Christina Kemanetzi, Elena Sotiriou, Zoe Apalla, Efstratios Vakirlis, Christina Fotiadou, Aimilios Lallas, Demetrios Ioannides

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    • Abstract
      In dermatology probiotic microorganisms have primarily been used orally for the prophylaxis and treatment of atopic disorders. In contrast to the successes achieved for gastrointestinal disorders, positive effects for atopic dermatitis only have been found in a few studies. New insights could now fundamentally change the impact of probiotics on dermatology. Probiotics are - like microflora of the skin - non-pathogenic microbes, which do not induce inflammatory responses in the skin. Common pathways for probiotics, non-pathogenic microbes, and microflora are characterized, in order to facilitate their more effective therapeutic use. These microbes display a majority of their effects directly at the site of application and thereby induce natural defense mechanisms. However, promotion of immunological tolerance is just as important in producing positive effects. Tolerance of the resident flora on surface organs developed during evolution and the mechanisms of action are multifaceted. Therefore, the topical application of probiotics and non-pathogenic microbes for prophylaxis and therapy of overwhelming cutaneous pro-inflammatory immune reactions is very promising. Results of recent clinical trials already have demonstrated the efficacy of this new therapeutic concept. Hautarzt. 2009 Oct;60(10):795-801. doi: 10.1007/s00105-009-1755-8.
      Outside-in. Probiotic topical agents.
      Volz T, Biedermann T.
    • Abstract
      INTRODUCTION AND OBJECTIVE:
      Normal human skin can produce a range of antimicrobial chemicals that play an important part in eliminating potential cutaneous pathogens. Lactobacillus plantarum is a gram-positive bacteria that produces antimicrobial peptides, which when applied to the skin can act like an anti-inflammatory as well as enhance the antimicrobial properties of the skin. Clinical studies were conducted to determine the effect of lactobacillus extract on improvement of skin barrier and reduction of erythema from chemical irritant, skin microflora, and acne. Results show that lactobacillus extract was effective in reducing skin erythema, repairing skin barrier, and reducing skin microflora, thereby exhibiting an effective reduction in acne lesion size and erythema at 5%, but not at 1%.
      CONCLUSION:
      Based on the results of these studies, lactobacillus extract (5%) can be used to treat mild acne lesions. J Cosmet Sci. 2012 Nov-Dec;63(6):385-95.
      Physiological effect of a probiotic on skin.
      Muizzuddin N, Maher W, Sullivan M, Schnittger S, Mammone T.
    • Related Articles Mindfulness-Based Cognitive Hypnotherapy and Skin Disorders. Am J Clin Hypn. 2018 Jul;61(1):34-44 Authors: Shenefelt PD Abstract
      Mindfulness-based cognitive hypnotherapy integrates mindfulness, cognitive-behavioral therapy, and hypnotherapy to improve physical, emotional, mental, and/or spiritual aspects of skin disorders. Meditation, including mindfulness meditation, and hypnosis both utilize trance phenomena to help produce focalization and specific improvements in skin disorders through psycho-neuro-endocrine-immunologic mechanisms. Hypnosis, cognitive hypnotherapy, focused meditation, and mindfulness meditation are discussed with respect to improving various skin disorders including acne, acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythema nodosum, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, prurigo nodularis, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Their integration into mindfulness-based cognitive hypnotherapy is then discussed and illustrated with improvement in a patient with systemic lupus erythematosus.
      PMID: 29771216 [PubMed - in process] {url} = URL to article
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