Bacteria and Rosacea in the Skin Microbiota

[Guide]

Staphylococcus epidermidis image courtesy of Wikimedia Commons

Bacteria has been implicated and investigated as the leading microbe associated with rosacea for over sixty years. Antibiotics have been prescribed for rosacea, particularly tetracycline and more recently with doxycycline, along with many other antibiotics, which leads to the bacteria theory on the cause of rosacea. There has been a bias in most, if not all, the clinical papers investigating the skin microbiome in rosacea patients ignoring other microbes, i.e., virus, archea, fungus, protozoa.  Demodex mites have been the other most investigated microbe of the skin microbiome with a vast number of clinical papers. A typical paper indicating this bias towards chiefly investigating bacteria and demodex is the following conclusion on this subject:

"Although we were not able to pinpoint a causative microbiota, our study provides a glimpse into the skin microbiota in rosacea and its modulation by systemic antibiotics.' 

J Clin Med. 2020 Jan; 9(1): 185.
Published online 2020 Jan 9. doi: 10.3390/jcm9010185
PMCID: PMC7019287
PMID: 31936625
Characterization and Analysis of the Skin Microbiota in Rosacea: Impact of Systemic Antibiotics
Yu Ri Woo, Se Hoon Lee, Sang Hyun Cho, Jeong Deuk Lee, and Hei Sung Kim

The above paper only investigated bacteria and mentions demodex and ignores all other microbes of the skin microbiota. 

Bacteria and Rosacea Theory

Microorganisms of the Human Microbiome