Demodectic Rosacea [Variant]

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This post has been promoted to an article

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 "Rosacea has also been linked to a dysbiosis of the skin microbiome. An increased abundance of Demodex mites are observed in this disease. An interesting suggestion was made by Parodi et al. who reported an interplay between the skin and bacterial overgrowth in the small intestine. Rosacea patients had a significantly higher overgrowth of gut bacteria than controls and elimination of the overgrowth, using an antibiotic, resulted in an almost complete regression of the skin pathology for a prolonged time. These findings support the pathogenetic role of the gut microbiome in rosacea lesions, although the exact relationship remains to be elucidated. Additionally, research even investigated the microbiota of the Demodex mites, but final conclusions are still outstanding."

Comput Struct Biotechnol J. 2021; 19: 624–631. Published online 2021 Jan 4. doi: 10.1016/j.csbj.2021.01.001
Skin microbiome transplantation and manipulation: Current state of the art
Chris Callewaert, Nastassia Knödlseder, Ante Karoglan, Marc Güell, Bernhard Paetzold

[Guide]

There is evidence that demodex infestation primarily changed the dominant flora and relative abundance of ocular surface microbial communities and meibomian gland dysfunction (MGD) may play an important role in this process.

Ophthalmol Ther. 2021 Sep; 10(3): 601–617.
Demodex Infection Changes Ocular Surface Microbial Communities, in Which Meibomian Gland Dysfunction May Play a Role

[ElaineA]

Nice hand waving survey article -).  The authors missed an important paper in the their literature survey showing that treating SIBO cleared the Rosacea in a large number of patients.

https://www.jaad.org/article/S0190-9622(12)02330-4/fulltext

It does point out several problems with current diagnostic techniques or the lack thereof.  Many dermatologists just do a "10 second glance exam" to diagnose skin issues.  The fast visual exam is followed by an almost automatic writing of harsh prescriptions that destroy the skin's microbiome.   They need to change their diagnosis and treatment approach. They need to do actual diagnostic tests to confirm or disprove their diagnoses.  Once an accurate diagnosis is made, then select the most appropriate method of solving the real skin problem.  That diagnostic approach should reduce the use of expensive but ineffective products.  It should also reduce the use of overly harsh products that destroy the skin's microbiome causing more problems than they solve..   Patients should see quicker and better results.