Frontiers in microbiologyJan 23, 2024

Rosacea, gut bacteria, and probiotics: how the gut and skin are connected

Gut-Brain Axis Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Mar 16, 2026

Abstract

Rosacea is an inflammatory skin disease that can significantly impact quality of life and mental health.

The condition involves a dysfunctional immune system that leads to excessive inflammation.
Vascular and nervous system changes may also play a role in rosacea symptoms.
Certain microorganisms on the skin are associated with triggering the onset of rosacea.
The gut-skin axis suggests a two-way interaction between gut and skin microbiota in inflammatory skin diseases.
Research on the gut and skin microbiota in rosacea is limited compared to other conditions like atopic dermatitis and psoriasis.
Probiotic supplementation may enhance clinical outcomes for patients with rosacea, similar to effects observed in other diseases.

Simplified

Rosacea is an inflammatory skin disease involving diverse symptoms with a variable clinical progress which can severely impact the patient's quality of life as well as their mental health. The pathophysiological model of rosacea involves an unbalanced immune system predisposed to excessive inflammation, in addition to vascular and nervous alterations, being certain cutaneous microorganisms' triggers of the symptoms onset. The gut-skin axis explains a bidirectional interaction between skin and gut microbiota in some inflammatory skin diseases such as atopic dermatitis, psoriasis, or rosacea. The introduction and consolidation of the next-generation sequencing in recent years has provided unprecedented information about the microbiome. However, the characterization of the gut and skin microbiota and the impact of the gut-skin axis in patients with rosacea has been little explored, in contrast to other inflammatory skin diseases such as atopic dermatitis or psoriasis. Furthermore, the clinical evolution of patients with rosacea is not always adequate and it is common for them to present a sustained symptomatology with frequent flare-ups. In this context, probiotic supplementation could improve the clinical evolution of these patients as happens in other pathologies. Through this review we aim to establish and compile the basics and directions of current knowledge to understand the mechanisms by which the microbiome influences the pathogenesis of rosacea, and how modulation of the skin and gut microbiota could benefit these patients.

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Competing interests

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

PubMed

Rosacea, gut bacteria, and probiotics: how the gut and skin are connected

Abstract

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Funding

Competing interests

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Abstract

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Funding

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Related papers

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