Thursday, March 28, 2013

Rosacea, Face Mites, the W.C. Fields Nose & Vitamin B2 (Riboflavin)

My mom was part-Irish, with fair skin prone to sunburns, blushing, and rosacea. She loved all the things that make rosacea flare up--coffee, wine, and spicy foods, and she lived in Florida where heat and humidity and sun were ever-present triggers.

I remember my mother's face when I was growing up. Her skin was fair and blemish free, and her nose had a natural profile. In her later years, it was often hard to look at her face, as she had grown a bulbous W.C. Fields nose and had frequent, unsightly eruptions. Sad but true. Especially sad as she was not at all interested in trying anything, neither supplements nor antibiotics, to heal her uncomfortable skin.

I'll never forget our last trip to Boston (May 2012). My mom trying valiantly to put on some of my make-up before going to the theater. She so wanted to look pretty for her big night out in the city, but she got tears in her eyes as she looked, really looked, perhaps for the first time in years, at her skin under those bright hotel bathroom lights.

I find that most chronic conditions yield to a combination of dietary change and nutritional therapy, if we can only find out what to do. Three nutritional deficiencies seem to be important with rosacea: (1) lack of enough stomach acid to digest proteins, (2) lack of the pancreatic enzyme lipase to digest fats, and (3) insufficient Vitamin B2 (riboflavin), the last deficiency being particularly interesting. It turns out that research on large doses of B-vitamins in treating rosacea has been around since at least 1929

Almost a century later, doctors are more likely to prescribe antibiotics instead of B vitamins. You may be wondering why a skin condition that looks like an inflammatory response that is out of control would be treated by antibiotics. Let's put the two pieces together.

You see, riboflavin deficiencies can create an inviting environment for the icky Demodex folliculorum (a skin mite that lives on 20-80% of adults). These little mites burrow into hair follicles, eating skin and oils on the face, and become overpopulated on the skin of rosacea patients.

Research shows it's not the mites that cause rosacea. Instead, it's the bacteria feeding on abundant fecal material inside the mites after the mites die that cause the rosacea patient's immune system to respond to the bacterial infestation, thus firing up inflammation and redness.

Michele Green, MD, a dermatologist at Lenox Hill Hospital in New York City, said: "It makes perfect sense to me." Green says the mite theory fits many features of the disease. She says many people with rosacea notice that their skin gets worse after exposure to heat and humidity, conditions that also help mites thrive.

Add supplemental riboflavin and skin conditions can start to clear up. Studies with rats show riboflavin-deficient rats can be infected with Demodex mite populations while normal rats (with good riboflavin status) remain free of mite infestations. Thus, supplemental B vitamins that include riboflavin (in addition to dietary and lifestyle changes) can help prevent mite infestations that lead to rosacea. It's a super-cheap therapy with none of the side effects of antibiotics.

Adding a complete B-Complex formula boosts other B vitamins, which aid digestion and production of hydrochloric acid, one of the missing elements in many rosacea patients' body chemistries. If you add 350-500mg of Pancreatic Enzymes before meals, you will have a good start on what leading naturopathic authors, Michael Murray and Joseph Pizzorno, recommend for rosacea in their Encyclopedia of Natural Medicine. They also recommend eliminating milk products and foods high in iodized salt along with things that make the face flush. 

Now you know the rest of the story of why antibiotics are given to rosacea patients. Me? I am just counting on good nutrition and living in a temperate climate  (in the San Francisco Bay Area) to help me avoid that distressingly ugly W.C. Fields nose! So far, so good, thankfully.

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