The Connection Between SIBO, Acne & Rosacea


SIBO & Skin Disease

In recent years, small intestinal bacterial overgrowth (SIBO), has been identified as an underlying problem in the majority of patients diagnosed with irritable bowel syndrome (IBS), and as a contributing factor in several common skin diseases. The evidence for a link between SIBO, acne and rosacea is stronger than for any other condition (1).


Rosacea is a common condition characterized by symptoms of facial flushing and a spectrum of clinical signs including redness and coarseness of skin, papulopustular eruptions and telangiectasia (small dilated blood vessels near the skins surface). The condition ranges from a minor cosmetic discomfort to severely disfiguring disease. A number of aggravating factors are recognized but the association of gut disease may explain many cases of rosacea. One study noted the prevalence of SIBO was higher in patients with rosacea than the controls (52/113) versus 3/60. Eradication of SIBO induced an almost complete regression of the patients cutaneous lesions and maintained this remarkable result for at least 9 months (2).


Acne vulgaris is a troublesome skin disease involving blockage and/or inflammation of the hair follicles and their accompanying sebaceous gland. It presents as comedomes, pustules, papules and nodules most commonly on the face, upper chest and back. Motility factors, hypochlorhydria (insufficient levels of stomach acid), food intolerance, antibiotic use etc. can set the stage for migration of bacteria from the colon to the distal portions of the small intestine, thus contributing not only to GI disturbance such as bloating, gas, heartburn and irregular bowel movements, but alterations in the normal intestinal microbiota, leading to increased intestinal permeability and systemic inflammation. Systemic inflammation, oxidative stress, glycemic control and hormonal imbalances have important implications in acne and there is enough supportive evidence to suggest that gut microbes, and the integrity of the GI tract itself, are contributing factors in the acne process (1). 

Final Thoughts

If you are suffering from a chronic skin condition like acne, rosacea, eczema, psoriasis or chronic hives, it may be time to explore the gut-skin connection. Booking an initial naturopathic visit with me will allow me to explore the reasons behind your skin condition, choose appropriate lab tests and start you on a path to clear skin and better overall health. 

In Health, 

Dr. Alaina




  1. Traub, M. SIBO and skin disease part 1. Naturopathic Doctor News and Review. 2017; retrieved march 4, 2018 from
  2. Parodi A, Paolino S, Greco A, et al. Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication. Clin Gastroenterol Hepatol. 2008;6(7):759-764.