Is Rosacea linked to reflux disease?

People with rosacea are more likely to have upper gastrointestinal disorders according to research.

While studies have identified a ‘significant link’ between gastroesophageal reflux disease (GORD/GERD) and the skin condition.

What is rosacea?

Rosacea is a chronic long-term skin condition that causes redness (blushing) or visible blood vessels on the face. It affects one in 10 people in the UK and 415 million worldwide.

The exact cause of it is unknown with a number of potential factors suggested. But common triggers include alcohol, spicy foods, cheese, caffeine, hot drinks and aerobic exercise.

What research shows

A 2022 pooled analysis of research studies found that the odds of GORD/GERD are increased in patients with the condition when compared to controls.

For example, a 2021 study – published in the Journal of the European Academy of Dermatology and Venereology – revealed that people with rosacea had a higher prevalence of GERD as well as oesophagitis, Barrett’s Oesophagus and gastritis.

While a 2015 study conducted by Rainer and colleagues at Johns Hopkins University of 130 individuals with rosacea found a significant association between rosacea and GERD as well as other gastrointestinal diseases.

Why does reflux link to rosacea?

Some theories suggest that vitamin deficiencies, particularly B vitamins such as B-12, may cause the condition. This is relevant because hydrochloric acid, which helps your body to break down, digest and absorb nutrients, is also necessary for the absorption of B12 but can have low levels in people suffering from reflux.

Another report says the link between rosacea and gastrointestinal comorbidities may involve common predisposing genetic, microbiota, and immunological factors, comprising the theory of the gut–skin axis.

Some common risk factors, such as smoking and alcohol use, are also shared by rosacea and GERD.

How is rosacea managed?

Typically, rosacea patients are prescribed skin creams, a course of antibiotics or even light treatment.

Experts say that recognition of this association can help provide counselling on interventions that simultaneously mitigate exacerbating factors of both conditions.