Rosacea
Gabriel treats rosacea as gut-skin condition with immune-vascular component, not just "sensitive skin.
1 identified
1 recommended
1 to test
2 modalities
Gabriel's Approach
Gabriel treats rosacea as gut-skin condition with immune-vascular component, not just "sensitive skin." SIBO extremely common in rosacea patients—treat gut, skin often clears. Protocol: 1) Test and treat SIBO (breath test, herbal antimicrobials or rifaximin—many rosacea patients clear when SIBO treated), 2) Treat H. pylori if present, 3) Address Demodex overgrowth (topical treatment, oral ivermectin if severe), 4) Identify food triggers (histamine-rich foods, alcohol, spicy—individual variation), 5) Reduce inflammation (omega-3, curcumin, quercetin—mast cell stabilization), 6) Gentle skincare (avoid harsh products, irritants), 7) Support gut healing, 8) Avoid triggers (sun, heat, stress, alcohol). Goal: clear skin, prevent flares, address root cause (gut, not just skin).
Root Causes
Why Conventional Fails
Topical treatments: Metronidazole gel (MetroGel, MetroCream—antimicrobial, anti-inflammatory), Azelaic Acid (Finacea—antimicrobial, anti-inflammatory), Ivermectin (Soolantra—kills Demodex, anti-inflammatory), Brimonidine (Mirvaso—vasoconstrictor, reduces redness temporarily but rebound redness can occur), Oxymetazoline (Rhofade—vasoconstrictor, similar to Mirvaso), Oral medications: Doxycycline low-dose (Oracea 40mg—anti-inflammatory, not antimicrobial dose), Isotretinoin (Accutane—for severe papulopustular, last resort), Procedures: Laser/IPL (intense pulsed light—reduces visible blood vessels, redness), Electrocautery (for visible blood vessels), Gentle skincare advice, Avoid triggers (often inadequate identification)
Topical metronidazole/azelaic acid: Modest improvement (not curative), Irritation in some, Doesn't address root cause (gut, systemic inflammation), Ivermectin (Soolantra): Effective for Demodex-driven rosacea (papulopustular type), Expensive ($500+/tube without insurance), Doesn't address gut component, Brimonidine/Oxymetazoline: Temporary redness reduction (vasoconstrictors—hours only), Rebound redness common (worse after wears off), Doesn't improve long-term, Expensive, Doxycycline: Low-dose anti-inflammatory (not antibiotic effect), Some benefit but: Doesn't address root cause, GI side effects, Photosensitivity, Long-term use concerns (gut microbiome effects even at low dose), Isotretinoin (Accutane): Effective for severe resistant cases BUT: Severe side effects (dry skin/lips/eyes, birth defects, depression risk, liver toxicity, requires monitoring), Last resort only, Lasers/IPL: Reduces visible vessels, redness (cosmetic improvement), Expensive ($300-500 per session, multiple needed), Doesn't prevent new vessels (recurrence common unless root cause addressed), Painful, Downtime, Conventional approach: Focuses on topical suppression and cosmetic procedures without: Testing for SIBO (50%+ of rosacea patients have SIBO—treating SIBO often CURES rosacea, breath test should be routine but rarely done), H. pylori testing (common in rosacea, eradicating improves outcomes), Assessing Demodex burden (overgrowth common, treatable), Comprehensive food trigger identification (alcohol, histamine-rich foods, spicy—needs detailed elimination), Gut healing (leaky gut, dysbiosis drive systemic inflammation—show up on face), Histamine intolerance evaluation (DAO deficiency, high-histamine diet trigger flushing), Mast cell stabilization (quercetin, vitamin C—reduce flushing/inflammation), Many rosacea patients dramatically improve or clear with: SIBO treatment (if positive—herbal or rifaximin), Eliminating food triggers (alcohol, histamine-rich foods, spicy, individual sensitivities), Treating Demodex (ivermectin, tea tree oil), Gut healing (probiotics, L-glutamine, digestive enzymes), Anti-inflammatory supplements (omega-3, curcumin, quercetin), Gentle skincare (avoid harsh products, irritants), Stress management, Sun protection, Avoid treating just the skin when it's systemic issue (gut-skin axis)
Your Complete Protocol
A comprehensive, tiered approach combining supplements, herbs, and advanced therapies
Your Protocol for Rosacea
Choose the level that's right for your healing journey
Essential Protocol
What's Included
- Gut-focused (CRITICAL for rosacea): SIBO treatment if positive: Herbal antimicrobials (Berberine 500mg 3x/day, Oregano oil 500mg 3x/day, Neem, Allicin—rotate), OR Rifaximin (prescription antibiotic for SIBO—very effective, discuss with doctor), Digestive Enzymes with meals, Probiotics (after SIBO treatment—Soil-based or Saccharomyces boulardii initially), H. pylori treatment if positive (see H. pylori protocol), L-Glutamine 5-10g/day (gut healing), Anti-inflammatory/Mast cell stabilization: Quercetin 1000mg 3x/day (mast cell stabilizer, reduces flushing), Omega-3 2-4g/day (anti-inflammatory), Curcumin 1g 2x/day (anti-inflammatory), Vitamin D3 5000 IU (immune modulation), DAO enzyme (if histamine intolerance—take with meals), Vitamin C 1000mg 2x/day (antihistamine effect), Zinc 30mg (skin health, anti-inflammatory), Niacinamide (vitamin B3) 500mg 2x/day (reduces flushing—NOT niacin which causes flushing), Azelaic Acid (topical—kills Demodex, anti-inflammatory), Green tea extract (topical and oral—anti-inflammatory, antioxidant), Chrysanthemum (traditional for rosacea—anti-inflammatory), Licorice Root Extract (topical—anti-inflammatory, but avoid oral if high BP), Demodex treatment (if overgrowth suspected): Tea Tree Oil (topical—diluted 5%, kills Demodex mites), Ivermectin (Soolantra topical or oral if severe—prescription, very effective for papulopustular rosacea), Sulfur-based products (traditional for rosacea—antimicrobial), Topical: Azelaic Acid 15-20% (Finacea—prescription or Melazepam OTC, anti-inflammatory, antimicrobial), Metronidazole gel (prescription—antimicrobial, anti-inflammatory), Niacinamide serum (reduces redness), Aloe vera gel (soothing), Green tea extract, Licorice root extract, Gentle moisturizer (ceramide-based, fragrance-free)
- Green Tea Extract (Lu Cha) — Reduces facial inflammation and redness
- Licorice Root (Gan Cao) — Soothes inflamed facial skin
Available through Fullscript
Practitioner-Grade Protocol
Practitioner-Grade — Not Available on Amazon
What's Included
- Standard Process whole food protocol
- Lophatherum and Gypsum Formula (Qing Wei San) — Clears stomach heat that rises to the face causing rosacea
- Coptis Decoction to Resolve Toxicity (Huang Lian Jie Du Tang) — Clears heat from the face and reduces facial inflammation
Whole food supplements by Standard Process
Complete Protocol
What's Included
- All Practitioner-Grade supplements & herbs
- BPC-157 (tissue repair + gut healing)
- Thymosin Alpha-1 (immune modulation)
Standard Process + Matter peptides
Recommended Treatments Near You
In-person therapies that complement your protocol
Red Light Therapy
$25-75 per session
Specific wavelengths of red and near-infrared light penetrate tissue to boost cellular energy, reduce inflammation, and accelerate healing.
The Cryo Studio
West Hollywood • Sunset Strip
First session free with any package
Next Health
West Hollywood • Robertson
10% off all services with Gabriel
HigherDOSE
West Hollywood • Melrose
$15 off infrared sauna session
Recommended Supplements
Key Lab Markers
Dietary Guidance
Identify and avoid food triggers (individual variation, keep food diary): Common triggers: Alcohol (vasodilator—major trigger, even small amounts, red wine especially), Spicy foods (capsaicin—triggers flushing), Hot beverages (temperature triggers flushing—let cool before drinking), Histamine-rich foods (if histamine intolerance): aged cheese, fermented foods, alcohol, leftovers, cured meats, tomatoes, eggplant, spinach, avocado, citrus, strawberries, shellfish, Cinnamaldehyde-containing foods (cinnamon, tomatoes, citrus, chocolate), Eliminate gluten and dairy trial (inflammatory for some), Anti-inflammatory diet: Omega-3 foods (wild fish 3x/week—anti-inflammatory), Colorful vegetables (antioxidants—berries, leafy greens, cruciferous), Green tea (anti-inflammatory, antioxidant), Turmeric and ginger (anti-inflammatory), Bone broth (gut healing), Probiotic foods (after SIBO treated—yogurt if tolerated, kefir, sauerkraut), Avoid: Sugar (inflammatory, feeds gut pathogens), Processed foods, Trans fats, Seed oils (inflammatory), Temperature considerations: Let hot foods/beverages cool (temperature triggers flushing), Cold/room temp foods better, Hydration (adequate water, room temperature), Organic (reduce toxin load)
Lifestyle Factors
Identify and avoid environmental triggers: Sun exposure (UV—major trigger, wear SPF 30+ daily, zinc oxide physical sunscreen better than chemical, wide-brim hat, seek shade), Heat (triggers flushing—avoid hot environments, overheating, saunas initially, use fans, cool environment), Cold wind (protective scarf in winter), Stress (major trigger—meditation, yoga, breathwork, therapy), Exercise (beneficial but overheating triggers flushing—exercise in cool environment, use fan, stay hydrated, low-intensity initially), Hot showers/baths (lukewarm only), Skincare: GENTLE routine (harsh products worsen rosacea): Gentle cleanser (fragrance-free, sulfate-free—Cetaphil, CeraVe, Vanicream), Avoid: alcohol-based products, witch hazel, menthol, peppermint, eucalyptus, fragrance, harsh scrubs, AHA/BHA (too harsh for many), retinoids (irritating initially—introduce slowly if at all), Moisturize (barrier repair—ceramide-based, fragrance-free, hyaluronic acid), Sunscreen daily (physical/mineral—zinc oxide, titanium dioxide less irritating than chemical), Makeup (if worn—mineral makeup, green-tinted primer neutralizes redness), Avoid touching face (irritation, Demodex spread), Wash pillowcases frequently (reduce Demodex), Adequate sleep (7-9 hours—skin repairs, reduces stress), Quit smoking (inflammatory, worsens rosacea), Limit alcohol or eliminate (major trigger), Stress management (meditation, therapy—stress triggers flares), Keep face cool (cold compresses during flares, fan, avoid overheating), Red light therapy (anti-inflammatory, promotes healing—some benefit), Gentle facial massage (improves lymphatic drainage—but avoid if too sensitive), Ocular rosacea (if eye symptoms—dry, irritated eyes): Warm compresses, Lid hygiene, Omega-3, Artificial tears, See ophthalmologist if severe, Treat Demodex if present (tea tree oil, Soolantra)
Recommended Treatments
Mind, Body & Spirit
Evidence-based practices that complement physical treatment protocols
Mind
Meditation & Mindfulness
strongDaily meditation practice to reduce stress, lower inflammation, and support healing.
Stress Management Techniques
strongDeveloping healthy coping strategies to reduce cortisol and support immune function.
Body
Therapeutic Breathwork
moderateConscious breathing techniques to regulate nervous system and reduce symptoms.
Spirit
Nature Connection
moderateTime in nature to reduce stress, improve mood, and support physical healing.
Curated for Rosacea
Supplements + Chinese herbal medicine
Standard Process + classical TCM
Standard Process + advanced peptide therapy
Find a Practitioner
Connect with specialists who treat Rosacea using root-cause approaches.
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