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Rosacea

Rosacea is redness and inflammation surfacing on the face — very often from the gut. We look underneath the flushing, not only at the surface.

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Eczema, psoriasis, acne, hives, and chronic skin issues treated with TCM and functional medicine. Downtown Seattle.

More Than a Red Face

Rosacea — facial redness, flushing, visible vessels, and sometimes bumps and pustules — is treated as a surface skin problem to be managed with topicals, but it behaves like what it is: a condition of blood vessels, inflammation, and very often the gut, surfacing on the face. The body is not malfunctioning; the face is reporting on something happening underneath.

This is the GoodMedizen lens. The body is not malfunctioning. It is responding accurately to the information it is being given. Change the inputs and the response begins to change with them.

What Rosacea Actually Is

Rosacea is a chronic inflammatory condition affecting the facial skin and its blood vessels, which become reactive and dilate easily, producing flushing, persistent redness, and visible capillaries, with bumps and pustules in some forms. It tends to flare with specific triggers and has an increasingly recognized connection to the gut, including links to SIBO and H. pylori. It is not caused by poor hygiene, and it is not acne, though it can look similar.

What Is Actually Driving It

  • Reactive, easily dilating facial blood vessels
  • Gut drivers — SIBO and H. pylori have recognized associations with rosacea
  • The skin microbiome, including overgrowth of Demodex mites
  • Systemic inflammation and an overactive innate immune response
  • Triggers that provoke flushing — heat, alcohol, spicy food, sun, stress
  • Histamine and mast-cell reactivity in some people

Why It Gets Missed

Rosacea is managed almost entirely at the surface — topicals, antibiotics, laser for the vessels — which can help appearances but leaves the gut and inflammatory drivers unaddressed, so it keeps flaring. The strong gut connection in particular is rarely investigated.

We look underneath the redness — the gut, the inflammation, the triggers — rather than only treating the surface.

Signs and Patterns

  • Easy flushing and blushing
  • Persistent redness across the cheeks, nose, chin, or forehead
  • Visible small blood vessels
  • Bumps or pustules that resemble acne
  • A stinging or burning sensation
  • Eye irritation and dryness (ocular rosacea)
  • Flares with heat, alcohol, spicy food, sun, or stress

How We Look at It — The Testing

  • The gut — GI-MAP through Diagnostic Solutions, including H. pylori, with assessment for SIBO, given their recognized links to rosacea
  • Inflammation — hs-CRP and a CBC with differential for the neutrophil-to-lymphocyte ratio
  • Histamine and reactivity — assessed clinically where flushing and reactivity are prominent
  • Foundations — 25-OH vitamin D around 60 to 70, a comprehensive metabolic panel with GGT, and zinc, which supports the skin
  • Hormones — where flares track the cycle, a full panel through ZRT

Broad baseline labs do not have to be expensive. Services such as Function Health let patients obtain large workups affordably, and we have no financial stake in that — we would rather your budget go toward care than toward lab markups. For targeted functional testing we order through Diagnostic Solutions (GI-MAP) for the microbiome, Quicksilver Scientific for heavy metals, and through Fullscript where it serves you best, with every marker read against optimal ranges rather than the wide line between “normal” and “abnormal.”

The Chinese Medicine Lens

Chinese medicine reads rosacea largely as heat in the blood and in the Stomach and Lung channels rising to the face — the redness and flushing are heat, the bumps and pustules are heat with damp — frequently with a digestive root, since the Stomach and Spleen channels cross the central face. This gut-to-face connection, recognized in Chinese medicine for centuries, lines up neatly with the modern findings on SIBO and H. pylori.

Treatment cools the blood heat, clears the heat from the affected channels, and addresses the digestive root feeding it.

How Acupuncture and Functional Medicine Help

Acupuncture helps calm the vascular reactivity and flushing, cools the inflammatory heat, and regulates the nervous system that triggers stress-related flares. It is gentle on already-reactive skin.

The functional work goes after the drivers: addressing SIBO or H. pylori where present, calming systemic inflammation, identifying and reducing personal flush triggers, supporting the skin microbiome, and steadying histamine reactivity, so the face has less to flare about. Calming the gut is often where the real change starts.

Care That Works With Your Dermatologist

We coordinate with your dermatologist, and treatments such as laser for visible vessels or prescription topicals can pair well with the internal work. We work alongside them and never advise stopping a prescribed medication.

Your Body Isn’t Broken

If you have spent years being told your labs look normal while you clearly do not feel normal, you have not been imagining it. With rosacea, the work is to cool the inflammation and address the gut driving it, so the face has less reason to flare. Your body is not broken. The support has just been missing.

At GoodMedizen in downtown Seattle, we treat the system driving the condition, not only the symptoms it produces.

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