INTESTINAL DYSBIOSIS AND ROSACEA: A CONTEMPORARY REVIEW OF MICROBIOME-MEDIATED GUT–SKIN INTERACTION MECHANISMS (LITERATURE REVIEW)

Rosacea is a chronic inflammatory skin condition with multifactorial etiology, affecting millions worldwide.It is increasingly recognized not only as a dermatological issue but also as a manifestation of systemic dysregulation involving the gut-skin axis.Recent studies have demonstrated a significant correlation between intestinal dysbiosis and the pathogenesis of rosacea.Alterations in gut microbial diversity and function can lead to increased intestinal permeability, systemic inflammation, and neurovascular dysregulation-all key mechanisms in rosacea development.These insights call for a re-evaluation of traditional treatment strategies focused solely on the skin.Instead, addressing gut health may offer additional therapeutic value.The concept of the gut-skin axis emphasizes the role of the intestinal microbiome as a mediator between gastrointestinal and dermatological health.Microbial metabolites such as short-chain fatty acids and tryptophan derivatives influence immune tolerance and inflammatory cascades.Dysbiosis shifts this balance, leading to heightened immune reactivity and oxidative stress.Such systemic responses contribute to facial erythema, papules, pustules, and even ocular or phymatous manifestations of rosacea.Evidence from interventional studies shows that antimicrobial therapy, dietary adjustments, and probiotics can improve skin symptoms by restoring microbial balance.These findings suggest a bidirectional relationship requiring integrated therapeutic approaches.Two common gastrointestinal conditions-small intestinal bacterial overgrowth (SIBO) and Helicobacter pylori infection-have been frequently associated with rosacea.Their eradication has shown parallel improvement in cutaneous symptoms in various trials.While the exact mechanisms remain under investigation, the reduction of systemic endotoxemia and modulation of immune pathways are likely contributing Журнал «Перспективи та інновації науки» № 12(58) 2025 1833 factors.Probiotic supplementation has also emerged as a supportive therapy to enhance gut barrier integrity and systemic immune tolerance.In addition, dietary patterns rich in fiber and plant-based nutrients appear to promote microbiome diversity and reduce inflammation.These findings strengthen the rationale for considering intestinal health in rosacea treatment plans.Emerging therapeutic strategies targeting the microbiome-such as prebiotics, postbiotics, and fecal microbiota transplantation (FMT)-represent a promising frontier in chronic dermatoses.Though still experimental in the dermatological context, these methods have shown success in gastrointestinal and autoimmune disorders.Their application in rosacea warrants further investigation through controlled clinical trials.Integrating microbiome analysis into routine dermatological diagnostics could help personalize treatment.Moreover, collaboration between dermatologists, gastroenterologists, and nutritionists can optimize outcomes in patients with overlapping cutaneous and gastrointestinal disorders.As evidence grows, a more systemic and holistic approach to rosacea care becomes imperative.In conclusion, the link between intestinal dysbiosis and rosacea reflects a broader interaction between host immunity, microbiota, and environmental factors.Recognizing this relationship has significant implications for both research and clinical practice.Therapeutic strategies that address not only skin inflammation but also microbial imbalances may provide enhanced and lasting relief for patients.The gutskin axis introduces a paradigm shift in rosacea management, encouraging multidisciplinary cooperation and personalized care.Future research should focus on longitudinal studies, mechanistic models, and the development of microbiome-targeted therapies.Understanding and harnessing this complex interplay may ultimately improve outcomes and quality of life in rosacea patients.