17 February, 2017

Natural anti inflammatory treatment options for rosacea (still being updated for now)

There are many ways in which you can treat and try to control rosacea symptoms. What works for one person with rosacea, might not work for another. This could be called the "X factor". This causes often confusion and debate in online health groups. Some people swear by their treatment protocol and state that anyone who isn't willing to try the same regimen, simply doesn't want to be cured. Or when they do and have poor results, there must be something they are doing wrong.

Unfortunately, this often isn't the case. Some people with rosacea can tolerate topical or systematic steroids, but most will find that their rosacea eventually worsens from it, especially once they stop with the steroids. Some people have very good results with antibiotic creams like metronidazole or rozex. For others, the creams are too harsh or they make the redness and burning actually worse. It's trial and error. It probably has to do with the idea that rosacea is a manifestation in the skin that can be rooted in different underlying causes (and it also mimics quite a few other illnesses). Someone with a severe food allergy can have rosacea symptoms, when triggered. Someone with eczema can get a butterfly rash all over the face, which is a very different underlying cause. Some people have demodex mite infections, others have issues with the central nervous system and/or hyper reactive blood vessels that don't function like they should. There are many more possible causes, but for now, there is not enough research done, to figure all of this out once and for all.

For me personally, regular medication is helping me most with my rosacea symptoms. For others, it is IPL or laser treatment that keeps symptoms at bay. Red light therapy helps some people to suppress the skin inflammation. Diet is a factor in many peoples rosacea, but not for everyone. Natural anti inflammatory supplements and herbs can also help with rosacea symptoms. They are part of the X-factor puzzle, and the same product might not work for everyone. They are considered 'natural' often, as they are extracted from natural sources, but don't be fooled; natural supplements can still cause side effects. An antidepressant herb called St. John's Worth, for instance, can cause photo sensitivity; irritation and flaring from sun exposure. Just like several tetracycline antibiotics can.

My medication (clonidine, propranolol, mirtazapine and xyzal) help with my flushing but they are not strictly anti inflammatory medication to combat the inflammation that is going on in the blood vessels and deeper inside the skin. They mainly help to keep the smaller blood vessels in your skin constricted, and to limit the flushing. As such they can also help to get inflammation in the face down, but they are technically not anti inflammatory medication. As you could read I have tried the anti inflammatory medications plaquenil and mepacrine recently (anti malarials), which are successfully used to limit inflammation in the skin of people with skin conditions like lupus. My dermatologist in London also has rosacea patients who benefit from these medication. I tried them too, twice over time, but unfortunately
I either flushed more from one of them (mepacrine), or developed an eye side effect from the other (plaquenil_. The plaquenil did seem promising and to reduce my redness a bit as well, but I kept getting gritty painful eyes from it, unfortunately. Plenty of people with rosacea are using them with success however. 

So, I am still on the lookout for the right and perfect anti inflammatory supplements that can help me combat the rosacea redness and swelling. Some natural anti inflammatory herbs have a decent track record on helping to deal with the inflammation that comes with rosacea. I tried to do a little investigation on them.

BTW: I don't believe in combining bags full of different types of vitamins and supplements.. If you mix and match too many, you might end up with too high levels of vitamins, and you won't know anymore then which of them might cause your skin to improve or deteriorate.. When you start taking more than one supplement or medication at the same time, if often becomes difficult to pinpoint later what it or isn't helping you. It can help then to try one thing first, to give it a good few weeks to start working (unless it makes you flush like mad straight away of course). Try to not eat weird things or face too many other triggers during your trial time, to be able to really evaluate in an honest way. And when you start adding more supplements, make sure you either do a proper google search on possible interactions, or ask your pharmacist or doctor about it.

Besides, with a balanced diet most people seem to get all the needed vitamins. If you suspect a vitamin deficiency, please have your blood levels tested by your local doctor. Vitamin D is one vitamin that is often too low in people with rosacea, especially if they avoid the sun. It is wise to try to keep your vitamin D levels in a healthy range, because it plays a role in the protection against all sorts of cancers. And low vitamin D levels are also linked to auto-immune diseases, including multiple sclerosis, rheumatoid arthritis, type 1 diabetes mellitus, and systemic lupus erythematosus (SLE). A new study conducted at Monash University in Australia has now shown that low vitamin D3 status in SLE was associated with higher disease activity while an increase in serum vitamin D3 levels reduced SLE activity. This study provides hope that many patients with SLE and other autoimmune disorders may benefit from vitamin D3 supplementation.

And last but not least, 'natural' doesn't always equal 'safe'. Just think of arsenic, daffodil or Belladonna which are so poisonous that they can kill you. Herbs and plants can also interact with each other or with regular prescription medication. 

Not all doctors or dermatologists are interested in dietary changes or herbal supplements for rosacea, unfortunately. If your doctor is, fabulous, discuss you trials with him or her. If not, still tell your doctor when you take supplements, because your doctor needs to know this, as well as your pharmacist (in case you take prescription medication as well).

If you try supplements on your own, just realize that not one thing works for all, when it comes to rosacea. When you notice that your rosacea worsens from a supplement, and this flare isn't temporary, then I would always advise to stop taking it. Wait for your skin to calm down again, and maybe try the supplement in question a second time, if you want. If it turns out that it really was the supplement that you were reacting to then don't think that your skin always has to become worse before it gets better; this is rarely the case. Rosacea is a fickle beast, and not everything that's good on paper works out well for our rosacea faces. One example; zinc and magnesium are supposed to be really good for the skin, but when I take them, they cause me to flush. The same happens with vitamin D supplements for me. Another example; fish oil is deemed healthy, but the histamine in fish oil can simply cause you a flare. In that case, avoid it. Flaring you skin day in day out with foods or supplements that you can avoid, might just make matters worse on the long run. It might take some trial and error, but many people with rosacea found relief in the end from supplements and diet. 

Due to the amount of time it takes me to write about each of these supplements, and my limited free time to do so, I will publish the first 6 supplements now and keep adding the rest of the supplements and their information in the upcoming weeks. 

Discussed anti inflammatory supplements (in random order):

1. Alpha Lipoic Acid
2. Boswellia (Serrata)
3. N-Acetyl Cysteine (NAC)
4. Milk thistle (silymarin)
5. Flax Seed Oil
6. Fish Oil 
7. Quercetin
8. Bromelain
9. Curcumin
10. Astaxanthine
11. Neem
12. Aloe
13. Oregano Oil
14. Grape Seed extract
15. White Willow Bark
16. Pycnogenol
17. Ginger
18. Zinc
19. Licorice Root
20. Solgar MSM
21. L-Lysine
22. Evening Primrose Oil
23. Viola Tricolor
24. Vitamin C
25. Turmeric

1. Alpha Lipoic Acid

Possible effects: anti inflammatory, reduction in redness 

Alpha lipoic acid (ALA) is a fatty acid, found naturally in every cell in the body. It's needed by the body to produce the energy for our body's normal functions. Alpha lipoic acid converts glucose (blood sugar) into energy. Other names for it are lipoic acid, thioctic acid, and ALA. Alpha Lipoic Acid is a coenzyme that also acts as an antioxidant (a substance that neutralizes potentially harmful chemicals called free radicals) and has anti-inflammatory properties, protecting blood vessels and the fatty tissues of the brain and nerves. 

Alpha Lipoic Acid is easily absorbed when you take it in pill form orally. It can regenerate other important antioxidants, like vitamins E, C and glutathione. Alpha lipoic acid is the only antioxidant that can boost cellular levels of glutathione, the body’s most important antioxidant to overall health and a long life. It is also important for regulating aspects of the immune system, in particular, T-lymphocytes.

Not all types of rosacea are linked to auto immune activity, but some cases certainly are. You can be tested by your doctor or internist for auto immune activity through blood tests, but regardless, rosacea is an inflammatory disease of the skin and blood vessels, and benefits as such often from anti-inflammatory supplements, medications or diets. The inflammatory process in the body is complex. Sometimes the body produces its own inflammation (in case of auto immunity), but otherwise there are also other ways in which your body endures inflammation; free radicals also promote inflammatory reactions, which antioxidants have been successful at diminishing.

What are free radicals: 

They are a byproduct from what scientists call 'oxidative stress'. Oxygen in the body splits into single atoms with unpaired electrons. Electrons like to be in pairs, so these atoms, called free radicals, scavenge the body to seek out other electrons so they can become a pair. This causes damage to cells, proteins and DNA. Free radicals are associated with human disease, including cancer, atherosclerosis, Alzheimer's disease, Parkinson's disease and many others. They also may have a link to aging, which has been defined as a gradual accumulation of free-radical damage.
Substances that generate free radicals can also be found in the food we eat, the medicines we take, the air we breathe and the water we drink. These substances include fried foods, alcohol, tobacco smoke, pesticides and air pollutants. Think of free radicals as waste products from various chemical reactions in the cell that when built up, harm the cells of the body.

But they aren't all bad, we also need free radicals to turn air and food into energy for our bodies, and to keep our immune system functioning (free radicals are floating through the veins and attacking foreign invaders).

The danger of free radicals: once free radicals are formed, a chain reaction can occur. The first free radical pulls an electron from a molecule, which destabilizes the molecule and turns it into a free radical. That molecule then takes an electron from another molecule, destabilizing it and tuning it into a free radical. This domino effect can eventually disrupt and damage the whole cell.
The free radical chain reaction may lead to broken cell membranes, which can alter what enters and exits the cell. The chain reaction may for instance change the structure of a lipid, making it more likely to become trapped in an artery. The damaged molecules may mutate and grow tumors. Or, the cascading damage may change DNA code.
Oxidative stress occurs when there are too many free radicals and too much cellular damage.
And oxidative stress plays a role in the development of many conditions, including macular degeneration, cardiovascular disease, certain cancers, emphysema, alcoholism, Alzheimer's disease, Parkinson's disease, ulcers and all inflammatory diseases, such as arthritis and lupus. Symptoms of oxidative stress may include fatigue, headaches, noise sensitivity, memory loss and brain fog, muscle and joint pain, wrinkles and gray hair, vision trouble and decreased immunity.

Antioxidants (like Alpha Lipoic Acid) keep free radicals in check. Antioxidants are molecules in cells that prevent free radicals from taking electrons and causing damage. Antioxidants are able to give an electron to a free radical without becoming destabilized themselves, thus stopping the free radical chain reaction. They also clean up the free radical waste in the cells. Well-known antioxidants include beta-carotene (found in carrots) and other carotenoids, alpha-lipoic acid, lutein, resveratrolvitamin C, vitamin E, lycopene and other phytonutrients.
Our body produces some antioxidants on its own, but an insufficient amount. Oxidative stress occurs when there is an imbalance of free radicals and antioxidants (too many free radicals and too few antioxidants). There are many antioxidants found in fruits and vegetables, especially colorful ones, for instance berries, tomatoes, broccoli, spinach and nuts.

Note: it is usually more effective and potentially safer to get antioxidants through whole foods rather than through supplements.

Natural food sources of Alpha Lipoic Acid:

You can boost the production and benefits of alpha lipoic acid by consuming more of these foods:

Brussels sprout
Red meat
Rice bran

Side effects of Alpha Lipoic Acid:

Consuming too much alpha lipoic acid is linked to some symptoms, like headache, skin rash, itching or hives, and muscle cramps. There have also been a few reports in Japan of a rare condition called insulin autoimmune syndrome in people using alpha lipoic acid. The condition causes hypoglycemia and antibodies directed against the body's own insulin without previous insulin therapy. 
Animal studies indicate that alpha lipoic acid may alter thyroid hormone levels, so it could theoretically have the same effect in humans. People taking thyroid medications such as levothyroxi ne should be monitored by their healthcare provider.
Dosage Recommendations: 25 to 30 milligrams is adequate for a young healthy person. Dr. Perricone recommends anywhere from 200 to 400 mg of alpha lipoic acid per day to patients with specific health concerns and those who are seeking to lose body fat. Consult with your physician first.

Research done with Alpha Lipoic Acid:

In this research, the effects of the antioxidants alpha lipoic acid and vitamin C and E were tested on NF-kappaB activity, which regulates the production of many inflammatory cytokines and adhesion molecules that play a role in inflammation and oxidative stress. Certain cells were treated first to cause and show oxidated stress. Then alpha lipoic acid, Vitamin E and C were added, to see if there was an effect. Both vitamin E and vitamin C had no effect, but Alpha Lipoic Acid reduced the oxidated stress. It has also shown to reduce inflammation in this and this research,

Alpha Lipoic Acid and rosacea:

In this research, rosacea patients were treated with topical Alpha Lipoic Acid. It was added in 5% strength to a cream with a lecithin base. In a blinded study, eight patients between 20 to 51 years of age, diagnosed with rosacea and photographed were given the 5% lipoic cream and an identical looking cream with no lipoic acid in it. The patients did not know which of the two creams they were given. They had to cleanse their faces and then apply one cream to one side of their faces twice daily during the duration of the study, and apply the other cream to the other side at the same time.

Patients were evaluated every two weeks. In every patient, marked improvement and a decrease in skin redness was seen on the face side that was treated with lipoic acid after two weeks. After four weeks, skin redness was even more markedly reduced on the face side where lipoic had been applied in every patient.

Alpha Lipoic Acid and rosacea, patient testimonials:

Mistica wrote on May 2009: "I have taken Alpha Lipoic Acid for about four years. I was in remission at the time, but it didn't prevent me from developing horrendous rosacea. Nor has it helped reduce any symptoms during my battle to beat the beast this time round. I suppose it might be helping at some level, by perhaps reducing further tissue damage? It is a potent antioxidant. I have also tried topical ALA and it was very irritating."

But on June 2011 Mistica updated: "I have recently started taking R-Alpha Lipoic acid on the advice of my GP, mostly for other reasons. I feared it thinking it would increase rosacea symptoms. So far I am pleased with effects on my rosacea, as they are a bit less."

KHM wrote on June 2005: "I started this when I was at my worst and the improvement was very noticeable - my naturopath immediately asked me what I had added to my regime."

Steve95301 wrote on September 2006: "I've recently upped my dosage of Alpha-Lipoic Acid from 100mg twice daily to 300mg twice daily, per Dr. Nase's website. Preliminary results are excellent, I'm glad I upped my dose. Has anyone else had success with ALA? [..] I noticed a reduction in redness the first day I took 300mg instead of my usual 100mg. I'm normally a little flushy mid-afternoon, and I noticed it knocked that down quite a bit. I've been very pleased with it. If anyone else has tried a large dose of ALA, I'd like to hear their results as well. As for myself, I would definitely recommend it."

And Steve95301 updated: "I just started the whole supplement thing, after I found that ibuprofen decreased background redness for me. Got me thinking that supplements might actually help. First, I started taking boswellia and fish oil. There was noticeable improvement, so I added some other stuff. I bought some Alpha Lipoic Acid, and Zinc Gluconate. I think the ALA really did it for me, I've been almost pale lately. I'm going to start taking more, to try to find the optimal level."

Bethanne wrote on September 2006: "I've tried several trials of ALA (most recently Swanson Vitamins brand) and although it really knocks back the redness, it causes me to break out. I've tested this cause and effect a number of times now. It even happens at 100 mg twice daily. So sadly, I have to give up on ALA."

Miltom: "I had the same exact reaction. Made me break out."

Twickle Purple wrote on October 2006: "I take this every day as well. It doesn't do anything for the flushing, I take it for other reasons. I get it direct from my old MDs office where I lived before, he focuses strictly on nutrition. I wonder when I read about the breakouts if it could be a filler that's causing it? I get a reaction to some of the fillers and dyes used in vitames and nutraceuticals. If you're seeing some good effects, it may be worth hunting about for a different brand, with different filler. Maybe inquire with the local pharmacist. [..] I use it for its antioxident properties (R + Lipoic Acid), along with N-acetyl L-carnetine. I use l-carnetine eye drops too."

DukeCity wrote on October 2006: "I've been taking 600 mg. ALA w/ 30 mg. grape seed extract combined in one capsule. -- I take 2 capsules a day."

Andy wrote on August 2005: "I've also been having great success with supplements the past few months. What works really good for me also is Alpha Lipoic Acid. I'm really amazed how well supplements in combination with Clonidine works. [..] I take 250 mg twice a day, a brand called Now Foods."
And: "Speaking for myself, since starting these (Barleans Omega Twin, Grape Seed Extract, Pycnogenol, Ester-C and Alpha Lipoic Acid) my skin has really improved a great deal and I've been going out these past few days with nothing on my skin, no Citrix, no ZincO, and let me tell you it was a long time since I had the courage to do that! My skin seems to be less sensitive, less red and less prone to flush."

lwemm wrote on October 2015: "I had type 2 and type 4 rosacea first with type 1 following. Diet did not become an issue for me until the type 1 arose, when it became obvious the flushing was linked to dietary triggers. Avoidance of triggers has been the only diet that I have followed. I've taken a lot of different supplements but the ones that have clearly helped the most are evening primrose oil for the ocular symptoms, triphala for digestive problems and alpha lipoic acid for redness. That's not to say the other supplements I take like zinc and probiotics aren't helping. I think a lot of them are but the change is too gradual to be very obvious."

IowaDacid wrote on November 2013: "You may experience flushing to ANY supplement you take, though it's rare. A quick list of what I take:

Grapeseed Extract
Fish Oil
Evening Primrose Oil
Alpha Lipoic Acid
Coenzyme Q 10
N-Acetyl Cysteine

The last 6 can be purchased in bulk powder and you can make your own capsules--way cheaper. They're extremely potent anti-inflammatories and mitochondrial boosters."

ShaunD wrote on May 2014: "I've got texture damage and lost the ability to sweat in the area where
I was treated with IPL. I've read that damage goes down to the dermis, I'm trying to gather as much information as possible on repairing damage. [..] I do think treating inflammation from within is a good start for damage and will help flushing as well, diet changes would help. Grape seed extract and vitamin C supplement has helped to an extent in reducing skin sensitivity which has been a relief. It's a good antioxidant and has properties to assist with damage. I've read that people have had good results using an alpha lipoic acid supplement, apparently it has the ability to slow down or prevent further damage by helping the body heal itself, don't know how effective it really is but something worth looking at. I will keep posting on anything I find."

Banshee wrote on April 2010: "I rarely devote individual threads to singing the praises of something, but this had an effect I felt was worth mentioning. Few supplements make my face go noticeably cooler...one is Ester-C, but I would say R-Alpha Lipoic is even more marked. I believe R-Lipoic is more bioavailable. It's used by cells more effectively and thus works better as an anti-oxidant et al.Within about an hour, I can feel it working. I've taken plain Alpha Lipoic with not as good results. It's not a miracle, but especially in conjunction with Superoxide Dismutase my face has been acting calmer in situations it would typically flush (like a cold barn). Both are anti-oxidants. I get the NSI Brand which are sold on vitacost.com. Add the C and pycnogenol to the above, and I have a fairly effective anti-flushing cocktail.

Hope this helps-

Royguy wrote on May 2013: "I started developing rosacea in my early 20s long before I knew it even existed. [..] I tried some things the oil cleansing method and other natural remedies. But since im really a health freak and I go to the gym too I found a new antioxidant while browsing in the supplement section of the online store I usually buy protein etc. I researched and read that it helped with big pores. Honestly I've gotten used to the redness and gave up trying to fix it. My major concern were the big pores. I read that Alpha lipoic acid was water soluble an I usually do my own tonics with basically just water since anything else harms my skin. In my search for a homemade pore minimizer I came across a recipe. skim milk mixed with brown sugar. What I do is first massage my skin with that mixture.leave it on for some minutes.Rinse and pat dry. And then I dissolve 1 capsule of ALA..alpha lipoic acid in a small container with water. I gently massage over and over again my face. I have to tell you it exceeded my expectations. In one day use you will see a difference but if you really stick to it and use it 2 or 3 times a day you will get smooth skin back. I honestly never thought I could go back to have normal skin around my nose. Its scary the change is dramatic.
I do look many years younger. Now I can touch the skin around my eyes,slide my finger down an I don't notice any difference in texture.truly amazing.If I don't use it for a day I see some dead cell flaky skin and pores,but if you are consistent this is amazing.
I'm not taking it internally yet, just topically. Now i can see my freckles again cause they stand out over the light skin. Before it was all read that you could barely see the freckles.
Don't buy creams lotion people. There always going to be a certain ingredient that irritates your skin.Find the ingredient that works for you,try to find it isolated and create your own tonics with water, chamomile tea, or green tea..Anything that work for you and doesn't irritate.
The same for moisturizer. My advice is buy the supplement. Either oil capsules, aspirin and create your own recipes. Its not only safer but cheaper and funny! My ALA bottle cost is 15. And with 1 capsule I have tonic for a whole week. Brings 90 caps. So do the math. Better than an expensive lotion.[..] I've suffered form rosacea for years.Not an extreme case but I work in modeling and it has hurt my self confidence having to go to castings and all that.
So I hope it helps you as much. If you don't get rid of redness at least I guarantee you will get an skin texture improvement. No doubt about it. And trust me I've tried everything."

I am optimistic about the promises of Alpha lipoic acid. I hope it will act as an anti inflammatory for me and reduce my redness and flushing. I might also get the additional papular outbreaks that some patients mentioned, but I normally don´t have any paps, just the redness and flushing. In fact, since stopping the plaquenil again I haven´t had one papular (that med gave me quite a few) and didn´t need the zinc cream anymore to cover them. I think I will try this supplement soon.


2. Boswellia (Serrata)

Possible effects: anti inflammatory, reduction in redness, reduction in seb derm, p&p's and sebum. 

Boswellia is a substance extracted from a Bonsai-looking tree that is known scientifically as Boswellia serrata.

It is even mentioned in the Bible, as a substance of sacred significance, called frankincense (it was one of the gifts fit for a king that the magi brought with them to present to the newborn Christ).  

Boswellia is an interesting herb, because it works as a natural anti inflammatory. In Ayurveda traditional Indian medicine, boswellia is used to treat conditions like diarrhea, parasites, skin and blood diseases, cardiovascular disorders, respiratory infections, hair loss, hemorrhoids, and asthma. Evidence also shows that it’s an effective remedy for arthritis.
Many studies have also shown that Boswellia is just as effective as non-steroidal anti-inflammatory drugs (NSAID's), which are the most commonly used treatment for issues of inflammation and chronic pain. NSAID's work by inhibiting the inflammatory promoting cyclooxygenase-2 (COX-2) enzymes. Unfortunately, these drugs also inhibit COX-1, which is essential for a healthy stomach lining. This is why these medications can cause stomach bleeding or stomach pains. Not ideal, therefore.

It's interesting to read that science says that Boswellia also reduces inflammation, but  through a different mechanism. It adjusts the pro-inflammatory enzyme 5-lipoxygenase (5-LOX). 5-LOX is the first enzyme released in the cytokine metabolic pathway (the chain effect of inflammation). This pathway creates leukotrienes, which are strong inflammatory substances that play a role in many diseases including cancer, rheumatoid arthritis and asthma. Boswellia reduces inflammatory chemicals and symptoms of inflammation. And Boswellia also reduces another inflammatory enzyme, called human leukocyte elastase (HLE). HLE and 5-LOX are both classically elevated in inflammatory conditions and diseases. Boswellia also reduces the cytokine tumor necrosis factor alpha (TNF-a),which plays a part in arthritis. Because of this, Boswellia has a proven positive effect on arthritis. And unlike NSAID's, Boswellia doesn't cause stomach bleeding. This is because NSAID's inhibit prostaglandins, which not only play a role in inflammation and pain sensations, but who also help to build up proper stomach lining. With fewer prostaglandins, the stomach lining will become thinner, causing stomach irritations and sometimes even ulcers, as the stomach acids can easily do such harm then. The same goes for the lining of the bowel.
The good thing about Boswellia is that it does not pose such problems, although it could still slightly upset your stomach and bowel as a possible side effect.

So Boswellia helps to reduce inflammation in the body, and is used to treat all types of inflammatory diseases, including Crohn's disease, Rheumatoid arthritis, asthma, allergies, osteoarthritis, & ulcerative colitis. But the boswellic acids are also powerful pain relievers that actually work better than non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. On top, Boswellia can help when you have gas, constipation, irritable bowel syndrome, cramps, and other forms of gastrointestinal discomfort. Studies have repeatedly shown that Boswellia is also a powerful immune system booster, helping to protect against harmful bacteria and viruses. When you suffer from an overactive immune system, this might be something to be careful about. Boswellia has also been shown to help balance hormone levels and prevent the excess buildup of estrogen that can lead to health problems in both men and women.

Boswellia is said to be helpful for the following health conditions:

*conditions of the heart and arteries
*skin conditions
*bowel diseases

Types of Boswellia

While Boswellia serrata is the most popular type of boswellia used to treat various disorders and symptoms, it’s not the only type. There are at least three other popular forms of boswellia: boswellia carteriboswellia frereana and boswellia sacra. Each comes from a different plant species, although all are closely related and medically used in similar ways. The four species of boswellia all produce frankincense resin, or extract, which comes in varying concentrations or “grades”. Boswellia carteri for instance, is used sometimes for tumor prevention and has anticancer effects.

Dosage and side effects of boswellia:

Boswellia is generally taken as a capsule or tablet, but it can also be taken as a dried herb, a standardized extract or as a pain-relieving gel. It is not entirely clear what the optimal dose is to balance safety and efficacy. The manufacturing of Boswellia products varies from one produce to the other and this makes it even more difficult for standardization to happen. In general, when you buy a Boswellia supplement, it is good to look for a brand that clearly indicates on the bottle what levels of boswellic acids it contains.

typical dose of boswellia is 350 or 400 mg 3 times a day of an extract standardized to contain 37.5% boswellic acids. You best take the Boswellia in with some oil, because this improves the absorption. This dose should be effective for relief from arthritic, asthmatic, or auto-immune symptoms. The dried herb can be put in smoothies and shakes and used throughout the day. Research has shown a greater absorption rate when taken with other forms of food.

Reports of boswellia side effects are relatively rare, but they do exist. In general, it seems to be well-tolerated - both when used topically and taken internally. The following side effects have been reported by people taking boswellia: diarrhea, skin rashes, nausea, abdominal pain, bloating, vomiting, burning sensation in stomach. In certain rare cases, allergies to boswellia are possible and could result in chest pain, wheezing, shortness of breath, anaphylaxis. You need to see a doctor right away then. An important possible side effect is that it makes the skin a bit more dry. This could be good for people with oily skin. Not so great for people with dry skin, like me. 
There are also possible drug interactions. Boswellia may increase the effects or toxicity of some drugs, according to Aetna Intelihealth, for instance medicines used to treat asthma such as Singulair; certain anticancer drugs; cholesterol-lowering supplements such as garlic or red yeast; antifungal agents such as tea tree oil; and supplements used to treat joint diseases, such as glucosamine or chondroitin. Boswellia may also reduce the effectiveness of anti-inflammatory pain relievers, such as aspirin, ibuprofen and naproxen and may interact with immunomodulators, drugs broken down by the liver, antibiotics, fat soluble drugs and sedatives. When in doubt, check with your doctor about any medications you’re currently taking and their possible interactions with Boswellia. Do not take Boswellia when you are pregnant.

Another possible unwanted side effect of supplements like boswellia, is discussed here.
Very basically, some studies suggest that the boswellia and other '5-LOX products', and Leukotriene B4 in particular, are quite probably a very key portion of our immune response and that blocking these 5-LOX products, and Leukotriene B4 in particular (something that boswellia also does), may lead to the unintended side-effect of increased infections (bacterial, fungal and viral).
Dan writes in that link, that he believes that:

"pathogens play some role in the pathogenesis of rosacea and co-conditions such as seb derm, etc, you may find that while 5-LOX inhibitors seem to help with symptoms for a period of time, at some point they may make rosacea and associated conditions worse over time. This is what seemed to happen for me when I took Boswellia personally. It relieved my symptoms almost completely for several months, but then my rosacea, allergies, seb derm, etc went nuts, and when I tried to wean myself from the Boswellia I realized I was much worse off than before I started taking it.
Please be careful when taking 5-LOX inhibitors or Leukotriene B4 blockers. Short term gains may really lead to long term pain..."

On the other hand: if rosacea is due to an overactive allergic/immune response on the skin as the Gallo studies suggest, then the anti-cathelicidin and anti-neutrophil properties of Boswellia may be useful in moderation, and could help dampen the immune response (high immune responses cause problems in many skin conditions and with allergies).

Research done on Boswellia:

In this PubMed research, the effect of Boswellia on Rheumatoid arthritis (RA) is investigated.
The aim was to evaluate the antioxidant and antiarthritic activity of Boswellia Serrata gum resin Extract in collagen induced arthritis. In rats with arthritis, Bowellia was administered at doses of 100 and 200mg/kg body weight once daily for 21 days. The effects of treatment in the rats were assessed by biochemical (articular elastase, MPO, LPO, GSH, catalase, SOD and NO), inflammatory mediators (IL-1β, IL-6, TNF-α, IL-10, IFN-γ and PGE2), and histological studies in joints.

Boswellia was effective in bringing significant changes on all the parameters hat were studied. When Boswellia was taken in pill form orally, it turned out to significantly reduce levels of inflammation. There was a decrease in arthritis, probably because Boswellia modulates the immune system.

In this research, researchers looked into Boswellia as well. Again, in vitro studies and animal models showed that boswellic acids were found to inhibit the synthesis of pro-inflammatory enzyme, 5-lipoxygenase (5-LO) including 5-hydroxyeicosatetraenoic acid (5-HETE) and leukotriene B4 (LTB-4). Other anti-inflammatory plant herbs, such as quercetin, also block this enzyme, "but they do so in a more general fashion, as an antioxidant, whereas boswellic acids seem to be specific inhibitor of 5-LO. 5-LO generates inflammatory leukotrienes, which cause inflammation by promoting free radical damage, calcium dislocation, cell-adhesion and migration of inflammation-producing cells to the inflamed body area". And they work with less side effects than the non-steroidal anti-inflammatory drugs (NSAIDS) give.

In vitro studies by Ammon et al. in 1993 also found that boswellic acids had anti-inflammatory effects, by the same mechanism as I described just yet. Boswellic acids have also been observed to inhibit human leukocyte elastase (HLE), which may be involved in the development of emphysema; a lung disease in which the lungs become stretched and breathing becomes difficult. It's good to have HLE levels reduced, because it also plays a role when too much mucus is built up, for instance in cystic fibrosis, chronic bronchitis and acute respiratory distress syndrome. HLE causes injury to the tissues which, in turn, triggers the inflammatory process. Boswellia both reduces this inflammation, as well as the substance that causes this type of inflammation to start in the first place.
The researchers also say that Boswellia has four different types of boswellic acids. The most powerful one is called 3-acetyl-11-keto-β-boswellic acid (AKBA).

Boswellia also proved to reduce paw oedema and inflammation in rats and mice, and Boswellia reduced arthritis around 45 to 67%. The boswellic acid from Boswellia serrata was also tested and shown to cause 35% reduction of inflammation. Boswellia works different than aspirin and steroidal drugs. A clinical trial conducted by Raychaudhuri and co-workers in India has shown that Boswellia serrata can reduce pain and considerably improves knee-joint functions, in some cases providing relief even within seven days.

This is a very interesting medical paper, detailing the positive effect of Boswellia Serrata on subtype 2 rosacea: 

"Recurring acne rosacea resistant to Metrogel, was successfully treated with Boswellia serrata."
Case Report: a 65 year old man with acne rosacea - intermittent episodes of blotches and pustules on his forehead, cheeks and neck - for more than 15 years; after being diagnosed he was treated with topical metronidazole (Metrogel), initially with some degree of success, but after about 2 years of treatment Metrogel had become ineffective against rosacea. Treatment with a topical steroid cream didn't give lasting improvement either. This man also suffered from arthritis, gastro-esophageal reflux disease, gastritis, hypertension stage 2 and type 2 diabetes (treated with metformin).
This man was given Boswellia serrate; 4 capsules a day of 500 mg dry extract of Boswellia serrata, taken for 2 months. Doctors decided to give Boswellia serrata a try, because regular anti-inflammatory medication would be too harsh on his stomach, since the man had gastric problems. Boswellia serrate doesn't have such side effects typically.
It worked well for the man; not only did he have a reduction in his arthritis pain, but his rosacea was also effectively treated, according to this paper. When he stopped Boswellia serrate after 2 months, his rosacea symptoms didn't return. The author of the paper, Felician Stancioiu, M.D., wrote:

"Treatment with Boswellia serrata 2 g/day in two divided doses for 4-8 weeks has minimal to none side effects and the effect is as close to a cure as possible."

"Even though the underlying pathological mechanism of acne rosacea is not fully understood
(besides an increase in inflammation on a predisposing hormonal background), the persistence of the
disease-free status after the discontinuation of the treatment and the lack of side effects of this
treatment are very strong arguments for which Boswellia serrata should be tried for this dermatologic
pathology, especially for difficult-to-treat cases of acnea rosacea."

Felician Stancioiu, M.D. continued to explain that in vitro studies and animal models show that boswellic acid inhibits 5-lipoxygenase selectively and has anti-inflammatory anti-arthritic effects. Boswellia reduces edema (swelling of the face) and inflammation in rodents. Boswellic acid also markedly decreases the production of the pro-inflammatory key cytokine TNF-á and the chemokine MCP-1 (17). Unlike other non-steroidal anti-inflammatory drugs, however, boswellic acid does not decrease fever however.

Other known actions of boswellia extracts at cellular level are:
- inhibition of the leukocytes infiltration and initial antibody formation
- inhibition of the classic and alternate path of complement activation
- inhibition of the leukocyte 5-lipooxygenase and elastase

It is important to note that boswellia is one of the very few substances with anti-inflammatory action
which does not cause gastric ulcers in animals. This suggests that the action of boswellic acid is
through other mechanisms than the inhibition of prostaglandin synthesis, which was confirmed
through studies - which shows that cyclooxygenase path is not inhibited by boswellic
acid. Combined with the fact that boswellia, unlike NSAIDs (non-steroidal anti-inflammatory drugs)
does not inhibit the synthesis of GAGs (glucose aminoglucans, which are important for the structural
integrity of the cartilages in the joints) there is a strong argument for its use in arthritic disease.
So far, based on the known inflammatory effects of this plant and the studies which were performed
to show its efficacy and safety for the treatment ot arthritis, asthma, colitis, inflammation and menstrual cramps. Dosage in the range of 1,5 - 2g/day divided in three daily administrations will maintain a useful plasma concentration for an anti-inflammatory effect in most patients who can benefit from it.

Boswellia and rosacea:

YankeeRTheBest wrote: "I've controlled my flushing over the past couple years, but continue to get broken blood vessels and telangetasia. I've been looking for something oral that can at least prevent them from continuing to form. ester C made me flush after a couple weeks, I had a weird burnings sensation from it after a while all over my skin and body. Grape-seed made my cystic acne break out, I'm not sure if it's cause it made toxins release quickly? Boswellia controlled my flushing and redness, but made me breakout in red bumps on my hands and elbows." 

SoSickOfThis wrote: "Hey I tried Boswellia for about a month once. It seemed to help a little, but not enough. Maybe it would have worked better if I gave it longer. You could try it and see if it works for you."

WinnieM wrote: ´I tried Boswellia before. It worked well for my seb derm but it caused some red bumps on my chin, probably it was an allergic reaction, then I had to stop it.´

KHM wrote: "Actually it has worked very well for me - is regular part of my regime now."

And: "I use Natures Way standardized to 65% Boswellic Acids (right now anyway). Divided doses - 1 am, 1 pm. It has to be separated from calcium, so needs to be taken before my morning vitamines. It helps with the "dermatitis" rashy stuff. I don't see it helping with my flushing. BTW - I have P&P form, dry skin, and Ivermectin is like a wonder drug for me. Other things I take/use that help are Protopic, Alpha Lipoic Acid (I think this does help with the flushing, which keeps the P&Ps down as well). I also use Singulair and it definitely helps as well. What gets me nervous is that almost everything that works for me (ALA and Ivermectin excepted) is an immune system modifier. A slightly "over busy" immune system does run in my family - we have Lupus, Addisons, and Fibromylangia in the family. And my allergic reactions are through the roof (most allergic people have reactions in the 1-4 scale range. Many of mine are 10+). So that may be a hint as to the type of people/skin this will work for."

Indian-boy wrote: "I took it once a few years ago. It dramatically reduced my sebum production after a couple of days, and with it a lot of my facial redness. Unfortunately, I had to stop because it was making me dizzy and a bit spaced out."

Joan wrote: "I started using this a couple of weeks ago. It makes me slightly lightheaded about 15 mins after I take it but my flushing doesn't last as long as it did and my permanent redness is about 10% less than it was, I will continue taking this, despite the lightheaded feeling!"

Max wrote: "I am saying this because I have been on Boswellia for 6 weeks, and it does not compare with accutane. What I've read both zileuton as well as boswellia (serrata) block same enzyme. In contrast to zileuton there are not many studies on boswellia (or i haven't been able to find those). maybe it's a matter of dose? I've tried boswellia and it had showed light anti-inflammation effect for me. (similar to cox-2 inhibitors I've tried). I couldn't get any information on how much boswellia matches one zileuton pill - maybe it needs more to show same actions?"

Steve95301rote: "I just started the whole supplement thing, after I found that ibuprofen decreased background redness for me. Got me thinking that supplements might actually help. First, I started taking boswellia and fish oil. There was noticeable improvement, so I added some other stuff. I bought some Alpha Lipoic Acid, and Zinc Gluconate. I think the ALA really did it for me, I've been almost pale lately. I'm going to start taking more, to try to find the optimal level."  

Mistica wrote: "Ages ago, iDan reported delayed adverse reactions to the supplement boswellia. He found a study/studies which showed that the inhibition of leukotrienes (using a different agent), resulted in increased pathogen load. Boswellic acids inhibit leukotrienes and as a result can be useful anti inflammatory agents. However, it would appear that the story is not as simple as it might appear. Plants are notorious for having multiple effects, many of which aren't documented. Prof Ayers used to tell me that plants were no friend of his, as it was impossible to determine all the effects, some of which are not always friendly. That aside, it would appear that the multiple effects of boswellic acids are many and they might include some anti bacterial effects. What that might mean to us, I have no idea. Perhaps it might be helpful against gut infections, but have the opposite effect on systemic infections due to absorption problems? What I can report is this. Recently I had an IPL treatment as my upper cheeks were a mess. (My antibiotic regime won't repair this). Despite discussion with the doc prior to treatment, he used too high an energy and my face swelled badly. I was very distraught and not wanting to take prednisone, I cautiously tried boswellia.
The brand I have is very high dose. That is all I could get. I felt weird, kind of spacy. My facial swelling did decrease however, although I am now much redder and have more visible vessels than prior to treatment <sigh>. Now I will have to have another treatment:( I had researched boswellia before testing it, but there always seems to be more info to find... after side effects set in! It would appear that in high doses, it can lower blood pressure. ( I have been monitoring mine over the past week and yes, it does). I hit the internet again and found it might have ACE inhibitor effects. Some people take these to reduce flushing. I began to wean myself off boswellia as I fear horrible rebound. The mention in the literature was attributed to boswellia elongate, not serrata, but seeing no one has fully documented all effects of the acids, I am not ruling out that my brand isn't capable of this effect as well. Especially as lowered blood pressure is mentioned in the general literature. I have noted that some people find their script ACE inhibitors start to lose their benefits and I have to wonder if this might be happening in those who initially find boswellia helpful, only to find they worsen over time? Irrespective of any other adverse immunomodulation which might happen?"

Andy wrote: "When it comes to Boswellia some members of a seb derm discussion group I'm in have had good results with it. Almost like a natural Accutane, without the side effects and maybe not so powerful, but still effective.."
And: "I've been using regular Skin Eternal, Pycnogeonol and Boswellia (all from Source Naturals) for little more than a week now and it could all be in my head but I think I do see a slight improvement, especially when it comes to my usual after work/evening-flush. It doesn't seem to last as long as it used to, and not so "intense"."

Fut wrote: ´I have been trying a natural way to stop sebum production - zinc gluconate and boswellia for a couple of weeks no. It doesn't seem the oil is stopping. My face gets so oily. Is accutane the only approach left? This is tough for me as I am in the middle of IPL treatments."

Clsykes00 wrote however: "I have been taking boswellia for about 2 months now with good results. that is, my sebum production has been cut by maybe 25%, which is better than nothing. i take four 300mg a day, and drink a cup of water with it. do not eat or drink things high in calcium. i'm using nature's way.| 
Faust405245 wrote: "So is the weakening of the immune system the only negative impact of too much anti-inflams? I've been taking a lot of anti inflammatories the past few days and I've seen some improvement in my skin already. I don't want any long term side effects, of course I don't, but I am willing to carry on doing this if the only side effect is a crappy, ineffective immune system."

Dfries2003 wrote: "I'm still seeing the following while taking Boswellic Acids: 1. A decrease in the number of Rosacea flares and almost complete reduction of redness and what was near constant burning on my face. 2. A very large reduction in sebum and P&P's - I'd agree with the findings of reduced sebum by 65% and reduced papules, pustules and acne by around 75%. I may be seeing even a better than 75% reduction in P&Ps - I'm almost completely clear.
3. A reduction or elimination of of some of my triggers - heat and hot showers are no longer seem to be a trigger - nor are hot liquids
4. Almost complete elimination of the Seb Derm on my scalp
5. Almost complete elimination of the odd KP like rash I had on my stomach, arms and legs
6. Reduction in the number of headaches I usually get - I still have not had one while taking Boswellia alone.
7. Clearing of allergy symptoms - almost complete clearing of sinuses and itchy/wather eyes, etc.
8. Greatly increased hydration of my normally oily, yet very dry skin.

The other group member reported positive results also. One of the possible side-effects with Boswellia (and Zileuton) is dyspepsia and other gastric upset. As I posted earlier, I started experiencing these side-effects after 10 days or so of use. The other group member noticed them almost immediately. Have currently been using calcium successfully as an antacid. Amino Acid Chelated form of Calcium Carbonate seems to work the best. Nature's Herbs Boswellia in the form of Boswellin, trademarked by the Sabinsa Corporation. Nature's Herbs is a division of TwinLabs. The supplements contain 250mg of Boswellia serrata Gum Extract standardized for 60% boswellic acids (or 150mg of Boswellic Acids). I take it 3x per day along with 1/2 of a 250mg cheap store brand Amino Acid Chelated Calcium Carbonate supplement. I take both with meals. The other group member is currently taking a whole 250mg Amino Acid Chelated Calcium Carbonate supplement along with the Boswellia, 3x per day."

Dan later updated: "Hi All, I thought I'd post an update. It's been 10 days, and I'm still
seeing remarkable and continually improving results with the Boswellia with still no negative side-effects. I should tell you that I'm lucky enough to be struggling with trying to roll back the last vestiges of rosacea. As my dermatologist put it recently, most people wouldn't realize I even have it anymore. I just refuse to put up with the continued - although greatly decreased - burning sensations, the occasional flare, and the resulting P&P's that I had been experiencing after successful treatment with Accutane, IPL and Noritate over the last 2 years, even though my Dermatologist suggested there was nothing further that could be done for this.  Also, I refuse to avoid the few Rosacea triggers that remain for me for the rest of my life, again as my doctor suggests I will have to do.
The Boswellia seems to have taken me another big step towards disease regression (for a lack of a better term). In the last week, I've discovered a hot (still not too hot) shower seems to no longer a be trigger for me, and I cannot tell you, after taking cold showers for the last 10 years, how nice this is. I'm sure some of you completely understand what I mean by this.
The benefits I'm seeing from the Boswellia may still reverse in the future, but I am hopeful. And again, some of the results I'm seeing may be due to where I was at in disease regression before starting the Boswellia. Also, I'm still very nervous about taking the supplements. Finally, I may soon start taking a baby Aspirin per day along with the Boswellia since the long-term effects of inhibiting 5-LOX with out inhibiting COX production worries me. I'll monitor my progress and stop taking the Aspirin if I see any decrease in benefits with dual inhibition. Dan"

Earlier, on January 12th 2005, Dan Fries (dfries2003) had written"Hi all, I don't have a science post on Zileuton, I was interested in learning more about 5-lipo-oxygenase, what it does, what might block its effects, etc and I came across an article, along with many others on the subject. All of the research on Boswellia (Boswellic Acids) as a natural
background, but after reading Dr Nase's inhibitor of 5-lipoxygenase peaked my interest so I did some further Google'ing. There seems to be plenty of other research on Boswellia, but not being a scientist, I'm not sure of its basis. Most of the  research seems to be in the area of inhibiting 5-lipo-oxygenase for asthma or arthritis, but it appears that Boswellia helps with these two disorders and might be potentially useful for 5-lipo-oxygenase inhibition for Acne and - it appears to me - Rosacea too. Thus the Zileuton trials for Acne and Dr Nase's interest in it for Rosacea.

Always willing to experiment, I ran down to the local healthfood store a week ago and purchased some Boswellia Serrata Gum Extract. According to a couple of the articles I read on Asthma, you should take at a minimum 150mg of Boswellic Acids 3 times per day to see results. The Gum Extract I purchased was 250mg standardized at 60% boswellic acids or 150mg of Boswellic Acids. I am having remarkable results with the Boswellia, with none of the harsh side effects of the Ivermectin I took. The first day I took Boswellia, I noticed an almost immediate - within 2 to 3 hours - reduction of sebum production. Since then, I've seen a further decrease in sebum production, burning sensations, P&Ps, the odd KP like rash I get on my arms, legs and stomach and the seb derm in my scalp. Each day, my skin seems to get better, and at this point, my skin is in AMAZING condition - the seb derm on my scalp is gone, my skin is pale (yes, this is a good thing), I've only had a couple of very short lived instances of burning sensations in the last week - one after way too much wine, and my skin looks clearer than it has in 30 years. My skin was in fairly good condition after the Ivermectin I took, but I was seeing a trailing off of the results, and I had a huge flare just before starting to take the Boswellia, with an increase in all symptoms listed above. It appears that much - although not all - of the benefit I personally saw from the Ivermectin (Stromectol) was due
to the side effect of sebum reduction or something else that was fairly short lived.

One odd thing I noticed in the article above is about Asprin and its affect on 5-LOX:
" ...Aspirin inhibits COX-2, but also COX-1 even to greater extent. Inhibiting only COX-2 leads to increased production of substances produced with the help of 5-LOX. For example aspirin can trigger asthma attack, because it inhibits COX-2, which leads to increased production 5-LOX products leukotrienes, which are involved in initiating asthma attack...."

Since my last HUGE rosacea flare was after taking aspirin for several days for headaches, I did a little more research on it too. Again there seems to be much more research about this in the Asthma arena.  It appears that large numbers of Asthmatics have problems with Aspirin and other NSAIDS due to the affects on 5-LOX products, and one of their symptoms is FLUSHING. Interesting since I've seen so much about Aspirin and its potential to help with the inflamation we experience. Potentially Aspirin and other NSAIDS might cause additional problems for SOME of us. I'm thinking they might for me. For the last several years, I have usually taken Tylenol instead of
Aspirin for headaches that on average I have had 4-5 times a week since I was 13 (I'm now 42). Every now and then I get worried about the effects on my liver so I switch back to Aspirin. Recently I had two episodes where after drinking 3-4 glasses of wine - wines I have consumed in the past - I took aspirin before going to bed. Within 2 hours, I woke up flushing like crazy (ears, face, neck, hands and feet), and itched so bad from head to toe that I had to take Benadryl to get the itching to stop. For several days following the episode, my Rosacea symptoms were at their worst. I assumed I was having an allergic reaction to the wine, but couldn't understand why I would be allergic to wine that I had consumed before, and without incident since. Now I'm really wondering if the aspirin might have been the culprit.

I have noticed that I haven't had a headache since taking the Boswellia. I even failed to have a headache when celebrating my birthday the other night with WAY too much to drink - an episode which should really have caused a massive headache and a horrible rosacea flare. Instead I had neither a headache nor the a big rosacea flare - just a little burning the next day with no flushing or other symptoms. While it will take weeks or months before I would be able to link Boswellia to headache reduction due to the nature of my headaches, the research I have read on histamines and
headaches makes me hopeful. Also, my sinuses have cleared so much while taking the Boswellia that this may be the reason for lack of headaches.

Finally, I'm concerned about a couple of other things. One is that since Boswellia is considered an herbal medicine, it is not regulated for purity - at least not here in the US. In my mind, it would be
very important to find a source that we could trust for purity. Dan"

Dan wrote in direct response to the decreasing of the immune system: "I believe strongly that the inflammation underlying rosacea is caused by infections, likely multiple infections, and that the only way to completely eliminate rosacea is to treat these infections rather than interfere with our bodies' already hindered immune response to these infections. Curcumin / Turmeric has been shown to be a potent 5-LOX inhibitor, which interferes with our bodies' ability to fight infections through the blocking of downstream Leukotrienes, particularly Leukotriene B4, as Leukotriene B4 has been shown to have very important interactions with internally produced antimicrobial peptides, including the very important human cathelicidin (LL-37). In short, although I'm certainly no expert, I'd recommend boosting the immune response through Vitamin D3, zinc and magnesium supplements. Studies suggest that zinc and magnesium are required for proper Vit D3 metabolism and use. I'd also highly recommend a good probiotic, particularly those that include L. reuteri since this probiotic strain has been shown to have antimicrobial effects against multiple pathogens in its own right."

And one of Dans last updates on his Boswellia serrate use was:  "I'm still seeing the following while taking Boswellic Acids:
1. A decrease in the number of Rosacea flares and almost complete reduction of redness and what was near constant burning on my face
2. A very large reduction in sebum and P&P's - I'd agree with the findings of reduced sebum by 65% and reduced papules, pustules and acne by around 75%. I may be seeing even a better than 75% reduction in P&Ps - I'm almost completely clear.
3. A reduction or elimination of of some of my triggers - heat and hot showers are no longer seem to be a trigger - nor are hot liquids
4. Almost complete elimination of the Seb Derm on my scalp
5. Almost complete elimination of the odd KP like rash I had on my stomach, arms and legs
6. Reduction in the number of headaches I usually get - I still have not had one while taking Boswellia alone.
7. Clearing of allergy symptoms - almost complete clearing of sinuses and itchy/wather eyes, etc.
8. Greatly increased hydration of my normally oily, yet very dry skin

The other group member reported positive results also. One of the possible side-effects with Boswellia (and Zileuton) is dyspepsia and other gastric upset. As I posted earlier, I started
experiencing these side-effects after 10 days or so of use. The other group member noticed them almost immediately. So we have been trying different combinations of supplements to help prevent these side-effects. As I posted earlier, I tried Ginger. It helped prevent the gastric troubles, but after a couple of days, seemed to decrease the effects of the Boswellia. It may be due to the COX
inhibitor qualities or the vasodilator qualities of Ginger. We both tried Curcumin (a reportedly fairly potent COX inhibitor) and it made us both flush when taken with the Boswellia. I also had a huge
headache after 2 doses of Curcumin, and didn't go away until I stopped taking the Curcumin.
So long story short, we have currently been using calcium successfully as an antacid. We've tried a couple of different forms of calcium, and the Amino Acid Chelated form of Calcium Carbonate seems to work the best. In fact Calcium Citrate didn't seem to work for the other group member at all.

In summary, here is what I'm currently taking: Nature's Herbs Boswellia in the form of Boswellin, trademarked by the Sabinsa Corporation. Nature's Herbs is a division of TwinLabs. The supplements contain 250mg of Boswellia serrata Gum Extract standardized for 60% boswellic acids (or 150mg of Boswellic Acids). I take it 3x per day along with 1/2 of a 250mg cheap store brand Amino Acid Chelated Calcium Carbonate supplement. I take both with meals. The other group member is currently taking a whole 250mg Amino Acid Chelated Calcium Carbonate supplement along with the Boswellia, 3x per day. Since dyspepsia (heartburn) and gastric upset are listed as only a "possible side-effects" of Boswellia, not everyone may need the calcium supplement.

Finally, several have asked. Due to the possible side-effects Accutane has on the liver as well as its sebun reducing effects, I don't think it would be wise to take Boswellia while taking Accutane.
Also, it might be risky to take Boswellia while undergoing laser treatment. I'm not really certain about this, so check with your doctor to be sure. If anyone finds an answer to this, please let us
know... Hope this helps...
Dan "

A friend of mine took boswellia for a while too, for his rosacea that both gives flushing and p&p's:  He said boswellia did nothing for his p&p's and made his skin more dry. 

I am no expert and every case of rosacea is a different one, but I know that in my case there is an overly active immune system, that has to be slowed down, rather than boosted. My immunologist stressed this at the time, and all types of immune boosters seem to make my rosacea redness and flushing flare; multivitamins, vitamin C etc. My London derm also experimented with immuno-suppressive medication on his worst rosacea patients (flushers) and found significant improvement. Downside of such serious medication are the side effects and the risks of infections. But with herbal supplements like boswellia, I think that a mild calming down of the immune system and inflammation could be a good thing. I don't believe that secondary infection is the underlying motor of all types of rosacea, although it certainly can be a factor. But in my own case, I am fairly convinced that it is the immune system being in overload and creating inflammation in the body, the fires it all up. I for instance also have colitis which fuels my rosacea, as well and have arthritis, Raynauds, allergies. 

I like how this supplement Boswellia is supposed to reduce inflammation. I like that it is natural and I like that some rosaceans have stated that it reduced their flushing as well. I am weary of the fact that it seems to reduce sebum: my skin is very very dry and I have no way of moisturizing it, as my skin can´t handle any topicals. What if my skin gets even more dry in this supplement? Stil it seems worth a try.

More link:

Antistaphylococcal and biofilm inhibitory activities of acetyl-11-keto-b-boswellic acid from Boswellia serrata (Link)
Blockade of Endogenous Leukotrienes Exacerbates Pulmonary Histoplasmosis (Link)
Another look at boswellic acids (Link)
COX Inhibitors (Link)
Arachidonic Acid Metabolites (Prostaglandins and Related Compounds)  (Link)

Human Genome Screen to Identify the Genetic Basis of the Anti-inflammatory Effects of Boswellia in Microvascular Endothelial Cells (Link)

3. N-Acetyl Cysteine

N-Acetyl Cysteine, also known as NAC, is an altered version of Cysteine. Cysteine is an amino acid containing sulfur. NAC plays a role in the replenishment and maintenance of Glutathione levels in the body. NAC in fact it boosts the blood levels of glutathione, which is an antioxidant that removes oxygen radicals - which cause cellular and tissue damage - from cells. On top it will help fight viruses and the flu. NAC has also been found to reduce inflammation in tissues and is named a "powerful anti-inflammatory and antioxidant" in this pubmed article.

NAC inhibits the expression of pro-inflammatory cytokines, suppresses NF-kappa B and regulates the gene for COX-2 thereby preventing inflammation and pain. These chemicals are involved in hundreds of inflammatory conditions and diseases. In other words, N-A-C is anti-inflammatory and can either blunt or reverse chronic inflammatory conditions. NAC not only can be ingested into the body orally, but also through inhalation.

NAC is also said to prevent LDL-cholesterol (“bad” cholesterol) from being oxidized and causing inflammatory damage to the blood vessels. NAC promises to lower the levels of homocysteine, which prevents the buildup of plaque in the arteries. The lower the homocysteine, the less likelihood of arterial blockage. NAC also dissolves mucous, making it easier to cough up, and as such can help treat conditions of the lungs like chronic bronchitis, asthma and sinusitis. Here are more benefits of NAC listed.

Research done on NAC:

A recent 2012 study by a team of scientists led by Dr Ahmed Sahib wanted to examine the effect of oral antioxidants on the severity of acne. A group of 56 acne patients were divided up into four different groups. They received either 200 mcg of selenium, 1200 mg of n-acetyl-cysteine, 210 mg of silymarin from milk thistle, and one group received a placebo. Acne hardly changed in the placebo group. Total acne lesion count in the selenium receiving patients fell by nearly 40%, which is pretty respectable. But it was the silymarin/milk thistle and the NAC group where the most astonishing drop in acne occurred. In both the silymarin and NAC groups, total acne lesion counts fell by a massive 50%.

N-Acetyl Cysteine (NAC) and rosacea:

Phlika wrote: "I tried NAC in combination with D3 but found that I could not tolerate the increased flushing (that may or may not have been the result of die off)." Link

IDan tried it as well: "I have taken NAC, but I stopped taking it when I read some studies that suggest that our immune system's defensins have disulfide bonds too (and theoretically the NAC could break these bonds just as it theoretically does with the disulfide bonds of Cpn)... This is my personal thought and not necessarily one supported by anyone on CpnHelp.org...." I think with my overactive immune system this could be a good thing though? 

Jamie1088 mentioned NAC: "Amino acid NAC for blushing? Was on BBC breakfast programme that this has been proven to help with a load of anxiety disorders. On the programme was a women who pulled her hair out when nervous or anxious. She just couldn't help it and would pull strands of hair at a time in a nervous reaction. She has now been on NAC and hasn't pulled any hair since. She said that studies prove that a deficiency in this vitamin causes nervous type reactions in people. It is proven to be as, if not more, effective than taking a course of CBT. I'll try to find a link to the interview. Very interesting."

Phlika replied: "I tried taking NAC when I was first trialling vitamin D3 about 2 years ago. One of the supplements made me flush quite badly. Whilst I cant say 100% which one I would go for the NAC as I am now taking vitamin D3 by itself and that is okay." 

Mistica wrote: "Whey also fights pathogens, plus it raises glutathione levels, which supposedly help fight pathogens as well. Perhaps it even has an affect on intracellular forms? NAC also raises glutathione levels. Dr Stratton believes it breaks down the cellular bonds. Something Dan took for most of this treatment. I dabbled in it recently, and found it caused too much flushing. I only tried it for about 5 days. I developed the well known NAC flu, but only mildly compared to others on the Cpn forum. Vitamin D is also supposed to raise glutathione levels, but perhaps not as much. I don't know."

She updated: "I mention this here as since this hell, I no longer react to NAC. It has a similar action on EB, without the antibiotic effect. I have never seen anything written about NAC's effects on biofilms, but I have to wonder if it might have some small impact. I developed the typical NAC flu after a couple of days initially. Have you tried it?". "If you find the infectious theory sparks your interest, you could test this by taking NAC 600 mg, once per day. If you experience what is termed 'the NAC flu', and (as in my case, inferno face), you probably carry a significant pathogen load."

-She later wrote more about NAC and using it as a means to kill of infections:
"NAC dosage. 600mg x once daily. Perhaps you could test this for a week? If nothing happens, take 1200mg daily. When taking NAC for a prolonged period of time, it is necessary to take around 3 times the amount of vitamin C to ward off oxidation. Dan took GliSODin, which is another option. NAC also binds metals, so do your homework. Die off includes any of the following. A flu type syndrome, a running nose, a cough, headache, an increase in symptoms in any other health issue you might have. The first two are pretty common effects. And of course, an increase in rosacea symptoms. Because most of us react to so many supplements, it could be said this doesn't mean much by itself. In my opinion, if Cpn has only set up shop in the face, systemic die off can't be expected. My mentor didn't have any side effects from NAC, yet she responded wonderfully to the CAP. My personal experience was a very mild running nose, a mild productive cough, so mild I barely noticed it. Given my impressive history of respiratory infections, I was a little surprised. I did experience a very noticeable flu type sydrome though. NAC works in a similar way to amoxicillin, without the antibiotic effects. In Cpn, supposedly it breaks down the Elementary bodies (The infectious phase) causing them to die and release toxins. This is what causes the side effects. Anyone who is seriously interested in the role of Cpn in chronic inflammatory diseases should read the Cpn website. It is rather tedious to navigate in some ways, but nevertheless it is full of information and very helpful people." 

John111 wrote: "Hi firstly can I say that I'm currently taking vitamin d3 and N-acetly cysteine NAC for 3 weeks and they have reduced the diffuse redness by approx 10-15 percent and also the burning and pain are almost gone from my cheeks even though i still flush.This has certainly helped and is the  first improvement i have seen after trying many supplements."

millerlite181 wrote on 18 Nov 2005:
 "Hey group, just thought i'd help you out a bit since i feel we should share anything that helps. Well, here it is. FOR ALL YOU WHO LIKE TO HAVE ALCOHOL AT TIMES. N-acetyl cysteine is a must. After doing much research on this natural antioxidant, there are many facts that it help detox alcohol, especially acteylaldehyde, which is responsible for such reactions to alcohol such as flushing, sweating, increased heart rate, etc.
DO a google search on this topic. "n-acetyl cysteine alcohol"..............from my experience so far......I have seen 75% reduced redness/flushing after drinking alcohol while ingesting NAC. I used NOW brand NAC with molybdenum/selenium. I take one 600 mg before drinking about 30 min with 1 more after 3 beers or cocktails/whatever......with 1 more later in the evening. works very efficiently. Sorry, as i'm kinda intoxicated as I wrote this, but I was soo excited at this that I needed to tell everyone here.....please do not let this go to waste, it really works and the theory behind it makes perfect sense. ACETYLALDEHYDE IS RESPONSIBLE FOR FLUSHING DUE TO ALCOHOL IN MOST CASES...1000 MORE TIMES TOXIC THAN ALCOHOL ITSELF!!!
I read somewhere that you should take 200 mg before drinking and then 200 mg for every ounce of alcohol you consume. This ounce is referring to hard liquor ounces, such as shots. SO, for every beer you should have about 200 mg or a tiny bit more, theoretically.
One more thing for all you health gurus out there. Vitamin C helps protect N-acetyl cysteine from causing kidney stones when used in high doses. It stabilizes it in the body. Take a low dose of vitamin c with your NAC just for extra protection, which is fine because C also helps with blood vessel stability and repair!!! Most sincerely, Chris"

Anonymous replied on 18 Nov 2005: "Chris, that's a very good and germane point. The acetylaldehyde (break down product) is probably one of the biggest instigators in flushing. I will look up NAC on the PDR Herbal Edition to see if they say anything else. Thanks for the info."

InverseCascade wrote a year ago: "Yeah, I am trying to help my body produce glutathione. Another option is N-Acetylcysteine (NAC) taken with alpha lipoic acid. They both help produce glutathione which is a powerful antioxidant and they both seem to affect metabolism (research). But, NAC can increase histamine issues. I do take alpha lipoic acid. Milk thistle is another, but I have ragweed allergy. Turmeric and green tea also help the body produce glutathione. I take Turmeric and one cup of de-caffeinated green tea (decaf has less antioxidants).
My situation is challenging because my condition was induced by Mirvaso (as I mentioned), which caused severe nerve pain and allergy-like intolerance to food and supplements. This experience has been extremely traumatic for me and has caused severe anxiety because of the nerve pain and reaction to eating, sleeping, breathing, relaxing. That's why I can't tolerate any caffeine because it increases my anxiety. I am still trying to recover from Mirvaso. It's pretty devastating that I was fine, healthy, happy. And this was all caused by a dermatologist. I'm having a very challenging time coping with the reality of this situation. I will look into taking MSM. Here are some other things that turn on the body's innate production of antioxidants (especially glutathione): Curcumin from turmeric, Green tea extract, DHA (omega 3 fatty acid), Sulforophane (contained in broccoli), Bacopa extract, Ashwaganda, Silymarin (milk thistle), Resveratrol (grapeseed & berries), Alpha lipoic acid, and N Acetylcystiene (NAC)."

Skyguy2005 wrote on 11 January 2017: "This is an open question: How often do you take NAC?
For me it's a pretty damn powerful supplement. If I take it more than 3 days in a row I feel seasick. If I skip it for 3 weeks and then take 1 it's like "woah!". I don't wanna take it too often then, in fact recently I've been taking it (600mg/day, the usual dose) mondays, tuesdays, and wednesdays. 3 on. 4 off. This seems to achieve good things.
 Perhaps the feeling sick is due to too much antioxidants, which is supposed to inhibit some vital processes like autophagy. Perhaps we should seek to keep the antioxidants level "just so" it seems."

Dosage and side effects of NAC:

There are no accepted ideal dosages for NAC. You could start at 600 mg daily and gradually build up to a maximum of 3000 mg daily. But one single 600 mg cap a day is usually good enough. If you want to take more, taking between 800 mg - 1,800 mg of NAC is usually recommended. Ideally, you should take it with an equivalent amount of vitamin C for maximum free radical scavenging effects.

Side Effects

Despite more than 40 years of clinical use by naturopaths, holistic medical doctors and nutritionists of virtually every stripe, NAC has a well-established safety record even at very high dosages over long periods of time. Some people experience nausea when taking NAC on an empty stomach, but the majority does not experience any side effects if they take it with food. Other potential side effects are vomiting, diarrhea, or constipation. NAC should be taken with food, at any time, but preferably in the morning.

4. Milk thistle (Silymarin)

Milk Thistle is a flowering herb used for thousands of years for all sorts of health problems, and also as a liver remedy.
Its herbal extract is standardized to 80% silymarin (and 20% fatty acids, including linoleic acid, known to help maintain healthy cell membranes and control cellular metabolism), and helps the body support healthy liver function by regenerating liver cells so that damaged areas of the liver may be renewed.
Silymarin is an antioxidant that protects against cell damage.

The Ancient Greeks and Romans used it to treat everything from liver ailments to snake bites; in the Middle Ages, it was considered a remedy for liver toxins. It's been an antidote for 'death cap' mushroom poisoning for centuries, and today, homeopathic practitioners use the compounds in milk thistle seeds to treat a range of disorders including jaundice, gallstones, and peritonitis.

Recently, Milk Thistle has been popping up as an herbal acne cure and anti-aging ingredient.

Silymarin may protect the body from chemicals by blocking toxins from entering the cell or by moving toxins out of the cell before damage begins. They can strengthen cell walls, stimulate enzymes that make toxins less harmful to the body, as well as block free radicals - responsible for signs of aging - from attacking cells.

And last but not least, milk thistle has a proven effect as an anti-angiogenic, meaning it can prevent the formation of new blood vessels. This is interesting for rosacea, as many people with rosacea have a more than average amount of blood vessels in the skin, and are also prone to the skin making even more blood vessels. On top of that, rosacea patients have often blood vessels that lay too close to the skins surface, and blood vessels that dilate too quickly and widely. 

And milk thistle can do wonders for the skin as well. All of these cleansing properties that milk thistle exhibits are thought to serve as a acne treatment from the inside out. Herbalists have been prescribing it for centuries, and recommend milk thistle as an oral supplement for acne sufferers. It is considered a 'bitter remedy,' and therefore  has cooling propertiesMilk thistle is thought to clear up acne along with other chronic inflammatory diseases of the skin. Ultimately, this antioxidant-laden herb is supposed to increase your liver function, therefore promoting more cleansing and consequently eliminating acne, according to Dr. Simon Mills at AcneToHealth.com.

It appears that milk thistle can work from the inside out, the outside in, and is a safe herbal supplement and product ingredient that's full of a powerful antioxidant. It also comes with a bonus benefit: it is a helpful cure for hangovers, flushing out liver toxins after one too many glasses of wine.

One of the possible underlying causes for facial flushing in females can be menopause. Patients experiencing menopause flushing may benefit from hormone therapy with estrogen to help alleviate symptoms, including facial flushing (always consult treatment with your healthcare provider). Milk thistle may be effective in decreasing menopausal symptoms.

Research done on milk thistle:

Milk thistle is also a popular herbal ingredient in topical creams, because of its antioxidant and cooling properties. In a double-blind study done on patients suffering from Stage I–III rosacea, patients were treated for one month with a topical cream containing silymarin, the powerhouse antioxidant component in Milk Thistle. A significant improvement in skin redness, papules, itching, hydration, and skin color occurred. 
In another study focusing on UV-induced Oxidative Stress, "Silymarin inhibited UV-induced oxidative stress in both epidermal and dermal cells." Its ability to block free radicals within the body can apparently also translate into topical skin creams as well, shielding the skin from UVB damage. I'm hoping that down the road, all of its toxin-blocking and cleansing properties within the liver will be translated to skin cells and milk thistle will be a real triple threat!

In this study, 46 patients with stage I-III rosacea participated in a double-blind, placebo-controlled study. They were given a topical treatment with silymarin/methylsulfonilmethane (S-MSM, to see if it would improve erythematous-telangiectactic rosacea (red skin with spider veins). Subjects were treated for 1 month. Their skin was evaluated after 10 and 20 days, and at the end of the study. Itching, stinging, erythema (redness of the skin), and papules were investigated clinically as well as hydration and erythema instrumentally with capacitance and color measurements.
A statistically significant improvement was seen, especially of skin redness, papules, itching, hydration, and skin color. The researchers concluded that silymarin and S-MSM can be useful in managing symptoms and condition of rosacea skin, especially in the rosacea subtype 1 erythemato-telangiectatic phase. "The action can be considered multicentric and multiphase because of the direct modulating action on cytokines and angiokines normally involved and up-regulated in the case of such skin condition."

This study found that milk thistle supplementation reduced the activity of the inflammatory master molecule NF-KappaB, which controls the release of many pro-inflammatory chemicals. That’s a good power to have, but it’s also found elsewhere, in sweet potatoes, garlic, bananasresveratrol and vitamin D.
It helps to improve the metabolization of hormones, which could help to reduce unhealthy estrogen metabolites like 4-hydroxy and 16-hydroxy estrogen. Those villains can cause acne through oxidative stress and inflammation.

A recent 2012 study by a team of scientists led by Dr Ahmed Sahib wanted to examine the effect of oral antioxidants on the severity of acne. A group of 56 acne patients were divided up into four different groups. They received either 200 mcg of selenium, 1200 mg of n-acetyl-cysteine, 210 mg of silymarin from milk thistle, and one group received a placebo. Acne hardly changed in the placebo group. Total acne lesion count in the selenium receiving patients fell by nearly 40%, which is pretty respectable. But it was the silymarin/milk thistle and the NAC group where the most astonishing drop in acne occurred. In both the silymarin and NAC groups, total acne lesion counts fell by a massive 50%.

You can use milk thistle in herb/pill form or as a cream

I would personally first try milk thistle as a herbal supplement, not as a cream, but there is a product out there in case you want to use it topical. David Pascoe wrote about a topic cream called Rosacure, from Canderm.

"The product’s genesis and marketing are  good, so lets look at some of the available background information and product reviews.

The marketing for rosacure says :

“Its two key ingredients are methylsulfonylmethane (MSM), a sulfur compound that is used in the treatment of inflammatory conditions and silymarin (Lady’s or Milk Thistle Extract), a bioflavonoid. The combination of MSM and silymarin exerts a synergistic effect in reducing the appearance of facial redness.”

Info from the product:

"Managing facial redness (erythema) is an important cosmetic goal in rosacea treatment. A cream combining silymarin, tacopheryl acetate, acetyl glucosamine, and hyaluronic acid in a hydrating oleosome base was formulated to provide control of cutaneous erythema and to improve homeostasis of cutaneous microcirculation. We conducted an open, prospective evaluation of results of applying this cream twice daily to reduce facial redness in both new and existing patients with rosacea. After 6 and 12 weeks, the mean redness score for all facial areas (cheek, chin, forehead, nose) was reduced (P>.001) in 29 of 32 enrolled patients, and the mean redness score was lower (P< .001) after 12 weeks than after 6 weeks. Concurrent use of topical metronidazole was well tolerated and did not alter the efficacy of the cream. One (3.5%) of the 29 patients discontinued therapy because of burning, stinging, and increased redness. Silymarin cream was safe and effective in reducing facial redness associated with rosacea."

These are the ingredients from this cream:


The cream contains more than one problematic ingredient, unfortunately, including paraben preservatives and propylene glycol, both known possible skin irritants.

Reviews from members of rosacea-support;

rose jill says: “I used rosacure for a very long time, a long time ago no results, at least it did not aggravate my skin.”

Aimee says: “I have been using Rosacure for many years now. It is a very good moisturizer for me and may help to reduce flushing, but I cant say for sure on that. It has not been a miracle for me, but as I have said before on this board that I always try new products that come out and when they don’t work because they are too harsh or too perfumey or any of the other million of things that go wrong with new products, I always go back to Rosacure.”

Marcella says: “I have used it for at least 5 years. Never has burned me….. easily tolerated and a great moisturizer. I highly recommend it.”

Bihbi Cat says: “Rosacure was the first topical I bought even before my derm diagnoses of rosacea, as a GP said they thought that might be what I had and I spotted a nice, convincing ad in a mag for Rosacure. It does moisturize but from memory it’s a bit greasy and I think it caused a bit of flushing for me — certainly didn’t do anything to curb the flushing, though I did hear someone here say you supposedly have to use it for some weeks to see results — they were still waiting for the results to kick in.”

flamepoint says: “I have been using Rosacure since last September. It’s my favorite product. It’s great in the winter if you have dry skin and I just go easy on it in the summer so it’s not too heavy. Shoppers Drug Mart carries it out here for about $35.00. Don’t need a prescription. Just ask for it at the pharmacy.”

Simon replied on April 24, 2008: "I have read the same comments from flamepoint verbatim on another website. blatant marketing campaign. don’t buy this product."

Erika says: “I’ve found that Rosacure didn’t do anything for me, good or bad. I found it too oily which for me results in redness.  I can see where it would be a helpful moisturizer in winter though”.

Mary wrote on October 23, 2007: "I used Rosacure, then Rosacure+, from 1999 to September 2007. It was a good moisturizer, well tolerated, but I never noticed any significant reduction in redness. My doctor said that at best, it would keep me from getting any redder, but I was careless about hot water and other triggers for several years, and am now redder than I was before. (Can’t blame the Rosacure for that, I guess). I stopped using it for a week this September when I ran out, but when I started using it again, I noticed that I would always redden on application, so I have stopped using it for now.
In addition, I looked at the before and after shots on their website, and only one person with severe erythema appears to be improved. The other two pictures show no significant difference to the naked eye. If these are their bragging photos, I wouldn’t be too optimistic about any improvement for most people. I’ve read the linked study, which uses different units than shown in the graph I’ve linked below, used unblinded evaluators — that is, someone who knew which patients were on placebos and which used Rosacure — to assess the reduction in redness. The numbers looks great, with a mean value of about 60% reduction in redness, but the pictures displayed aren’t consistent with those numbers (to my eyes, anyway)."

Milk thistle and acne:

There’s a good explanation for how milk thistle works these acne miracles – its ability to increase glutathione production. The study above also analysed levels of serum antioxidant levels and what they did they find? Blood glutathione levels increased three fold, by 271%. A separate study found that milk thistle boosts glutathione by 35%. Glutathione is the most important out of all the antioxidants which your body manufactures itself. Acne patients have been shown repeatedly to have lower levels than average.
Increasing gluthathione production is also how milk thistle helps your liver, since glutathione is also your body’s most important detoxification agent.

There’s a lot of hype and nonsense about toxins and their effect on acne and rosacea; for example, you should never believe any stories about a weak liver diverting toxins to your skin, where they get forced out through your pores and then collect in your pores. Nor should you believe that toxins get stored in the liver itself and that to cure acne, you have to perform a liver cleanse with an insane acne diet like eating nothing but kale for two weeks. Nevertheless, improving your detoxification systems and providing more resources does allow you to remove acne-causing and otherwise harmful chemicals. For example, glutathione is responsible for detoxifying the heavy metals mercury and arsenic by transferring a molecule to them and preventing them from reacting with cells.
Mercury causes acne through massive inflammation and arsenic is notorious for increasing keratin and dead skin cell turnover.

If you don’t have enough glutathione, these metals as well as many other chemical contaminants like herbicides or BPA can be recycled endlessly back into the bloodstream. They continue to cause acne over and over. Other chemicals, like inflammatory phthalates found in cheap plastics, can be stored long-term in your fat cells.

Possibly the biggest problem is glutathione’s dual function – it functions both as a detoxification agent and an antioxidant. You need glutathione’s antioxidants to keep your skin strong, but if it’s side-tracked with detoxifying toxin after toxin flooding in, your levels get depleted. You won’t have enough to defend against acne from air pollution and cigarette smoke. By supplementing with milk thistle or any other glutathione boosting agent, you can ensure that your supplies are plentiful enough both to detoxify harmful chemicals and directly keep acne at bay. In the 21st century, we are exposed to more acne-causing chemicals in cosmetics, herbicides, heavy metals, pesticides, and food additives than ever. Acne-prone people need more glutathione than ever and that’s why milk thistle can work wonders for acne.

Milk thistle and rosacea:

On Dr. Glenn S. Rothfeld's Nutrition and Healing page, a doctor suggested milk thistle for rosacea.
The patient asked"The rosacea on my cheeks has become so embarrassing that I don’t even like to have my picture taken any more. Makeup is only working to a point, and I’m worried it could make my rosacea worse. I’ve tried over-the-counter creams and even a prescription gel, and I’ve been really disappointed. I’m out of ideas. How about you?"

Dr. Wright replied: "I understand your frustration. Rosacea, an inflammatory skin condition that mainly affects the faces of older men and women, can be notoriously difficult to treat. Fortunately, I may indeed have one more trick up my sleeve that you have not yet tried. In fact, most people have never heard about this course of treatment at all. If you have been reading e-Tips for a while, you’re probably already familiar with the health benefits of the natural remedy milk thistle, also known in the herbal world as Silybum marianum. Milk thistle can protect your liver from a toxic attack, and even helps remove excess iron from your body. But in a study published several years ago, scientists discovered that milk thistle may also help clear stubborn rosacea. In a placebo-controlled clinical study, researchers asked 46 patients battling the condition to apply either a placebo cream or a cream containing silymarin (a concentrated extract from milk thistle) and MSM. The silymarin/ MSM group showed a significant improvement, with big reductions in redness, itching, and acne. General measures of skin health—such as hydration and color—were also dramatically improved.
The good news is that it couldn’t be cheaper or easier to see if a silymarin/MSM topical solution can work for you. There are products available online and in health food stores right now that will run you about a dollar a day. Good luck!"

Jack wrote on March 14, 2009: "I have suffered a lot for high redness of  the face, recently the Derm doc told me this is Rosacea, I am taking Rozex gel for more then 1 year now, the redness improved but still exist and I have flare-ups from time to time. Recently I noticed that Sylimarin (milk thistle) can help with Rosacea. I took Milk Thistle for about 2 years before treatment and stopped it while I was on treatment. My question - would it be ok to take Milk Thistle now? Can it cause any problem? Anyone here know if it can really help with Rosacea? Thank you, Jack"

HCA replied on March 14, 2009: "I've never found anything scientific to support the notion that milk thistle has any hepatic benefit-or that suggests that it's harmful.
I think that even today there is talk of a study dosing it intravenously.
Until some good evidence comes along I think the only conclusion can be-as my first liver doctor said- 'It probably doesn't do any harm!' If I've missed some important news on this I will cheerfully change my opinion."

Hopeful587 replied on March 15, 2009: "My moderate to severe rosacea of the face and eyes gradually improved then completely cleared over my eight years on Milk Thistle.  In fact, all the strange breakouts on arms and shoulders also cleared. None of the meds, topical and oral phased it. I have the fair skin and the sun damage factors. Also followed the general measures afore mentioned. I still flush during exertion, but not as badly. Interestingly enough since starting tx my pigmentation spots on fading. Only in 4th wk of tx, hope that it won't return. Good to know about these studies and more info on tx rosacea.  Just wanted to let you know that Milk Thistle worked for me. Hopeful"

pvk wrote on August 4, 2008: "Is there a connection between hep c and acne or rosacea? I've had hep c for 30 years or more, mild liver damage and haven't treated yet. A year or so ago I started getting pretty dramatic acne-like red sores on my face, especially my nose. I thought this was related to liver function but my hepatologist and a dermatologist were skeptical and thought it was just 'normal' rosacea or adult acne. The dermatologist prescribed some creams which didn't help at all. Well, a few months ago I started taking milk thistle and the problem has diminished significantly. I wonder if the improvement is due to improved liver function due to the milk thistle. I was just wondering whether anyone has any experience with this and whether it's similar to mine or not. Also, if my theory is correct, and the milk thistle is having a positive effect on my liver function, does this mean that I'm in a little less danger from liver damage from the hep c virus?"

j-tah wrote on October 22nd 2009: "Hi. I just learned that milk thistle can be beneficial for rosacea because it cleans the liver. Has anyone had success with this? If so, please explain what brand and
dosage you find works for you. Thanks!"

MasK replied on October 23rd, 2009: "I don't have any brand to give to you, but silybum marianum (the latin name of milk thistle) works great, and is proven by scientific studies to support the work of the liver, and when the liver is detoxifying the chemicals, drugs, toxines, salycilates, histamine, and many other things from the body like it has to do it, it's the whole health and body functions that are improved. Your skin will be cleaner too, digestion etc. But be careful with the "natural" remedies, they could have side effects too, on high dosage. For the liver, I prefer to take desmodium (about 600mg/day when on a 2 months cure, and the liver "cleaning" is more effective on spring according to the eastern medecines).
Add probiotics to your diet, and omega 3 oils (flax oil, or colza oil except if you suffer from thyroid problems since colza and all the cabbage family aggravate hyperthyroidism) because they lessen inflammation over the body (2 tablespoons a day on meal). Choose them extra virgin.
Hope this will help. Best regards."

Jason1984 wrote on February 9th 2009: "Hi, I was wondering if anyone has had any success taking milk thistle? It is mentioned on the Australian Science website being beneficial. Thanks

Yvette replied on February 9th 2009: "Hi, I have Milk Thistle and take it fairly regularly, but I also take a boat load of vitamins, probably 15 or so a day. I couldn't tell you how well it works since I think all the vitamins I'm taking help some. I read it can help the liver and can also reduce inflammation. I think it's worth a shot for you to try. I recently started Quercetin and that seems to be working pretty well also. My favorites are Tumeric, Evening Primrose, Grape Seed, CoQ10, Quercetin, pycengenol, Olive Leaf, and UGN (anti fungal) supplement. Good luck. Regards, Yvette"

brasileirao wrote on July 19th 2007: "Hi Friends! 2 question - can taking Milk Thriste cause some skin reaction? Like flushing? Also, I have been SUPER good about putting on sun screen, but today I was in a hurry and didn't have time. The only time I caught ANY sun was on the walk from my car to my house, seriously like 20 steps. I noticed that my skin has now been a bit redder - is there ANYWAY that 30 seconds in the Sun could cause that? Thanks! Tony"

-ToadStooL- replied on July 19th 2007: "I just want to say my 2 cents...First, I have taken milk thistle before. I generally prefer to take it at night... I do not recall have any flushing reaction to it. I'd also like to assume that you are taking Milk thistle, perhaps because you either have some live condition.. and/or you suspect liver toxicity to play a major role in your symptoms. If you do.. I just would like to add that yes milk thistle is a good idea... many studies support that it has some beneficial properties to it. I'd also like to mention all the MANY other things that in fact go through your liver, which, results in the "toxicity" and or your liver not functioning to its full potential. Everything you eat, drink, put on your skin does sink in and goes through the liver. There is not much we can do regarding food... (unless we buy only organic...) but we can and do have control over what we expose ourselves to. Such as chemically based body washes,, shampoos, toothpastes..chlorine waters.... etc...etc... So if we can limit our exposure to these things.. then perhaps we can give our livers a well deserved break?

I'd like to introduce the idea of sunscreen now. In my personal opinion... sunscreen is the WORSE thing to put on your skin. Its FULL of chemicals.. many of which I wouldn't doubt are potentially cancer causing.... the skin is a sponge. It soaks up and STORES everything.
I too was very sensitive to the sun.. but, when I look back I wasn't always this way. Years spent indoors weakens us to outside assailants.. like UV...Vitamin D is a very natural and important element to our health... to avoid something so important.. simply leads us to more complications... as does a processed diet full of hormones.. and lacking substance.
Complications occur when we do not give our bodies what we need.. All vitamins.. and minerals...
I at one time used to react very harshly to anything and everything.. showers.. .. all moisturizers.... cleansers everything. Eventually I kept up exposing myself to these extremes... I understand that no one case is the same.. I overcame these.. I no longer react to them...  I don't know if I have helped at all... I kinda got sidetracked a little...Good luck hopefully someone else can offer sound advice."

BrunoP wrote on October 10th 2011: "Hi, i saw this info about this product:

Milk Thistle is an herbal supplement you can find at your local store or pharmacy in the vitamin section. It’s quite cheap and readily available. Begin by taking the recommended dosage, but increase the dosage as desired. There are no ill side effects to Milk Thistle and it’s completely safe. 
It will help your liver heal so it can cleanse and metabolize toxins and other chemicals much more efficiently so your blood doesn’t have to expel these toxins through the skin – the main trigger of rosacea.

I know that some people take this as a pill or tea along with supplements etc, but have it been effective? should i give it a try? Thanks"

Ghost replied on October 10th 2011: "I'm a great believer in clearing out the liver, etc., But do start SLOW on the milk thistle, it's powerful stuff. Take less than the instructions say. If it says 3x per day, do it 2x. You can make yourself pretty queasy when the liver starts releasing stuff. You can also clean your liver quickly by doing a liver flush. You can look up information all over the web. curezone.com has long threads about it that are informative. I did around 25 of these years ago until I was sure I got all the gunk out."

parsonsc6901 wrote on October 10th 2011: "I used milk thistle because my nose was red all the time and around my nose was red from seb derm I bought it at GNC. I did see good results. It did look like the redness had gone down in my skin. It is safe for you to take. I would start off with a small amount. It is worth a try.
I bought herbal plus standardized milk thistle for 23.99. I have never used the tea. It says on the bottle take 1-3 capsules a day.I took two everyday but I am very small. They also have one there for a little bit cheaper for 18$. I would just get the smallest,cheapest bottle to see if it works for you first."

BrunoP wrote on October 15th 2011: "I went to a shop here and I found it, well it's St.Mary's thistle but it's the same (searched on google) in Portugal it's called Cardo Mariano, it's 500 mg and it says to take 3 pills a day before meals! i'll start tomorrow and let you know! it's 60 pills, so it's only for 10 days, i don´t think it's enough, how many days should this be done? how was your experience in this milk thistle? Bruno"

Ghost wrote on October 15th 2011: "Wait -- 3 pills before EACH meal? Or 3 pills per day, one before each meal? Makes a BIG diff. I find milk thistle to be quite effective. Go slower rather than faster."

BrunoP wrote on October 15th 2011: "I will start with 2 pills before meals, this weekend, one before lunch and one before bed, and Monday i'll take 3, in the morning, lunch or bed
i'm sorry if i wrote it wrong, i should had listening more to English classes in the high school
"My condition is redness in my cheeks and nose, and after oral pills and antibiotics, you know the rest... i had 6 sessions of IPL, but i didn't notice any improvement, and as you, i had no ideia the possibility of having mites, and i still don't know cause i never had a test, as you. The IPL was done to eliminate the blood vessels, but in this case it would kill the mites too."
"By the way i bought the milk thistle pills for liver and took 60 pills, 3 times a day. i don't known if i should take another or wait, i couldn't notice changes in my rosacea"

Caran wrote on January 30th 2008: "I have been taking turmeric,milk thistle and various other herbs as much for their antiangiogenesis properties as much as anything else.I would hate not to have something to slow down new blood vessel growth."

Iceman1981 wrote"Hi, I'm 28 and I have a serious acne problem that doesn't seem to want to go away. Here is a a brief history of my diet and lifestyle: I never had acne while I was a teenager (ate the typical american diet). I developed mild acne at the age of 21. Ever since I started getting a zit here and there. I changed my diet around big time. I cut out junk food, no soda, no sugar, no gluten, no dairy and what ever foods I had a allergic reaction to. I drank only water, vegetable juice and herbal teas. I exercised regularly and ate tons of vegetables and some fruit every day with lean meat (chicken, turkey). This really helped my acne and it went away. I have 1 to 2 large, well formed bowel movements per day. I would only get a pimple if I really ate something bad.
Last october 2009 I decided to take a liver supplement containing:
Milk Thistle Extract (Silybum marianum) (Fruit and Seeds) (Standardized to 80% Silymarin Flavonoids) 300 mg
- Dandelion Root Extract (Taraxacum officinale) (4:1) 100 mg
- Artichoke Extract (Cynara scolymus) (Leaf) (Standardized to 2% Cynarin) 50 mg

I read so many reviews on milk thistle and how it helps the liver and people with acne. So, I bought a bottle and used the liver supplement (above) 3 capsules a day for two weeks in October 2009. I started breaking out big time. So, I stopped taking it. I developed severe acne with red cysts and white heads. I would get these every week. It is now may 2010 and I still have these cysts that appear every week and I am really really depressed. It has left a ton of marks on my face. I never had this problem before and I don't know what to do. Do you think my liver is trying to get rid of the extra toxins and hormones by expelling them into my colon and my colon can't eliminate them quick enough, so the excess toxins is coming out of my skin?

I'm taking the following supplements. (I took these before last october and never broke out):

Multi Vitamin
Vitamin D3
Fish Oil Liquid
Coconut Oil
Saw Palmetto
Beta Carotene
Calcium & Magnesium
Digestive Enzymes
Vitamin E
B Complex
Psyllium & Bentonite shake twice a day for the past 2 weeks

I used to wash my face with Proactiv for the last 8 years and it has helped a lot. Now the Proactiv has stopped working. No matter what I put on my face, it doesn't seem to help. I'm using manuka honey, coconut oil, aloe vera and I'm exfoliating. I've narrowed this down to these things: Colon/Intestines/Leaky Gut and Liver. I never had hormonal acne before, so I don't think it's that. It's probably the toxins in my bowels that is getting into my blood causing me to break out. I also want to go on a serries of colonic hydrotherapy to get all of the mucoid plaque out. I'm sorry for the long post, but if there is anyone out there that can help me or put me in the right direction, I would appreciate it very much. It's very stressful to go from smooth clear skin to a face that has acne and marks. Thank You !!!"

SeattleTom replied: "Hi Iceman - You've done some excellent work on your health--good for you. I had an experience similar to yours years ago. I read a lot of good things about milk thistle and dandelion, and started taking them 14 years ago. My liver started detoxing rapidly and I had numerous healing crises for many years. I learned a few years ago that detoxing the liver causes it to dump lots of old toxins into the colon and bloodstream. For this reason, it's better to cleanse the colon and kidneys before one starts cleansing the liver. I had to learn this the hard way.
In your case, your liver is probably releasing old toxins faster than your colon and kidneys can eliminate them. This is why it's releasing them through your skin, causing the severe acne. I think you'd be wise to continue the colon cleansing you're already doing, do some colonics, and do some kidney cleansing. You might to read "The Detox Book" by Bruce Fife, ND, to learn more about this. Also, http://www.drlwilson.com
and http://www.arltma.com
have good articles on detox and related issues. Tom"

Mr Natural wrote on Sep 24, 2012: "Hey up folks just wondering if anyone here ever suffered with Rosacea which is pretty much red rash on the cheeks and neck and various other places. My skin only seems to get like this when training and this does seem to be a symptom of Rosacea as when i was fasting and only having around 2 meals a day my skin was clear but their was no exercise during this period to but now that I'm training and eating more protein it flares up some days and others its fine. Someone at the gym suggested try milk thistle as this would clear up the liver of any toxins etc and one suggest maybe having digestive enzymes with meals.
I'm interested in what fellow TM users have to say.
P.S: I'm going to see a dermatologist on Wednesday so would like to have some ideas as most in the medical field are like oh don't have protein shakes and don't train that's what the last one said, I'd like to make them this time actually provide a solution as my skin was always clear just past year seems to have been flaring up."

SK-XO replied on Sep 24, 2012: "I had mild Rosacea on my upper right cheek under my eye and onto nose a bit. Was just red and irritated/sore/itchy. Worth a shot but I know a lot of beauty salon owners and one of them did a facial/micro derm brasion on my face. Not sure 100% which one but it got rid of it, basically removing layers of the skin and allowing for new skin cells to develop seemed to "cure" it. Imo your skin has a huge build up over the months/years of crap/oils/rubbish etc that clogs pours and can result in skin conditions happening.
Really can't see milk thistle causing this.... Liver toxins imo has zero to do with it as well. I'm on chemo drugs and my liver is constantly elevated along with gilberts disease which is very high bilirubin so a lot of toxins going on! but my skin is very clear. I think it may just be a result of build up of sh1t, also hormones imo could contribute due to increased oils in the skin or even drying out of the skin which can cause irritation. Noticed you said fasting as well maybe make sure your taking a good multi vit or eating enough to supplement the vital nutrients to get rid of free radicals a , c's and e's.

Mr Natural replied on Sep 24, 2012: "Cheers for the response i was fasting not any more that was around 4 weeks ago but skin was fine so was wondering if i added in some milk thistle as it has been reported to help clear skin as it flushes out the liver and i've never used chemicals so it winds me up that my skins doing this."

brian_harvey wrote on June 4, 2011: "I stumbled across this thread a few weeks ago and I thought I'd give milk thistle a try. It's been 3 weeks now and along with eating a lot healthier (cutting out sugar and diary), drinking carrot juice in the morning, the regular salicylic acid wash, and face wipes my forehead acne has improved greatly. Minocycline and Benzyl Peroxide never did a thing but with a combo of the above my skin has improved such a lot. I've still had a couple of pimples but it wasn't like the clusters I had been steadily getting for years. Also this week I've had a week off milk thistle (heeding the warning here [to not use itfor long periods at a time]!) and ate / drank a ton of crap because I was on holiday and my skin is still doing well. I guess it's still early days but just thought I'd post to say it's worth trying for forehead acne (which can be linked to the liver right?)."

Heyeddy wrote on April 10th 2016: "Hello all, I've been through various acne treatments over the last 15 years. In short topical things do not work for me (I've tried every one of them literally), antibiotics do not work, accutane is to be tested (120mg/kg dosage, i've tried low dose course before). However so far only two things worked:
- ketogenic diet (two days and 95% of pustules/cysts were gone) (i can't follow this diet any more due to personal reasons)
- Milk thistle or NAC (i can use them in exchange) - 2 hours after eating the capsule my acne stops hurting, 2-3 days after it is healing rapidly (although the acne is not cured 100% - i am 95% clear).
Obviously next day I stop the supplements (or the diet) I am getting painful breakouts (cystic) typically all around my mouth and jaw line. The questions is why those supplements help me? I know they are antioxidants but so is vitamin C and vitamin E and they have never helped me (including massive dosage). I've seen one study that claims milk thistle is antiandrogenic and it is helpful for people with prostate cancer. On the other hand though there was a study where they found NAC + selenium to be a testosterone booster. There is one other study saying this is because of this supplement effect on oxidative stress.
So what is the probable explanation here? and what are the chances of accutane nuking it for good in this case? Please keep in mind all my hormones are in range appending to the blood tests. Same goes for liver and overall health. Thanks for hints"

heyeddy wrote on April 21st 2016: "I've made another test, I've stopped eating milk thistle for 2 days and got highly inflamed pimples (cysts) mouth/jawline area within 48hrs. Then again I've used milk thistle and literally over night 85% of inflammation was gone. This is not 100% cure but still something sensational for me. But I still don't understand how can it work so fast !? it makes no sense. My inflammation and pimple size is 90% reduced right now, not painful at all. However my chin is still oily.

heyeddy updated on April 25th 2016: "Ok I'm still on milk thistle + dandelion root my acne seems to still be improving. However I started to have problems with urination - voiding mainly (sign of BPH). This is not severe but it seems to correlate with my theory regarding hormonal influences of this supplement."

I've managed to do some medical tests which confirmed my primary suspects:
After 2 week sylimarin (milk thistle) course - dosage: 500mg:
Estradiol - 56 pg/ml (norm: 20-47) - HIGH
Prolactin - 7 ng/ml (norm: 2.7 - 13.3)
FSH - 5 mlU/ml (norm: 1.27 - 19.3)
LH - 5.7 mlU/ml (norm: 1.24 - 8.62)
DHEA SO4 - 220 ug/dl (90 - 470)
Testosterone - 620 ng/dl (175 - 790)

As you can see the only abnormal result here is Estradiol which seems to be increased. So for two weeks I've stopped the milk thistle supplementation and did one more test just to verify my theory:
Estradiol - 40 pg/ml (20-47) - NORMAL

As you can see my estrogen level dropped to normal levels and acne re-appeared again.
There are some problems with this approach (supplementing milk thistle):
- acne is not solved 100% - I would say 90% better, I still experience breakouts after serious physical activity
- milk thistle makes me tired, can't lift
- brain fog
- prostate enlargement, trouble urinating !!!

Those side effects mostly go away after stopping the treatment but then acne reappears.
I suspect those side effects are due to elevated estradiol. Now questions for you guys:
- Can this situation lead to more problems in the future?
- Secondly would it be better to risk using isotretinoin with hormonal acne like this? "

gamesguru replied on May 30th 2016: "salcylic acid may help. It's also possible milk whistle has selective antibiotic properties toward Acne, which I believe, is how retinols and Accutane work.
I think between the liver protection, antioxidative and antibacterial effect, and antiandrogen activity, milk thistle is kind of a perfect storm. not sure how it ties in with nac and selenium
"... growth of the tested bacteria was completely attenuated after 2–6 h of treatment with the MBC of silibinin, regardless of whether it was administered alone or with ampicillin or gentamicin." 

Vader replied on September 26th 2016: "Milk thistle and NAC should be good combo, NAC should reverse any risk of BHP supposedly."

Adyus wrote on June 20th 2006: "If you have any problems taking doxycycline, you could use silymarin( milk thistle). It's often prescribed by doctors when the patient is taking too many pills, to help the liver and the stomach. Silymarin is also good for rosacea. Regards, Adrian

IowaDavid wrote on February 2nd 2006: "Apparently silymarin is also an antiangiogenic supplement as well? I just read that in passing at the rosacea-support site. I'll have to do some googling on it, but milk thistle supplements are pretty damn cheap compared to others that are mentioned for rosacea. David"

Callah wrote on February 6th 2016: "I can't say I've noticed a hormonal pattern to my rosacea, but I do think milk thistle has helped. I've been taking it for several months and in that time my flushing has reduced considerably, meaning fewer papules and pustules (in my case they seem to be linked). I saw an improvement within the first couple of weeks."

Karen_breeze wrote on January 8th 2006: "I've been taking neem for several months now, and so far it's working very well, it seems to reduce sensitivities to food so I don't flush as much as i used to(but i am very careful with my diet). I take it for about 4 weeks then milk thistle for a week. It's the only supplement i've taken and noticed an improvement. I've tried grape seed extract, ester c, but no noticable improvement. I've started taking superoxide dismutase, I think it's also helping with the flushing. I've had about 10/11 yag laser treatments, which helps to keep the flushing/redness under control. Why stop taking neem every 2 months, not sure, i read this somewhere but gave no explanation as to why every 2 months."
"I also find Milk Thistle has a positive effect on my skin...Neem, Milk Thistle, routine works well for me."

Lwemm wrote on June 21st 2015: "I've also tried milk thistle (a liver cleanser/tonic) for a few weeks but can't say that I noticed a marked difference. I stopped because I did not have clear information on how long it is safe to take milk thistle. After doing a little more reading this morning, I think I'm going to up my consumption of raw broccoli and see if it helps at all. After all, it has to be good for you."

Mrsmoof wrote on May 18th 2011:  "Dr. Meschino [treats rosacea with natural medicine] also uses the herb milk thistle, which contains a flavonoid compound called silymarin. Silymarin concentrates in the liver and has been shown to boost the detoxification enzyme system and to help to regenerate damaged liver cells, he says.

"Some studies have shown that people with psoriasis, for instance, if you give them milk thistle supplementation, it reduces the toxins in the bloodstream, reduces the inflammatory response and their skin will clear," Dr. Meschino says.

"I have had a chance to work with rosacea patients using the same strategy, and, for many, it has been successful. The therapy involves a combination supplement that has indole-3-carbinol and silymarin from milk thistle, given in conjunction with two herbal agents that seem to regulate the immune system quite effectively. They are reishi mushroom extract and astragalus."

Dr. Meschino gives rosacea patients 600 mg a day of milk thistle (studies indicate that up to 1,000 mg is safe), and 120 mg daily of reishi mushroom extract, standardized to 10 percent polysaccharide content. He recommends 400 mg daily of astragalus.

"I have had good success, and other estheticians whom I have worked with and some plastic surgeons have seen good results using this regimen with their rosacea patients," he says. "It is primarily
subjective, with patients noticing improvement. I would say that about 50 percent of patients notice a positive change."

Dr. Meschino uses these doses until the skin condition is under control, and then maintains results by cutting the doses in half. "The problem never really goes away ” what you are trying to do is manage it more effectively," he says.

Mistica wrote on February 11th 2015: "My experience with a low dose B complex was superficial, but marked flushing, buzzing in my skin and the rapid appearance of numerous fine capillaries. It was like the growing of weeds. After nearly one year, I have not fully recovered from this. I took two tablets. For your interest, in case you get the urge to experiment again (much like me, ha ha), I also react very badly to Grapeseed Extract, Milk Thistle, Citrus Bioflavanoids, quercetin and a few other 'goodies' which are supposed to be good for rosacea. My particular reactions to these supplements are very much the same as my reactions to B vitamins. Interesting.
One of the the actions they have in common is the interference with Glucose. The potential for herbal supplements to be deemed toxic by the body is always possible too and that has happened to me as well. My medical team which includes a couple of scientists, have told me that in general it is the minerals that people are more likely to lack. That seems to hold truth with me as well. Again, I have been tested."

Mistica wrote on March 24th 2015: "Many posters find small benefits from grape seed extract, citrus bioflavonoids, milk thistle etc, all of which share a few things in common, one of which is the lowering of blood glucose."

Eastmangoboy wrote on March 2nd 2015: "For me, I never had hangovers from alcohol, for example. Instead, I would get p&p and a flaky red face the days following. When I take dandelion root or Milk thistle, which are liver-assisting supplements, flushing decreases and skin conditions improve."

Foods that can help you increase glutathione, or fight acne inflammation

There are other strategies for increasing glutathione btw, through diet. If you want to increase glutathione synthesis then you’ve got to optimize selenium first. The chance you’ll benefit is huge because acne patients have much lower selenium levels than average. Two 5 gram Brazil nuts per day increases blood selenium levels just as effectively as an actual supplement, according to this study.

Raw milk and eggs are also terrific and are packed with other acne nutrients. Again, one dead easy strategy is to simply eat two Brazil nuts per day; this provides over 200% of the recommended daily allowance for selenium and many other acne benefits such as lowered inflammation.

You also have to optimize zinc, which is another key glutathione precursor. This study analysed the effect of zinc on antioxidant levels in rats. The first group received zinc supplements and easily had the highest serum glutathione levels, while the second group received nothing and had glutathione levels at rock bottom. One study on acne found that 54.1% of acne patients were zinc deficient, whereas in clear-skinned people the rate was just 10%. Milk thistle provides a big bonus but selenium, zinc, and also magnesium are fundamental.

And good old vitamin C was demonstrated in one study to boost glutathione more effectively than silymarin. Vitamin C can also clear cortisol from your bloodstream and accelerate the healing of your old acne. Glutathione is a sulphurous compound, and eating sulphurous foods like garlic or onions or even plain old broccoli can provide the building blocks.

Dosage and side effects of milk thistle:

The standard dosage of milk thistle is 200 mg, 2 to 3 times a day of an extract standardized to contain 70% silymarin. There is some evidence that silymarin bound to phosphatidylcholine may be better absorbed. This form should be taken at a dosage of 100 mg to 200 mg twice a day. For antioxidant effects, 140 milligrams of silymarin taken by mouth three times daily for three weeks is recommended. For rosacea, it is wise to start with a low dose of milk thistle. It's powerful stuff. You best take less than the instructions say. Wait and see how your body and skin handle this herb and whether or not you get side effects, before upping the dose. It is also wise to discuss the use with your dermatologist or GP.

According to the NCCAM, in clinical trials, milk thistle generally has few side effects when taken as an oral supplement. Occasionally, people report a laxative effect, diarrhea, and bloating, heartburn, or a mild upset stomach. Most milk thistle supplements are measured by how much silybin they contain. Some users also reported insomnia. Insomnia is not a good condition for acne or rosacea at all because sleep deprivation can worsen insulin resistance and increase facial flushing threshold.
Milk thistle can produce allergic reactions, which tend to be more common among people who are allergic to plants in the same family (for example, ragweed, chrysanthemum, marigold, and daisy).

The plant is actually the most researched and best understood of all the medicinal herbs. In fact, study after study has confirmed its most significant property: namely, the ability to protect and actually regenerate the liver with new cells. Women who are breastfeeding or pregnant should avoid using milk thistle. If you have a ragweed allergy, you should also avoid milk thistle. Milk thistle may cause a rash or lead to severe allergic reaction.

Since milk thistle may mimic the effects of estrogen, some women should avoid this herb. This includes women who have fibroid tumors or endometriosis. Additionally, women with breast, uterine, and ovarian cancers should not take milk thistle. On the other hand, milk thistle does contain natural estrogens as potent at activating estrogen receptors as the dreaded soy isoflavones, however, these are counteracted by milk thistle’s beneficial effect on your hormone metabolization; this study found that milk thistle led to increased clearance of estrogen overall.

Please note that some liver enzymes play a major role in drug breakdown and detoxification by the liver. Echinacea, milk thistle and chamomile can interfere with some of these enzymes and increase or decrease the effects of some medications. This can lead to increased side effects or reduced benefit from taking these medicines. Levels of these medications may increase if taken by people who are also using milk thistle. This list is not exhaustive:
* methadone

* heart drugs - Tambocor (flecainide), Rythmol (propafenone)

* antibiotics - erythromycin, rifampin

* anti-seizure drugs - carbamazepine (Tegretol)

* antidepressants - St. John's wort, Zyban/Wellbutrin (bupropion), Paxil (paroxetine), Prozac (fluoxetine), Luvox (fluvoxetine) Serzone (nefazodone), Zoloft (sertraline), Effexor (venlafaxine)

* antihistamines - Hismanal (astemizole), Seldane (terfenadine)

* antifungals - itraconazole (Sporanox), Ketoconazole (Nizoral)

* gastrointestinal motility agents - Prepulsid (Cisapride)

* ergot drugs - Ergonovine, Ergomar (ergotamine)

* anti-psychotics - Clozaril (clozapine), Orap (pimozide)

* sedatives/sleeping pills - Ambien (zolpidem), Halcion (triazolam), Versed (midazolam)

* lipid-lowering drugs (statins) - Lescol (fluvastatin), Mevacor (lovastatin), Pravachol (pravastatin) and Zocor (simvastatin), Baycol (cerivastatin)

* transplant drugs - cyclosporine (Neoral, Sandimmune), ProGraf (tacrolimus)

Milk thistle also has the potential to lower levels of the following drugs:

* anti-parasite drugs - Mepron (atovaquone)

* sedatives/sleeping pills - Ativan (lorazepam)

* hormones - estrogen

5. Flax seed oil 

Flax seed oil is a colorless to yellowish oil obtained from the dried ripe seeds of the flax plant. Flax seeds contain lignans, a type of phytoestrogens that have antioxidant and cancer-preventing properties. It contains the highest level of the omega-3 fatty acid ALA among vegetable oils. Regular flaxseed oil contains between 52% and 63% ALA. Some of the fat in flax seed oil converts to EPA and DHA, the same active components in fish oil. Flax seed oil can be a good addition to fish oil, especially if you are on a low-fat diet or have dermatitis — dry, scaly, itchy skin. Or when the histamine in fish oil makes you flush. Some brands of supplement have lignans added during production. Flax seed oil is easily oxidized, and rapidly becomes rancid, with an unpleasant odor, unless refrigerated. Even when kept under cool conditions, it has a shelf life of only a few weeks. Another option is to buy dry flax seed flakes and chew on them or add them to your meal.

There is a story behind the Omega fats. There is omega 3 and omega 6. Our bodies don’t have the enzymes to produce them and therefore we must get them from the diet. No. 3 is considered anti-inflammatory, while omega 6 can be pro-inflammatory. And inflammation may be one of the leading drivers of the most serious diseases we are dealing with today, including heart disease, metabolic syndrome, diabetes, arthritis, Alzheimer’s, many types of cancer, etc. Inflammation is most certainly a problem in rosacea. Omega-6 fats, also known as linoleic acid, are available only in food. The human body can’t make them, so they're considered essential fats. They support brain function, bone health, reproductive health, hair growth and regulation of metabolism. Omega-6 fats also make hormones in the body that, in turn, stimulate the cells and blood clotting. Increasing foods with omega-6 fatty acids may ease insulin resistance for diabetics, but increased omega 6 fats are also linked to a enormous host of inflammatory diseases..

You should always look for a ratio of around 3:1 (omega 6/ omega 3) within your daily diet.

Pubmed states about this:

 Several sources of information suggest that human beings evolved on a diet with a ratio of omega-6 to omega-3 essential fatty acids (EFA) of approximately 1 whereas in Western diets the ratio is 15/1-16.7/1. Western diets are deficient in omega-3 fatty acids, and have excessive amounts of omega-6 fatty acids compared with the diet on which human beings evolved and their genetic patterns were established. Excessive amounts of omega-6 polyunsaturated fatty acids (PUFA) and a very high omega-6/omega-3 ratio, as is found in today's Western diets, promote the pathogenesis of many diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases, whereas increased levels of omega-3 PUFA (a low omega-6/omega-3 ratio) exert suppressive effects

In the secondary prevention of cardiovascular disease, a ratio of 4/1 was associated with a 70% decrease in total mortality. A ratio of 2.5/1 reduced rectal cell proliferation in patients with colorectal cancer, whereas a ratio of 4/1 with the same amount of omega-3 PUFA had no effect. The lower omega-6/omega-3 ratio in women with breast cancer was associated with decreased risk. A ratio of 2-3/1 suppressed inflammation in patients with rheumatoid arthritis, and a ratio of 5/1 had a beneficial effect on patients with asthma, whereas a ratio of 10/1 had adverse consequences. 

These studies indicate that the optimal ratio may vary with the disease under consideration. This is consistent with the fact that chronic diseases are multigenic and multifactorial. Therefore, it is quite possible that the therapeutic dose of omega-3 fatty acids will depend on the degree of severity of disease resulting from the genetic predisposition. A lower ratio of omega-6/omega-3 fatty acids is more desirable in reducing the risk of many of the chronic diseases of high prevalence in Western societies, as well as in the developing countries, that are being exported to the rest of the world.

Avoid processed seed- and vegetable oils that are loaded with Omega-6

According to Dr. Stephan Guyenet, who has done a lot of research on non-industrial populations, typical Omega-6:Omega-3 ratios for non-industrial populations ranged from 4:1 to 1:4. Hunter-gatherers eating mostly land animals had a ratio of 2:1 to 4:1, while the Inuit, who ate mostly Omega-3 rich seafoods, had a ratio of 1:4. Other non-industrial populations were somewhere in between.
These populations didn’t appear to suffer from the chronic diseases that are currently killing us Westerners by the millions. Keep in mind that none of these populations were eating a lot of Omega-6. It is probably a bad idea to eat tons of Omega-6, then a whole lot of Omega-3 to compensate. Having a relatively low, balanced amount of each is best. Anthropological evidence also suggests that the ratio human beings evolved eating is somewhere around 1:1, while the ratio today is about 16:1!

Not only are people eating much less Omega-3, but they are eating large amounts of processed seed- and vegetable oils, which are loaded with Omega-6. We simply didn’t have the technology to process these oils until about a 100 years ago and we have not had time to genetically adapt to these high amounts of Omega-6.

Here is a chart with some common fats and oils. Try to avoid or limit all that have a high proportion of Omega-6 (blue bars). You can see that butter, coconut oil, lard, palm oil and olive oil are all relatively low in Omega-6. However, sunflower, Corn, Soybean and Cottonseed oils are by far the worst. 

Oils that are high in Omega-6 fats include vegetable oils. Sunflower oil, corn oil, soybean oil, avocado oil and canola oil. Nuts are also high in omega-6 fatty acids, especially walnuts, safflower seeds, brazil nuts and sesame seeds. Also pumpkin seeds and squash, peanuts and peanut butter. 
Ideally you want to have a ratio around 3:1 (omega 6: omega 3), but cashew nuts have a ratio of something like 47:1. The least Omega 3/6 imbalance risk is in macadamias, the second best would be cashews and almonds. Walnuts have the worst Omega 6 / Omega 3 imbalance.
Other foods that are high in omega-6 are snacks like corn puffs, chips, fast food, cakes, pastries, muffins and cookies and pork products. 

People only need to consume 5 percent to 10 percent of omega-6 fatty acids in their diets for health benefits. The recommended intake ratio of omega-6 fats to omega-3 fats is 2:1 to 4:1. This means that you should eat double the omega-6 to omega-3 fats and no more than four times the amount. Western diet however tends to have a ratio of 14:1 to 25:1 of omega-6 vs. omega-3 fatty acids. This can be more harmful than beneficial since some omega-6 fats have inflammatory tendencies.

Eat Animal Foods That Are High in Omega-3

Animal foods are the best sources of the preformed Omega-3 fatty acids, EPA and DHA. Fish and lean meats for instance. One problem today is that animals are usually fed grain-based feeds with soy and corn. This reduces the Omega-3 content. Therefore, if you can afford it financially, organic (or at least grass-fed) meat is still the wisest choice. Some conventionally raised meats like chicken and pork are particularly high in Omega-6. If you want to bring your intake of Omega-6 down as much as possible, then it makes sense to choose the leaner portions of those meats.

By far the best and healthiest way to increase your Omega-3 intake is to eat seafood once or twice per week. Fatty fish like salmon, mackerel, sardines and kippers are a particularly good source. Wild caught fish is best, but even farmed is better than no fish at all. You can also consider taking a fish oil supplement. Cod liver oil is best, because it is also loaded with Vitamin D and Vitamin A. The problem for people with rosacea, however, might be that fish oil supplements are naturally high in histamine, which can cause a rosacea flare or flush for some people.

If this is the case for you, then there are also some plant sources of Omega-3. Flax seed is the best one of the bunch here, and chia seeds are considered good too. However, these contain a type of Omega-3 called ALA. Humans are inefficient converters of ALA into the active forms, EPA and DHA. For this reason, animal sources of Omega-3 like fish and grass-fed animals are considered the best.

So, in summary; most western diets are too high in omega 6 fatty acids, and too low in omega 3 fatty acids. And this makes us more prone to (inflammatory) diseases. Rosacea is also an inflammatory disease, and many rosacea patients have underlying other health issues, often of the bowel, digestive tract or allergies and auto-immune conditions. Omega 6 fats can lead to an increased risk of cardiovascular disease, cancer, inflammatory, and autoimmune diseases. For most people, the amount of Omega 6 fats should be reduced and the amount of Omega 3 fats should be increased. 

Omega 3 is anti inflammatory, but this effect gets wiped out when omega 6 intake is too high as both kinds of fat compete with each other for incorporation into cell membranes.

Flaxseed Oil:

Flaxseed oil is being heavily promoted as an alternative to fish oil. The health benefits of fish oil are believed to rely mostly on two omega-3 fats; eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Flaxseed oil contains a third, plant-based omega-3, alpha-linolenic acid (ALA). Other foods (especially walnuts) and oils (canola and soybean, for example) contain ALA. But at about 7 grams per tablespoon, flaxseed oil is by far the richest source.

The main problem with ALA, the plant based omega-3 substance, is that it needs to be converted first, before it gives our body the good effects of omega-3's. Enzymes in our body first need to convert the ALA into 2 two omega-3 fats EPA and DHA. As a result, only a small fraction of flax seeds ALA in the end has omega-3's effects; 10%–15%, maybe less. The remaining 85%–90% gets burned up as energy or metabolized in other ways. So in terms of omega-3 "power," a tablespoon of flaxseed oil is worth about 700 milligrams (mg) of EPA and DHA. That's still more than the 300 mg of EPA and DHA in many1-gram fish oil capsules, but far less than what the 7 grams listed on the label might imply.

Another problem with flaxseed oil though, is its omega-6 content (about two grams per tablespoon). Omega-6 metabolism competes with ALA for some of the same enzymes, so ALA might not reach its full omega-3 potential if there's a lot of omega-6 around.

So, fish oil capsules contain much more omega-3 in the end. However, fish oil can cause a rosacea flare due to its high histamine content, so flax seed oil is still far better than nothing, I reckon. 
Flaxseed oil will give your diet a nice little omega-3 boost in the form of alpha-linolenic acid. 
Fish oil is more condensed and fresh fish might not give you the same histamine problems. I eat fish once a week at least and take an antihistamine tablet half an hour before dinner. Even though flax seed delivers omega 3, don't automatically give up on eating fish. Especially fatty fish types. If you are worried about mercury content: salmon, pollock, and catfish are all low in mercury. And canned light tuna is lower in mercury than albacore ("white") tuna.

Another option could of course be to take mega doses of flax seed oil. Then you make sure that the 15-5% of omega 3 that in the end is formed, is still a high enough amount. Unfortunately, like every rosacea treatment, flaxseed oil also seems to not agree with everybodies rosacea. Some people seem to have increased flushing while taking this supplement. But for others it improves the rosacea. 

Flax seed oil and rosacea:

Quadrophenia wrote on January 28th 2009: "I have some permanent redness in my cheeks, but my biggest problem has always been flushing. Very annoying when you love sports and beer. I have tried lots of things, including IPL and various supplements. IPL helped for a few months, green tea extract also, but what helped the most was coffee. I have tried fish oil on several occasions, and it always made me worse. Recently, I was made aware of flax seed oil. I decided to try it, although I was 90% sure it would make me flushy. It didn´t. After only 3 days (!) with 2 capsules daily, my flushing problem was almost completely gone. It´s been 7 weeks and I´m still shocked. 2 capsules of flax seed oil each day was the simple solution to my biggest problem for the past 25 years! Now, I can exercise harder and much longer without turning horribly red! My permanent redness is still there, but it has faded a little. Why does flax seed oil help me and fish oil not? Does anybody know?"

And: "Well, after some research, I think I know why flax oil works for me. The capsules I use are lignan-rich. Lignans can reduce hot flushes. Regular bottled flax oil does not contain much lignans.[..]The capsules I use (norwegian brand) has 190 mg lignans. I take 2 each day."

Sweetness & Light wrote on January 22nd 2009: "I have tried many alternative therapies for every ailment I have suffered and pleased to say that I have had success with some. Recently, I started taking Omega 3 Flaxseed oil in the hope that it would relieve some symptoms I have been suffering for several years: aches, pains, digestive discomfort, depression, hormonal imbalances and of course my blotchy, lumpy, dry and inflamed skin. It's only been about 6 weeks that i have been taking Flaxseed oil in increasing amounts and i have to say i have noticed a difference in my skin. I noticed however, that the Flaxseed seemed to show an improvement in my skin only after I started to increase my daily dosage. And I mean a huge increase. I started by taking the recommended dose on the bottle which is 1-2 capsules a day or two teaspoons (5ml) of oil but researched this and found that the people who were having huge benefits from Flaxseed oil were taking one to three TABLESPOONS (15ml) of the oil daily. The capsule equivalent would be about 14 (1000mg) capsules daily. 14 capsules to equal one tablespoon. That's a heck of a lot of caps to swallow!! The oil is recommend but I found it messy (although I could tolerate the taste) and while I was ill with the flu I couldn't be bothered going down to the fridge to take it. Capsules are way more convenient.
My bottled organic flaxseed oil only lasted about two and a half weeks and then it turned cloudy and yukky. And it was refrigerated at all times! I now use capsules again and break them open, pour the oil onto a spoon to make my daily tablespoon or three. It's a lot of capsules to break open but at least I am not having to eat them or waste my money on the bottled oil.
Since taking up to three tablespoons of flaxseed oil daily, my rosacea seems to be under control. My face doesn't flare up red at the usual triggers of heat and the dryness is slowly improving although the paps pimples, etc come and go but not as severely or stubbornly as used to be. But this is only maintained by taking a high dose of flaxseed oil, if I let my daily amount slip then I noticed some redness and dryness returns to my face."

Artist wrote on January 29th 2009: "I've had mixed results in the past with flax oil and omega 3 supplements, but I tried again with a fish oil supplement a few months ago and I do think it's helping (or at least not hurting.) My opinion is that adding omega-3 to your diet should help in the long run if you tolerate it. Studies show that it lowers inflammation, but I'm guessing it probably takes a month or two to see results."

Ambily wrote::"Hi, last year I was diagnosed with rosacea, and they said there was not a real cure but just maintenance drugs, or at least this is what they told me. She gave me metrogel and this did nothing to "maintain''. Anyway, long story short, I started taking flax seed oil because I had other health issues (heart) and I noticed my rosacea bumps disappeared, then I doubled my dose and everything went away. I have no idea why or how. I take 6 tea spoons of cold pressed flax seed oil a day. I know that's way over the recommended dose. So I feel like I can not "recommend" that anyone take this. But when i see someone in public with rosacea, I feel for them and I want to tell them what worked for me, but I cant do that because I don't have the guts, and I don't want to embarrass them, and I don't want to get in trouble for giving out medical advice when I am not a doctor. So I'm posting this here, because I saw some one today that looked like my face looked, and I thought maybe he would read a forum like this or eventually , if it works for others like it did for me, the word would get around.
Ps. my rosacea was quite bad. bumps and redness, it would show through my makeup, and now I dont feel like I have to wear makeup, except for lips and eyes bit not on skin."

Ebareaalne replied: "I've been taking flaxseed for about week and half. redness hasn't disappeared, but my skin feels better. How long did it take for you to see difference in redness? Am glad you found something that helps your rosacea. I believe that the main reason flax helps your condition is because of the Omega 7 fatty acid (palmitoleic acid) content. Omega 7 is a rare compound with HUGE benefits to skin and other similar membranes(gastrointestinal, urogenital, etc.) The best source for Omega 7 is actually Seabuckthorn (specifically seabuckthorn fruit oil or pulp)."

Auburn wrote on March 30th 2010: "I had been taking flaxseed oil and flaxseed meal daily for quite some time (a couple of years, I think) when I came across this article. I did some more research and learned that:

"Although studies have found that eating fish (which contains the omega-3 fatty acids EPA and DHA) regularly may reduce the risk of macular degeneration, a recent study including two large groups of men and women found that diets rich in ALA may substantially increase the risk of this eye disease. More research is needed. Until then, people with macular degeneration should get omega-3 fatty acids from sources of EPA and DHA (such as fish or fish oil), rather than ALA."

Flaxseed oil contains the essential fatty acid alpha-linolenic acid (ALA), which the body converts into EPA and DHA rather inefficiently. Omega-3 fatty acids have been shown to reduce inflammation and help prevent certain chronic diseases. Studies are mixed about whether flaxseed oil is useful for the same conditions. So I stopped consuming flaxseed meal/oil because, papers aside, I don't really think that humans are supposed to eat massive quantities of any particular substance (and it takes massive amounts of flaxseed to make the same amount of omega-3 you can get from a piece of wild salmon). In other words, if flaxseed/flax oil were something our bodies were designed to use, then it would be readily available, like fish has always been. In any case, I developed mild ocular rosacea symptoms last year, while supplementing with flax. I started supplementing with wild salmon and cod liver oils a few months before I stopped taking the flax so it's been a while now. My ocular symptoms come and go but remain mild. I think that dry indoor air worsens the condition, at least in my case."

Melissa W wrote: "Omega 3's all the way. Aim for at least 1000 mg per day of EPA and DHA combined. Fish oil is better than flaxseed for this. [..] Flaxseed is good but you have to eat loads and loads to get what you need as compared to the supplement or fish."

Stimpson65 wrote on July 27th, 2008: "I am certain this topic has been covered on this board previously, however, I would like to report yet another unmitigated success with this dietary supplement. The interesting thing about this was it was quite accidental and we discovered it as a result of having Flaxseed oil recommended for an entirely different condition: Chronic Dry-Eye.
My mother, who is 78 and has suffered with Rosacea since it's sudden onset in her late 40's (most likely due to menopausal symptoms related to hormonal fluctuations), was advised by her doctor to try Flaxseed oil as a dietary supplement to aid with her chronic dry-eye symptoms. My mother was not happy about the exorbitant cost of prescription medication which was proving to be ineffective. Her doctor was also concerned about how the cost of such medications was affecting ALL of her patients.
After reading many things about this supplement, I (and the rest of my family) are convinced. It has COMPLETELY inhibited any effects of Rosacea while also mitigating the effects of Dry-eye.
However, there has been one significant oversight in much of the material I have read about this dietary supplement: The form of the product! After consulting with her doctor, they have made clear the importance of ensuring the only form of consistently effective Flaxseed oil is COLD PRESSED oil in liquid form!

If you have tried this supplement in pill form and had no success, this may be the culprit! Try the COLD-PRESSED liquid form! There are apparently compounds absent in the pill form which have not been removed in the cold-pressed form and are necessary for treating the symptoms. Two tablespoons in any of the food you consume, every other day have resulted in the COMPLETE disappearance of all Rosacea symptoms and dry-eye symptoms. The supplement seems to take from 10 days to 2 weeks to show improvement with all symptoms disappearing completely after 1 month of continued use. We even have empirical evidence, having run out of the cold-pressed form, and attempted to use pills in it's stead. The pill form allowed symptoms to return almost immediately! (shocked) COLD-PRESSED liquid form is the secret  (shh) and we are convinced!
Give it a try if you've had little or no success with the pill form. Be advised that you must be consistent and use it regularly. If your half-assed about it, it won't do much for you. Give it time to work! I think you will be pleased with the results!"

Lisamouries replied on July 29th 2008: "Hmmm. I took Omega 3, 6 and 9 for a while but did tend to get redder/flushed so that would make sense. I did feel it helped with my ocular Rosacea though so maybe I'll try omega 3 only. Thanks for the input. Lisa M."

CrabbyCathy replied on August 1st 2008: "Greetings! I tried Omega 3-6-9 too, and it made me worse. Regular old flaxseed oil (capsules), however, make my skin better. I might try the liquid form, mixed into salad dressing, though. Couldn't hurt! I will admit I bought the liquid form to use topically, thinking that if it was good internally, why not topically? I haven't yet, though. Has anyone else, or is this a hare-brained idea?"

Sweetness & Light replied on February 1st 2009: "I agree that Omega 6 seems to worsen rosacea while Omega 3 (Flaxseed or Fish oils) improves it. I also agree that the organic cold pressed bottled oil seems to work better than the capsules. Sweetness x"

Lookout14 replied on February 1st 2009: "Guess I am the odd man out or I should say odd woman out! I took 2tbs....every other day of high quality cold pressed flaxseed oil from an ND I was being treated by at the time.....and within 10 days my rosacea was off the charts! My face was constantly flushing and burning and beet red constantly.....it was a nightmare.....same experience with FO again best quality (Dr.Sears/Zone Diet) and even my gums and teeth were HYPER reactive/sensitive to the point of pain.....I know this goes against all the published papers out there on the benefits and anti-inflammatory benefits BUT my body actually responds with a huge increase in inflammation!
Glad it works for you but anytime I see posts like these where ever I am I feel compelled to share my very extremely negative experiences with these as I would hate to think of anyone out there like myself taking these and having a neg affect and not being able to figure out that it's those oils!
I wanted to also mention....I can't use any of the topical omega's either.....oils that are rich in them....olive oil, jojoba oil, safflower, and any other I can't think of them all right now! I just use mineral oil and I have no reactions as it contains NO omega's.....so inside & outside omega's are bad for my rosacea."

And: "In my case I think since I already have an auto-immune disease (hashimotos) that the Omega's turn up my immune system which causes an increase overall in body inflammation....that's why my gums and teeth even became inflamed....I had nothing wrong with them....just those omega's in a high amount which these doc's consider the effective dose but in truth I couldn't even manage the full dose they recommended and it still had a powerful effect on my body's inflammatory response....attacking my organs....skin, gums, teeth and at that time my thyroid gland....I believe they even caused my antibodies count to be sky high!"

JennyD replied on March 10th 2009: "Hi Lookout 14 - I am quite lucky that my Rosacea is confined to my nose (mainly) but it also affects my eyes - now I know that exercise  (tears) and flaxseed affect me. It's that stupid Celtic heritage! I have been taking the Omega 3 Flaxseed oil capsules for about a year now and have had no adverse reaction to them, but reading the posts I see that some people have no beneficial results from the capsules, perhaps that's why I have had no adverse reaction to them - perverse, but perhaps whatever is missing in the capsules that is in the oil itself could be the ingredient causing my issue. Have you found any Omega 3 oils that don't affect your rosacea? I am a vegetarian so fish oil is definitely out."

Research done on Flax seed oil for menopausal hot flushes:

Flaxseed can also help with menopausal hot flushes. They are a common symptom of menopause and there is some evidence to suggest that flaxseed may offer some relief for these symptoms, and reduces the severity and frequency of hot flushes. Menopausal hot flushes are common among women, approximately 80% of menopausal women have to deal with them. Although they are linked to changing hormone levels, they mimic the type of hot flushes and facial flushing we have to deal with as rosacea patients. Both are linked to the central thermoregulatory centre in our bodies. Typically, hot flushes affect the head and neck and last for a few minutes, whereas rosacea flushing can last far longer.

Flaxseeds lignans, a group of chemicals found in plants, can offer a beneficial effect for women experiencing hot flushes.
In research, scientists tend to test ground flaxseed, rather than flaxseed oil, but they work more or less the same.
Studies show that a higher intake of omega 3, and therefore a better balance of fatty acids within a woman’s diet, leads to less severe menopause symptoms. Flaxseed is also high in the essential fatty acid alpha linoleic acid (ALA), which the body later turns partly into omega 3.

A review of 2 studies found that a higher intake of omega 3 fatty acids was linked to less severe menopausal symptoms. It is also believed the high omega 3 intake of Japanese women is why they have very few menopausal symptoms at all. Flaxseeds lignans are a natural phytoestrogen, and replicates female oestrogen within the body. This replication helps to balance natural estrogen, as women go through perimenopause and menopause: many menopausal symptoms are related to changes in hormone levels, specifically estrogen and progesterone.

A small study in Canada found that whilst flaxseed had some health benefits in terms of reducing cholesterol, there was no statistically significant improvement in other menopausal symptoms. Although the study was small, it was well designed, with a placebo being given to participants, as well as flaxseed and wheatgerm.

However, another smaller study found that flaxseed did offer reductions in the number of hot flushes women were experiencing. The researchers gave the participants 40g of flaxseed each day. Unlike the previous study mentioned, there was no placebo making the study design weaker. Some of the participants withdrew early because of digestive complaints.

A study by Pruthi et al, found that whilst there was no statistically significant reduction in hot flushes using initially flaxseed and then a flaxseed bar, there was still a reduction in their hot flush scores. The study used the standard 40g dose daily of flaxseed. Again, the study was small but for some of the participants, there did appear to be a reduction in the severity and frequency of their hot flushes.

The most effective dose of flaxseed fibre was found to be 40g per day, usually split into two servings. This could be mixed into porridge, or served on top of fruit and yogurt. It can also be used in cooking and other recipes. As this is a natural remedy, it does need to be given time to work, so allow 2-3 weeks of daily use before expecting to see results. Flaxseed is high in fibre and therefore may cause some digestive discomfort, diarrhoea or bloating. If you have a diagnosed digestive complaint such as IBS, colitis, Crohn’s or any other diseases, seek medical advice before starting to include flaxseed in your diet.

Dosage and side effects of Flax seed oil:

Flax seed oil doesn’t have a set recommended dosage. It really depends on how much EPA and DHA you have in your diet, as well as your overall health. As stated above, it depends whether or not you use ground flaxseed (fibre) or flax seed oil. For ground flaxseed, 40g per day is said to be enough for menopause hot flushes. However, for rosacea I found that most people benefit from higher doses. Many people take 2 table spoons of flax seed oil daily. The general recommendation is 1 to 2 tablespoons per day.

If you’re taking flax seed oil capsules, the University of Maryland Medical Center recommends that you take one to two each day. Your doctor will have to give you an exact dosage to suit your body’s requirements, however. Taking too much flax seed oil can inhibit the absorption of medications, supplements and nutrients.
Flax seed fibre could be mixed into porridge, or served on top of fruit and yogurt. It can also be used in cooking and other recipes. As this is a natural remedy, it does need to be given time to work, so allow 2-3 weeks of daily use before expecting to see results.
Flaxseed is high in fibre and therefore may cause some digestive discomfort, diarrhoea or bloating. If you have a diagnosed digestive complaint such as IBS, colitis, Crohn’s or any other diseases, seek medical advice before starting to include flaxseed in your diet. Large doses of 30 grams of flax seed oil per day and higher can cause loose stools and diarrhea. Allergic reactions have occurred while taking flaxseed oil.

Flaxseed oil might increase the risk of bleeding during and after surgery. Stop using it at least 2 weeks before a scheduled surgery.

Fish oil might be a better source of omega 3 and EPA and DHA (here and here you can find a comparison of the two), but it is also loaded with histamine, which makes me personally flush badly every time I try them, and break out on top of that. However, my immunologist swears by fish oil when trying to lower auto immune response in auto immune disease. If you want to avoid fish oil then flaxseed oil, or algae sea weed capsules might be an option for you. They don't have the same amount of histamine and also contain or can be formed into omega 3 (although quite a bit less than the normal fish oil).

6. Fish oil 

Fish oil comes from the tissues of oily fish. The best sources are cold-water, fatty fish. When it comes to human consumption of fish oil, you can get it from fish themselves or from a fish oil supplement. Fish oil is a concentrated source of omega-3 fats. Our bodies are able to make most of the fats we need need, but that’s not true for omega-3 fatty acids. When it comes to these essential fats, we need to get them from omega-3 foods or supplements.
Fish oil contains two very important omega-3  polyunsaturated fatty acids (PUFAs). Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). DHA and EPA mainly come from fish. Some of the best fish to eat for fish oil are wild-caught salmon, herring, white fish, sardines and anchovies (fatty fish).

Fish oil is rich in omega-3 fatty acids, which decrease the body’s production of a long list of pro-inflammatory biochemicals, including the same ones targeted by most NSAIDs — cyclooxygenase (COX 1 and 2). It also helps to reduce levels of inflammatory interleukins, specifically interleukin-1, a marker of chronic inflammation. In studies, people with rheumatoid arthritis who took fish oil were able to reduce their dosage of anti-inflammatory drugs. They also reported less pain and stiffness. It’s reported to help asthma, cystitis, hepatitis, pancreatitis, prostatitis and dermatitis. Other fish oil benefits include decreasing the risk of heart disease and stroke while also helping reduce symptoms of depression, hypertension, attention deficit hyperactivity disorder (ADHD), joint pain and chronic skin ailments like eczema.

Because fish oil and fatty fishg are both naturally high in histamine, a blood vessel dilator, they can (but not always and not for everyone!) cause skin flushing. Taking an antihistamine might help to prevent this.  

There is also evidence that Omega 3 is actually good for rosacea sufferers, as it nourishes the skin and help it heal faster.

Research done on Fish oil for rosacea/ menopausal hot flashes:

Research indicates that fish oil might help alleviate menopausal hot flashes. A group of 120 women between the ages of 40 and 55 were separated into two groups. The first group of women took three gel capsules containing an amount that added up to one gram of EPA, the omega-3 fatty acid that comes from fish oils, every day for a total period of eight weeks. The women in the second group also took three gel capsules in the same manner. However, instead of taking Omega-3 Fish Oil (with EPA), the second group of women took capsules that contained sunflower oil instead.
The women who had taken the omega-3 fish oils reported significant improvements in their menopausal hot flashes. Before taking the fish oil, the average number of hot flashes experienced by the women was 2.8 times per day. After they started taking the omega-3 fish oils, the number of hot flashes reported dropped to 1.2 per day compared to the women taking sunflower oil of 2.3 times a day. Comparatively, the women who took the fish oil had the same kind of improved results as those women who took hormone therapy and anti-depressants.

Another study from Italy compared the benefits of using a soy isoflavone supplement compared to taking omega-3 fish oil capsules. While the soy isoflavone group had the same results as the placebo group, the fish oil users, again, experienced a steady decline in hot flash frequency.
“PUFAs [polyunsaturated fatty acids], particularly omega-3 fatty acids, could reduce hot flashes through their influence on neuronal [brain cell] membranes and/or the modulation of the neurotransmitter function and the serotoninergic system.” The “serotoninergic system” is the metabolic process that produces serotonin, a key mood-modulating chemical in the brain.

Not surprisingly, some antidepressants that affect serotonin levels in the brain, including Remeron and Celexa, also can make rosacea flushing less severe. They seem to regulate your inner thermostat and make you less likely to flush, and less severely flushed.

Fish oil for (menopausal) depression:

Research also shows that fish oil an help with depression, also depression during menopause.
Researcher Dr. Michel Lucas and his colleagues at Université Laval's Faculty of Medicine
enlisted the help of 120 women between the ages of 40 and 55 and separated them into two groups. The first group of women took three gel capsules containing an amount that added up to one gram of EPA, the omega-3 fatty acid that comes from fish oils, every day for a total period of eight weeks. The women in the second group also took three gel capsules in the same manner. However, instead of taking Omega-3 Fish Oil (with EPA), the second group of women took capsules that contained sunflower oil instead.

Once the eight-week period was over and all the women were tested again, they found that the Omega-3 fish oil capsules had greatly and statistically improved the menopausal symptoms of the women who had mild depression and experienced some psychological distress. Unfortunately, those women who were experiencing severe depression did not have the same positive effects, only those women who had mild symptoms felt better indicating the need for the more severely depressed women to seek professional help and guidance.
"The differences we observed between the two groups are noteworthy," commented Dr Lucas, "especially considering that omega-3s have very few side effects and are beneficial to cardiovascular health."

Fish oil for acne:

This research indicates that fish oil can reduce acne.

"Given that acne is a rare condition in societies with higher consumption of omega-3 (n-3) relative to omega-6 (n-6) fatty acids, supplementation with n-3 may suppress inflammatory cytokine production and thereby reduce acne severity.
13 individuals with inflammatory acne were given three grams of fish oil containing 930 mg of EPA to their unchanged diet and existing acne remedies for 12 weeks. Acne was assessed using an overall severity grading scale, total inflammatory lesion counts, and colorimetry."

"There was no significant change in acne grading and inflammatory counts at week 12 compared to baseline. However, there was a broad range of response to the intervention on an individual basis. The results showed that acne severity improved in 8 individuals, worsened in 4, and remained unchanged in 1. Interestingly, among the individuals who showed improvement, 7 were classified as having moderate to severe acne at baseline, while 3 of the 4 whose acne deteriorated were classified as having mild acne.

There is some evidence that fish oil supplementation is associated with an improvement in overall acne severity, especially for individuals with moderate to severe acne. Divergent responses to fish oil in our pilot study indicates that dietary and supplemental lipids are worthy of further investigation in acne."

Oral supplementation with fish oil also proved to reduce dryness and skin itchness

This study evaluated the effect of dietary fatty acids in the skin physiology via an itch-related animal model with and without supplementation with fish oil, a source of polyunsaturated fatty acids (PUFA), especially omega 3.

Male Wistar rats were divided into two groups-non-supplemented (control) and supplemented with fish oil (3g/kg/day) for 90 days. Every 30 days, scratching and skin parameters (transepidermal water loss (TEWL), hydration, and local blood flow) were evaluated before and after dorsal skin exposure to acetone to induce the itch-related dry skin. At the end of the study skin samples were collected for fatty acids composition analysis.

Fish oil supplementation reduced the transepidermal water loss and increased the skin hydration, with significant changes from day 60 on, while skin microcirculation registered no changes. It also alleviated the acetone induced skin barrier alteration, revealed by a faster resolution of transepidermal water loss and hydration, and elimination of itch-related scratching induced by dry skin. These changes were associated with the shift in the skin fatty acids incorporation pattern (richer in n-3 with n-6/n-3<5) resulting from the fish oil supplementation.
Skin barrier dynamics seem to be influenced by fish oils omega 3. It reduced the scratching behaviour induced by dry skin. Hence, long-term supplementation with omega 3 fatty acids might reinforce and restore skin integrity and function (reduce skin dryness, improve normal skin function).

However, when you are allergic to fish, fish oil can also cause a rash and facial flushing:

This research described a patient with documented seafood allergy, who arrived in the emergency department 4 days after she had started taking a prescription brand name fish oil capsules. She complained of chest tightness, shortness of breath, tingling of upper extremities, flushing, and pruritus (skin itching), that was only slightly relieved after she was given excessive nonprescription diphenhydramine administration (an antihistamine drug for allergies). During follow-up, the patient later reported that all her symptoms had resolved within 5 days of stopping the fish oil capsules, and after throwing away all medications that had come in contact with the fish oil capsules.
Due to the patient's allergic history, timing of onset/offset of the reaction, laboratory evidence, and the use of the Naranjo probability scale, prescription fish oil capsules were deemed the probable cause of this patient's pruritus and flushing of the face and trunk.

Fish oil and rosacea:

Freeme3 wrote on March 5th 2012: "Hi. Does anyone here flush/flare from Omega 3 Fish Oil? Well, my eye doctor told me to increase my intake of fish oil up to 4000 mgs a day (for dry eyes). I began increasing it to 3 a day on Friday and have been doing so since then. Well, today my skin is a mess.. more red bumps am flushier and redder. I'm going to stop taking it asap! I'm confused though because I thought fish oil helped inflammation?? Has this ever happened to anyone else? I am taking Vitamin World Triple Strength Ester Omega 3 Fish Oil 1360 mg (950 active Omega 3). It contains Mixed Natural Topherols, anchovy, mackeral, and sardine). I am was taking 3 of them for the past 2 days and my face is hot and red. I am not sure if it's from that but my face does not normally feel hot to the touch. I ate almonds and strawberries yesterday and on Friday but did not have any today.. I am still in the flare. It could be other things too, I am sure, but I made a huge change to my fish oil consumption, so it got me thinking... Thanks!"

Labrynth replied on March 5th 2012: "Freeme ~ I was checking this brand to make sure it does not contain gluten/dairy/corn/or yeast, and it does not, so you are not reacting to those things. I know that some forms of fish oil, derived from larger fish higher in the food chain, can contain higher incriments of things like mercury and PCB's, contaminants. This brand states specifically that it is free of quantitative amounts, so this is good. I would guess this is a high-quality brand which is unlikely to cause adverse effects. Fish oil is Omega-3 fatty acids, which counter inflammation. They should not have induced an inflammatory response in your skin. It could be coincidence that you are having a flare up at the same time you increased the dosage.  I wish I could help you further...I just wanted you to state this information to help someone else to better answer your question. Hopefully, someone will answer soon..."

Freeme3 replied on March 5th 2012: "Thanks, Meridian for your help and researching the brand of fish oil I am taking. I did a little more research and found that fish oil is high in histamine. I have been wondering if histamine is part of my problem, but am not really sure. I think I will cut it out and see what happens. Thanks again for your help on this!"

Vicky replied on March 5th 2012: "Fish oil makes me flare too. So does seaweed. (Not sure if there's a connection-iodine maybe?) I can eat a piece of fish occasionally without a flare, however. Haven't tried shellfish since being diagnosed--just salmon and fluke. Any smoked fish is a complete disaster. I wonder if reacting to fish oil is somehow connected with having fibromyalgia and rosacea?"

Freeme3 replied on March 5th 2012: "Hi Vicki, Thanks for your response. I think I have trouble with high histamine foods... I am starting to make the connection. I'm not sure though... my flare began after eating a lot of chocolate ice cream,.then almonds, then large doses of fish oil and finally strawberries. ..those are all high in histamine. (Actually, not sure about the almonds). Re: Fibro and histamine... people who have fibromyalgia have overactive mast cells causing histamine reactions. PM me if you want more info: there is definitely a connection. Thanks again!"

Bellableu wrote on March 14th 2010: "I'm wondering if anyone here has had success supplementing with Cod Liver Oil (I did see threads on D3 supplementation, and the jury appears to still be out - could it have something to do with dosage levels & co-factors like Vitamin A?). Would love some thoughts on this topic ... Based on the reading I've done here & elsewhere it certainly seems as tho' we Rosaceans may be deficient in some necessary vitamins, co-factors, proteins, natural hormones, etc. ... My diet is excellent & anti-inflammatory already, but here I am dealing with what has turned out to be a four-month long flare. Diet has always always affected my skin (immediate breakouts, paps, itchy nodules following ingestion of certain foods, for example). But I have always been ultra-careful about the sun, so I'm not someone who has pointedly spent time tanning, burning, or otherwise.
I have ordered an excellent D3 supplement with co-factors to try. But now I am more inclined to begin supplementing with high quality Cod Liver Oil immediately. I would love to have my D levels checked before I start supplementing, but I don't know when or if the clinic here will get me in. Anyway, if you're familiar with Weston Price and his supporters, you know Cod Liver Oil is considered one of the 'superfoods' suggested for boosting one's health. It is is very high in Vitamin D, Vitamin A, EFA', and a few co-factors. Does anyone have any thoughts on Cod Liver Oil or further thoughts on vitamin deficiency /malabsorption as a factor in Rosacea? Do we all agree that the immune system is part of the issue? Does it makes sense that malabsorption/poor processing/deficiency of certain nutrients would could create/cause Rosacea?"

Debbee wrote on March 14th 2010: "Hi, I'm new to the forum, but I have come to believe strongly over the years that my skin is best when I'm taking Vitamins A and B-complex in particular. I used to get my Vitamin A via my Solgar Cod Liver Oil capsule, but now I take a low dosage Solgar A & D3 combo capsule, which I alternate with a low dosage Solgar beta carotene tablet. I like Solgar's low dosage B-complex also. For my skin I also take a couple of times a week a Nordic Naturals Omega 3 caspule, a Solgar Evening Primrose Oil capsule, and a Solgar 30 mg. pycnogenol dry capsule, although not all at the same time. I always take my vitamins after a meal. I'm big on moderation and balance, and I take a low dosage multi-vitamin every two or three days also. I watch the amount of Vitamin A I take carefully; I would personally never take more than 10,000 IU per day from all sources."

Auburn replied on March 14th 2010: "Hi Bellableu, regarding cod liver oil, I have been taking a teaspoon daily of Nordic Naturals Arctic-D, which is high in omega-3s. Honestly, I couldn't tell you if/how it works because I started taking it at the same time I began eating more wild fish, animal fat, coconut oil, raw dairy, and raw honey. My skin has remained calm (I still flush -because of heat /emotions- every now and then but it subsides quickly) and my digestion has improved a lot."

Dpart wrote on March 14th 2010: "I believe in WAPF advice and I do take cod liver oil occasionally for Vit D, A, K2 etc. I'm only taking the fermented cod liver oil, which I believe are the only good one to take (given that there is no other with only natural occurring vitamins). The fermented cod liver oil also has a lot of co-factors and several different variants of D3. I had very good success with this oil together with normal vitamin D3 supplements and juicing in the Vitamin D thread, but unfortunately I suffered from some strange side effects after a while (maybe some sort of overdose effects, I don't know). The side effects was among others, muscle vibrations and dizziness (you can read all about it in the D3 thread). When testing later, the side effects was from D3 alone and not from vit A or cod liver oil in particular."

MissMary wrote on April 22nd 2013: "Hi folks, I'm having a full-on red almost purple flush after eating fish (cod) for the first time in months. Has this ever happened to you? Why would fish cause a flush? (It's painful!) Thanks for any insight. It was cod, baked with sliced zucchini and yellow pepper, s+p, olive oil and maybe 1/4 tsp "herbes de Provence." It looks like cod is moderate or low, but not lowest, in mercury levels...?

Starlite  replied on April 22nd 2013: "Well from my experience.. your millage may very ...  My flushing is directly connected to large fluctuations in blood sugar. For example I could be eating low carb and very high in raw veggies for a week then have some pizza one night. The next day or three is when my blood sugar is just crazy.. eating anything can cause a flush, or when what I have eaten gets burned off I flush too. My flush is never connected to the first day of going off of diet plan. I can recreate this at will.. so I am sure that's what's going on for me. So I guess the next question might be.. have you eaten something that you don't usually eat in the last day or two? Or gezz even better.. how often do you experience flushing? Is this so unusual that it caused you to post on a forum about it?"

Jrlhamcat2 replied on April 22nd 2013: "Histamine intolerance?"

Arb161 wrote on April 22nd 2013: "Hi missmary. I sometimes do and sometimes don't flush to fish. Just has a full round of allergy testing (2nd time) and not a single type of fish came up positive. So I thought it was maybe histamane - also normal.Like many other things with this disease it's weird

Jrlhamcat2 replied on April 22nd 2013: "It could also be sulfites if the fish was treated with sulfites. Personally I think it's really hard to figure out cause and effect with this disease because our skin gets so sensitive and often seems to react without any apparent provocation. I'd guess it's also the case that if you're far below your threshold for flushing, something that might be a trigger when you're closer to the threshold might have no effect."

Scot Viking replied on April 27th 2013: "I am in my 12th week. My rosacea, my redness, the pustules, the burning and heat, the swelling - it is ALL completely gone. I do not even recognize myself when I look in the mirror. Eliminated: Wheat, Dairy, Corn, Safflower Oil, Corn Oil, Canola Oil, Cottonseed Oil, Corn Syrup, potato, Wheat based derivatives and preservatives, wheat and casein protein powders, red meat. Added: grapes, blueberries, almonds, blackberries, walnuts, cocao, almond milk, sauer kraut, vinegar with the mother, psyllium. Moderate: Rice
25 years of horrid rosacea (never abated for even 6 straight days) - put to an END. ZERO rosacea for 10 weeks and 3 days."

Moonfire241 wrote on August 29th 2016: "I had read somewhere that foods with omega 3 fatty acids, like salmon, were good for those with our disease. However, tonight, I read that omega 3 fatty acids keep the blood vessels from constricting. I'd been taking fish oil pills thinking omega 3 fatty acids were good for the skin and eyes. Should I stop? I'm confused now. Please help.

Sheis4 replied on September 7th 2016: "I really doubt about it... I've heard lots of people saying that Omega 3 saved them from this condition, or at least made them feel and look lots better. That's why I started to take Omega 3 supplements a couple of days ago. I would recommend to do some more research about it and you'll see that it helps."

Faith1989 wrote on September 7th 2016: "Omega 3 is really good for rosacea. It is anti inflammatory. This is especially good if you have ocular."

Sheis4 replied on September 8th 2016: "Can you just explain the difference between omega 3, 6 and 9? is this the same thing or i have to use just omega 3 for total effect?"

Driven wrote on September 9th 2016: "The problem with this over-simplified statement is that it's repeated on thousands of health web sites with nothing more specific. People automatically think that "anti-inflammatory" means less facial redness/flushing, but that's not what it means at all. Type 1 rosacea is very different from (for example) bursitis. I went for years making the same assumption. Stopping Omega 3/6 and no longer thinking of my rosacea as "inflammation" were my first steps on the road to remission. There was a rapid, noticeable reduction in flushing. It's also one of those dietary triggers where the flushing response is delayed (up to 24+ hours), which is why it took me so long to put 2 and 2 together. I've also since figured out that virtually anything with claims of being anti-inflammatory - such as ibuprofin and numerous vitamins and minerals and foods - actually cause flushing. In my case, at least. I'm beginning to think that the body's inflammatory response (it's there for a reason) being purposely muted is what helps the actual causes (intestinal bacterial overgrowth or whatever) to work against us. I'm not saying it's unhealthy or causes flushing in everyone, but I believe that making it a permanent addition to your diet just because holistic-whatever.com says it's anti-inflammatory is counterproductive."

Mistica wrote on September 12th 2016: "Driven has beaten me to it. He made an excellent post and I agree with him. In addition, I'd like to add that PUFAs (Polyunsaturated fatty acids) can be very inflammatory, depending on the individual. They oxidize very quickly and if the individual is lacking antioxidants, which most rosaceans/flushers do, (as shown in the few decent studies that have been done), all fats will oxidize quicker. Thus, the more lipids, the more oxidation and the effects of PUFA's in particular can be destructive. Anyone who has hypothyroidism also has an inability to clear lipids in a timely manner. The ensuing oxidative stress perpetuates the cycle and increases inflammation.

Then there is the obvious culprit. Excessive vasodilation, something we can certainly do without. Ages ago I read a study which suggested that candida can be fueled by omega 3's, but I have been unable to follow this up elsewhere. It seems contradictory that omega 3's can help calm ocular rosacea. I am not disputing the evidence as there are a number of posters on here who claim improvements. The results pose more questions as to the complete effects of these PUFA's.
It is much safer to get omega 3 from food such as fish.
Some months ago, Prof Jaminet (from the Perfect Health Diet) suggested I supplement with Tocotrienols to help protect against lipid oxidation. (Not tocopherols). Apparently they have antioxidant effects, and some other interesting benefits of their own. I was reluctant at first, as my brief experience with tocopherols was horrendous. Massive flushing, which took some weeks to settle down. And that was from only two capsules. I am pleased to say, I find some benefit from tocotrienols. I started with Doctor's Best which contains 50mg of mixed tocotrienols and 17iu of tocopherols. I seem to tolerate the small amount of the latter.
Taurine was also recommended to me as an antioxidant. I made a separate post about it months ago.
So for those people who find benefits from fish oil for ocular rosacea, but who also find it worsens their faces, it might be worth while trialing these antioxidants to see if they can control the side effects. Anyone who finds dietary fats inflammatory, might consider giving these supplements a whirl as well. Taurine is an inhibitory amino acid and seems to dampen flushing slightly. Initial, temporary side effect in me were headaches."

Moonfire241 wrote on September 15th 2016: "Thank you for the information. I quit taking the fish oil pills in case this would make things worse. I get migraine like headaches from the dilated blood vessels when I go too long without taking ibuprofin. I know it's not good to rely on this long term. Are these rebound headaches that will eventually go away if I stop taking it? Should I reduce it slowly? I believe you about anti inflammatories sometimes making things worse, from things that I've read. I just don't know how to stop relying on this. I'm also afraid of rebound flushing/inflammation."

Queta wrote on February 6th 2014: "Hello: I have been taking fish oil for the past several weeks to see if it helps with my rosacea symptoms. My symptoms are primarily swelling, red and swollen eyes, and orange peel texture. I think it is helping my skin texture. A few days ago, my friend commented that my skin "looks really good and smooth." I hope that she is right. I started the fish oil after reading research on the effects of fish oil on ocular rosacea. Anyway, I will post my results on this thread. I am taking quite a bit...six 1000 mg capsules a day. Regards, Queta."

Maroon5 wrote on February 7th 2014: "I tried this a few years ago and didn't really find they helped me dramatically personally. But everyone says omega oils are good for the skin so stick with it for a few months and let us know if you notice any difference."

Queta replied on March 2nd 2014: "Hello: I was taking quite a bit of fish oil (6000 mg per day) religiously for six weeks. My skin texture, swelling, and ocular symptoms did seem to improve. However, I developed an eye twitch on the lower part of my right eye. I was very concerned. I stopped the fish oil in case it was the problem. Now I am thinking of switching to 3000 mg of flax oil daily. Will keep you posted. Regards, Queta"

Tonny wrote on March 29th 2014: "Emmmm i just want to say you here that millions of Americans take fish oil supplements to promote heart and vascular health. But a new analysis suggests that some consumers may not always get what they are paying for."

David147 wrote on July 15th 2015: "Fish oil also aids in weight loss process. Research conducted by Professor Peter Howe at the University of South Australia has shown that fish oil improves the efficacy of exercise in reducing weight. Volunteers who were given fish oil diet showed greater weight loss as compared to those who did not consume fish oil diet."

GreenGables wrote on November 2nd 2015: "I have found that anything that lowers blood pressure or thins the blood tends to produce a flush. I'm still not sure why. Fish oil / omega oil is a blood thinner. Magnesium also lowers blood pressure and may provoke a flush.

Terrieb wrote on November 14th 2015: "Omega 3 is good for lots of reasons.....Omega-3 fatty acids are thought to provide a wide range of health benefits, including a lower risk of coronary heart disease and improvement in cholesterol. There have also been promising results from studies looking at omega-3 for cancer, depression, and attention-deficit hyperactivity disorder (ADHD). I take mine in supplement capsules. I buy the one a day, non fishy taste ones and burpless. I also eat a lot of Salmon, both fresh and frozen. But I have always done this even before acquiring Rosacea (December 2014). Whether a person has Rosacea or not, it's just a good supplement to take on a daily basis.

Kundalini wrote on April 29th 2015: "Fish can be high in histamine, canned fish smoked fish etc, if it's canned it will eventually be high histamine the longer it's there, fresh fish is different low histamine, I stay well away from fish in general as some can be high in mercury, I used always ate sardines daily until I fond out it's high histamine. look up the high and low histamine foods you'll be surprised on what you see."

BigW wrote on July 17th 2016: "Could Fish Oil Be Responsible For Flushing? Hi All, I've been having quite a bit of success lately with my facial flushing. I've been gluten free since May 2015 and a few months ago really stepped up my dietary fat intake. I lowered my carbs, lowered protein to moderate servings (I'm into weight training) added MCT Oil to my pre-workout coffee for extra energy and increased butter, Olive Oil and Avocado Oil to my meals and cooking. Even when my meal is cooked I add butter to the meat portion and drizzle Olive Oil over the veges. Only one big meal when I get home from work and snacks during the day and only if I'm hungry. There's a lot of calories in fats compared to protein and carbs. I also added 2-3 grams daily of MSM in divided doses. The great thing about it is my face flushing has dropped dramatically to the point where I hardly think about it.

Yesterday, due to an ongoing knee injury, I was reading about Fish Oil and inflammation and decide to add a tablespoon to breakfast and dinner. After having a spoonful of Fish Oil with breakfast (eggs and butter) my wife and I went to a dept. store and almost immediately felt my nose starting to tingle. In 20 minutes it was a deep red colour and my cheeks also flushed but not to the same colour as my nose. This, of course, completely ruined my day, my wife's day and then the depression settled in leading me to just wanting to be on my own asap and my usual happy, positive self was gone.
It's been many months since this happened. Is it possible the Fish Oil could have been responsible? I've racked my brains and it's really the only thing I did differently and I dropped it many months ago from my diet which would coincide with the decrease in flushing. Anyway, I hope someone can enlighten me. Much health and happiness to you all."

ShaunD replied on July 17th 2016: "I've read that fish oil is fairly high in histamine, maybe that's a problem for you."

Lwemm replied on July 17th 2016: "Yep, it is probably the fish oil. I was taking some but did not like it all that well (the taste and greasiness- yuck) so kept "forgetting" to take it. It had been in my fridge quite a while before I remembered to take it again and that week, I was flushing a lot at work. It happened a few hours later. I quit taking the fish oil and have not had that problem since. The freshness of the oil can be a big factor in whether it will cause a flush due to the build up of histamines."

BigW replied on July 23rd 2016: "Many thanks for the tips on histamines. I've been reading a lot about them over the last few days and picked up some great info. Time to start making some dietary changes."

Bradley wrote on September 25th 2005: "If you want to see results then take at least 3-5 grams of purified Omega-3 obtained from fish oils (remember this is around 8-10 grams of fish oils). You can even take up to 10 grams of omega-3 (like the Eskimos) but there isn't much documentary evidence suggesting doses above 5 grams have any more benefits.The problem with flaxseed is that it contains alpha-linolenic acid (ALA) but no EPA and DHA. The EPA and DHA is what the body uses to suppress inflammation especially EPA which is more beneficial. If you are taking flaxseed then the body needs to convert the ALA into EPA & DHA. Unfortunately a lot of scientific evidence suggests the conversion rate of ALA to EPA&DHA is only in the region of 4-15% and in some cases where this conversion is inefficient to non-existent. So you need to take quite a lot of flaxseed to get even the slightest of benefits.
The benefit with fish oils is that they already contain BOTH EPA and DHA so no conversion process needs to take place. Therefore a lot of what you intake is not going to waste as with flaxseed. This being said flaxseed is still good for your skin but not as good as fish oils and it has some other notable benefits as it also contains lignans which are anti-carcinogens.
With regards to Omega-6, the majority of these EFAs promote inflammation so you should be careful to reduce your intake so you have a good balance of Omega-3 to Omega-6 about 3:1 or 2:1 over the short term. In the long term it should be 1:1. But GLA is one of the only omega-6's that is good for your skin and you can obtain it from Evening Primrose Oil or Borage Oil. Borage oil has a higher content of GLA per gram however it is questionable whether it should be taken over the long term and so EPO is usually recommended instead."

Dosage and side effects of Fish oil:

The American Heart Association recommends that healthy adults eat fish at least twice weekly. Fatty fish such as catfish, halibut, salmon, striped sea bass, and albacore tuna are particularly recommended. Plant-based sources of ALA such as tofu, walnuts, and canola oil are also recommended. The World Health Organization recommends a daily EPA and DHA intake of 0.3-0.5 grams and a daily ALA intake of 0.8-1.1 grams.

On top of that you can supplement with fish oil capsules, but more isn't always good here. A typical fish oil capsule that you can buy at most health food stores and pharmacies contains 180 mg of the omega-3 EPA, 120 mg of the omega-3 DHA, for a total of 300 mg per capsule. Many bottles will suggest a dosage of 2-3 capsules per day.
This daily dosage approximates the two servings of fish per week. Some over-the-counter nutritional supplements contain 500, 600, and all the way up to 850 mg omega-3 fatty acids per capsule. So, thew recommended dosage depends a bit on the level of omega 3 fatty acids in the supplement. The higher the dose of omega-3 fatty acids, the less capsules you need to take. But don't take more fish oil than the label of your tube recommends. This is very important.

Fish oil is said to be safe even at high doses, with few or no side-effects beyond stomach upset or belching (which can be minimized by taking with meals, refrigerating the capsules, or taking enteric-coated fish oil tablets). Look here for more info.

Also take into consideration that fish oil can possibly cause oxidative stress and damage in the body.
Taking several grams of fish oil per day may be hazardous to your health. When fat particles oxidize, they break down into smaller compounds, like malondialdehyde (MDA), that can be dangerous because they damage proteins, DNA, and other important cellular structures.
A study by Mata et al demonstrated that oxidative damage increases as intake of omega-3 fat increases. But if you are very concerned about this, it is also wise to cut down on the levels of
omega-6 fat in your regular diet, found in industrial seed oils and processed and refined foods.
Fish oils, like for instance, fermented cod liver oil, are however also a condensed source of fat-soluble vitamins (A, D, K2 and E). Also, the risk of oxidative damage that may occur with the odd capsule of cod liver oils is outweighed by the benefits of its fat-soluble vitamins.

Eating fresh fish is in my view the healthiest way to receive your omega 3 fatty acids. And when you notice that your rosacea worsens from either fish or fish oil, then I would discontinue it. Maybe try it a second time after you skin has calmed down again, to be entirely sure that it really was the fish oil that you were reacting to, but if this proves to be the case, don't think that your skin always has to become worse before it gets better; this is rarely the case. The histamine in fish can simply cause you a flare. In that case, avoid foods very high in histamine. Alternatives for fish oil are flax seed oil (described above) and algae oil; they also have omega 3 fatty acids, but like with flax seed oil, you need a halluvalot of algae oil to get the same high dose as fish oil provides. That is the downside of both. For vegans and for people with a sensitivity to fish or histamine, they are however safer alternatives.