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- [00:00]
SkinScript Professional Skincare Narrator
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Maggie Stasik
Hello and welcome to ASCP and the Rogue Pharmacist with Benjamin Knight Fuchs. In each episode, we'll explore how internal and external factors can impact the skin. I'm Maggie Stasik, ASCP's program director, and joining me is Ben Fuchs, skincare formulator and pharmacist. Hi, Ben.
- [01:11]
Benjamin Knight Fuchs
Hello, Maggie. Good to see you. Happy New Year.
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Maggie Stasik
Happy New Year, Ben. We hear the word rosacea used as if it's one single condition, but clinically, that's not really accurate. Can you break down why rosacea should be thought of as multiple conditions rather than one diagnosis?
- [01:29]
Benjamin Knight Fuchs
Yes. It all goes back to the idea that a principle of natural healing, as opposed to pharmaceutical healing and medical healing. Natural healing, which estheticians practice for the most part, is where you see the problem, is not where the problem begins. That's just a principle. So, for example, if you have heart disease, it doesn't start at the heart. If you have schizophrenia or mental health problem, it doesn't start in the brain. If you have arthritis, it doesn't start in the joints. You got to go upstream to address a health problem. At the causal level, I always think of the analogy of fruit and root. You have an apple that's rotten on the tree, you can't do anything about the rotten apple. You got to go to the fruit, you got to go to the root, and you got to go to the soil. And it's the same thing with health and the same thing with the skin. In fact, it's especially true about the skin because it's very rare. Very, very, very, very rare. Almost never does a skin problem occur because something's going wrong with the skin. It does happen occasionally, but for the most part, you're going upstream and nothing exemplifies that more than rosacea, which, by the way, means red. Rosy, like rosy.
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Maggie Stasik
Red makes sense.
- [02:33]
Benjamin Knight Fuchs
Whenever you see red, rashiness, redness in the body, you can pretty much assume you've got some kind of immune activity and redness is part of the four. Is one of the four cardinal signs of inflammation. Dolor, cholor, rubor, and tumor. If you go to medical school, they say there's four cardinal signs of inflammation. Dolor, pain, choler, heat, tumor growth or swelling, and rhubar redness. So it's the redness component of inflammation. Inflammation is the calling card of the immune system. It's how we visibly see immune activity. So when you have redness, you can pretty much assume that you're dealing with some kind of immune activity. Inflammation and immune activity. Where does the immune system live mostly? The immune system mostly lives in the digestive tract, in the intestine, specifically. And so it's somewhat obvious because everybody who has this condition knows that certain foods will trigger a response. And it always amazes me how we. We know that, right? Even non clinicians know that certain foods will trigger a redness response. But for some reason, when we see rosacea, we automatically assume a skin problem. For example, you probably heard of this thing about the mites, right? That's the big thing now is the demodex mites. What they don't tell you is everybody has demodex mites. They're part of the microbiome, the normal skin microbiome. So everybody. Shabar Rozacev is really demodex mites. Well, it's not demodex mites because obviously people who have rosacea know certain foods will trigger a redness response. And we know that there's comorbidities associated with rosacea. Things like people who have rosacea are more prone towards psychiatric issues, they're more prone towards digestive issues, they're even more prone towards cardiovascular health issues. So every pointer tells us that rosacea is not a skin problem. It's an internal problem caused by multiple factors, most importantly the digestive factors. And so if you really want to address rosacea, you've got to address, and this is true, by the way, about all skin conditions. Actually, let me backtrack. It's true about all health conditions. You always want to go back to the digestive system. And sometimes I feel like I'm, you know, beating a dead horse here, because how have we ever talked about anything with the skin and not talked about the digestive system? They go hand in hand. And I've been saying this for decades, since I've learned about in pharmacy school in the 1980s, and it's just now starting to get understood that there's a connection between the digestive system, slash, immune system, because the immune system lives in the intestine, as I said, and skin problems like rosacea, also. Rosacea. Where does it occur? It occurs right in the middle of the face. Right. Sometimes there's ocular rosacea, and sometimes people have rosacea will have some other skin issues in the T zone. But for the most part, you're dealing with right this middle band in the face where the nose is and the cheeks. What do you have there? You have a concentration of lymph. The lymphatic system is concentrated in that cheek area. And it's like a belt, a lymphatic belt you can think of it as. And what does the lymph tell us when you have a lymphatic issue? It tells us that there's lymphocytes, there's white blood cells, there's immunity. That's what the lymph does. Lymph does other things too, but one of its major roles is to transport immune factors and toxicity. So all pointers tell us that when you're dealing with rosacea, you're dealing with an internal condition, which means an immune condition, an inflammatory condition, and that can involve many factors. We mentioned the intestine, but also the stomach. There's a bacteria called H. Pylori. Have you heard of this? Yeah. So H. Pylori is also associated with. Elevated levels of H. Pylori in the stomach are also associated with rosacea. And it turns out that that H. Pylori in the stomach is associated with something called achlorhydria, or low stomach acid. And low stomach acid is another cause of inflammation and immunity, because downstream from or upstream from low or downstream from low stomach acid, you have intestinal problems, because you need stomach acid in order to have effective processing of food at the level of the intestine. So everything tells us that when you're dealing with rosacea, you're dealing with an internal condition, an immune condition, an inflammatory condition. And whenever that happens, you always want first things first. You always want to focus on digestive health from a topical perspective. There are certain things that you can do if you go to a doctor, what do they give you for rosacea? And they give you antibiotics. Right. And antibiotics are a little misleading because while antibiotics obviously kill bacteria, there's a secondary mechanism of action that antibiotics have, and that is anti inflammation. And so some of the effects that you're getting from metronidazole, which is the standard antibiotic that they give for rosacea are due to their anti inflammatory effects. First of all, every chronic health issue, every one of them are inflammatory. There's no such thing as a chronic health condition, dermatological or otherwise, that's not inflammatory. That's first of all. So given that we want to address this, maybe we should think of what is inflammation. Well, inflammation is a defensive response. It's like an airbag going off. It's a protection. So if you have an, if you have a protective response that you want to get rid of, you can do a couple things. There's two mechanisms. You can go outside in or top down and just suppress inflammation. And this is the standard strategy that skincare companies use or that dermatologists use or the medical community uses. But doesn't it make more sense to figure out what the offending agent is? It seems like, right, yeah. So you can go top down and just like kind of press down on the inflammatory response and maybe you may even do it effectively, but you still have the enemy, if you will. The bad guy is still there. The way I look at it, let's figure out the bad guy. Let's take care of the initial cause of the protective response, the offending agent. And that's why food is so important. And that's why digestive health strategies are so important. And that's why nutritional supplements that support digestive health are so important. You and I have talked about sibo. Sibo is a serious health problem systemically, but it's also a serious problem for the skin. And it's involved in rosacea, small intestinal bacterial overgrowth. So doing the fodmaps diet that is eliminating the foods that trigger the growth of bacteria. Are you familiar with fodmaps?
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Maggie Stasik
I am, yeah.
- [08:37]
Benjamin Knight Fuchs
Yeah. These are the sugars that feed bacteria. So eliminating FODMAPs kind of foods, some of which are so called good foods, could be fodmap foods like certain fruits and vegetables. Eliminating histamine producing foods, that's also important. This is not just for rosacea, this is for all inflammatory conditions, but including rosacea. Eliminating histamine inducing foods or foods that contain histamine. Protecting against leaky gut, using collagen peptides, vitamin A. Eliminating fried fats. I don't know if you know this, I think we've talked about this, but fried fats are very inflammatory for the intestine. And who doesn't like fried fats, right? French fries, pizza, hush puppies, fried okra, I don't know. There's zillions of these foods. Very inflammatory for the intestine. And it's very possible that our collective addiction, our national addiction or obsession with fried foods is behind almost epidemic levels of leaky gut. And that's another issue, leaky gut. So patching up a leaky gut, eliminating fried fats, estrogen can be involved in leaky gut. You know, leaky gut affects women a lot more than men. There's an estrogen component. So working with the hormone system is important. Using things like collagen peptides, high hyaluronic acid, fucoidin, aloe vera, vitamin A, all of these can have a beneficial effect for the intestine. And another thing, when you have an intestinal health issue that kind of goes under the radar, not only are you not going to, not only are going to be dealing with toxicity in the blood, and now you have this, all this immune inflammatory activity. But when you have an inflamed intestine, you're not absorbing your nutrients, right? So you're not absorbing your vitamins, you're not absorbing minerals, you're not absorbing electrolytes, you're not absorbing aminos. And what ends up happening is now you get this one, two punch of toxicity and malnutrition. So working on the gut is super, super important. With the achlorhydria element, the low stomach acid, using apple cider vinegar with meals, using aloe vera with meals, betaine HCl, betaine hydrochloride, things like that work on digestive health, intestinal health, and then work on, at the level of the stomach. And even things like chewing foods can be beneficial and then food elimination. And those are really the most important strategies for dealing with rosacea. Focus on digestive health. Focus on the enemy that is causing the inflammation. And the good news is, is once you do that, you'll never have rosacea again. Number one, you won't have to be on antibiotics. And because if you have digestive issues, you're at higher risk for other health challenges. And you're going to reduce your risks of accelerated aging, you're going to reduce your risks of joint disease, you're going to reduce your risk of autoimmunity, et cetera, et cetera. So to me, as a natural pharmacist, I'm saying, let's go to the root. Don't worry about the fruit. Take care of the root, and the fruit will get taken care of. And if anybody tells you that it's Demodex mites that are causing, causing rosacea, that's just pure silliness. Focus on the triggers, which everybody knows are things that you put in your mouth. And it's not, sometimes it's not just food, it could also be alcohol or wine. Sometimes those will trigger a inflammatory response that looks like rosacea as well.
- [11:38]
Maggie Stasik
So to recap, bottom line is inflammation in the gut is causing inflammation on the skin. That's a secondary response.
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Benjamin Knight Fuchs
Yes, it's in, it's inflammation, it's an inflammatory condition in the gut. But the inflammatory condition in the gut itself is caused by triggers. So the inflammation is in the gut, it's already secondary, and then by the time it's on the skin, it's tertiary. The primary cause is the triggers of the inflammation at the level of the gut. And that is obviously it's gonna be food based. Although once you have leaky gut, it could have to do with the bacteria and the small intestinal bacterial overgrowth condition. So there are strategies that you can use to take care of the bacteria as well.
- [12:19]
Maggie Stasik
Okay. And you also mentioned low acid as.
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Benjamin Knight Fuchs
Well, low stomach acid, achlorhydria or hypochlorhydria as they say. And interestingly this is really kind of counterintuitive, but it's true. Low stomach acid can actually trigger acid reflux. And so a lot of people who are dealing with acid reflux are actually using antacids, when in reality what they're doing is making the condition worse. And they should be using things like apple cider vinegar and aloe vera, et cetera, betaine, hcl to acidify the contents in the stomach. And then if you want it, topical strategy for actually for, for rosacea. Can't really do much about the redness itself, although there are a few anti redness ingredients. But the redness is actually the body trying to deal with the problem. So you don't really want to suppress the, the redness. The redness is the body's coping strategy. But there, there are secondary oils that are produced and a lot of times rosacea patients will have oily skin and even breakouts. And those can be addressed topically with things like salicylic acid for, for the sebaceous secretions or alpha hydroxy acids in general. And then you're not going to really. One of the, and you've probably seen this where people have breakouts along the lymphatic area in that band that I'm talking about, that belt across the face. And they're trying to use benzoyl peroxide and retinoic acid. That doesn't really work that effectively. But sebum, you can use things like alpha hydroxy acids and even salicylic acid to get rid of sebaceous secretions.
- [13:45]
Maggie Stasik
That concludes our show for today, and we thank you for listening. But if you just can't get enough of Ben Fuchs, the ASCP's rogue pharmacist, you can find him at truthtreatments. Com. For more information on this episode, or for ways to connect with Ben Fuchs, or to learn more about ascp, check out the show notes.