Acne and rosacea are interesting diseases caused by multiple factors: hormonal disbalance, smoking, wrong diet or cosmetics, stress, and others. There is also strong evidence for the relationship between acne and gut microbiome imbalance. But could Helicobacter pylori, which lives in the stomach, cause flushes and acne flares? Let’s find out!

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What Are Helicobacter Pylori?

Helicobacter pylori are bacteria that infect the stomach. It is estimated that more than half of people worldwide have been infected with H. pylori, but not everybody is aware of them as they might not cause any problems.

Helicobacter Pylori bacteria in the stomach
Helicobacter Pylori (Getty Images via Essentials Collection)

It is not a novel bacterium. Primitive people also had this bacterium. We only found out about them a short time ago. People get infected with H. pylori through direct contact (saliva, stool, vomit) or contaminated food and water.

In some people, H. pylori may cause gastritis, peptic ulcers, and stomach cancer. Moreover, H. pylori bacteria were linked to many skin diseases, including chronic urticaria and thrombocytopenic purpura. Also, a few documented associations were found in patients with atopic dermatitis, cutaneous pruritus, and other skin issues.

Can Helicobacter Pylori Cause Acne?

Regarding stomach problems, we already know that H. pylori bacteria are involved in some issues, and doctors know how to deal with them. But what about acne? Can H. pylori cause acne pimples or comedones?

One study in 2014 first time in history, found a connection between severe acne and H. pylori infection. But there was no apparent link to H. pylori in people with mild or moderate acne. This study was small and limited.

Another study in Egypt found similar results, showing that H. pylori eradication reduced acne lesion count. But again – this a small study.

Although few small studies showed a link between H. pylori and SEVERE acne, further investigations and more extensive studies are needed to confirm this association. There is no evident proof that H. pylori cause acne.

Can Helicobacter Pylori Cause Rosacea?

Rosacea is an inflammatory disease affecting the central part of the face (cheeks, nose, chin, and forehead or the skin around the eyes in some cases). The affected areas look red, with tiny capillaries and telangiectasias, burning sensation is often felt.

Dilated vessels cause increased skin temperature, which leads to Demodex mite overgrowth in the skin. Demodex mites live in hair follicles and can damage them or oil glands, thus causing pimples (papules or pustules) on the face that might look just like acne.

Illustration "Signs of Rosacea"
Signs of Rosacea (Shutterstock)

According to science, H. pylori infection is strongly associated with rosacea. Numerous studies have found that rosacea patients tend to test positive for H. pylori. These bacteria can stimulate the immune system to synthesize many inflammatory mediators causing rosacea inflammation and skin flushing.

H. pylori can cause skin inflammation through two mechanisms:

1. H. pylori increases the nitrous oxide (N2O) concentration, which dilates the vessels and causes facial redness. Also, nitric oxide works as a pro-inflammatory mediator in abnormal situations that triggers inflammation.

2. H. pylori can induce a cytotoxic reaction, turn on cytotoxic genes and induce various inflammatory reactions.

H. pylori infection is more often seen in people with papulopustular rosacea, experiencing facial redness AND pimples.

There is a definite relationship between H. pylori and rosacea; therefore, testing for H. pylori if you have rosacea is advised.

How to Test for H. Pylori?

Positive Helicobacter Pylori test
H.pylori positive test (Getty Images via Essential Collection)

There are several ways to test for H. pylori:

  • Breath test – easy, quick, and reliable test. During the test, you will swallow a substance containing radioactive urea (no worries, urea is very slightly radioactive, so there is no risk to your health). If H. pylori are present, they convert the urea into carbon dioxide, detected in your exhaled breath after 10 minutes. The test can also show if the infection was fully treated. The disadvantage of the test – you need to stop taking some medications up to 2 weeks before the test (antibiotics, proton pump inhibitors (such as omeprazole), and bismuth medicines (such as Pepto-Bismol).
  • Blood test – can show antibodies for H. pylori. The disadvantage of the blood test is that it can be positive for years even after you successfully treat the infection. So, this test cannot be used to confirm the eradication of H. pylori.
  • Stool test – detects traces of H. pylori in the stool. The test can prove the diagnosis of H. pylori and the eradication of the bacteria.
  • Biopsy – the most accurate way to tell if you have H. pylori. During the endoscopy (often called scope), the tissue sample from the stomach lining is taken. It is usually performed for other reasons: to diagnose other gastric diseases or treat bleeding. It is not performed just for diagnosing H. pylori.

How to Treat H. Pylori and How Long Is the Treatment?

If you have tested positive for H. pylori and have this infection, you need a complete eradication of the bacteria.

The treatment usually includes:

  • A course of 2 antibiotics. Usually, amoxicillin, clarithromycin, and metronidazole are prescribed. If the infection is not fully treated, other antibiotics will be prescribed to eradicate H. pylori.
  • A proton pump inhibitor (PPI) medication (more frequently), such as omeprazole, pantoprazole, and lansoprazole, or H2-receptor antagonists (rarely), such as ranitidine, cimetidine. PPI medications block the tiny pumps that produce acid, and H2- receptor antagonists block the action of histamine, which stimulates the stomach to make more acid.
  • Antacids (Bismuth subsalicylate, sold as Pepto-Bismol, Kaopectate, or Maalox Total Relief) may also be given to relieve symptoms in the short term. They neutralize the stomach acid if needed.

The ideal length of treatment ranges from 7 to 14 days, with the evidence that 14 days of treatment show the best results.

At least 4 weeks after treatment, you should test for H. pylori again to ensure that the bacteria were killed entirely and the infection fully treated.

Also, rosacea patients should continue other treatments for their skin. One is acaricide (anti-parasitic), a pesticide that kills mites.

Rosacea Treatment Options
Rosacea Treatment (Shutterstock)

Also, topical azelaic acid gel, topical metronidazole, encapsulated benzoyl peroxide, or performing a salicylic or azelaic acid chemical peel in the office are used to treat rosacea. Read more here.

What Foods or Supplements Kill H. Pylori?

Indeed, some substances in natural products show a potential anti-H. Pylori activity. Here are some examples that have been scientifically proven:

  • Lactoferrin is a body’s natural protein, an immune system component. It allows greater penetration of antibiotics and enhances the eradication rate when combined with antibiotics. It is found in milk (human or cow), but don’t worry about drinking milk – you can take lactoferrin as a supplement.
  • Green tea – inhibits urease and prevents and even eradicates H. pylori infection.
  • Ginger, propolis, turmeric (curcumin), Virgin olive oil, and cranberries are high in polyphenols and show H. pylori growth and enzyme activity inhibition.
  • Broccoli sprout (as a supplement sulforaphane) has a dual action: the anti-H. pylori activity and the blocking gastric tumor formation.
  • Garlic and Chinese chive. The allicin in garlic shows anti-H. pylori activity and synergic effect with omeprazole. The water extract in Chinese chive was stable with low gastric pH.
  • Essential oils. Lemon grass showed the highest activity against H. pylori.


To conclude our question of whether Helicobacter pylori cause acne and rosacea and what to do, the scientific data shows a slight link between severe acne and the infection (mild or moderate acne appears not to have any associations with H. pylori).

However, rosacea is strongly associated with H. pylori, especially in people with papulopustular rosacea. Therefore, testing for H. pylori and eradicating the infection is suggested for rosacea patients.

Tests are quick and easy; treatment is well-researched and does not take too long. Also, other skin treatments are applicable for rosacea patients.

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