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Sufficient evidence exists to support the notion that the gut microbiome plays a role in the inflammatory cutaneous response and there appear to be associations with small intestinal bacterial overgrowth and <jats:italic>Helicobacter pylori<\/jats:italic> infection. A dysbiotic microbiome and an innate immune system dysregulation contribute to the pathophysiology of rosacea, and further exploration of their roles is warranted. Greater understanding of this condition and the effect of the gut\u2013skin axis could allow for more efficacious and timely treatment. 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