Rosacea can be classified in 4 stages. The first stage is characterized by redness on the cheeks, nose, chin or forehead, occasional flushing, and permanent redness. The second stage is characterized development of pimples called acne rosacea. The third stage entails broken and enlarged blood vessels that are readily visualized in affected area. The fourth stage involves development of scar tissue called “rhinophyma.” While the only treatment option for the fourth stage is surgical intervention, stages 1 to 3 are traditionally managed by the uses of topical metronidazole, oral tetracycline, and oral retinoid. Many environmental triggers are known to aggravate rosacea. The list includes strenuous exercise, excessive sun exposure, stress, anxiety, cold, heat, alcohol, caffeine, foods high in histamines and spicy food. Rosacea is thought to be inflammatory condition of unknown cause. Many possible causes have been described as inducing the disease or contributing to its manifestation, such as genetic predisposition, abnormal vascular reactivity, changes in vascular mediating mechanisms, Helicobacter pylori infection, Demodex folliculorum infestation, seborrhea, sunlight, hypertension, and psychogenic factors. It has been suggested that dermal stimulation causing flushing and blood vessels damage in rosacea is, in fact, caused by inflammation from hypersensitive sensory nerve cells. This neurological inflammation is caused by signal proteins and peptides released due to overgrowth of bacteria in the digestive tract. Indeed a recent clinical confirms that rosacea patients exhibit a very significant bacterial overgrowth in the small intestine and the eradication of this overgrowth results in complete remission of symptoms in 96% patients without additional treatments. Successful management of rosacea requires careful patient evaluation and individualized therapy with appropriate variations and modifications, as the severity of the disorder fluctuates. The rosacea treatment program at Skinlife Vancouver entails gastrointestinal, neurological, and dermatological rehabilitation. Relevant laboratory evaluations are utilized to identify underlying gastrointestinal imbalances such as bacterial overgrowth and intestinal permeability. Based on laboratory and clinical findings, most appropriate medications and supplements are chosen to correct underlying gastrointestinal imbalances and to minimize nerve cell involvement. In the meantime, any active dermatological manifestations of rosacea are treated with topic and oral medications, vascular lasers, and intensive pulsed light therapy to improve cosmetic appearance.