Rosacea is a chronic inflammatory skin disease affecting approximately 5.5% of the general population, primarily affecting individuals aged 45–60 years. It presents with persistent erythema, papules, pustules, telangiectasia, and other symptoms, and is often accompanied by ocular rosacea. The disease is associated with various systemic comorbidities, including hypertension, dyslipidemia, cardiovascular diseases, and mental health issues. Rosacea is classified into several subtypes, including erythematotelangiectatic (ETR), papulopustular (PPR), phymatous, and ocular rosacea. The 2017 classification system emphasizes the importance of phenotypic and severity-based diagnosis. The pathophysiology of rosacea involves an imbalanced immune system, vascular and nervous dysfunction, and the role of cutaneous microorganisms. The gut-skin axis, a bidirectional interaction between the gut and skin microbiota, is increasingly recognized in inflammatory skin diseases such as rosacea. Recent advances in next-generation sequencing have provided new insights into the microbiome, but the role of the gut and skin microbiota in rosacea remains underexplored compared to other skin diseases. The gut-skin axis is influenced by genetic, lifestyle, and immune factors, with the skin and gut microbiota playing key roles. The gut microbiota is closely linked to the immune system, and dysbiosis can lead to immune disturbances and inflammatory responses. Probiotics are being explored as a potential therapeutic target for rosacea due to their ability to modulate the gut and skin microbiota. The microbiome of rosacea patients is characterized by a dysbiotic state, with increased levels of certain bacteria such as Demodex mites and Bacillus oleronius. These bacteria can contribute to the inflammatory response in rosacea. The gut microbiota is also involved in the pathophysiology of rosacea, with dysbiosis potentially leading to increased intestinal permeability and translocation of harmful bacteria and compounds into the bloodstream, which can affect skin health. The role of the gut-skin axis in rosacea is complex, with evidence suggesting that probiotics may help modulate the microbiota and reduce inflammation. However, further research is needed to fully understand the mechanisms and develop effective treatments for rosacea.Rosacea is a chronic inflammatory skin disease affecting approximately 5.5% of the general population, primarily affecting individuals aged 45–60 years. It presents with persistent erythema, papules, pustules, telangiectasia, and other symptoms, and is often accompanied by ocular rosacea. The disease is associated with various systemic comorbidities, including hypertension, dyslipidemia, cardiovascular diseases, and mental health issues. Rosacea is classified into several subtypes, including erythematotelangiectatic (ETR), papulopustular (PPR), phymatous, and ocular rosacea. The 2017 classification system emphasizes the importance of phenotypic and severity-based diagnosis. The pathophysiology of rosacea involves an imbalanced immune system, vascular and nervous dysfunction, and the role of cutaneous microorganisms. The gut-skin axis, a bidirectional interaction between the gut and skin microbiota, is increasingly recognized in inflammatory skin diseases such as rosacea. Recent advances in next-generation sequencing have provided new insights into the microbiome, but the role of the gut and skin microbiota in rosacea remains underexplored compared to other skin diseases. The gut-skin axis is influenced by genetic, lifestyle, and immune factors, with the skin and gut microbiota playing key roles. The gut microbiota is closely linked to the immune system, and dysbiosis can lead to immune disturbances and inflammatory responses. Probiotics are being explored as a potential therapeutic target for rosacea due to their ability to modulate the gut and skin microbiota. The microbiome of rosacea patients is characterized by a dysbiotic state, with increased levels of certain bacteria such as Demodex mites and Bacillus oleronius. These bacteria can contribute to the inflammatory response in rosacea. The gut microbiota is also involved in the pathophysiology of rosacea, with dysbiosis potentially leading to increased intestinal permeability and translocation of harmful bacteria and compounds into the bloodstream, which can affect skin health. The role of the gut-skin axis in rosacea is complex, with evidence suggesting that probiotics may help modulate the microbiota and reduce inflammation. However, further research is needed to fully understand the mechanisms and develop effective treatments for rosacea.