Case Report: Naturopathic Treatment for Rashes

The following is a naturopathic case report summary of a patient with rashes, and no overtly apparent cause. She received nutrients, medications, and dietary counseling from a naturopathic doctor overseeing her care. There are many layers of a naturopathic approach to and this is just one of the many ways these types of symptoms can be diagnosed and treated. This case report is for informational purposes only and should not be used to diagnose or self-treat for this or any other condition. 

Here’s What We Know

  • Unexplained rashes may be a symptom of a larger health issue.
  • Gut microbiome imbalance may cause symptoms that show up outside of the digestive system.

Hypothesis for Treatment: Under a doctor’s recommendation, restoring the microbiome imbalance (when bad gut bacteria outnumber good gut bacteria) with nutrients, medications, and dietary changes, may safely resolve unexplained skin rashes.*

An Itchy, Burning Rash That Spread Across Her Body

When 32-year-old LS** first came to see Dr. Alisha Ghajar, ND, she was frustrated. 

One month earlier, LS awoke with a red, itching, burning rash on her neck and hands. She had eaten Thai food the night before, but that was nothing unusual. She often enjoyed this spicy cuisine. Over the past month, the rash had slowly spread to the rest of her body. 

When an internist prescribed steroid medication in both pill and cream form. LS declined the pill. And although she used the cream, she only gained minimal relief. 

LS noticed her rash worsened after eating spicy foods, during times of stress, and when her body became overheated. She found temporary relief by applying moisturizers, ice packs and taking cold showers.

A microbiome imbalance in the body can cause rashes on the skin

Delving into her past, Dr. Ghajar could not see a history of rashes or extreme allergic reactions (anaphylaxis). One year earlier, LS woke up vomiting almost every morning for a month. An internist ruled out pregnancy, appendicitis, and gallstones. Thorough blood testing was done, which came back normal. Unfortunately, by the time she got an appointment with a gastroenterologist, her symptoms had disappeared, and she did not pursue further testing. 

During this first appointment, LS reported several symptoms in addition to the rash. She was frequently tired, and her migraines were getting worse. She couldn’t think clearly, felt light-headed, and had chemical sensitivities (chemicals such as paint and perfume may cause headaches, brain fog, and other symptoms). She had a history of summer allergies. Particularly troubling, she would wake up vomiting once or twice a week, every three to four weeks. At times, she felt a sharp stomach pain after eating, which would last for a few minutes. 

Despite the stomach pains, Dr. Ghajar noted LS was not experiencing constipation, diarrhea, or heartburn when assessing digestive symptoms.

When assessing potential food allergies, Dr. Ghajar noted her diet was varied, with no food restrictions. She did not experience severe allergic reactions such as shortness of breath or swelling of her eyes, throat, or tongue. 

When looking at her chemical sensitivities, Dr. Ghajar noted LS used only unscented cleaning products and laundry detergent designed for sensitive skin. LS told her doctor that she had not started using any new personal care products. 

LS worked from home for a software company and had not recently traveled. She lived with her partner, who reported no illness or rashes.

Her physician’s complete physical exam revealed a red rash across her entire body, including the palms of her hands and soles of her feet. Only her face was spared. Except for frequent throat clearing and a mild cough when laughing, all other exam findings were normal.  

What Happens in the Gut, May Not Stay in the Gut

Dr. Ghajar gained a great deal of information at this first visit. But there were more questions than answers. Dr. Ghajar took all her symptoms and history into account explored a few potential causes. 

Gluten in bread could over stimulate the immune system and create a gut imbalance and cause rashes.

Could the rash result from an allergy to foods like gluten, or another substance? Due to her ongoing nausea and vomiting, Dr. Ghajar also suspected an imbalance in her gut microbiome. It is common that when bad gut bacteria outnumber good gut bacteria, a gut-related infection could be a factor.  

To narrow down the options, Dr. Ghajar ordered a lab test to assess whether she had celiac disease (when eating gluten over stimulates the immune system and causes small intestine damage). She also ordered a DNA stool test to see what was going on in her gut. 

LS did not have insurance at the time, so the cost was a concern. Until the test results came back to shed more light on the potential causes of the rash, Dr. Ghajar advised LS to take over-the-counter allergy medications loratadine (Claritin) or diphenhydramine (Benadryl) daily, which would test whether seasonal allergies were contributing to the rash. 

When LS returned for her second visit two weeks later, she reported mixed results. The good news? She hadn’t experienced any nausea or vomiting. The bad news? Although taking diphenhydramine every night eased the rash for a short time, it was no longer working. 

Dr. Ghajar also had news to share. The lab test results were back, celiac disease was ruled out. LS’ recent experience also ruled out seasonal allergies. The DNA stool test was more telling. It turns out that LS had an H. Pylori (bacterial) infection. No antibiotic-resistant genes were identified, which means that the strain of H. Pylori in her gut would likely respond well to antibiotic treatment. 

H. Pylori is best known for raising peptic ulcer risk. It weakens the stomach lining and the first part of the small intestine, allowing acid to enter causing ulcers to develop. But LS had seen other doctors – how did they miss this bacterial infection?

Dr. Ghajar knew that in conventional medicine, doctors are unlikely to test for H. Pylori unless the patient shows signs of peptic ulcers. She also knew several studies had linked skin diseases like rosacea and psoriasis with H. Pylori infections. 

With a new focus on H. Pylori, Dr. Ghajar advised LS of two treatment options: an herbal combination or triple therapy (the first-line conventional treatment that is a combination of antibiotics and medications that reduce stomach acid). 

LS was in significant discomfort from the rash and preferred pharmaceutical treatment. By this time, she had secured insurance which included drug coverage, but it did not cover herbal therapies. LS opted for triple therapy and was prescribed a combination of three medications— clarithromycin, metronidazole and omeprazole, for two weeks. 

Dr. Ghajar also knew that H. Pylori could form biofilms – a sticky layer that protects bacteria from the body’s efforts to get rid of them. Research shows that biofilms can make bacterial infections harder to treat by making them resistant to antibiotics and generally allowing bacterial growth to get out of control. Although the DNA stool test showed that LS was not harboring antibiotic-resistant H. Pylori, she was keen to address the potential impact of biofilms. Dr. Ghajar prescribed a supplement containing a mix of enzymes designed to eradicate existing biofilms and prevent new ones from forming. 

Dr. Ghajar also advised LS to support her liver’s detoxification abilities by cutting out processed foods and alcohol, and eating more cruciferous vegetables (like broccoli and cabbage), whole grains and grass-fed, free-range protein. 

But Dr. Ghajar didn’t rule out that her rash was solely related to H. Pylori, at least not just yet. With the celiac disease testing coming back negative, she ordered more testing to explore the potential role of other food allergies. 

At her third visit two weeks later, LS had excellent news. Her rash had  started to clear up after just one week of treatment, and only remained on the palms of her hands and her legs.  It wasn’t just the rash that had improved;  her cough was gone, and she no longer needed to clear her throat frequently.  

The food sensitivity testing came back with good news—no food allergies were identified. Best of all,  Dr. Ghajar performed a breath test which showed that LS no longer had an H. Pylori infection. 

At the final visit two weeks later, LS was still going strong. The nausea and vomiting had not returned. Most importantly, the rash was completely gone from all areas of her body.

How a Naturopathic Doctor May Address Unexplained Rashes 

In cases of unexplained rashes where gut microbiome imbalance is a factor, a targeted combination of nutrients, medications and dietary changes may safely clear up rashes. 

After six  weeks of naturopathic treatment, LS’ full-body rash (and the itching and burning sensations) are entirely gone. The troubling nausea and vomiting has not returned, and her cough was resolved.  

Editor’s Note

This case report is not meant to diagnose or treat rashes or any other disease. It is provided for educational purposes only. This case report is a short summary of  one treatment for one patient’s experience and does not reflect a comprehensive naturopathic approach to rashes. Naturopathic medicine is designed to treat each person individually with whole-person care If you are experiencing health issues that need treatment, please consult with a naturopathic doctor right away. 

What does LS’ case tell us about Naturopathic Medicine and unexplained rashes? Here are some key takeaways:  

Naturopathic doctors work with patients to find affordable treatment recommendations. LS’ lack of health insurance in the United States (at the first visit) limited which lab tests could be ordered. Fortunately, LS negotiated lower cost cash-pay labs for some of the tests. When LS did secure insurance, it did not cover herbal treatments. The instead prescribed triple therapy, was both effective and covered by her insurance. 

Naturopathic doctors listen carefully to all symptoms and consider  them into account when exploring diagnosis options. LS had very few signs, symptoms, or risk factors for H. pylori infection. The American College of Gastroenterology released a 2017 guideline for the “Treatment of Helicobacter pylori infection”. Unfortunately, LS would not have qualified for testing under these guidelines. It is only due to the naturopathic principle of Treat the Whole Person that the off-handed mention of intermittent nausea and vomiting was considered a factor for her rash.  Indeed, prior medical visits resulted in steroid prescriptions to suppress inflammation without digging deeper. 

Naturopathic doctors know how to combine pharmaceutical and natural treatment options for complete patient care. Although triple therapy is the gold standard treatment for H. pylori infections, Dr. Ghajar didn’t stop there. Adding an enzyme supplement to rid biofilms and making dietary recommendations to support detoxification represents a truly personalized, integrative medicine approach.

There are over 500,000 people estimated to have chronic urticaria (hives) in the United States,” according to research. Are you wondering if a naturopathic therapy may help you or your loved ones with unexplained rashes? A naturopathic doctor can help. Find a Naturopathic Doctor in your area with our Find an ND search portal.

More Resources from the Institute for Natural Medicine: 

Under What Circumstances Should I Choose to See a Naturopathic Doctor?

Improve the Gut Microbiome Naturally with Naturopathic Medicine


This article is provided by the Institute for Natural Medicine, a non-profit 501(c)(3) organization, partnered with the American Association of Naturopathic Physicians. INM’s mission is to transform healthcare in America by increasing both public awareness of naturopathic medicine and access to naturopathic doctors for patients. INM believes that naturopathic medicine, with its unique principles and practices, has the potential to reverse the tide of chronic illness that overwhelms existing health care systems and to empower people to achieve and maintain their optimal lifelong health. INM strives to achieve this mission through the following initiatives:

  • Education – Reveal the unique benefits and outcomes of naturopathic medicine
  • Access – Connect patients to licensed naturopathic doctors
  • Research – Expand quality research of this complex and comprehensive system of medicine

Clinical References from Dr. Ghajar, ND 
  1. Chey, W. D., Leontiadis, G. I., Howden, C. W., & Moss, S. F. (2017). ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. American Journal of Gastroenterology, 112(2), 212–239.
  2. Chey, W. D., Leontiadis, G. I., et al (2017). ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. American Journal of Gastroenterology, 112(2), 212-239. doi:10.1038/ajg.2016.563
  3. Connor, B. (2017). Helicobacter pylori – Chapter 4 – 2020 Yellow Book | Travelers’ Health | CDC.; Retrieved Sept. 11,2020, from
  4. Gravina, A. G., Zagari, R. M., De Musis, C., Romano, L., Loguercio, C., & Romano, M.

(2018). Helicobacter pylori and extragastric diseases: A review. World journal of

Gastroenterology, 24(29), 3204–3221.

Clinical References from the Editor  
  1. Baj, J., Forma, A., Flieger, W., Morawska, I., Michalski, A., Buszewicz, G., Sitarz, E., Portincasa, P., Garruti, G., Flieger, M., & Teresiński, G. (2021). Helicobacter pylori Infection and Extragastric Diseases—A Focus on the Central Nervous System. Cells, 10(9), 2191.
  2. Cui, Y.-L., Zhou, B.-Y., & Gao, G.-C. (2021). A systematic review and meta-analysis of the correlation between Helicobacter pylori infection and chronic urticaria. Annals of Palliative Medicine, 10(10), 10584–10590.
  3. Essrani, R., Sullivan, M., & Shah, H. (2019). Chronic Urticaria Associated with Helicobacter pylori. Cureus.
  4. Fauzia, K. A., Miftahussurur, M., Syam, A. F., Waskito, L. A., Doohan, D., Rezkitha, Y. A. A., Matsumoto, T., Tuan, V. P., Akada, J., Yonezawa, H., Kamiya, S., & Yamaoka, Y. (2020). Biofilm Formation and Antibiotic Resistance Phenotype of Helicobacter pylori Clinical Isolates. Toxins, 12(8), 473.
  5. Gravina, A. G., Priadko, K., Ciamarra, P., Granata, L., Facchiano, A., Miranda, A., Dallio, M., Federico, A., & Romano, M. (2020a). Extra-Gastric Manifestations of Helicobacter pylori Infection. Journal of Clinical Medicine, 9(12).
  6. Gravina, A. G., Priadko, K., Ciamarra, P., Granata, L., Facchiano, A., Miranda, A., Dallio, M., Federico, A., & Romano, M. (2020b). Extra-Gastric Manifestations of Helicobacter pylori Infection. Journal of Clinical Medicine, 9(12).
  7. Guarneri, C., Ceccarelli, M., Rinaldi, L., Cacopardo, B., Nunnari, G., & Guarneri, F. (2020). Helicobacter pylori and skin disorders: a comprehensive review of the available literature. Eur Rev Med Pharmacol Sci., 24(23), 12267–12287.
  8. Hathroubi, S., Servetas, S. L., Windham, I., Merrell, D. S., & Ottemann, K. M. (2018). Helicobacter pyloriBiofilm Formation and Its Potential Role in Pathogenesis. Microbiology and Molecular Biology Reviews, 82(2).
  9. Krzyżek, P., Grande, R., Migdał, P., Paluch, E., & Gościniak, G. (2020). Biofilm Formation as a Complex Result of Virulence and Adaptive Responses of Helicobacter pylori. Pathogens, 9(12), 1062.
  10. Lewinska, A., & Wnuk, M. (2017). Helicobacter pylori-induced premature senescence of extragastric cells may contribute to chronic skin diseases. Biogerontology, 18(2), 293–299.
  11. Santos, M. L. C., Brito, B. B. de, Silva, F. A. F. da, Sampaio, M. M., Marques, H. S., Silva, N. O. e, Queiroz, D. M. de M., & Melo, F. F. de. (2020). Helicobacter pylori infection: Beyond gastric manifestations. World Journal of Gastroenterology, 26(28), 4076–4093.
  12. Zhang, C., & Wei, Y. (2021). Association Between Helicobacter pylori-Negative Peptic Ulcer Disease and Chronic Urticaria: A Retrospective Observational Study. Clinical, Cosmetic and Investigational Dermatology, Volume 14(14), 1637–1643.

Anna-Liza Badaloo is a writer and program consultant, working at the intersection of health, environment, and social justice. With over 10 years of experience at non-profit organizations, she brings a combination of content writing, copywriting, and journalism to her work. Using her strong storytelling ethic, Anna-Liza strives to amplify traditionally silenced voices such as BIPOC, youth, and 2SLGBTQIA+ communities.

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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

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Michelle Simon

Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.