Can Your Daily Diet Trigger—or Heal—Rosacea?
Some of your favorite spices and snacks have been shown to cause flares. The science is still out, however, on whether other foods can stop an attack in its tracks.by Barbara O'Dair Health Writer
Rosacea is a chronic, inflammatory skin condition without a cure, unapologetically announcing itself where everyone focuses their immediate attention: your face and eyes. Which can make you feel like you can run but you can’t hide from the obvious red bumps, swelling pustules, and broken blood vessels that trail across your nose, cheeks, and forehead, and even emerge sometimes in your tear ducts during a rosacea flare.
The good news: There are medications and drug therapies that can help ease these symptoms. But can you help decrease the severity and frequency of rosacea attacks naturally? Do the common foods you eat every day play a role, either by triggering fresh flareups or helping tame existing ones?
The science isn’t conclusive on this, as even the underlying causes of rosacea remain murky. Affecting more than 16 million people in the U.S.—most whom are aged 30 to 50, female (although when men do get it, it tends to be more severe), and fair-skinned—this condition may be the result of “a combination of underlying genetic susceptibility, dysregulation of the immune system, which causes a lot of inflammation in the skin, and imbalance in the natural microbiome of both skin and gut,” says Teo Soleymani, M.D., Health Sciences Clinical Instructor, Dermatology at UCLA’s David Geffen School of Medicine.
In other words, rosacea may be the result of biology and the environment crashing—and then clashing—leaving you with the flushing, blushing, sometimes painful, and occasionally scarring results. With multiple factors likely at rosacea’s root, the impact of diet (and how it potentially soothes or, conversely, stirs things up) is just one area of concern and ongoing study. Keep reading. We’ll tell you all we know.
Foods to Avoid if You Have Rosacea
According to a 2017 study published in Dermatology Practical and Conceptual, “certain foods and beverages may act as ‘triggers’ for rosacea exacerbations.” Many leading experts buy into the food-trigger theory. “If you change your diet to avoid [specific foods], it definitely helps,” says Elika Hoss, M.D., a dermatologist and assistant professor for Mayo Clinic Alix School of Medicine in Scottsdale, AZ. In addition to other known rosacea triggers such as sunlight, stress, and intense exercise, a handful of aggravating foods are right up there on the known offenders’ list, she adds.
Still, even triggering foods are not universal among people with this condition. “What …to avoid depends on the person,” says Anne Chang, M.D., a dermatologist at Stanford Health Care in Palo Alto, CA. The best way to determine the food-skin connection is to test different foods and determine which substances seem to trigger flares in you, then cut that food from your diet. Keeping a journal of everything you eat will help you figure out which foods are problematic. “If spicy food is a trigger, try to avoid that,” Dr. Chang suggests.
In the end, “there is not a diet that will mitigate the rosacea problem," says Dr. Soleymani. "But there are definitely categories of food that will exacerbate any existing skin disease.”
It’s also important to know the usual triggering suspects—for instance, heat is not your friend, so something as innocuous as a steaming bowl of soup can quickly put you in the red zone, says Dr. Chang. Let’s take a closer look at some foods you might want to skip if you have rosacea:
Go Easy on Spicy Foods
Along with high-temperature bevvies, other kinds of “hot” substances such as foods that contain capsaicin (a chemical compound that is an active component of chili peppers), are well-known for causing rosacea flares. Capsaicin is a vasodilator, which means it widens the tiny blood vessels under your skin, increasing blood flow, which can contribute to chronic inflammation.
“Spices can activate receptors on nerves in the skin, which releases proteins that dilate blood vessels,” further explains Dr. Hoss. So, the spicy foods that are probably best left alone (or better yet, eliminated altogether) on your spice rack include:
All other spicy ingredients that can cause your blood vessels to dilate
Know These Surprising Food Suspects
But it’s not just spicy foods that can cause you and your skin some grief. Another vasodilator, cinnamaldehyde, is a known trigger, as well. It’s found in:
And, BTW, don’t try to sneak doughnuts or bacon (or even bacon doughnuts), either: Foods high in saturated fats can cause inflammation, which has been linked with rosacea (and other skin disorder) flares. Processed foods and refined sugars are also big no-nos.
Limit or Avoid Alcohol
Your favorite buzz-inducing beverages do not directly cause rosacea—remember, there are plenty of teetotalers who have this condition, too—but alcohol is a tried-and-true trigger for many folks who battle flareups. One culprit you’ve likely heard of is red wine—more cases of rosacea are triggered by red wine than any other alcohol, largely due to its greater quantities of tyramines and histamines that contribute to redness.
But don’t stop there. Be wary of white wine, too, as well as beer, champagne, vodka, tequila, bourbon, and other alcoholic drinks—all dilate your blood vessels, and voila!, your face is on fire. For some people with rosacea, it only takes a single drink to bring on the blush.
These Foods Are Your Friends
So, now you know what you might want to avoid. But can diet actually heal rosacea—or help stop a flare from happening? “It’s not clear,” says Dr. Chang. “I have not seen any systemic studies about foods [that control rosacea]. I don't know of any foods that tame or prevent it.”
On the other hand, there is some recent research linking rosacea and flareups to a higher prevalence of gastrointestinal disorders and bacterial overgrowth. In these cases, foods high in fiber, called prebiotics, may help reduce flares and inflammation. “There’s growing evidence that there’s a connection between gut bacteria and the skin,” says Dr. Hoss. So, while diet may not directly “heal” you, certain foods might help tame inflammation—which just might help your skin.
While prebiotics don't attract as much attention as the bacteria they support (probiotics), they play a crucial role in developing and maintaining a diverse and balanced population of gut bacteria. “Limited studies have shown that a high-fiber, prebiotics diet helps [rosacea],” she adds.
Here are some prebiotic foods to consider adding to the menu:
Foods that are high in omega-3 fatty acids, like salmon and other fatty fish
All “promote growth of good bacteria,” Dr. Hoss says, but she cautions that more clinical trials are needed to make strong recommendations for a particular diet.
Group Support Might Help
As researchers dig deeper into the science behind this stubborn disorder, they will be able to study food triggers along with other smoking guns, so that maybe, someday soon, patients can enjoy their glass of wine, chicken curry, and chocolate cake without looking over one shoulder.
For now, individuals with rosacea may just have to curb their appetites—or deal with the consequences of that delicious bacon doughnut. Some experts suggest finding substitutes for rosacea no-no foods. For instance, replace that cup of boiling caffeine with an iced coffee. It’s the heat, after all, not the rocket fuel you have to fear.
Online support groups for rosacea, some overseen by the National Rosacea Society, can help. “People find support leaning on each other,” says Matt Traube, a marriage and family therapist in Santa Barbara, CA, who specializes in “the psychological aspects of skin.” “They feel less ostracized. It’s also a good way to exchange information—it gets the latest research out there on a patient-to-patient level.”
“You can’t prevent [rosacea],” he says, “but you can manage your relationship with it, which can change the quality of your life.” Overhauling your diet to determine which food triggers tend to set off your condition may be a first step in this regard, with (hopefully) calmer skin the happy result.
- Rosacea in the U.S. Population: National Rosacea Society. (2010). “Rosacea Now Estimated to Affect at Least 16 Million Americans.” rosacea.org/rosacea-review/2010/winter/rosacea-now-estimated-to-affect-at-least-16-million-americans
- Rosacea Basics: American Academy of Dermatology Foundation. (2018). “Skin Conditions by the Numbers.” aad.org/media/stats-numbers
- Rosacea Symptoms: Mayo Clinic. (n.d.). “Rosacea Overview.” mayoclinic.org/diseases-conditions/rosacea/symptoms-causes/syc-20353815
- Ocular Rosacea: American Academy of Ophthalmology. (2020). “Ocular Rosacea.” aao.org/eye-health/diseases/ocular-rosacea-facts
- Immune System and Rosacea: National Institute of Health. (2017). “Diet and Rosacea: the Role of Dietary Change in the Management of Rosacea.” ncbi.nlm.nih.gov/pmc/articles/PMC5718124/
- Abnormalities in Skin Barrier With Rosacea: Anais Brasileiros de Dermatologia. (2016). “Skin Barrier in Rosacea.” ncbi.nlm.nih.gov/pmc/articles/PMC4782648/
- Skin and the Microbiome: Dermatology Times. (2020). “Skin Microbiome Altered in Some Rosacea Sub-Types.” dermatologytimes.com/view/skin-microbiome-altered-in-some-rosacea-subtypes
- Rosacea Myths: National Rosacea Society. (2014). “Debunking the Top Rosacea Myths.” rosacea.org/blog/2014/january/debunking-the-top-rosacea-myths
- Psychology and Rosacea: National Rosacea Society. (2013). “Coping with rosacea: managing psychosocial aspects of rosacea.” rosacea.org/patients/materials/coping/managing.php#Managing
- Rosacea and Flares: American Academy of Dermatology Association. (n.d.). “How to Prevent Rosacea Flare-Ups.” aad.org/public/diseases/rosacea/triggers/prevent
- Bacteria and Rosacea: American Gastroenterological Association. (2008). “Small Intestinal Bacterial Overgrowth in Rosacea: Clinical Effectiveness of Its Eradication.” researchgate.net/publication/5395491_Small_Intestinal_Bacterial_Overgrowth_in_Rosacea_Clinical_Effectiveness_of_Its_Eradication
- Diet and Rosacea: Dermatology Times. (2017). “Diet and Rosacea: the Role of Dietary Change in the Management of Rosacea.” ncbi.nlm.nih.gov/pmc/articles/PMC5718124/
- Foods as Triggers in Rosacea (1): Dermatology Times. (2017). “Diet and Rosacea: the Role of Dietary Change in the Management of Rosacea.” ncbi.nlm.nih.gov/pmc/articles/PMC5718124/
- Foods as Triggers in Rosacea (2): National Rosacea Society. (2018). “Common Connection Between Rosacea Dietary Triggers.” rosacea.org/blog/2018/august/common-connection-between-rosacea-dietary-triggers
- Foods as Triggers in Rosacea (3): National Rosacea Society. (2018). “Common Connection Between Rosacea Diet Triggers.” rosacea.org/blog/2018/august/common-connection-between-rosacea-dietary-triggers
- Wine as a Rosacea Trigger: National Rosacea Society. (2004). “Survey Lists Wine as Top Alcohol Trigger.” rosacea.org/rosacea-review/2004/winter/survey-lists-wine-as-top-alcohol-trigger
- Online Support Groups: National Rosacea Society. (2016). Blog. rosacea-support.org/articles/national-rosacea-society