- Rosacea triggers cause rosacea symptoms to worsen.
- Common rosacea triggers include food and beverages, sun exposure, stress, weather extremes and some skin care products.
- Through patience and vigilance, it’s possible to avoid or reduce rosacea triggers.
- Adhering to prescribed treatment, combined with reducing exposure to triggers, are important steps toward addressing rosacea.
Rosacea, a chronic skin condition that primarily affects the face, causes skin redness and sensitivity. This condition has no cure and its causes aren’t well understood, but certain foods, beverages, sun exposure and stress are known rosacea triggers.
Because rosacea causes the skin to be more sensitive, people with rosacea may be more susceptible to triggers. Successfully identifying and removing these triggers can help to reduce symptoms and improve the appearance of skin.
It’s unclear what the precise causes of rosacea are, but there are a number of issues that appear to contribute to it. However, as there are potentially multiple factors at play, it’s challenging for dermatologists to pinpoint a definitive cause.
Blood vessel abnormalities are associated with rosacea. When the blood vessels of the face dilate, blood flow to the area increases, resulting in redness and flushing.
Small, protein-like structures called cathelicidins have been identified through research as a potential contributing factor to rosacea’s development. The study’s findings support the widely hypothesized notion that immune system abnormalities may contribute to this condition.
Demodex dust mites
Microscopic dust mites called Demodex may be one cause of rosacea. One study revealed that people with rosacea have significantly higher Demodex counts on their skin and in their eyelashes than those without.
It’s also possible that rosacea could be hereditary. One recent study indicates that genes associated with inflammation could be a contributing factor to rosacea; the condition is passed down from generation to generation.
There are four types of rosacea, each characterized by unique traits. The symptoms you experience depend largely on the type of rosacea you have. Rosacea’s primary characteristics—redness, sensitivity and a warm sensation—span all four types.
Symptoms associated with acne rosacea include:
People with erythematotelangiectatic rosacea (ETR) experience:
- Flushed, red appearance
- Spider veins
- Stinging sensation
- Rough, dry skin
- Redness due to triggers
Ocular rosacea symptoms include:
- Red, itchy eyes
- Eyelid swelling
- Inflammation of the eye’s surface
- Corneal damage
Rhinophyma, is the final stage of rosacea, and is characterized by:
- Disfiguring growth of bumps (nodules) on the lower half of the nose
Many people with rosacea report experiencing worse symptoms after being exposed to certain triggers such as food, beverages, emotional stress, sun exposure and some cosmetics. While each person’s triggers will vary, several common triggers have been reported.
Food and beverages
There is little research on food and rosacea, but the following dietary triggers have been frequently referenced by those with rosacea:
- Alcohol (wine, hard liquor)
- Artificial sweeteners
- Carbonated drinks
- Foods that contain capsaicin (hot peppers, spicy foods)
- Foods that contain cinnamaldehyde (chocolate, cinnamon, tomatoes and citrus)
- Fried foods
- Histamine-releasing foods (fermented foods, dried meats, dairy and some fruits)
- Hot drinks (tea, hot cocoa, coffee)
- Preservatives and food additives
- Processed foods and oils
- Refined sugar and flour
The heat in hot foods and beverages is thought to dilate the blood vessels in the face, bringing more blood to the skin’s surface and triggering worse flushing. Capsaicin found in spicy foods affects the face’s pain receptors, causing a heated sensation.
Of note, a recent study suggests that caffeine, while previously thought to be a rosacea trigger, may actually reduce the risk of rosacea. Caffeine is a vasoconstrictor, which means it may serve to narrow blood vessels. However, caffeinated hot coffee could still trigger a flare due to the temperature.
Unprotected or excessive sun exposure can worsen rosacea symptoms. Sunburns, in particular, further aggravate already inflamed skin.
Feeling stressed or upset can trigger a rosacea flare. The activation of the body’s sympathetic nervous system during stress can trigger inflammation in some individuals with skin conditions. In rosacea patients, this could manifest as redness and dilated blood vessels at the skin’s surface.
Extreme cold, heat or wind can worsen rosacea symptoms, particularly if the humidity is low. This combination can cause exposed skin to become dry and red.
In the case of wind exposure, skin can be wind-burned, which affects the skin similarly to a sunburn; these weather conditions can exacerbate any existing rosacea symptoms.
Skin care products
Common skin irritants that aggravate rosacea symptoms include synthetic fragrances, witch hazel, alcohol, peppermint, menthol and eucalyptus oil. Harsh astringents and many exfoliants may also be damaging to highly sensitive skin.
Various other triggers have been reported to cause rosacea flare-ups. Most involve a rush of blood to the face due to the dilation of blood vessels.
- Health conditions (menopause, chronic cough and caffeine withdrawal)
- Hot baths
- Indoor heat
- Medications (vasodilators, niacin, steroids and beta-blockers)
- Strenuous exercise
Trigger occurrence frequency
The occurrence of rosacea triggers varies in frequency from one individual to the next, but a number of people often report overlapping triggers.
In a recent survey of 1,066 patients, 81% cited sun exposure as a trigger, while 79% said emotional stress was a factor. Other commonly reported triggers included heat (75%), cold (49%), humidity (44%), indoor heat (41%) and wind (57%); strenuous exercise (56%); alcohol (52%), spicy foods (45%) and hot drinks (36%); some skin care products (41%).
The prevalence and commonality of triggers illustrates how challenging it can be to not only pinpoint rosacea triggers, but to eliminate them completely.
Why Do Triggers Worsen Rosacea Symptoms?
Most rosacea triggers appear to worsen rosacea symptoms in several ways: by dilating the blood vessels on the face, irritating the skin or triggering inflammation. Because more in-depth research is needed on this condition and the factors that contribute to it, the reasons for some triggers aren’t yet well understood.
Tips to Avoid Rosacea Triggers
It’s possible to decrease your symptoms by avoiding exposure to rosacea triggers. Identifying your triggers requires vigilance and patience; it can take time to narrow down a long list of possibilities.
- Eliminate specific foods or beverages from your diet that appear to be the issue
- Replace irritating skin care products with soothing ones, preferably fragrance-free and allergy-tested
- Reduce the number of products you apply to your face to decrease your exposure to potential irritants
- Take measures to identify and reduce emotional stressors
- Reduce sun exposure by wearing sunscreen daily; wear a wide-brimmed hat to shield your face if you’re planning to spend a lot of time outdoors
- Protect your face from weather extremes by applying moisturizer, covering your face with a scarf (in the case of cold weather or wind) and limiting your exposure to the elements
- If exercise causes a flare-up, try dividing your workouts into several shorter segments.
- Avoid taking hot baths or showers; opt for a warm bath
- Ask your doctor about changing medications if you suspect your current treatment is ineffective or worsening your rosacea
Identify your triggers
Note those triggers you already suspect. Then, record your flare-ups in a journal with the dates and times they occur along with the potential triggers. Journaling your rosacea flares will give you valuable insights into your triggers.
Another method of identifying your triggers is by elimination. Remove one suspect trigger group, such as foods or beverages, at a time. Wait at least two weeks, and then reintroduce that trigger group, one item at a time. Pay attention to when you have a flare during this process to pinpoint specific triggers.
People with rosacea have reported a number of triggers that cause a symptom flare. Certain foods and beverages, sun exposure, weather extremes, heredity, emotional stress and cosmetic products are among the most commonly reported rosacea triggers. Journaling and carefully observing your symptom flares can help you identify and avoid your triggers.
It’s important not only to identify your rosacea triggers, but also to ensure you treat your rosacea effectively. Your dermatologist will be able to diagnose what type of rosacea you have, prescribe the appropriate treatments and help you identify and eliminate triggers that may be worsening your condition.
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