Rosacea and Diet: What Do We Know?

Conceptual shot of Acne & Problem Skin on female face.
Alcohol and fatty foods have shown the potential to trigger rosacea flare-ups, while certain supplements have shown promise in reducing symptoms.

Rosacea, an inflammatory skin condition that causes a rash and reddened skin, can leave patients in long-term pain and discomfort.¹ This can be exacerbated in the event of ocular rosacea, in which a patient’s eyes are left sore and itchy with the potential to develop styes. 

Rosacea does not have a known cure, but combinations of medical treatment and self-care can mitigate symptom burden. Your patients may want to know what they can do to help alleviate rosacea symptoms and what they should do to reduce their risk.

Dietary choices have shown to play a potential role in triggering rosacea flares, though it isn’t quite known how much of an impact they can have. What do we know about diet and rosacea? Can certain foods help or hurt symptoms?

Are There Foods That Help Rosacea?

Research has not shown much regarding the ability of food to help alleviate rosacea symptoms. However, there are a number of vitamins and supplements that have shown promise as a result of the healthy fats and nutrients they contain.² 

In December 2021, researchers published a review in the Journal of Clinical and Aesthetic Dermatology highlighting the findings from different studies regarding the effects of foods on rosacea.³ These are the supplements that they found had potential benefits for patients.

Omega-3 Fatty Acids

The researchers found that omega-3 fatty acids consistently showed benefits for patients with ocular rosacea. Patients who present ocular symptoms for rosacea, they claimed, often found positive results from taking supplemental omega-3 fatty acid capsules, which improved dry eye symptoms.

Probiotics and Prebiotics

It has been suggested that an imbalance in gut microbiome may play a role in triggering rosacea flare-ups.² Probiotics have shown to both alter gut microbiome and reduce inflammation, both of which may be able to help lessen rosacea symptoms.³

Prebiotics, like probiotics, have also shown to alter gut bacteria. Many dietary plant fibers have shown to act as prebiotics in stimulating gut microbiome, improving overall gut health, which may help rosacea.⁴

Dairy

Some foods have shown varying results that make it hard to conclude that they can definitively affect rosacea in one way or another. Dairy has particularly inconsistent results. Some have suggested that dairy can be a rosacea trigger³; however, a 2019 study in the Journal of Dermatology found dairy to have a significant negative correlation with rosacea severity.⁵

Are There Foods That Make Rosacea Worse?

While some supplements have shown promise in helping rosacea, there are many foods patients should avoid if they’re looking to greatly reduce the number of flare-ups they have. Here are some of the foods and beverages linked to rosacea flares.

Spicy Foods

Studies have varied on the severity of spicy foods on rosacea. The aforementioned Journal of Dermatology study suggested that while spicy foods may aggravate symptoms like flushing, it could be independent of rosacea subtype.⁵ However, health care professionals generally warn patients with rosacea to avoid spicier foods. In particular, foods with capsaicin may affect rosacea due to its ability to affect pain receptors triggered by warmth.² This includes chili peppers, hot sauce, and jalapenos.

Alcohol

Alcohol — wine and liquor in particular — is one of the most common rosacea triggers.³ Even a small amount of alcohol can correlate with an increase in rosacea incidence for symptoms like flushing, with the positive correlation increasing in severity the more alcohol is consumed.

Fatty Foods

Diets high in fatty foods can often cause chronic inflammation, and as such can correlate positively with an increase in rosacea symptoms and severity.³ Health care professionals should recommend that patients with rosacea avoid frequent consumption of fatty foods.

Histamine

Patients with rosacea should also avoid consuming anything rich in histamine or that can cause a release of histamine into the body. Those with allergies or histamine intolerance may be prone to rosacea flare-ups as a result. Some of the foods and beverages that should be avoided include:⁶

  • Alcohol
  • Dried fruits
  • Shellfish
  • Aged cheese
  • Avocados
  • Processed meats
  • Chocolate
  • Bananas
  • Citrus fruits
  • Beans

Cinnamaldehyde

Some of the previously mentioned foods, like chocolate and citrus fruits, may also trigger rosacea symptoms because they contain cinnamaldehyde.² Cinnamaldehyde is the compound that helps gives cinnamon its flavor, but is also found in a number of other foods such as tomatoes. The warming sensation of cinnamaldehyde can potentially trigger rosacea symptoms.

While many of these foods have the potential to trigger rosacea symptoms, patients should also know that not everyone with rosacea has the same triggers. Some will have more or less pronounced flares from these foods than others. Patients will have to find out what does and does not affect their symptoms, and discuss the matter with their health care professional.

References:

  1. Acne rosacea causes, symptoms & treatment. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/rosacea. Updated May 2021. Accessed November 7, 2022.
  2. Iftikhar N. How your diet may help reduce rosacea flare-ups. Healthline. https://www.healthline.com/health/rosacea-diet. Updated February 1, 2021. Accessed November 7, 2022.
  3. Searle T, Ali FR, Carolides S, Al-Niaimi F. Rosacea and diet: what is new in 2021? J Clin Aesthet Dermatol. 2021 Dec;14(12):49-54. PMID: 35096255; PMCID: PMC8794493.
  4. Weiss E, Katta R. Diet and rosacea: the role of dietary change in the management of rosacea. Dermatol Pract Concept. 2017 Oct 31;7(4):31-37. doi: 10.5826/dpc.0704a08. PMID: 29214107; PMCID: PMC5718124.
  5. Yuan X, Huang X, Wang B, Huang YX, Zhang YY, Tang Y, Yang JY, Chen Q, Jian D, Xie HF, Shi W, Li J. Relationship between rosacea and dietary factors: A multicenter retrospective case-control survey. J Dermatol. 2019 Mar;46(3):219-225. doi: 10.1111/1346-8138.14771. Epub 2019 Jan 18. PMID: 30656725.
  6. Anthony K. Histamine intolerance: causes, symptoms, and diagnosis. Healthline. https://www.healthline.com/health/histamine-intolerance. Updated March 7, 2019. Accessed November 8, 2022.