I have rosacea: This is something I’ve mentioned several times before in my writing. I consider myself lucky because it’s easily masked by a simple wash of BB cream or tinted moisturizer—and for the most part doesn’t come with too many pimple-like breakouts. It’s a mild to (sometimes) moderate case that I find more of an annoyance than anything else.
My biggest grief with my rosacea is that the condition’s most common triggers are so many of the things I love: coffee, spicy food, wine. Well, according to National Rosacea Society grant-funded research that was presented at the American Academy of Dermatology’s recent virtual annual meeting, there are a few other foods and drinks I need to add to the list.
A quick recap: What’s rosacea?
Rosacea is an inflammatory skin condition that affects the appearance of your skin in a variety of ways. It affects anywhere from 1 to 20% of the population and can form on any skin type, gender, tone, or age group.
“The skin is extra sensitive and overly reactive to the environment. Patients typically develop facial redness, flushing, and commonly complain of burning or stinging,” Zeichner adds. Rosacea can also present itself as acne-like bumps, swelling, and uneven texture. “The inflammation caused by rosacea can lead to acne in some patients, called acne rosacea,” says board-certified dermatologist Adarsh Vijay Mudgil, M.D., noting that this type of rosacea is often confused for acne itself. “This is where there is significant overlap, which can understandably lead to confusion.”
A new look at rosacea’s food triggers.
Food, environmental stressors, and lifestyle habits are commonly understood triggers. “We know that sun, hot beverages, chocolate, spicy food, and alcohol—many ‘fun’ things in life can exacerbate rosacea,” Vivian Shi, M.D., associate professor of dermatology at the University of Arkansas for Medical Sciences, said in a statement. “But something that we don’t hear a lot about is that cold and formaldehyde-containing foods may also affect rosacea.”
The first group of triggers is better understood: They cause our outermost layer of your skin cells to produce a pretty fancy-sounding protein called transient receptor potential vanilloid 4 (TRPV4). And this protein? It sets off a chain reaction that ultimately results in the release of histamines and cathelicidins by your skin’s immune system. (You may recognize histamines, for example, from allergy talk.) These substances are what cause the irritation, flushing, and pimple-like bumps.
It turns out that these aren’t the only groups of food and drink to cause flares. Cold drinks, some herbs and spices (mustard oil and a compound found in cinnamon), certain fruits (papayas, oranges, pears, and bananas), and some animal products (milk, fish, poultry) can also give your skin pause—but through an entirely different skin mechanism.
See, formaldehyde occurs naturally in trace amounts in many living organisms. This sounds alarming, but it’s actually a completely normal byproduct in natural foods—and is in such small quantities that it’s not harmful to human health. (Problems arise when it’s used as a preservative in foods and personal care products.)
This group of foods causes the release of another fancy-sounding protein of another name, transient receptor potential alkyrin 1 (TRPA1). This protein, too, releases histamines and cathelicidins, leading to flushing and inflammation, as well as itching sensations.
How to care for your skin.
If you have rosacea, you should be mindful of your triggers as best you can. But every single case is unique—so just because one of your favorite foods makes the list doesn’t necessarily mean it’s affecting you. That’s why it’s so important to try to ID your unique circumstances.
For example, stress is a common flare-up inducer, so you should do your best to develop mindfulness practices to help keep your cortisol levels even and balanced. And, of course, you should keep an eye on your food and drink triggers, but don’t let it consume your life. I still have my morning cup of coffee and margaritas with friends—I just know that it may end up causing a flare-up later in the day. And that’s OK! I just deal with it.
You can also be careful with your skin care practices. The general rule with rosacea is that you should default to gentle cleansers and soothing face creams—and a minimal routine. Introducing too many actives or steps can irritate the skin.
Or try the popular azelaic acid. In patients with rosacea, “neutrophils release proteases that break down collagen and elastin, contributing to swelling and flushing,” says board-certified dermatologist Jessie Cheung, M.D. However, azelaic acid can inhibit the function of these neutrophils, thus reducing inflammatory symptoms. This effect was observed in one study, where azelaic acid gel significantly improved inflammatory lesions in people with rosacea.