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Rosacea Diet: Foods to Eat and Avoid to Reduce Flares

Trying to keep your rosacea from flaring up? You may want to take a look at your diet.

Rosacea is a common skin condition that causes flushing or redness on the face. You may also notice visible blood vessels, small bumps on your face, and thickening of the skin on your nose.

While the cause of rosacea is unknown, different factors can trigger the condition in different people. These triggers include spicy food, hot drinks, and alcohol.

Here, we look at what to eat and drink and what to avoid to prevent your rosacea from flaring up.

Different foods and drinks may trigger a rosacea flare-up for different people, but some seem more likely to cause a reaction.

According to one review, the most commonly reported triggers for rosacea include alcohol; spicy food; hot drinks; histamine-rich foods, such as aged cheese, wine, and processed meats; and cinnamaldehyde-containing foods, such as tomatoes, citrus fruits, and chocolate.

Here’s a closer look at some of the most common food and beverage triggers for rosacea:

Alcohol

Tingwei Zhang, deputy chief physician in the department of dermatology and plastic surgery at Zibo Municipal Hospital in Shandong, China, and former visiting scholar at the Nell Hodgson Woodruff School of Nursing at Emory University in Atlanta, advises people with rosacea to “limit alcoholic beverages, especially red wine.”

When the body processes alcohol, it releases histamine, a chemical that plays a role in the immune system, leading to swelling and other symptoms. Histamine is believed to affect the blood vessels under the skin, resulting in flushing.

“Alcohol can dilate blood vessels and increase blood flow to the face, exacerbating redness and flushing reactions. Red wine, in particular, contains a lot of histamine, which can trigger inflammatory responses and is not very friendly for rosacea patients,” says Dr. Zhang.

In a past National Rosacea Society survey of 1,066 people with rosacea, the most common rosacea triggers included alcohol (52 percent of respondents), particularly wine (red was said to be worse than white wine) and spirits.

The following tips may help you avoid rosacea symptoms when drinking alcohol:

  • Opt for white wine instead of red.
  • Add soda or lemonade to alcoholic beverages to reduce the amount of alcohol.
  • Limit yourself to one or two alcoholic drinks and have a large, cold glass of water after each one.
  • Experiment with mocktails or nonalcoholic beers and wines to avoid alcohol.

Spicy Foods

Many people with rosacea say spicy food can trigger a flare. In another past NRS survey of more than 400 people with rosacea, 78 percent of respondents said they had changed their diet to control their rosacea, and a whopping 75 percent cited spices as triggers. Specifically, 54 percent cited hot sauce, 47 percent cited cayenne pepper, and 37 percent cited red pepper as triggers.

Research suggests that capsaicin — the organic compound that gives chilis and some other spicy peppers their “hotness” — might activate nerve cells known as TRVP1 receptors, causing your blood vessels to dilate and your face to flush.

“Try to avoid spicy foods as much as possible, like chili peppers and hot sauces,” advises Zhang. “These types of foods can stimulate the nerve endings in your skin, leading to facial vasodilation. The capsaicin in chili peppers can cause the skin to feel hot, especially in patients with rosacea, as their skin is very sensitive to heat and irritation. After eating spicy foods, it’s likely you'll experience increased redness and warmth.“

To avoid rosacea flare-ups from spicy foods, use milder spices such as cumin or turmeric. Or flavor dishes with herbs instead of spices.

Certain Fruits and Vegetables

Foods containing cinnamaldehyde, the compound that gives cinnamon its flavor but is also present in other foods, were also cited as rosacea triggers in the NRS survey of more than 400 people.

These foods, including cinnamon, tomatoes, citrus fruits, and chocolate, may affect sensory nerves in the skin, causing blood vessels to dilate. This can lead to redness, spider veins (visible blood vessels), swelling, and flushing.

If you have rosacea, you may want to avoid consuming these foods.

Hot Drinks

Hot drinks warm the body, dilating blood vessels. In people with rosacea, this can cause flushing and spider veins.

In the past NRS survey of more than 400 rosacea patients, respondents cited hot coffee (33 percent) hot tea (30 percent) as triggers.

To reduce the negative effects of hot drinks on rosacea, try these tips:

  • Opt for iced tea or coffee.
  • Let hot beverages cool before drinking them.

Histamine-Rich Foods

As mentioned above, foods that contain or increase levels of histamine may worsen rosacea symptoms such as flushing.

“Fermented and pickled foods are rich in histamine, such as sauerkraut, pickles, aged cheese, and cured meats,” says Zhang. “These foods accumulate histamine during fermentation, and the skin of rosacea patients is often sensitive to histamine, which can easily cause symptoms like redness and stinging.”

Fatty Foods

One large study in China found that people with rosacea who frequently consumed fatty food, such as fatty meat, fried food, and lard, had worse symptoms than those who didn’t, possibly due to inflammation.

While a fatty diet may cause an imbalance in the skin and compromise the skin barrier, leading to rosacea symptoms such as pain, burning, and stinging, not enough research has been done on fatty foods and rosacea to fully understand why this happens.

Niacin

Niacin, or vitamin B3, is another reported rosacea trigger, because it causes blood vessels to dilate, promoting redness, flushing, and stinging. Niacin-rich foods include liver, chicken breast, salmon, peanuts, and tuna. However, definitive evidence that niacin-rich foods trigger rosacea is lacking.

Other Possible Triggers

According to case reports or small studies, other possible food triggers for rosacea include:

  • Yogurt
  • Eggplant
  • Spinach
  • Lime
  • Soy sauce
  • Yeast products
  • Cream
  • White beans
  • Peas
  • Avocadoes
  • Bananas
  • Plums
  • Raisins
  • Figs
  • Vanilla
  • Vinegar
  • Foods high in sugar

“High-sugar foods, like desserts and pastries, can cause fluctuations in blood sugar, leading to increased insulin secretion. Insulin can stimulate the production of inflammatory factors, worsening skin inflammation,” says Zhang.

How to Identify Your Food Triggers

Figuring out what improves and worsens your rosacea symptoms can help you pinpoint your triggers. If you’re unsure what’s triggering a flare-up, try cutting out foods one by one for a while to see if it makes a difference.

“Since triggers can vary between individuals, an elimination diet may be helpful,” says Jennifer Frediani, PhD, RD, assistant professor and nutrition scientist at the Emory Nell Hodgson Woodruff School of Nursing in Atlanta.

“To do this, start keeping a symptom diary,” suggests Dr. Frediani. “Track your meals, especially common triggers like spicy foods, alcohol, and hot beverages. Also keep track of any symptoms you have around the same time as your meals, or at least within the same day. After a few weeks take a look back at your diary. Do you see any patterns around certain foods? If so, those could be your triggers. Try to stay away from those particular foods and see if your symptoms improve.”

It can take time and patience to work out which foods make a difference. Cutting out items for a short time might not have an effect, while eliminating too many at once means you won’t know which one was the trigger. Avoiding too many foods could also negatively affect your nutritional intake.

“Dietary adjustments should be a gradual process,” explains Zhang. “You can try to reduce your intake of these foods and observe your skin's response. For example, limit spicy foods and alcohol intake for a week and then monitor your skin condition. If there’s no significant reaction, enjoying them in moderation is fine. The key is to identify your skin's sensitivities and maintain a balanced diet.”

Certain foods can actually help alleviate rosacea symptoms, says Zhang. “We can improve skin condition by incorporating some anti-inflammatory and nutrient-rich foods,” he explains.

Some of these foods include:

Omega-3 Foods

Omega-3 fatty acids are present in plant oils, such as flaxseed and canola oils, walnuts, and oily fish, such as salmon and sardines. Among other things, they help keep blood vessels and the immune system healthy.

“Foods rich in omega-3 fatty acids can help reduce inflammatory responses in the body, alleviating redness and stinging sensations in the skin,” says Zhang.

Dietary Fiber and Whole Grains

Foods rich in dietary fiber (fruits, veggies, nuts, seeds, and grains) and whole grains (brown rice, oatmeal) can benefit gut health, which may play a role in inflammation, says Zhang.

“Foods rich in dietary fiber are beneficial for rosacea,” he explains. “Dietary fiber promotes gut health and the growth of beneficial bacteria. The health of the gut can influence the skin's inflammatory response, so improving gut health through dietary fiber can help relieve symptoms.”

Probiotics

There is some evidence suggesting that the relationship between skin and gut microbiota, called the gut-skin axis, may play a role in rosacea.

One way to maintain a healthy gut microbiome may be to consume probiotics or prebiotics.

Probiotics contain live organisms that can help improve the gut microbiome. Yogurt and sauerkraut are examples of probiotic foods.

Prebiotics act as “food” for these organisms. They include high-fiber foods such as whole grains and vegetables.

“Foods containing prebiotics and probiotics, such as yogurt and low-sugar kefir, can help regulate gut microbiota, indirectly benefiting the skin's immune response,” says Zhang. “Prebiotics and probiotics can improve the gut barrier, reducing the impact of inflammation on the skin.”

While there is some evidence that probiotics can help treat chronic inflammatory conditions such as rosacea by reducing inflammation, improving the skin barrier, and reducing blood vessel dilation, swelling, and other symptoms, more research is needed.

Caffeine

While hot drinks are a known rosacea trigger, one large cohort study found a significant association between decreased rosacea risk and increased caffeine intake, particularly from coffee.

Caffeine is known to decrease vasodilation — or prevent the blood vessels from dilating — and suppress the immune system, which could help prevent rosacea symptoms. However, people with rosacea may still want to avoid hot coffee, because hot drinks are a known trigger.

Dairy

The previously mentioned Chinese study found evidence that dairy products might be good for people with rosacea.

However, research on links between dairy and rosacea is very limited, and there is some evidence that dairy can actually be a rosacea trigger for some people.

Antioxidants

Antioxidants, present in many plant-based foods, help combat free radicals, which are byproducts of natural bodily processes. The body usually eliminates them, but sometimes levels rise too high and become toxic. This is called oxidative stress. Oxidative stress can lead to inflammation, tissue damage, and other issues.

Getting enough antioxidants can help prevent oxidative stress, and research suggests dietary antioxidants may help improve quality of life in people who have rosacea.

Sources of antioxidants include fruits, vegetables, and other plant-based foods. “Foods high in antioxidants, such as blueberries, strawberries, spinach, and carrots, are good [for rosacea],” says Zhang. “These foods are rich in vitamins C, E, and carotenoids. Antioxidants neutralize free radicals, which can worsen skin stress and inflammation. Therefore, eating more antioxidant-rich foods can help balance the skin's condition and reduce inflammation.”

The exact cause of rosacea is still unknown, but it could be due to an interplay between environmental and genetic factors, which may lead to an increased immune response, affecting the blood vessels and leading to rosacea symptoms.

While different foods and drinks are believed to be triggers, there is still a lack of evidence definitively showing that dietary factors cause rosacea.

  • Rosacea is an inflammatory condition that causes facial flushing and other symptoms.
  • Certain food and drinks may trigger rosacea flares.
  • Avoiding alcohol, spices, hot drinks, processed meats, and other foods and beverages may help reduce rosacea symptoms.
  • Foods containing omega-3 fatty acids, antioxidants, and dietary fiber may help prevent rosacea flares.

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