Diet and rosacea

Yes. In many people with rosacea, certain foods or drinks can trigger or aggravate the episodes of redness (flushing), the sensation of heat or the inflammatory flares.

However, there is no diet that cures rosacea nor do all patients react the same way.

Therefore, the objective is not to eliminate foods indiscriminately, but to identify those that can act as triggers in each person.

Rosacea is a chronic inflammatory disease of the skin that mainly affects the centre of the face.

It can manifest through:

• Persistent redness.
• Episodes of intense flushing.
• Visible blood vessels.
• Papules and pustules.
• Sensation of burning or stinging.
• Greater skin sensitivity.

Its evolution usually alternates periods of improvement and flares.

Many dietary triggers favour the dilation of the blood vessels of the skin or stimulate certain inflammatory pathways.

In predisposed people this can translate into:

• Greater redness.
• Sensation of heat.
• Worsening of the symptoms.
• Appearance of new flares.

The intensity of this response varies considerably between patients.

The most frequent are:

Alcoholic drinks. Especially red wine, spirits and some fermented drinks. Not all people react the same way.

Very hot drinks. Coffee, infusions or any drink consumed at very high temperatures can favour flushing. Frequently the temperature has more influence than the drink itself.

Very spicy foods. Spiciness is one of the best-known triggers of rosacea. It can provoke an intense vasodilation in sensitive patients.

Very hot foods. Meals served at very high temperatures can also favour facial redness.

Some patients identify a relation with:

• Chocolate.
• Cinnamon.
• Tomato.
• Citrus fruits.
• Vinegar.
• Certain cured cheeses.

However, the scientific evidence is limited and these associations do not appear in all patients.

No.

The current recommendation consists of identifying the individual triggers.

Eliminating foods without reason can make the diet unnecessarily restrictive and difficult to maintain.

Yes. Although it does not cure rosacea, the Mediterranean diet favours a healthy nutritional pattern, rich in:

• Vegetables.
• Fruits.
• Legumes.
• Extra virgin olive oil.
• Fish.
• Natural nuts.

This type of diet can contribute to decreasing the general inflammation of the organism.

In recent years the possible relation between the intestinal microbiota and rosacea has been researched.

Although some studies suggest a connection between the two, there is still not enough evidence to recommend a specific nutritional strategy based on the microbiota for all patients.

Research continues to advance.

Some studies show promising results, but currently there are no universal recommendations to use probiotics in all patients with rosacea.

Many people improve when they:

• Identify their personal triggers.
• Maintain a balanced diet.
• Avoid excessively hot meals.
• Reduce alcohol consumption if they observe a relation.
• Maintain good hydration.
• Control stress.

No.

Diet constitutes a complement to the treatment.

The control of rosacea usually also requires:

• Specific skin care.
• Daily photoprotection.
• Topical treatments when they are indicated.
• Oral medication in some patients.
• Technologies such as IPL or certain lasers to treat the vascular component, when appropriate.

• Myth: All patients with rosacea should stop coffee. Fact: In many cases the problem is the temperature of the drink and not the coffee itself.
• Myth: Wine always worsens rosacea. Fact: It can be a frequent trigger, but it does not affect all people equally.
• Myth: There is a diet that cures rosacea. Fact: Currently there is no diet capable of curing the disease.
• Myth: All spicy foods are forbidden. Fact: They should only be avoided when they trigger symptoms in that specific patient.
• Myth: Eliminating many foods always improves rosacea. Fact: Unnecessary restrictions can be harmful and do not provide demonstrated benefits.

• Diet can influence rosacea, but each patient has different triggers.
• Alcohol, spiciness and very hot drinks are the most frequent triggers.
• There is no diet capable of curing rosacea.
• The Mediterranean diet constitutes a healthy and advisable dietary pattern.
• Identifying the individual triggers is more useful than eliminating numerous foods without reason.
• Diet complements, but does not replace, the medical treatment of rosacea.