Foods to Eat and Avoid to Reduce Flares

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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.”



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