Do you suffer from rosacea and are curious about how nutrition affects acne? Read my guide to everything you need to know about diet and rosacea for the latest science-backed information. Learn about dietary triggers for rosacea and how the gut microbiota may play a role.
What is rosacea?
Rosacea is a long-term skin condition that affects women more than men and is more evident on lighter skin tones. It can affect up to 15% of certain populations, with increased prevalence among light-skinned individuals of European origin (1).
The first signs of rosacea are:
- Intermittent redness on the nose, cheeks, forehead and chin
- A burning or stinging sensation on the skin when using water or skincare products
For more information on symptoms, see here.
Why does rosacea occur?
It is not known exactly why rosacea occurs. It is thought that there may be a genetic link, but no specific causal gene has yet been identified. It likely results from a combination of genetic risk, dysregulation of the immune system, abnormalities in neurological and vascular signaling, and an imbalance (dysbiosis) of microorganisms (microbiota) leading to inflammation and skin sensitivity. .
What can trigger rosacea?
There are many triggers for rosacea, some directly leading to dilation of surface blood vessels, such as hot temperatures, while others trigger skin inflammation. Sun and food can trigger rosacea. Although there is less research on dietary triggers for rosacea, in a National Rosacea Society survey of more than 400 patients, 78% reported changing their diet because of rosacea, and among 95% reported a reduction in subsequent flare-ups (1). .
Common triggers are:
- exposure to the sun
- heat
- alcohol
- capsaicin
- cinemaldehyde
Sun
Sun exposure is a very common trigger for redness and worsening rosacea symptoms. This happens both through UV light but also through the pro-inflammatory effects of vitamin D on the skin. To help reduce the triggering effects of the sun, avoid the midday sun, cover your skin if possible, and use a quality, high-factor sunscreen that blocks both UVA and UVB.
Rosacea Food Triggers
Hot drinks like tea and coffee can trigger symptoms in up to 30% of people (1). Alcohol and foods containing capsaicin, such as certain spices like cayenne pepper as well as bell peppers and chili peppers, are also triggers. Another trigger are foods containing cinemaldehyde like tomatoes, citrus fruits, cinnamon and chocolate.
All of these triggers are thought to increase blood flow to the skin, leading to symptoms of redness and burning.
The gut-skin connection
While gut health plays an important role in immune function, there is also a link between the gut microbiota and those that live on the skin. The gut is home to billions of microorganisms, while the skin is also colonized by an equally complex microbiota that varies depending on genetics and environment.
There is now growing evidence for the role of gut health in rosacea, but the exact role is unknown. In a large study of nearly 50,000 participants, people with rosacea were more likely to have it. Helicobacter pylori infection and bacterial overgrowth of the small intestine (2). Small intestinal bacterial overgrowth is, as the name suggests, an increase in bacterial growth and can lead to diarrhea, pain and bloating. In another study, people with rosacea were thirteen times more likely to have bacterial overgrowth in the small intestine (3). Remarkably, treating the bacterial overgrowth with antibiotics led in all cases to remission of rosacea, which persisted for three years. Additionally, people with rosacea are more likely to have inflammatory bowel disease, with both sharing a genetic overlap on the histocompatibility complex class II HLA gene (DRB1*03:01).
Further research is needed to understand whether dietary interventions aimed at modulating the gut microbiota can affect skin and rosacea.
How to improve your gut health
While it’s unclear whether changing your gut microbiota can benefit skin microbiota and rosacea, your gut microbiota is so important to overall health that optimizing your diet can only help. There are simple tips to improve your gut health, including in your diet:
- a range of fruits and vegetables
- beans and lentils
- whole grain carbohydrates
- fermented foods like kefir and sauerkraut
- avoid trans fats and sweeteners
The role of prebiotics and probiotics
Given the link between the gut microbiota and rosacea, the role of probiotics is an active area of research, but more information is needed.
The role of supplements in rosacea
Currently, there is no evidence supporting the role of supplements in the treatment of rosacea.
Practical advice
First try to figure out what your triggers are, then avoid them as much as possible. Try to eat a diet that supports optimal gut health and immunity by including the following:
- avoid any food triggers
- fruits and vegetables
- whole grain carbohydrates
- fermented foods and drinks
- beans and legumes
- avoid sweeteners and trans fats.
I hope you found this summary helpful and are now aware of the dietary triggers for rosacea and the importance of gut health.
References
1. Weiss E, Katta R. Diet and rosacea: the role of dietary change in rosacea management. Dermatology practice concept. 7(4):31–October 7, 2017.
2. Egeberg A, Weinstock LB, Thyssen EP, Gislason GH, Thyssen JP. Rosacea and gastrointestinal disorders: a population-based cohort study. Fr. J Dermatol. January 2017; 176(1): 100–6.
3. Drago F, De Col E, Agnoletti AF, Schiavetti I, Savarino V, Rebora A et al. The role of bacterial proliferation of the small intestine in rosacea: a 3-year follow-up. I am Acad Dermatol. September 2016; 75(3):e113–5.
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