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Rosacea is a chronic skin condition characterised by facial redness, visible blood vessels, and sometimes acne-like bumps. While there’s no permanent cure, there are many effective treatments and lifestyle changes that can significantly reduce symptoms and improve skin health.

The main 4 triggers are:

Stress:

• Stress is a powerful trigger for rosacea flare-ups
• For some people, psychological stress alone can be the main driver of flare-ups.
• Clinical evidence shows that stress management can significantly reduce flare-up frequency and severity in many patients.

Diet:

• Diet is highly influential for many rosacea patients.
• Key dietary triggers include spicy foods, alcohol (especially red wine), hot beverages, and histamine-rich foods.
• Gut health is linked to rosacea (gut-skin axis), and an anti-inflammatory or gut-friendly diet (e.g. Mediterranean-style diet, probiotic foods) can help reduce symptoms.

Other Lifestyle Factors:

• Sun exposure, hot and cold weather, and vigorous exercise are common non-dietary lifestyle triggers.
• Bikram yoga, saunas, and hot showers can cause flushing and inflammation which can directly affect the skin barrier.

Skincare and treatments:

• Selection of unsuitable active skincare including fragrances, frequently over-exfoliating and having harsh in clinic treatments.

Practical steps to manage and reduce stress:

1. Mindfulness and meditation:

• Mindfulness practises where you are focused on breathing and being present in the moment can reduce stress-related inflammation.
• Guided sessions or Apps such as Calm, Headspace or Insight Timer can provide structured meditation practices.

2. Deep Breathing Exercises:

• Box breathing (inhale 4 seconds, hold 4 seconds, exhale 4 seconds, hold 4 seconds) helps lower the heart rate and reduce stress responses.
• Diaphragmatic breathing (deep belly breathing) calms the nervous system

3. Gentle Movement & Exercise:

• Yoga and Tai chi: Combine gentle movement with breathwork to calm the nervous system.
• Daily walks outdoors in a nearby greenbelt help clear the mind and lower cortisol levels.

4. Cognitive Strategies

• Reframing negative thoughts: Noticing unhelpful thinking patterns and replacing them with balanced perspectives.
• Gratitude practice: Writing down or reflecting on things you are grateful for can reduce stress.

5. Self-care & Lifestyle Habits

• Adequate sleep: Prioritising 7-9 hours of good-quality sleep to reduce cortisol levels
• Balanced diet: Anti-inflammatory foods (fruit, vegetables, healthy fats) support gut and skin health.
• Limit Stimulants: Reducing caffeine and alcohol, which can heighten stress, increase your cortisol levels and affect your sleep

6. Social Connection

• Talking to trusted friends/family: Sharing your worries can help reduce social anxiety
• Professional support: Seeking counselling or therapy if needed, especially if stress feels overwhelming.

7. Setting Boundaries & Time out

• Boundaries: Learn to say “No” or reduce commitments when stress levels are high.
• Taking breaks: Even short breaks throughout the day can help recalibrate stress levels.

Diet and Rosacea:

• Trigger Foods:
  • Many individuals with rosacea report that certain foods trigger or worsen symptoms. Common dietary triggers include:
    • Alcohol (especially red wine)
    • Spicy foods
    • Hot beverages
    • Dishes that are high in sugar and some fruits
    • Histamine foods, especially those found in aged or fermented foods
    • Dairy (in some individuals)

• • These foods can promote vasodilation (dilating blood vessels) and inflammation, which can exacerbate rosacea’s hallmark redness, flushing, and swelling.

Anti-Inflammatory Diets have reduced systemic inflammation and reduced elevated cortisol levels that may help calm rosacea symptoms:

Fruits:

• Berries, blueberries, blackberries, strawberries, raspberries & avocado (High in antioxidants and low in acidity). Apples and pears are high in fibre, particularly pectin which acts as a prebiotic, feeding beneficial gut bacteria, however they are also high in fructose which can cause bloating and digestive discomfort in some individuals – please only consume small portions. Dragon fruit, contains antioxidants, prebiotic, is high in fibre and may lower blood sugar levels. Red grapes (natural antihistamine – only consume a handful as they are high in sugar)

Vegetables:

• Kale and broccoli (two nutrient rich superfoods); collard greens and cruciferous vegetables such as broccoli, brussels sprouts, green beans, cauliflower, and cabbage; beetroots (body cleanser, eliminate toxins); fennel (flush out excess fluid and toxins); garlic (potent cocktail of antioxidants). Sweet potato (rich in Vit A, improves circulation of oxygen in your skin). Watercress is loaded with antioxidants. Zucchini and cucumber are excellent for their cooling effect and the legume family including lentils and chickpeas are good vegetarian protein options

Dietary Fibre & whole grains:

• Quinoa, brown rice, oats, barley, buckwheat. Whole-wheat bread (gentler change in blood sugar spikes), lentils, chickpeas.

 Protein:  

• Fatty fish such as salmon, mackerel, tuna, herring and sardines (high in omega 3’s and vitamin D), lean chicken or turkey, beef and lamb. Flaxseed, chia seeds and walnuts (good sources of ALA, plant based Omega 3), oysters, tofu, nuts, lentils, chickpeas, eggs and yoghurt etc. are also a good source of protein.

The Gut-Skin Axis and Sensitive skin:

• Increasing evidence suggests that gut health and the gut microbiome are linked to skin conditions, including rosacea.
• Individuals with rosacea have been found to have a higher prevalence of small intestinal bacterial overgrowth (SIBO) and Helicobacter pylori infections, suggesting gut dysbiosis may play a role, including disrupting the immune system and nutrient absorption.

What connects the Gut-Skin Axis and Inflammatory Pathways:

• Dysbiosis in the gut can lead to increased intestinal permeability (“leaky gut”), systemic inflammation, and release of pro-inflammatory cytokines that can influence skin health.
• Conversely, gut-friendly diets (high in fibre, low in processed foods) support a balanced gut microbiome and may reduce systemic inflammation

Skin Microbiome and Rosacea:

• Rosacea has been associated with an imbalance in the skin microbiome, including overgrowth of Demodex mites (microscopic skin parasites) and certain bacteria (e.g. Demodex Folliculorum (microscopic mites found at the base of the eyelashes), Staphylococcus epidermidis).
• While the diet’s impact on the skin microbiome is less direct, dietary factors that reduce systemic inflammation (like reducing sugar intake) may help modulate skin microbiome balance.

Practical Dietary Guidance for Rosacea and Microbiome Health
✔️ Identify and reduce dietary triggers – Keep a food diary to monitor symptoms and identify foods that worsen flushing or redness. Everyone’s journey differs when it comes to food.
✔️ Anti-inflammatory diet – Emphasise plant-based foods, healthy fats (olive oil, avocados), and limit processed foods.
✔️ Consider probiotics/prebiotics – Incorporate fermented foods (yoghurt, kefir, kimchi) and prebiotic-rich foods (asparagus, garlic, onions) to support gut microbial balance.
✔️ Limit alcohol and hot beverages – These can trigger flushing.
✔️ Hydrate well – Adequate hydration supports your kidney function, removing normal waste and maintaining a balance of electrolytes, that support proper cell signalling and may improve skin repair mechanisms.

Conclusion
While rosacea can be challenging, adopting an anti-inflammatory diet, in combination with targeted treatments, protective skincare, and mindful lifestyle adjustments can dramatically improve the condition. If your rosacea does not improve or become manageable after 6 months, then it’s best to consult a dermatologist for a personalised medical plan to manage the condition effectively.

Schedule a consultation to discuss how our effective treatments may assist you.

Disclaimer:
The content of this blog is provided for informational purposes only and is not intended to in any way substitute professional medical advice.

Tagged: dry skin, Fullarton, irritated skin, itchy skin, rosacea, Sensitive skin, SIBO, skin flushing, skin redness, visible blood vessels