Rosacea is one of the most common inflammatory skin conditions, affecting approximately 5% of the adult population globally including millions of people across North America alone.
the most prevalent rosacea symptom is recurrent facial flushing concentrated in the center of the face, and as it worsens, a person may also experience undesirable flares of painful skin burning, lesions, and more.
To combat these symptoms a standard rosacea intervention primarily involves the use of topical and/or oral antibiotics.
But what role, if any, might dietary changes and supplementation play in managing this complex condition?
That’s what today’s article is all about.
Written and researched by my Kaleigraphy intern Kat Durston, the sections to come will take you on a deep dive into what the best available science has to say about the connection between what you eat and your rosacea symptoms.
Take it away Kat!
Diet And Rosacea
Today’s article is divided into distinct sub topics, each relating directly to the connection between nutrition, supplementation and rosacea.
With that said, let’s get right into it anyway!
Your Gut Microbiome & Rosacea
The most prominent correlation between rosacea and our diet appears to lie in the relationship between the skin and the gut microbiome.
Current research has confirmed that a disturbance in the skin and gut microbial community plays a seemingly crucial role in the development of rosacea.
This makes some sense because the composition of our microbiome is vital for correct immune function in our skin and rosacea is what is known as an immune-mediated inflammatory disease.
A 2021 cross-sectional study out of the British Journal of Dermatology analyzed stool samples from 15 patients with rosacea against healthy controls and found a specific combination of intestinal microbes in rosacea patients that indicate intestinal dysbiosis (an imbalance between good and bad bacteria).
The beneficial effects of probiotics ( yogurt, kefir) in this regard may explain why a 2019 Journal Of Dermatology study found that dairy intake showed a beneficial effect on rosacea severity.
Even further, this 2021 case-controlled trial found significant differences in microbiome composition in rosacea patients compared to age and gender-matched subjects without rosacea.
Want to learn more about how different types of foods alter your gut microbiome? Read this piece.
Rosacea and Gastrointestinal Disorders
A 2017 cohort study found that rosacea patients were more likely to suffer from Crohn’s disease, ulcerative colitis, SIBO, IBS, IBD and celiac disease compared to non-rosacea patients.
A 2020 review article published in the Australasian Journal of Dermatology noted that small intestinal bacterial overgrowth (SIBO) has been shown to be multiple times more common to occur in rosacea patients.
In a 2008 randomized controlled trial, patients with both SIBO and rosacea had significant and long-lasting symptom resolution after being treated with the antibiotic rifaximin for 10 days.
You can also read my article on the best probiotics for SIBO to learn more.
Although limited in scope, the results of these types of studies seem to underline the importance of good management of any co-existing gut health conditions in those hoping to lessen the severity of their rosacea.
Given the complexity of these conditions, seeking proper care and guidance from a specialist in this area would be advisable.
In the next few sections I will also go through some general nutritional considerations to keep in mind for those looking to optimize their gut health.
High-Fiber Foods & Prebiotics
Although specific gut conditions inevitably warrant customized guidance relating to fibre intake, it is safe to say on a general level that a diet rich in various types of fibre (including prebiotic fibre) supports a healthy and well-balanced gut microbiome.
Foods generally high in fibre include legumes (ie; lentils/chickpeas), whole grains (ie; brown rice, quinoa,) nuts, seeds and most fruits/veggies whereas certain foods in these categories are especially high in prebiotic fibre such as garlic, artichoke, onions, bananas, apples, barley, leeks, flax, seaweed oatmeal and asparagus.
Prebiotic fibre facilitates the growth and flourishing of our “good gut bacteria” which in turn produce anti-inflammatory compounds known as SCFAs.
A group of anti-inflammatory compounds known as polyphenols may also have prebiotic effects on the human gut, you can learn which foods contain them in Andy’s article below:
I must also note that individuals living with both IBS and rosacea may not tolerate prebiotic-rich foods as well as others and could benefit from foods that are higher in soluble fibre (including a psyllium fibre supplement).
See Andy’s article below for a full list of such soluble-fibre rich foods.
The inclusion of probiotic-rich foods such as sauerkraut, kimchi, kefir, miso, and yogurt may also benefit your microbiome diversity.
As I’m sure you are starting to realize, there isn’t a great deal of high-quality research available that is directly related to nutrition and rosacea.
With that said, zinc sulfate is really the only potential supplement of interest that deserves an honorable mention.
A 2006 randomized-controlled trial out of the International Journal Of Dermatology found a significant reduction in rosacea symptoms after 4 weeks of oral zinc sulfate supplementation (100 mg x3 a day), and the decrease in symptoms were concurrent with your typical antibiotic intervention for rosacea.
Despite this seemingly positive outcome, a study conducted six years later in the same journal found no significant improvement in rosacea with a slightly different dosage (220 mg x2 a day).
This makes it challenging to make any claim about the usefulness of zinc sulfate in managing rosacea symptoms, however it is a supplement that is considered safe and without significant side effects.
Rosacea sufferers with dry eye may also benefit from an omega-3 supplement.
Rosacea Food Triggers
The term “trigger food” often refers to food items that have been anecdotally reported to exacerbate rosacea symptoms by increasing the likelihood and/or severity of skin inflammation.
While research in this area is limited and anecdotal, it may be advisable for rosacea patients to be slightly more diligent and observant when it comes to these commonly reported foods.
The National Rosacea Society conducted a survey of over 400 rosacea patients and 95% reported a substantial reduction in flares when eliminating their perceived dietary triggers.
These are often reported to include:
Alcohol (wine, liquor)
Hot beverages (mainly coffee, tea )
You can find a recently conducted National Rosacea Society trigger survey here.
The pathophysiology behind why these foods trigger rosacea symptoms is still unknown, but it is thought that they activate certain receptor channels that increase blood flow thus leading to the burning and flushing of skin.
Despite a lack of directly relevant scientific trials on the impact of diet on rosacea severity, there is just enough preliminary evidence to offer some meaningful insights and guidance.
I have a gut feeling that we will begin to see more modern-day scientific findings that support the link between rosacea, our diet and our gut microbiome.
And in turn, there can only be mountains of hope that dietary modifications may have a substantial impact on this challenging condition.
Until next time,
Are you looking to make sense of today’s blog post and learn how to apply these principles to your own life and diet? Andy can help – reach out to discuss working together.