Could Rosacea be Caused by Diet ?

If indeed acne, and perhaps other inflammatory skin conditions like rosacea are mediated by diet, then why are there no studies ?

This is an important series of questions that are asked by this paper. If cited papers is a measure of how well the background research is, this paper shines with 106 references to date.

It will be interesting to see if inflammatory pathways causing rosacea can be tied back to what we eat.

Implications for the Role of Diet in Acne, Seminars in Cutaneous Medicine and Surgery Volume 24, Issue 2, June 2005, Pages 84-91, Advances in Acne Research, Cordain L.

Within the dermatology community, a general consensus has emerged that diet is unrelated to the etiology of acne. Except for 2 poorly designed studies, now more than 30 years old, there are few objective data to support this notion. In contrast, a large body of evidence now exists showing how diet may directly or indirectly influence the following 5 proximate causes of acne:

  1. increased proliferation of basal keratinocytes within the pilosebaceous duct
  2. incomplete separation of ductal corneocytes from one another via impairment of apoptosis and subsequent obstruction of the pilosebaceous duct
  3. androgen-mediated increases in sebum production
  4. colonization of the comedo by Propionibacterium acnes
  5. inflammation both within and adjacent to the comedo

This article will provide a review of the currently available literature on the association between diet and acne vulgaris as well as a discussion of the physiologic principles that may underlie this association.

Conclusion and Recommendations

The last diet-acne trial was published in 1971.

In the ensuing 34 years, great strides have been made in understanding how diet influences long-term health and well being.

Unfortunately, appreciation of this information has generally gone unnoticed in the dermatology community, as witnessed by the 34-year vacuum since the last dietary intervention in acne patients.

A substantial body of literature now exists that directly implicates diet as the most likely environmental factor underlying the development of acne.

Confirmation of the diet-acne hypothesis will require numerous well controlled dietary interventions examining multiple nutritional factors. As a starting point, future experiments testing the diet– acne hypothesis should employ diets that mimic the nutritional characteristics of diets found in nonwesternized populations known to be free of acne.

Although there is no single nonwesternized diet, there are certain universal characteristics that have a theoretical basis for testing. These diets are free of processed foods, cereal grains, dairy products, refined sugars, and refined oils and almost entirely comprise unprocessed fresh, fruits, vegetables, and lean meats, fish, and seafood.

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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11 Reader Comments

  1. Bernice Sadamune says:

    My skin is in remission for the first time in two years. There’s damage, large pores, red veins, but there’s an underlying whiteness to my cheeks that I have not seen in a long time.
    It is due to the fact that I have stopped drinking 2 – 3 cups of really strong, black tea (with soymilk) every day.
    My rosacea was moderately bad. I had marked redness and 3 or 4 pustules on each cheek. Sometimes it spread down the sides of my mouth to my neck and chest. Some afternoons, I could feel my cheeks burning. I never made the connection to the tea.
    I continue to use my metronidazole cream every day. I may try giving it up next week if this continues.
    I found this website about tannins. One role it may play in rosacea is that it can kill off intestinal flora and affect nutrient absorption.
    I do hope there are more studies about diet and rosacea. Especially with tannins.

  2. maureen rosky says:

    I also have noticed a big difference in the coloring on my cheeks, after I quit coffee and started drinking Only one cup of green Tazo Tea. If I drink more than one cup in the morning then I have trouble
    I feel there are a lot of foods that effect all of us with this disease. Stopping wheat and dairy really help also, and you feel so good
    I agree, more studies need to be done. But for now I’ll keep my eyes on the diet.
    Good Luck!

  3. Karen says:

    Thank you for your posts, they are very helpful and encouraging. I have been looking at a lot of posts in chat rooms lately about Rosacea, there is a lot of talk about what we shouldn’t eat or drink, but do you know what would be especially good to eat or drink for Rosacea?

    There is a Skin Detox tea by Yogi Tea that I drank consistently for a week back in November, and it seemed that my skin was less red, but I’m going to have to test it out a few more times for accuracy. (I just ordered 6 boxes of it on Amazon 😉

    Bernice and Maureen, it would be great to hear about what you are also eating that could potentially be inhibiting the rosacea. It would be educational but also encouraging, as I love to cook, and I can try to cook more with those ingredients…

    So far it seems like everything I like (chocolate, decaf coffee, red wine, sun and wheat) contributes to Rosacea.

    Woud love to hear more of your thoughts.

  4. Gina says:

    I was prescribed Doxycycline for ocular rosacea and my skin has improved as a by product of that, but even before that, just the sterile water eyelid scrub wipes I was using on my eyelidss seemed to be helping my face.

    I also think that regular Stridex facial soft touch pads are great because they have Salicylic acid in them which helps clear up acne. I have sensitive skin and the 0.5% ones have helped me in the past when I had flare-ups. With sensitive skin you have to clean and moisturize. A Dr. told me lanolin is the best moisturizer for skin, so you can look for discount store moisturizers with that in there and natural oils. I’m using clear basics from Family Dollar and it is great.

  5. teri barnes says:

    My rosacea symptoms started when I was in my twenties and became extreme in my mid 30s. Mine was not a mild case. My face would swell & burn so badly that it would bring me to tears and I could go nowhere in public without foundation and concealer makeup on hand for regular touch ups through the day. I of coarse sought out the advice of multiple dermatologists and each time left their offices with a heavy heart knowing full well topical creams and avoiding strenuous exercise and hot showers and similar externally based solutions were not the answer. I finally did some research and experimentation on my own and my complexion is now clear and calm and comfortable and I no longer hide under layers of makeup morning to night. I did this by eliminating all NIGHTSHADES from my diet…no more potato, peppers, tomato, chilli powder in any form or amount…processed or whole. I know emphatically that this diet change is 99% the reason I cured my condition. The other 1% was just a generally less inflammatory diet that steered away from the things we all know are better to avoid like sugar and animal fats and processed foods. I also stopped using moisturizers with harsh acidic anti aging ingredients the cosmetic companies are constantly pushing. I switched to a sparingly used water-based organic product. I can still trigger a quick flush that lasts an hour or two…all it takes is a handful of potato chips and the reaction is immediate, but my days of slathering on metro cream and painful embarrassing suffering is over. It’s puzzling to see the medical community investing so heavily in drug based research when clearly the answers are linked more to diet sensitivities and imbalances in the digestive system. I know i’m sounding more than a little smug but i really want to get it out there that there’s a way to manage this & if I can do it anyone can.
    Sincerely T Barnes

  6. ela says:

    Dear Teri,
    I’ve had a horrible summer with unbelievable face, full of beet-color lesions and swellings. For the first time ever.I tried everything, almost. I used apple cider vinegar, it worked for a couple of weeks, then I tried pills from Merry Clinic, expensive, maybe they worked but my stomach could not take it and after a month I was in constant pain and my stomach was so loud at all times. Then I discovered fresh aloe vera leaves and marigold flowers (dried, boiled, as a mask) it all made wonders, basically eliminated everything for two months. Now suddenly my cheek is super red and swollen, I wake up to a new spot or five. None of the previous methods works at all. I’m on Alzaeic acid recently and it doesn’t do much. Please tell me about your diet, I’m going crazy, my face is so terribly damaged, and I’m on an anti-depressant cause I can’t take it any more.Thank you!!! I do drink coffee, eat sugar and candy. I’m willing to redo everything just point me in the right direction, please! grateful Ela

  7. teri says:

    hi Ela,

    I’m sorry you had such a struggle this summer. I really believe in the diet link. i haven’t had a summer like what you described in more than 7 years now – but i clearly remember how it felt. Basically all the changes i made i mentioned in my earlier comment. The most significant change was wiping out even the tiniest amount of nightshades. If i had continued to eat mashed potatoes every week and topped off my salads with sliced tomato, my skin would be just as raw and red today as it was 10 years ago. No nightshades was key for me…i can’t emphasis that enough. Beyond that i just try to make meal choices that are very anti-inflammatory, very alkaline and there is a ton of reading and recipe books out there on this “style” of eating and following their guidelines more consistantly, is what improved my skin more and more. My diet is mostly veggies and fruit and fish – probably about 80% of the time. I still eat meats but it’s turkey and chicken usually. I still eat dairy but its usually low fat with lots of probiotics like plain yogurt i mix with fresh fruit. i eat breads and pasta in moderation and always whole grain. I stay away from salt, sugar, alcohol, artificial sweeteners, white flour, pastries, high fat meats and sauces and i would recommend you do so as well, very strictly, for at least the first 3 months to give your body a chance to rebalance itself and heal. How you cook effects how acidic and inflammatory your foods become too – i broil, steam and bake rather than frying or charring on a BBQ. When i first decided to eliminate nightshades it was because of a book i had read by a dr. john pagano – a chiropractor who has for decades helped psoriasis patients cure their condition using a highly alkaline low inflammation diet/lifestyle plan. I highly recommend his book!!

  8. Comment via email from Laura,

    “I am a 51 year old woman who has been struggling off and on with Acne Rosacea since I was in high school.

    For all the years that I have been going to a dermatologist, I’ve alway suspected that something in my diet was causing it. But, I was always told that my diet had nothing to do with the disease. I have been on and off antibiotics for years, the most recent stint being 4 years (Doxy). Honestly, my experience has been that the antibiotics only keep it at bay. For the past four years I was continuing to experience breakouts even while on doxy. Every time I go to the derm I ask about new treatments/information and leave without any solid answers.

    At one point, I thought maybe drinking milk was the problem. But giving that up didn’t completely make a difference. However, recently, after reading about dairy and acne, I decided to eliminate ALL dairy from my diet and I have seen a HUGE difference.

    I am no longer experiencing the blemishes. My skin has cleared up and I am not even as red as I was while on dairy. To think that all these years of suffering was in part determined from a flawed 1960’s study that falsely concluded that diet had nothing to do with acne (when I was just a child)!!!!!.

    What a failure on the part of the medical profession! Let’s hope the dairy industry wasn’t involved in manipulating that information! If I were to do it over, I would have explored dietary triggers a long time ago. My advice to Rosacea suffers: Try working with a medical nutritionist to find out if there is something you are eating that is causing redness and/or blemishes.”

    • teri says:

      I wholeheartedly agree that a nutritionist/allergist/naturopath is who to turn to when experiencing a chronic skin condition. It’s bizarre how resistant dermatologists and family physicians are to any notion that diet and digestive problems are the root cause of conditions like rosacea. How can they be so educated in the ways of the human body and simultaneously dense? It has to be the pharmaceutical industry and their strangle hold on the medical community. Antibiotics and steroids for everyone…forever!!

  9. Linda Kirkella says:

    I am 71 years old and have had rosacea for too many years to remember. In my mid sixties I went to my first dermatologist where I learned that rosacea is what I have. many creams and medicines later I decided to quit using the creams and taking pills and because I am also a diabetic, I really have tried changing my diet. well obviously sugar had to be cut out completely and lo and behold my rosacea slowly cleared up !! I only use Burts Bees sensitive face wash and aveenos sun screen when I go out, which does not last long so you have to reapply often and a face cream with clary sage in it. I look so much nicer and my skin feels normal, and no wine , the hard part

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