Just when your rosacea is under control, those red bumps and rosy glow appear out of nowhere. What caused this sudden outbreak? That hot bubble bath or can of soda could be to blame. Here’s how to tame the top 9 rosacea triggers. Plus, how much do you know about skin care? Take our quiz and find out...
You really want to order that glass of wine. Or just spend a hot day outside in the sun.
But if you’re one of 14 million Americans with rosacea, you know what will happen if you do: Your face reddens with bumps and pus-filled pimples. Eyes tear and eyelids swell; then the itching starts.
These are classic symptoms of the chronic inflammatory skin condition.
At first you may just blush easily.
But if left untreated, blood vessels can show up like lines of red ink. Remember old-time actor W.C. Fields? His ruddy skin, bulbous nose and spidery veins were partly due to an extreme case of rosacea.
Fields' skin problem affects men 25 times more than women, says dermatologist Charles E. Crutchfield III, M.D., medical director of Crutchfield Dermatology in Eagan, Minn.
Experts don't know what causes the disorder. It’s common in people with fair skin – especially people from Scotland, Ireland and England – and typically affects men and women older than 30. And if your parents had it, there’s a greater chance you’ll get it too.
It’s important to get “rosacea under control and keep skin clear so you don’t have those secondary side effects,” says Bruce Katz, M.D., director of the Juva Skin & Laser Clinic in New York City. “It’s not a dangerous condition and not a hard one to control.”
But it's a challenge, because many factors set off a red skin response and they vary from one person to the next.
“Rarely is everyone [set off] by everything on the list,” Crutchfield says.
Stress can set off an outbreak in some; others by favorite indulgences, like a hot bath, big mug of coffee or a long run.
“The key is to find out which triggers are yours, so you can avoid them,” Crutchfield says.
Here are 9 common rosacea triggers and natural tips to combat them:
1. Spicy foods
Hot peppers topped the list of trigger foods, according to a 2003 survey of 502 women with rosacea by the National Rosacea Society. Mexican-style foods, such as hot salsas, ranked second, followed by chili, hot sausage and Cajun foods. Even horseradish and vinegar can bring on scarlet in some.
Rosacea tip: Don’t worry, you’re not doomed to bland meals.
“Try spices, like Mrs. Dash [salt-free seasoning blend], that add flavor but not extreme spiciness,” Crutchfield says.
In recipes that call for red pepper or chili powder, substitute 2 parts cumin and 1 part oregano.
Other flavor boosters: Swap out a spicy salsa for a refreshing fruit salsa with peaches, raspberries, orange juice, chopped mint, a pinch of cinnamon and a splash of balsamic vinegar (skip the last ingredient if it causes inflammation).
2. Hot beverages
That grande latte will give you more than an energy boost.
“Having a hot cup of tea or coffee causes your blood vessels to dilate, so you get flushing,” Katz says.
Rosacea tip: Let steamy drinks cool down to room temperature before sipping – or order them iced.
3. Stress
According to a 2001 survey by the National Rosacea Society involving 700 people with the disorder, 91% said that emotional strain was a rosacea trigger.
Although the link between rosacea and anxiety isn’t clear, experts, including Katz, often point to the “target organ” theory: Some people hold stress in their stomachs or get migraines. Others get rosacea’s red glare.
Rosacea tip: In the survey, 83% of those who used stress management techniques reported fewer outbreaks.
When you feel stressed, the National Rosacea Society suggests you take a deep breath to the count of 10, then breathe out slowly, also counting to
10. Repeat until you feel calmer.
Or practice visualization: Close your eyes and picture a scene you love – a beach, picnic spot, your patio – and sit quietly for several minutes as you do.
4. Hot baths
Soaking in the tub feels wonderful on a chilly day, but not if you have rosacea. Hot baths set off outbreaks in 53% of those surveyed in a 2010 National Rosacea Society survey of 424 patients.
Why? The hot water makes blood vessels dilate, triggering red skin, says Doris Day, M.D., a New York City dermatologist and author of Forget the Facelift (Avery).
Rosacea tip: Keep your bath water about body temperature or cooler.
But don’t go cold: Your skin doesn’t like temperature extremes.
“The water should be as cool as you can stand,” Day says. “You shouldn’t have to acclimate to it.”
And skip the heavy scrubbing – it can further irritate your skin. Use a soft cloth and a gentle hand.
5. Strenuous exercise
Don’t stop exercising – just be mindful of how you do it.
Rosacea tip: To avoid a flare-up, follow these doctor-recommended tips to keep your temperature under control when exercising:
Warm up for 5 minutes by stretching and lifting light weights before you pick up the pace.
Exercise in the early morning or evening when weather is coolest. “Or exercise in an air-conditioned room,” Day advises. That means you can still go for that long run on hot days, as long as you do it on a treadmill at the gym.
Work out more often but for shorter periods.
Stay cool by drinking cold water while you exercise.
6. Alcohol
There’s no truth to the myth that too much booze causes rosacea, but alcoholic drinks, particularly wine, make blood vessels open and skin flush, says Crutchfield.
Plus, drinks are dehydrating, which shrinks pores, making it easier for them to clog. (Clogged pores are the first step toward rosacea blemishes and infection.)
Alcohol is also a triple threat because it leads to poor sleep, which increases stress, and that can trigger rosacea.
Rosacea tip: It’s best to avoid alcoholic drinks if you want to avoid ruddy skin. But having rosacea doesn’t mean you have to be a complete teetotaler – if you’re willing to accept the consequences.
“I have several patients who say that on New Year’s Eve or on their birthday, they’re going to have a glass of champagne,” Crutchfield says. “It’s a risk that at times they’re willing to accept.”
And sip water to keep from getting dehydrated, further subduing this rosacea trigger.
7. Extreme hot and cold weather
Just like steamy beverages, a hot, sunny day can dilate blood vessels, leaving you rosy-cheeked.
Actually, the sun is a double whammy, because sunlight irritates the skin of as many as 61% of rosacea sufferers, according to the non-profit International Rosacea Foundation.
Cold weather is not much better because pores can clog more easily.
Rosacea tip: Stay as close to 70˚-80˚temperatures as much as possible.
“When you go out in cold or windy weather, put on a jacket and scarf to avoid getting too cold,” Day says.
If you’re sensitive to sunlight, wear sunscreen, sunglasses and a hat year-round – and stay in the shade as much as possible, she adds.
8. Dehydration
We’re made up of at least 50%-60% water, Day points out. “One important function of skin is temperature and water balance,” she says.
Drinking water helps wash out toxins that otherwise clog your skin.
Rosacea tip: Stay hydrated. Choose icy water to cool your system and keep blood vessels from dilating, the reason behind your red skin.
9. Stimulants
Rosacea’s ruddiness is another good reason to cut down on caffeinated drinks, cigarettes and excessive sugar: All expand blood vessels and bring on that ruddy skin.
They also make you sweat more, which clogs pores, and increases stress by revving up your nervous system. Even artificial sweeteners like aspartame can activate a flare-up.
Rosacea tip: Reducing stress can help cut cravings for guilty pleasures.
“People tend to have more stimulants when they’re stressed – and stress is itself a stimulant,” Day says.
If soda is the culprit, switch to caffeine-free to see if it’s sugar or caffeine that’s aggravating your condition.
“Caffeine may not be a trigger for everyone with rosacea,” Day says. “But if you notice that it makes you red or flushed, [cut back].”
Health writer Dorothy Foltz-Gray is a frequent contributor to Lifescript.
For more information, visit our Skin Heath Center.
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