Are Mystery Triggers Causing Your Rosacea Flare-ups?

If you have rosacea, you know how inexplicably your face can redden — even when you haven’t exercised or spent any time in the sun. Maybe you’ve figured out some of your triggers, like certain foods or lifestyle choices, but other times, you’re still puzzled about why your rosacea has flared up.

Experts don’t have a clear understanding of exactly what causes this chronic skin condition, but they do know that it runs in families.

“A number of things commonly act as triggers for rosacea flare-ups and not everyone has the same triggers. But if an individual or physician can determine specific triggers, that person may have an easier time controlling rosacea symptoms,” explains dermatologist John Anthony, MD.

He says five of the most common triggers include:

1. Alcohol. Alcohol can dilate the tiny blood vessels in the face, causing the face to flush. Drink in moderation only on special occasions, if at all. Not only can drinking alcoholic beverages cause flare-ups, but so can topically applied alcohol in various facial cleansing products. Always check product ingredients and avoid those containing alcohol or other overly drying ingredients.
2. Spicy or hot foods and drinks. Foods that contain spicy ingredients can affect the blushing areas of the face, leading to redness. If you love spicy food, go with mild spice and only enjoy these dishes on occasion. Since hot (temperature-wise) food and drinks often trigger facial flushing, you should allow your food or warm beverage to cool a bit before consuming.
3. Exercise. Regular exercise is important for everyone, but it’s also a common trigger for rosacea flare-ups. But don’t abandon your exercise routine. Rather, limit outdoor exercising to morning or evening hours to avoid midday heat and sun exposure. When exercising outdoors, use shaded trails for cycling or jogging. And always remember to keep yourself well hydrated.
4. Sun and wind exposure. Sun exposure, hot and cold temperatures and wind exposure frequently aggravate rosacea symptoms. Always wear a broad spectrum sunscreen when outside, even on cloudy days. If possible, stay inside on particularly hot, humid days. If you must venture out in the cold or wind, cover your cheeks and nose with a scarf.
5. Anxiety and stress. Stress and anxiety can cause rosacea symptoms to worsen, so use stress management techniques when needed. Make sure to get plenty of rest and practice deep breathing when you feel anxiety creeping up.

Rosacea treatments

Dermatologist-prescribed medications that you apply directly to the skin, called topical treatments, that can help control rosacea symptoms and progression. Your physician may recommend an over-the-counter emollient cream to help repair the skin. For some forms of rosacea, you may need a topical or oral antibiotic to help control blemishes that occur during flare-ups.

“Treatments for rosacea include topical brimonidine, which helps control the redness of rosacea, and topical ivermectin, which helps with the papules and pustules that occur with some forms of rosacea,” says Dr. Anthony. These can complement many of the previously available treatments, when necessary.

He says that sulfur is a natural agent used effectively for many years as a home remedy for rosacea. You can purchase soaps and lotions containing sulfur in over-the-counter formulations at most pharmacies.

Dermatologists can remove thickening skin of the nose and flushing areas of the face using dermabrasion or electrocautery.

How to know if your rosacea is mild or severe

When discussing your rosacea with you, dermatologists ask how much the condition bothers you. Some patients don’t mind fairly extensive redness and pustules, while these symptoms affect others profoundly. “I tailor treatment to address the individual concerns of the patient,” says Dr. Anthony.

According to Dr. Anthony, rosacea most commonly appears on the face, but people can also experience symptoms on the neck, chest, scalp and ears. “When a person notices symptoms appearing in these other areas, it should prompt further evaluation by a medical professional,” he says.

Even less commonly, a form of rosacea called ocular rosacea can affect the eyes. Dr. Anthony considers this type more severe, warranting more aggressive treatment.

Talk to your doctor if you have frequent, unexplained flushing and prolonged redness in the facial area. A dermatologist can evaluate your condition, identify triggers and prescribe treatments to alleviate symptoms and prevent progression.

Why it’s important to treat rosacea

“The condition most commonly begins with frequent flushing of the facial skin and can progress, eventually causing the skin to appear red all the time,” says Dr. Anthony. Without treatment, you may begin to see a web of tiny blood vessels appear in the center of your face, usually the nose.

People with rosacea also may have thickening of the skin and frequent breakouts that are not due to acne.