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Julia Malacoff/SHAPE.COM
May 05, 2018 @ 8:30 am

Having an irritated, tender, pimply face as an adult can be incredibly frustrating. Many people wonder: Isn't this stuff supposed to stop when you finish puberty?! Well, as anyone with adult acne can tell you, that's certainly not always the case. I discovered that there are several other non-acne skin conditions that can cause that splotchy look when at 27, I developed red, itchy, pimple-like bumps all over my face, accompanied by a red nose that rivaled Rudolph's. 

After several visits to dermatologists, it was determined that I had rosacea, a chronic inflammatory skin condition that affects an estimated 16 million people in the U.S., according to the National Rosacea Society. And I found out that while topical creams and antibiotics can help with rosacea, so can your diet.

Here's what I learned from trying out the "rosacea diet" for myself, plus what you need to know if you're considering it, too.

What's Rosacea and What Does Food Have to Do With It?

"Rosacea is a skin condition that affects the central part of the face (especially around the nose), where patients develop flushing and blushing, burning and stinging, and red bumps and pus pimples," says Joshua Zeichner, M.D., director of cosmetic and clinical research in dermatology at the Mount Sinai Hospital in New York City. It's also a chronic condition, which means once you have it, you'll always have to deal with it to some degree. So while the flare-ups might become less frequent and milder once you have it under control, they'll never be gone completely. Womp-womp.

"In rosacea, the skin is extra sensitive to the environment and over-reactive to triggers like spicy foods, hot beverages, alcohol, emotional stress, and hot weather," Dr. Zeichner explains. Other common triggers include exercise, sun exposure, and hot showers. "All of these lead to worsening of redness and the development of red bumps on the face." 

Even more fun: "We don't totally understand what causes rosacea, but we know that the skin barrier is not working as well as it should be, there is extra inflammation in the skin, and blood vessels become easily dilated," he says. Rosacea most commonly affects those with fair skin, but it can happen to anyone.

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Rosacea is commonly treated with prescription creams and sometimes even antibiotics, but one of the most common non-pharmaceutical solutions is simply avoiding triggers—especially certain types of food. "We know that your diet can have a large impact on many skin conditions, including rosacea," Dr. Zeichner says. "Any foods that cause blood vessels to dilate can cause a flare-up of rosacea. The more flare-ups a patient gets, the more permanent the effects become." That's why derms like Dr. Zeichner recommend their patients avoid spicy food, alcohol, and super-hot (temperature-wise) foods or beverages since they can cause more long-term effects, including redder skin and more broken capillaries.

Avoiding these few very common triggers doesn't work for everyone, though, so sometimes a more specific diet is required. "When these changes are insufficient, I recommend an anti-inflammatory diet," Dr. Zeichner says. While not all anti-inflammatory diets are the same, they generally have a few main things in common. They're high in omega-3 fatty acids (which have been shown to help reduce rosacea-related inflammation) and low in refined sugar, fried foods, and processed meats. While more research is needed on how the gut-skin connection factors into the rosacea equation, research suggests that dietary changes do make a difference, particularly when people with rosacea avoid inflammatory foods.

But Does It Actually Work?

I encountered the "rosacea diet" while desperately searching around the internet for ways to deal with my rosacea. As someone who exercises most days and spends a great deal of time outside, many common triggers—such as hot/cold weather and sweating—are unavoidable for me. And while topical medications definitely help, they don't solve everything. But one thing I felt fairly confident I could control? My diet.

Being a health writer, I already eat pretty healthy in general and avoid processed foods when possible. But there are a few changes to my diet that I had been advised to make that I simply didn't want to commit to, most notably: not drinking hot coffee, not drinking alcohol, and not eating spicy foods (three things that were regular parts of my diet!). I wondered, if I committed to making these changes in addition to eating an anti-inflammatory diet, would I see skin results?

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So I decided to try it out for two weeks. I didn't want to give up coffee completely, so I swapped lattes for homemade cold brew and my nightly hot tea for a sparkling water. I vowed to skip jalapeños on taco night, avoid dousing my eggs with hot sauce, and stop adding so much chili powder to my Instant Pot meal prep dinners. I incorporated fish oil supplements into my daily routine, since I'm a vegetarian and eating fish frequently isn't an option for me. I also loaded up on anti-inflammatory foods including all types of berries, green leafy veggies, nuts, and seeds.

Lastly, I decided to try to avoid one other type of dietary trigger that research says may have an impact: cinnamaldehyde. Cinnamaldehyde is found in warming foods like cinnamon, tomatoes, chocolate, and citrus fruits. Some research suggests that it may cause a burning skin sensation in people with rosacea, and while the evidence isn't super strong and not all dermatologists recommend avoiding it, plenty of people are triggered by foods containing the substance. (I've always been of the opinion that fruits and veggies shouldn't be excluded from a diet unless you're allergic to them, so to say I was skeptical about excluding things like tomatoes and oranges from my diet would be an understatement.)

After my two weeks were up, my takeaway was pretty clear: Changing my diet helped clear up and prevent rosacea flare-ups, but it didn't eliminate them completely. I still had redness and new bumps pop up over the course of the two weeks, despite adhering to my "rosacea diet." To be fair, this type of diet probably produces best results over the long term, and I will continue to follow some of the recommendations because they were actually helpful.

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Namely, I learned that the benefits of staying away from alcohol are real. Waking up the morning after having a few drinks with seriously irritated skin is a normal occurrence for me, and avoiding alcohol completely for two weeks allowed me to wake up each morning with relatively clear skin. (Although I still noticed redness develop throughout the day from other triggers like exercise and spending time outside.) I'll also continue taking fish oil, because whether or not it's truly helping my rosacea, there are so many other benefits to taking it.

On the flip side, I'll be adding tomatoes, citrus fruits, and chocolate back into my diet stat—avoiding them didn't' seem to make an impact for me personally, and I didn't notice any ill effects when I reintroduced them into my diet. All in all, I found that tinkering with my diet to deal with rosacea symptoms was worthwhile, but certainly not a miracle solution.

Tips for Adjusting Your Diet If You Have Rosacea

If you're thinking about adjusting your diet to help deal with rosacea, here's what experts want you to know.

Be realistic about results. Unfortunately, as I experienced, a diet change won't make your rosacea go away completely. "Remember to have realistic experience expectations," says Kristina Goldenberg, M.D., of Goldenberg Dermatology in New York City. "Unfortunately, no cure exists for rosacea. Therefore, the goal of the diet should be to minimize flare-ups rather than to eliminate them completely."

You won't be able to avoid triggers all the time. It would be nice to feel like you're in total control over what goes into your food at all times, but that's simply not possible for most people, especially if you want to eat out. "Unless you prepare all your meals, it is impossible to avoid certain ingredients," says Michele Green, M.D., a dermatologist and RealSelf contributor. Doing the best you can is all you can expect from yourself. "Eating in moderation is the key to avoiding rosacea flares and minimizing your symptoms," she adds.

It's not one-size-fits-all. Triggers are often highly individual, so what worked for someone else may not work for you. "There are common foods that can cause rosacea flare-ups such as tomatoes, alcohol, spicy foods, cheese, coffee, and chocolate," Dr. Green says. "But these foods are not triggers for everyone. Therefore you should chart which foods trigger your rosacea and avoid them in your diet." Keeping a food journal that also notes your skin symptoms can help you figure out your own individual problem foods.

Talk to your derm. Above all, skin pros emphasize that getting a dermatologist involved in your rosacea treatment is essential. "If adjustments in diet aren't showing results, try not to get frustrated," Dr. Zeichner says. "If you suffer from rosacea, visit a board-certified dermatologist for evaluation and potential treatment options." They're most up-to-date on all the available options, and they'll be able to suggest different tactics to try when you feel like you've hit a dead end.

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