Should we follow a specific diet if we suffer from rosacea?

The characteristic symptom of rosacea is the presence of a widespread and diffuse redness on the face. Mainly concentrated on the centre of the face, namely the forehead, nose, cheeks and chin, this is the result of the dilation of blood vessels. Moreover, these can become visible, especially on the fairest skin types. Rosacea is also accompanied by numerous invisible symptoms, such as significant skin sensitivity, burning sensations and tingling around the affected areas.

This skin condition tends to progress over time and operates in cycles. Thus, symptoms can present themselves for weeks or months, then may disappear before reappearing more intensely. Indeed, while rosacea initially causes redness, more severe symptoms can emerge over time, such as pus-filled red bumps, significant skin thickening, or even eye damage.

Four subtypes of rosacea have been identified.

• Vascular rosacea or thread veins.

  This is the most common form. It primarily induces hot flushes, temporary or permanent redness, referred to as erythrosis, an increased sensitivity of the skin, and the dilation of vessels beneath the skin, becoming visible.

• Papulopustular rosacea.

  It is sometimes mistaken for acne due to the presence of red spots, and even pustules, in addition to redness. Papulopustular rosacea is also accompanied by feelings of tightness, and sensations of burning and discomfort.

• Hypertrophic rosacea.

  This rare form is characterised by a thickening of the skin and a dilation of the skin pores on the nose, referred to as "rhinophyma". This is a major complication of rosacea, due to the aesthetic damage it causes. The skin thickening is sometimes associated with papulo-pustules and can extend to the rest of the face.

• The Ocular Rosacea.

  Rosacea sometimes affects the eyes. In such cases, patients exhibit redness on the eyelids, conjunctivitis, and dry eyes. Often, they also suffer from a persistent sensation of having grains of sand in their eyes.

It is important to consult a dermatologist as soon as the first signs appear. Mild rosacea can quickly lead to complications, particularly affecting the eyes.

Just as certain foods can trigger an inflammatory response and promote rosacea, others can conversely help to reduce its symptoms. Let's explore together these foods that can sometimes alleviate rosacea flare-ups.

Caffeine.

Caffeine has long been considered a food that exacerbates the symptoms of rosacea. However, several recent studies have shown that it is actually the high temperature at which this drink is consumed that is responsible. Indeed, hot drinks promote the dilation of blood vessels, which leads to the appearance of red patches and hot flushes.

Contrarily, it has been demonstrated that coffee consumption reduces the risk of developing rosacea. Indeed, in one study, the consumption of 400 mg or more of caffeine per day, equivalent to about 4 cups of coffee, helped to limit rosacea flare-ups. The following hypothesis was formulated: the caffeine contained in this beverage has a vasoconstrictive effect that helps to reduce the symptoms of this skin disorder, such as redness. However, no link between rosacea and other caffeine-containing beverages like tea or sodas could be established.

Foods containing Vitamin B2, such as nuts, green vegetables, and rice.

It was in 1947 when it was first proposed thata deficiency in vitamin B2 could be responsible for an intensification of rosacea symptoms. Subsequent studies have shown that the topical application of a cream containing this active ingredient can improve the appearance of the skin in individuals suffering from rosacea.

The mechanism behind the beneficial properties of Vitamin B2 is still under investigation. However, it has been hypothesised that it is capable of reducing the adherence of pro-inflammatory cells to the surface of the epithelium, thereby inhibiting inflammation.

However, no research has been conducted on the oral intake of vitamin B2 and its effect on rosacea. Thus, we can only speculate that nuts, green vegetables, rice, and other ingredients rich in this vitamin have benefits for skin affected by this skin disorder.

Foods high in zinc, such as seafood, offal, and meats.

Several studies have been conducted to highlight a link between zinc consumption and the symptoms of rosacea, but the results are contradictory. For instance, in a study spanning 3 months and involving nearly 45 patients, the oral administration of 220 mg of zinc twice a day did not induce any improvement in rosacea compared to the administration of a placebo.

On the other hand, another study was subsequently conducted over 6 months on 25 individuals suffering from rosacea. This time, the oral administration of 100 mg of zinc picolinate, the form best absorbed by the body, three times a day, resulted in a decrease in the severity score of rosacea. It appears that zinc may, to some extent, have beneficial effects on skin suffering from rosacea.

Various speculations have been made regarding the mechanism of action of zinc. It is suggested that it interacts with the NF-κB protein and inhibits its function. This protein is notably capable of activating the synthesis of TNF-α and IL-1β, which are pro-inflammatory mediators. Through this mechanism, zinc would thus have a anti-inflammatory effect.

Dairy products.

The consumption of dairy products by individuals suffering from rosacea is a highly debated topic. Scientific studies present conflicting views on this matter: some highlight that dairy products could trigger rosacea flare-ups, while others suggest they might instead help to alleviate them. The mechanisms behind these properties remain unclear. Some studies propose that dairy fatty acids, such as conjugated linoleic acids, could modulate the production of pro-inflammatory cytokines, thereby endowing these products with anti-inflammatory properties.

Individuals with rosacea do not always react the same way to different foods. The best method to determine what is beneficial or detrimental for you is to maintain a detailed food diary, noting the frequency and intensity of rosacea flare-ups.

• STEINHOFF M. & al. Recent advances in understanding and managing rosacea. F1000 Research (2018).

• ALI F. & al. Rosacea. British Journal of Hospital Medicine (2021).

• AL-NIAIMI F. & al. Rosacea and diet: what is new in 2021? Journal of Clinical and Aesthetic Dermatology (2021).