Is a specific diet necessary if you have rosacea?

The rosacea is a chronic inflammatory skin disorder primarily affecting the central face. It manifests as a diffuse redness resulting from persistent dilation of blood vessels, often accompanied by heightened skin sensitivity and sensations of burning or tingling. The evolution of rosacea is generally cyclical, with phases of exacerbation and periods of remission. Over time, the redness may become permanent and be accompanied by other inflammatory signs.

One can distinguish several clinical forms of rosacea : vascular rosacea (or couperose), characterized by redness and vasomotor flushing, the papulopustular rosacea, characterized by inflammatory papules that may resemble acne, the hypertrophic subtype, which is less common and is associated with skin thickening, such as rhinophyma, and the ocular rosacea, which affects the eyelids and the ocular surface with redness and dry eyes.

Given the diverse clinical manifestations and the risk of rosacea exacerbation, we recommend consulting a dermatologist as soon as any indicative symptoms appear. A medical evaluation provides an accurate diagnosis and allows for tailored management before any changes to your diet are considered.

Rosacea is a chronic inflammatory skin disease that manifests as diffuse redness associated with persistent dilation of blood vessels. The evolution of rosacea is generally cyclical, with phases of exacerbation and periods of calm.

If diet is not a direct cause of rosacea, it can influence the severity and frequency of flare-ups in certain individuals. Many patients report that specific foods trigger or worsen redness, while others appear better tolerated. To date, there is no universally recommended dietary regimen for rosacea. However, some foods exhibit mechanisms related to inflammation and vascularization, suggesting they may help space out rosacea flare-ups.

Coffee or tea.

Coffee is often listed among the foods that trigger a rosacea flare, mainly due to its caffeine content. However, scientific evidence adds nuance to this notion. In practice, it is not so much the caffeine itself as the high temperature of the beverages that seems to promote redness. Very hot drinks induce a reflex vasodilation of the skin’s blood vessels, which can worsen the vasomotor flushes characteristic of rosacea. In some individuals, coffee or tea consumed at very high temperatures can thus transiently trigger flushing.

In contrast, a large prospective study (82,737 women followed from 1991 to 2005) found an inverse association between caffeine intake and the risk of developing rosacea.

Participants with high caffeine intake indeed showed a reduced risk of rosacea. More specifically, consuming four cups of coffee per day or more was associated with a significant reduction in the risk of a rosacea flare-up, whereas decaffeinated coffee did not show a significant association.

These results suggest that caffeine may exert a vasoconstrictive effect that could theoretically limit rosacea. However, this association has not been observed for caffeine from other sources such as tea, sodas, or chocolate. Based on current knowledge, coffee could therefore be of interest, provided it is consumed warm rather than very hot. Nevertheless, further research is still needed to confirm this.

Foods containing vitamin B2.

The hypothesis of a link between vitamin B2 (riboflavin) and rosacea dates back to the 1940s, when a riboflavin deficiency was suggested as a factor that could exacerbate certain inflammatory skin manifestations. Riboflavin plays a key role in the cellular energy metabolism and in the functioning of antioxidant systems, notably via its coenzymatic derivatives (FAD and FMN). Some clinical observations have reported that topical application of vitamin B2 could improve the skin appearance in individuals affected by rosacea, particularly by reducing erythema and inflammation.

The exact mechanism remains under debate, however. It has been suggested that riboflavin may modulate the inflammatory response by limiting immune cell adhesion to the endothelium and by reducing the oxidative stress locally. Since inflammation and vascular dysfunction are directly involved in rosacea pathophysiology, this effect could theoretically help alleviate symptoms. However, the data mainly concern topical use; no study has shown that oral supplementation alters the clinical course of the disease. It is therefore difficult to consider vitamin B2 as a food to favor in cases of rosacea. A balanced diet, covering riboflavin needs in particular, undoubtedly contributes to maintaining healthy skin, but it does not constitute a treatment for rosacea per se.

As a guideline, the recommended dietary intake of vitamin B2 for adults is approximately 1.6 to 2 mg per day.

Zinc-rich foods.

The zinc is a trace element involved in regulating immunity, wound healing, and the inflammatory response, which explains its relevance in inflammatory dermatoses. However, clinical data on oral zinc supplementation in patients with rosacea remain mixed. A double-blind study evaluated the effect of zinc sulfate (220 mg twice daily for 90 days) in 44 rosacea patients. At the end of three months, an improvement in severity scores was observed in both groups (zinc and placebo), but without a statistically significant difference between them. Serum zinc levels were predictably higher in the supplemented group, but this did not translate into a clinical benefit. The authors concluded that oral zinc did not demonstrate significant efficacy compared to placebo in this population.

In contrast, another study conducted in Baghdad between 2002 and 2004, including 25 patients, reported more favorable results. Participants received 100 mg of zinc sulfate three times daily under a double-blind protocol with group crossover after three months. In patients treated with zinc from the outset, the mean severity score (initially 8 ± 2.0) decreased significantly as early as the first month. After switching to placebo, a slight rebound in the score was observed, without returning to the initial level. In the original placebo group, improvement only appeared after zinc was introduced.

These methodological discrepancies (small sample sizes, varying dosages, and variable durations) complicate interpretation. Mechanistically, zinc may modulate inflammation by inhibiting activation of the transcription factor NF-κB, which is involved in the production of pro-inflammatory cytokines such as TNF-α and IL-1β. However, the data remain insufficient to systematically recommend zinc supplementation to patients with rosacea. It is preferable to naturally incorporate zinc-rich foods into one’s diet to meet the body’s needs, without expecting a significant effect on rosacea flare-ups.

For reference, the recommended dietary intake of zinc for adults is approximately 8 to 11 mg per day.

Foods containing omega-3 fatty acids.

Omega-3 fatty acids (notably EPA and DHA) are recognized for their anti-inflammatory and immunomodulatory properties. They are involved in the synthesis of lipid mediators capable of modulating the inflammatory response and limiting the production of pro-inflammatory cytokines. However, rosacea is partly based on immune and neurovascular dysregulation, with excessive activation of inflammatory pathways. From this perspective, omega-3s are among the foods to be prioritized in cases of rosacea, although human clinical data remain limited.

A recent experimental study investigated their role in a murine model of rosacea induced by the peptide LL37. Dietary omega-3 supplementation reduced skin erythema and decreased dermal infiltration of inflammatory cells such as mast cells, neutrophils, and CD4+ lymphocytes. The authors also demonstrated inhibition of the TLR2/MyD88/NF-κB pathway involved in inflammatory activation, as well as a reduction in proinflammatory cytokines. Bioinformatics analyses revealed a significant overlap between the pathways modulated by omega-3s and those implicated in the pathophysiology of rosacea, especially the erythematotelangiectatic subtype. Although these results are promising, they come from an animal model: they suggest potential nutritional benefits, but do not yet allow us to conclude on the efficacy of omega-3s in mitigating rosacea flare-ups in humans.

The recommended intake of omega-3s varies depending on the source, but regularly consuming fatty fish (1 to 2 times per week) is generally advised as part of a balanced diet.

Is the Mediterranean diet the most suitable for rosacea?

The Mediterranean diet is often cited among beneficial dietary models in inflammatory contexts. Rich in fruits, vegetables, legumes, whole grains, fish, olive oil, and nuts, and low in red meats and ultra-processed foods, it is characterized by a high intake of antioxidants, fiber, and mono- and polyunsaturated fatty acids. This nutritional profile could theoretically modulate the inflammatory pathways involved in rosacea, while supporting the gut microbiota, whose role is being increasingly studied in this skin condition.

A prospective study conducted between 2018 and 2021 involving 3,496 adults explored the link between adherence to a Mediterranean-style diet and the risk of rosacea. The researchers used an adherence score (Mediterranean Diet Score) based on seven food groups. After adjustment, each one-point increase in the score was associated with a significant decrease in the risk of rosacea. Interestingly, this protective association was observed in participants with a BMI of less than 24.5 kg/m², but not in those who were overweight or obese, suggesting an interaction between metabolic status and inflammatory response.

These findings support the idea that the Mediterranean diet might be preferable, especially for individuals with rosacea.

Tip : Individuals with rosacea do not always react to foods in the same way. The most effective method to ascertain what benefits or triggers your condition is to maintain a journal that details your diet and records the frequency and intensity of rosacea flare-ups.

While diet may have an effect on rosacea flare-ups, it can in no way substitute for medical treatment and dermatological monitoring.

While some foods appear compatible with redness-prone skin, others are consistently reported as triggers for flare-ups. However, there is no universally valid list of good and bad foods for rosacea: sensitivity varies from one individual to another. That said, the following foods are frequently not recommended for people with rosacea.

Spicy foods.

Spicy foods rank among the most frequently reported triggers of a rosacea flare-up. Capsaicin, found in chili peppers and certain spices, activates the TRPV1 receptor (Transient Receptor Potential Vanilloid 1), which is expressed notably by cutaneous nerve fibers. This receptor plays a key role in nociceptive and neurovascular mechanisms. Its activation leads to the release of neuropeptides such as CGRP (calcitonin gene‐related peptide) and PACAP, which induce a vasodilation of blood vessels. In individuals with rosacea, who already exhibit vascular hyperreactivity, this stimulation can increase erythema and the sensation of heat. Furthermore, repeated activation of these neuroinflammatory pathways may perpetuate local inflammation. Therefore, highly spicy dishes are generally among the foods to avoid if one suffers from rosacea.

Alcoholic beverages.

Alcohol is frequently listed among foods to avoid if you suffer from rosacea, due to its vasodilatory effect. From a physiological standpoint, alcohol promotes the release of mediators such as bradykinin and certain catecholamines, which leads to a dilation of the cutaneous blood vessels and a localized rise in temperature. Moreover, alcohol stimulates the production of pro-inflammatory cytokines, which can promote rosacea flare-ups. Epidemiologically, a large prospective study of 82,737 women followed over 14 years identified 4,945 new cases of rosacea. Analyses showed a progressively increasing risk associated with alcohol consumption. Certain beverages, notably white wine and spirits, appeared more strongly linked to risk than other types of alcohol.

However, it would be unfair to systematically associate rosacea with the consumption of alcohol : although alcohol can exacerbate symptoms, the vast majority of rosacea cases occur independently of any alcohol.

Hot beverages.

Whether it’s tea, coffee, or hot chocolate, it’s not recommended to consume these beverages at very high temperatures when suffering from rosacea. Note that it’s not the drinks themselves that are to blame, but their temperature. When consumed extremely hot, they promote a dilation of blood vessels, which leads to redness and flushing.

Dairy products.

The role of dairy products in rosacea remains a matter of debate.

Some observations suggest that dairy products may act as triggers for rosacea, while other epidemiological studies have not confirmed this association, or have even observed a neutral or protective effect depending on the type of product consumed. Several hypotheses have been proposed. Dairy products contain bioactive proteins and growth factors that can influence inflammatory signaling. They may also modulate the gut microbiota, which is increasingly studied in rosacea due to links between dysbiosis and low-grade systemic inflammation. Given the current state of knowledge, it is therefore difficult to make a general recommendation.

Note : Fermented products, such as yogurt, provide probiotics that may support intestinal balance, which could theoretically alleviate the skin inflammation seen in rosacea.

Foods rich in saturated fats.

Foods high in saturated fats, such as cured meats, fried foods, and certain ultra-processed products, are often mentioned among the foods to avoid if you suffer from rosacea, although direct evidence remains limited. That said, it is true that a diet rich in saturated fatty acids promotes a low-grade systemic inflammatory state, which could theoretically exacerbate rosacea symptoms.

Even though there is no formal evidence for rosacea, moderate fat consumption fits within a coherent overall health strategy.

Foods containing cinnamaldehyde, such as cinnamon.

Cinnamaldehyde is a compound capable of activating the TRPA1 (Transient Receptor Potential Ankyrin 1) receptor. This receptor, expressed by cutaneous sensory nerve fibers, is involved in neurovascular and inflammatory processes. Its activation can lead to the release of vasoactive neuropeptides, promoting vasodilation of dermal capillaries and the onset of redness or sensations of warmth. However, the threshold dose required to induce a reaction has not been clearly established, and sensitivity varies greatly between individuals.

Good to know : In addition to cinnamon, cinnamaldehyde is present in tomatoes, carrots, chocolate, apples, and oranges, which does not necessarily mean these foods must be avoided if you have rosacea. You can still eat them, and by tracking when you experience flare-ups, you can determine whether your skin is sensitive to these foods.

Whether or not you have rosacea, any major dietary changes should ideally be discussed with a healthcare professional in advance. The latter can help you distinguish the real triggering factors from simple coincidences and can give you advice depending on the subtype of rosacea, especially in case of papulopustulose or ocular rosacea. The objective is to act globally, without multiplying unnecessary restrictions.

• TULIPAN L. Acne rosacea – A vitamin B complex deficiency. JAMA Dermatology (1947).

• AL-SALMAN H. N. & al. Oral zinc sulfate in the treatment of rosacea: A double-blind, placebo-controlled study. International Journal of Dermatology (2006).

• JOHNSON B. P. & al. Randomized, double-blind trial of 220 mg zinc sulfate twice daily in the treatment of rosacea. International Journal of Dermatology (2012).

• LI W. Q. & al. Alcohol intake and risk of rosacea in US women. Journal of the American Academy of Dermatology (2017).

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

• DRUCKER M. A. & al. Association of caffeine intake and caffeinated coffee consumption with risk of incident rosacea in women. JAMA Dermatology (2018).

• CAPACCI A. & al. Influence of mediterranean diet on human gut microbiota. Nutrients (2020).

• LI J. & al. Relationship between rosacea and dietary factors: A multicenter retrospective case-control survey. The Journal of Dermatology (2019).

• 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).

• REINHOLZ M. & al. Dietary patterns in acne and rosacea patients – A controlled study and comprehensive analysis. Nutrients (2023).

• SHEN M. & al. Associations of adherence to Mediterranean-like diet pattern with incident rosacea: A prospective cohort study of government employees in China. Frontiers in Nutrition (2023).

• WANG P. & al. Dietary supplementation of n-3 PUFAs ameliorates LL37-induced rosacea-like skin inflammation via inhibition of TLR2/MyD88/NF-κB pathway. Biomedicine & Pharmacotherapy (2023).