Causes and triggers of rosacea

It is not yet known what causes rosacea to develop in some people. For some genetics may be the cause, for example you may be more likely to get rosacea if one of your parents has the condition. Some evidence has also suggested links between certain bacteria found on the skin and common mites also found on the skin.

There is no clear evidence to suggest that any one or all of these issues causes rosacea; for some they may simply be prone to the condition.

It is widely accepted that are certain triggers that can cause a flare-up or worsen rosacea symptoms. These vary greatly from person to person, however it may be helpful to keep a diary of possible triggers to help avoid future flare-ups.

Below is a list of some common triggers which people living with the condition have found can trigger flare-ups. Again these will vary depending on the person – you may find that you can relate to many or just a few triggers. However they are worth keeping in mind when you are trying to control your rosacea symptoms.

Flare-ups and triggers

  • Diet, alcohol and caffeine intake - these triggers can be linked to rosacea however they are not key factors, and their effect is different for each individual.

    Diet is regularly explored in relation to rosacea. Most evidence suggests that diet does not play a critical role in the development or symptoms of rosacea. However, there is some evidence to suggest that certain foods and drinks, in particular spicy foods, caffeine and alcohol, can worsen the symptoms of rosacea, in particular facial redness.

    If you believe that your diet has an effect on your rosacea, it may be useful to keep a diary to monitor triggers. By making a note of the food and drink items consumed and the severity of your symptoms, you may be able to identify food and drink that should be avoided.

  • Body temperature, stress and emotions - there is a link between these and the symptoms and development of rosacea.

    Rapid increase in body temperature from hot drinks, exercise, weather, stress or other heightened emotional responses (such as feeling angry, embarrassed, stressed) can make the symptoms of rosacea worse.

  • Environmental triggers - there is some evidence that hot/cold weather, baths and showers which are too hot, strong winds and sunburn has an impact on rosacea.

    There are some suggestions for treatments to prevent rosacea symptoms worsening due to the effects of weather. Wind and exposure to sunlight can worsen the condition so take care to cover skin in these conditions. A broad spectrum sunscreen is recommended for all patients with rosacea, in particular a sunscreen that protects against UV-A and UV-B light. Titanium dioxide and zinc oxide are good ingredients to look for when choosing a sunscreen. These ingredients are well tolerated by those with rosacea-prone skin and also act as physical blockers against the sun’s rays.

  • Skincare triggers - Certain products used as part of a skincare regime may worsen the symptoms of rosacea.

    The impact of products applied to the skin will depend on the individual; however there are some products that should generally be avoided by all those affected by rosacea. These include:
    - soap and detergents (for example shower gels, bubble baths, hard soaps)
    - alcohol (many products contain alcohol so read labels carefully to check for ingredients such as SD alcohol, denatured alcohol, ethyl alcohol)
    - acne remedies (especially those containing benzoyl peroxide)
    - natural products (those containing witch-hazel, tea-tree oil, grapefruit)
    - topical steroids (medication applied to the skin for skin complaints such as eczema)

  • Medication - certain medications may cause ‘flare ups’ of rosacea symptoms.

    Examples of these medications include Amiodarone (a medicine used to restore normal heart rhythm), topical steroids (steroids applied to the skin which are used to reduce inflammation in the treatment of eczema, psoriasis and other skin conditions), nasal steroids (steroids which are inhaled to treat allergies such as hay fever), and high doses of vitamins B-6 and B-12. If you are taking any of these medications it may be helpful to monitor their effects on your rosacea. If you think your medication may be making your rosacea symptoms worse, speak to your doctor for advice on what to do next. It is important that you do not stop taking any medication without first seeking advice from your doctor.

There are a variety of trigger factors that may make rosacea worse; sometimes it can be difficult to separate out what may be the trigger or if several things may be acting as a trigger. Some people find eliminating one thing at a time is helpful in order to see if this makes a difference to their rosacea symptoms. Alternatively, eliminating a few possible triggers then bringing one back in slowly may be a useful way to see if the symptoms worsen or reoccur.

It is worth noting that the term ‘acne rosacea’ has previously been used to describe rosacea. This is no longer widely used as a label as it has been found that rosacea is unrelated to acne.

Sources of evidence available on request.

Information contained in this Articles page has been written by talkhealth based on available medical evidence. Our evidence-based articles are certified by the Information Standard and our sources are available on request. The content is not, though, written by medical professionals and should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands, or treatments.

Information written by the talkhealth team

Last revised: 12 April 2016

Next review: 12 April 2019