Rosacea? Let’s Not

Rosacea is a common condition we see and treat at Skin Resus

The key features of this disorder include facial redness, often combined with inflamed lumps, pustules, and broken capillaries. In some cases, intermittent flushing also occurs. The central face—nose, chin, forehead, and inner cheeks—is most commonly affected, though less commonly, the neck, chest, and even eyes can be involved.

The causes of rosacea are not well understood, but like acne, it originates in the sebaceous glands. These glands are strongly influenced by dietary factors, such as the intake of simple carbohydrates and inflammatory fats. This can trigger hormonal changes, leading to excess sebum production and bacterial overgrowth.

Once established, these changes can be difficult to reverse, and rosacea-prone skin is easily irritated by environmental and dietary factors (see below for more on dietary triggers).

Treatment of Rosacea

1.  IPL (Intense Pulsed Light) – Our core treatment

Clears broken capillaries, reduces redness, and helps settle acne-like lesions. Best performed as two to three treatment sessions, spaced four weeks apart.

2.  Reduce sebaceous gland activity

• Maintain a healthy diet – Fish and salad only… just joking! But you know a good diet when you see it.
• Vitamin A (25,000 IU daily) – Speak to a doctor before starting this.
• Hormone replacement therapy (HRT) – Some forms may be beneficial, but always consult a doctor first.

4.  Topical serums

• Niacinamide (10–15%) is well tolerated and effective.
• Retinol can help but requires a cautious approach and patience when starting.

5.  Probiotics and prebiotics

• Include both soluble and insoluble fibre, plus fermented foods (e.g., yoghurt, kefir).
• Add a good mix of fibre to your diet—rice bran, oat bran, psyllium, wheat bran.

6.  Antibiotics

• Topical antibiotics are commonly used.
• Oral antibiotics may be beneficial for acne-like rosacea.

7.  Foods and Rosacea

Certain foods can trigger or worsen rosacea. The most common culprits include:

• Alcohol
• Spicy foods
• Tomatoes and citrus
• Chocolate
• Histamine-rich foods (e.g., cheese, wine, processed meats)

Interestingly, some studies suggest that dairy consumption may improve rosacea, while fatty foods seem to worsen it, possibly due to inflammatory reactions. Caffeinated drinks have also been linked to benefits, as they can constrict blood flow to the skin.

By Dr David Main