Conditions that Trigger Rosacea Flare Ups

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This article on Rosacea and its triggers originally appeared in the July/August issue of The Triangle Physician. You can download a copy here.


As yet, no cure for rosacea has been identified, and its exact cause remains unknown. However, by avoiding the most well-known triggers, a rosacea sufferer may be able to mitigate its symptoms. As each patient is unique, there is no guaranteed method for preventing a flare, and as with most conditions, specific rosacea triggers tend to vary from person to person.


Heat can pose a problem for individuals with rosacea – coming from various sources. Excess sun exposure is especially problematic, and
even the heat from a hot beverage, such as coffee or tea, can be a culprit. Rosacea patients need to be careful when exercising, as the excess body heat created by some workouts and routines may bring on a flare as well. Rosacea patients are generally advised to avoid hot tubs and saunas and to take lukewarm showers.

Extreme Cold

Just as heat can bring on a rosacea flare, cold temperatures can have the same effect, especially when strong windchill is present. Some ointments can protect the skin against harsh winter temperatures. It is advisable to cover the skin with protective and warm clothing on cold days.

The Wrong Skin-Care Products

Some types of moisturizers, facemasks, chemical peels, cosmetics and other topical products can aggravate rosacea. In general, fragrance-free and hypoallergenic products tend to be safer, but patients should consult with dermatologists about any creams, lotions or skin products they plan to use. This also includes sunscreens and barrier ointments.

Food Triggers

Spicy foods, especially dishes prepared with hot peppers, are the most commonly known aggravators of rosacea. Not only “heat” from
spices, but also thermal heat from a dish, can act as a trigger. It is not necessary to limit oneself to cold or room-temperature meals, but rosacea patients should avoid eating food while it is still piping hot.

Foods high in histamine are believed to trigger rosacea flares. Various food categories are high in histamine, including foods that contain
vinegar, such as ketchup, mayonnaise, pickled foods, dried fruits and fermented vegetables like sauerkraut and kimchee. Sufferers should also avoid avocado, eggplant, spinach, citrus fruits, bananas and tomatoes.

Alcoholic Beverages

All types of alcohol are potential triggers. Beer and wine (especially red wine) are particularly problematic, and some types of liquor can bring on a flare.

Stress and Anxiety

Heightened emotional states have been known to exacerbate rosacea, especially since strong emotions can sometimes result in a fight-or-flight response that naturally elevates the body’s temperature. It is not always possible to avoid stressors, such as difficult work situations, but it is important to pay close attention to the specific factors that create stress and to take appropriate steps to mitigate it.

While avoiding triggers will not eliminate rosacea symptoms entirely, being aware of the factors that bring on a flare can help to make life
with rosacea more manageable. It is also important for each patient to observe and be aware of his or her own personal triggers. Individuals who believe they may be affected by rosacea should undergo thorough examination by their dermatologists to receive a proper diagnosis and identify possible treatment options.

Dr. WilmothDr. Gregory Wilmoth, a board-certified dermatologist at Southern Dermatology & Skin Cancer Center in Raleigh, specializes in Mohs surgery and skin cancer reconstruction, among other specialties. He earned his bachelor of science degree in chemistry from the University of North Carolina at Chapel Hill and his medical degree from Bowman Gray School of Medicine, Wake Forest University. He completed his internship at North Carolina Baptist Hospital and residency at Mayo Clinic, Rochester, Minn. Dr. Wilmoth is a fellow of the American Society for Mohs Surgery. He is a member of the American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, American Academy of Dermatology, American Medical Association and the North Carolina Medical Society.