Rosacea typically occurs on the central part of the face around the cheeks and nose, but can also affect the chin, forehead, eyelids, and eyes (ocular rosacea). (2) Ocular rosacea can cause a number of eye symptoms, such as redness, watery eyes, a gritty sensation, and blurry vision. (3) Rosacea is a chronic condition that can come and go throughout your life. (1) Understanding its causes and triggers can potentially reduce your number of flares, resulting in clearer, symptom-free skin.
What Are Common Causes of Rosacea?
Although the exact cause of rosacea is unknown, experts believe that certain factors may play a role in the development of this skin condition. (1) This includes:
Abnormal Blood Vessels
Some people with rosacea have enlarged blood vessels in their face, resulting in redness around their cheeks and nose. One theory is that these individuals have an abnormality in their blood vessels, which makes them more susceptible to swelling and inflammation. The reason for this abnormality isn’t clear. (4)
Genetics
Family history or genetics may also contribute to rosacea. In fact, many people diagnosed with this skin condition also have a close family member with similar symptoms. (5)
Overactive Immune System
Rosacea might also arise from an overactive immune system. It’s your immune system’s job to protect you from infections, and inflammation is an integral part of your body’s immune system response. Inflammation acts as a defense mechanism, helping your body heal and fight off bacteria. (6,7) Sometimes, though, the immune system overreacts, triggering too much inflammation. This response can lead to dilated blood vessels and redness in the face.
Microscopic Mites
Everyone’s skin contains demodex mites that live near or on hair follicles. These mites are usually harmless and go unnoticed. But for reasons that aren’t clear, these mites seem to play a role in the development of rosacea. (6) It appears that people with rosacea have a larger number of these mites on their skin than others, explains Anna D.Guanche, MD, a board-certified dermatologist based in Calabasas, California.
Helicobacter Pylori Bacteria (H. pylori)
This bacteria normally lives in the digestive system or gut. Although the connection between H. pylori and rosacea hasn’t been proven, it’s been found that some people who have rosacea also have this bacteria. One theory is that the bacteria stimulates the production of a protein that causes blood vessels to dilate. This makes blood vessels more visible, resulting in persistent redness in the face. (4)
Cathelicidin
Cathelicidin is a protein that protects the skin from infection. If you have rosacea, you may have too much of this protein on your skin, which can trigger redness and swelling. (5)
Other Risk Factors
Rosacea can affect anyone at any age, yet certain people are at greater risk. Not only does this include people with a family history of rosacea, but also descendants from Scandinavian or Celtic families. Rosacea is also more common in women than men. (1,5) In women, rosacea is more likely to occur on the cheeks and chin, whereas men are more likely to have thickening of the nose. (1,4) Rosacea is also common between the ages of 30 and 60, and tends to affect those who are fair-skinned with blonde hair and blue eyes. (8) The risk also increases if you smoke. Smoking can cause blood vessels to dilate.
Clearing Up Misconceptions About Rosacea Causes
It’s also important to note factors that don’t cause rosacea. Rosacea isn’t caused by poor hygiene, nor is it a contagious or infectious disease. So you can’t pass this skin condition to another person through direct or indirect skin contact. (1,5)
What Can Trigger a Rosacea Flare-Up?
The good news is that rosacea can go into remission, which is a period when symptoms disappear. Still, since rosacea is also an ongoing condition, symptoms can return. Keep in mind that anything that increases blood flow to the facial area can exacerbate this condition. (1) Once you’re diagnosed with rosacea, understanding your triggers can potentially reduce your number of flares. Common rosacea triggers include:
Hot Drinks and Spicy Foods
Both of these can increase blood flow to your face and cause flushing or skin redness. But while spicy foods and hot drinks are triggers for some people with rosacea, they don’t affect everyone with the condition. (1) To help identify which food and drinks to avoid, keep a food journal and make a note of everything you consume. Does your rosacea worsen or flare after eating or drinking certain things? If so, eliminate these items and see if your condition improves.
Alcohol
Alcohol doesn’t cause rosacea, but drinking alcoholic beverages can cause dilated blood vessels in your skin, resulting in flushing and redness, says Tsippora Shainhouse, MD, a board-certified dermatologist based in Los Angeles. For this reason, you should avoid any alcoholic beverage that triggers a flare, such as red wine, beer, gin, champagne, or vodka. (5)
Extreme Temperatures
Extreme temperatures (hot or cold) can also trigger rosacea. You might notice worsening symptoms when you’re overheated or after exposure to cold air or wind. Avoiding hot baths or saunas, as well as protecting your skin from cold air can potentially limit flares. (8,9)
Exposure to Sunlight
Sunlight can also irritate rosacea. (9) So the more you’re exposed to sun, the more rosacea flares you may experience. For this reason, you might need to make SPF your BFF, recommends Kristel Polder, MD, a board-certified dermatologist in Dallas. Sunscreen not only helps improve rosacea redness, it can also help acne-prone skin, she continues. To guard your skin and reduce flares, apply a broad-spectrum sunscreen with at least SPF 50 or higher, stay indoors during the heat of the day, and wear protective clothing and sunglasses to cover your skin and eyes. (9)
High-Histamine Foods
High-histamine foods, such as dairy, shellfish, legumes, and smoked meats, can also cause dilated blood vessels, which can worsen rosacea or trigger a new flare. Avoiding these foods may improve the appearance of your skin. Again, use a food journal to pinpoint possible food triggers. (10)
Cosmetics
“Rosacea-prone people tend to have sensitive skin and are more likely to react to various ingredients and chemicals in personal skin care products,” explains Dr. Shainhouse. This can include products containing alcohol or an astringent. Look for fragrance-free versions, instead, says Shainhouse, and use a mild cleanser on your face. Also, practice gentle skin care — don’t scrub or rub your skin too roughly. This can exacerbate redness. (9)
Stress
Stress also triggers rosacea in some people. Take steps to reduce your stress level. Exercise, get plenty of sleep, and practice relaxation techniques, like yoga or deep breathing. Choose low-intensity workouts, as extreme or heavy workouts are also a rosacea trigger. (5) Other reported rosacea triggers include hormonal changes (such as menopause), and certain medicines, like corticosteroids or those prescribed to treat high blood pressure. (1,5)
Final Word on Rosacea Causes and Triggers
Talk to your doctor if you experience signs or symptoms of this condition. Although there’s no cure for rosacea, treatment options can help you control it. If left untreated, rosacea can progress and cause complications, such as permanent redness or a build up of tissue around the nose. (1)
