Rosacea is a chronic skin condition that causes a stubborn redness of the forehead, cheeks and nose. Most patients use topical rosacea treatments to keep the condition under control. However, even with the best rosacea treatments, patients often are faced with flare-ups that are caused by so-called rosacea triggers.

Many rosacea trigger factors exist, which aggravate the chronic inflammation of the facial skin. Anything that can stimulate the immune system, that can cause blood vessels to dilate or anything that has a direct effect on the skin, can be a trigger factor. Many different trigger factors are present simultaneously, which makes it hard for rosacea sufferers to figure out what trigger factors affect their condition. Rosacea trigger factors can be classified as:

• Stress and stress related factors
• Sun exposure
• Food ingredients
• Weather Conditions

Unless you are forced to be outside all the time (for a job perhaps), weather and sun exposure are trigger factors that can be controlled the easiest. Rosacea patients are frequently advised to limit their sun exposure and to protect their skin with a sun block. Sunscreens that contain titanium dioxide or zinc-oxide instead of chemical sunscreens are usually better for rosacea. Limiting the exposure of the skin to extreme hot or cold weather is something everyone can do.

Stress is a trigger factor that is a little harder to control. Although we may not want to become stressed out over something, stress can happen before we realize it. Stress-related emotions such as anxiety, excessive worrying and embarrassment directly or indirectly stimulate the flushing processes of the skin and could therefore make rosacea symptoms worse. Stress has a very negative effect on our health, weakening our immune system and stimulating the production of certain hormones. A more balanced way of life combined with a good diet and perhaps vitamin B supplements will reduce the effect of stress on our health.

Food ingredients make up the largest group of rosacea triggers. There are numerous ingredients that cause rosacea flare-ups and not every rosacea patient reacts the same. Sometimes, it can take a long time to figure out exactly which foods make rosacea symptoms worse. For that reason, it may help to keep a detailed food diary. Eliminate one food ingredient at a time and wait a few days to observe the effect of the elimination. While it may take 24 hours to see an adverse effect of a particular food item on rosacea, it usually takes at least twice as long to see a potential improvement after eliminating a food ingredient.

Aged foods are often high in histamine and tyramine can aggravate rosacea symptoms. Foods such as aged cheeses, wine, beer, chocolate, tomatoes, bell peppers, cabbages, lettuce often have to be eliminated from the diet. Also, alcohol and caffeine containing drinks should be limited, since alcohol and caffeine stimulate flushing of the face. However, even if you’re successful in eliminating trigger foods from your diet, there could be spices, food flavorings and preservatives that can act as triggers.

Finally, there are foods or drugs that can increase the amount of nitric oxide (NO) in the blood, which acts as a vasodilator. Foods that contain high levels of the amino acid arginine (such as certain nuts, soy and chocolate) can increase nitric oxide. Also, the nitrate preservatives often found in cured meats increase NO in the blood. Drugs such as the erectile dysfunction drugs also work to increase nitric oxide in the blood and can therefore aggravate rosacea.

Identifying the various rosacea triggers in food and the environment is the first step toward better looking skin. This, combined with an appropriate topical treatment for rosacea will lead to a successful long-term management of symptoms for many rosacea patients.

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