Rosacea: Causes, Symptoms & Effective Treatment Plans

What is Rosacea?

Rosacea (pronounced rose-ay-sha) is a chronic skin condition that appears as persistent redness, resembling sunburn. Over time, acne-like bumps may develop, leading to skin thickening and, in severe cases, a bulbous nose. Symptoms include dryness, burning sensations, and sensitivity, commonly affecting the cheeks, nose, chin, and forehead.

Rosacea typically develops between ages 35 and 45 (Ref. FC Powell) and is primarily a disorder of facial blood vessels.

What is Couperose?

Couperose refers to broken capillaries causing redness and sensitivity. While it shares similarities with rosacea, couperose is milder and does not progress to more severe symptoms.

Rosacea Facts

Rosacea isn’t contagious or infectious, the rosiness or blushing effect is actually caused by enlarged blood vessels under the skin and these blood vessels fail to function like normal ones. Rosacea sufferers may also develop pimples and have dry, burning and gritty sensations in the eyes. A thickening of the skin, caused by enlarged sebaceous glands, can also lead to the nose becoming larger and disfigured (bulbous).1,2

• There are approximately 45 million rosacea sufferers worldwide.3
• Fair skinned adults are more likely to get rosacea than darker skinned folks.
• Rosacea can occur at any age, however it’s more common in middle-aged women.

How to Prevent Rosacea

In the rosacea management plan you’ll find out how to look after your skin condition and minimise discomfort. The Rosacea Management Plan details factors that can exacerbate rosacea. After the management plan comes the Rosacea Treatment Plan. This program shows you how to improve your health and clear up your skin condition from the inside out. Rosacea is said to be irreversible once it becomes chronic but I believe any stage of rosacea can be eliminated or at least minimised and controlled with the right health program. This program is divided into five steps.

The supplemental advice in the Rosacea Treatment Plan is designed for adults. If you have a child with rosacea, you can read this section however you should follow the ‘Children’s Clear Skin Program’ (Chapter 16 in The Healthy Skin Diet) or at least implement a daily exercise routine for your child.

Rosacea Management Steps:

1. Use skincare to restore the skin barrier
2. Take supplements that promote healthy blood flow
3. Identify and limit histamine reactions
4. Maintain good intestinal health
5. Exercise regularly
6. Follow a rosacea-friendly diet

Step 1: Use Skincare to Protect and Restore

Rosacea can be challenging to manage, but the right cream for facial redness can make all the difference. Look for ingredients such as 5% dexpanthenol (provitamin B5) to restore the skin barrier and repair skin. Plus mango butter, castor oil and camellia seed oil to nourish and protect your skin.

Incorporating a rosacea cream or a rosacea supplement into your skincare routine for mild rosacea can help soothe irritation and improve skin health over time. 

For those dealing with redness, dryness, or irritation, products like a rosacea-friendly moisturiser or rosacea-friendly skincare can provide relief. Additionally, supplements such as vitamins for rosacea support the skin from within, enhancing hydration and reducing redness. 

Explore related options like our moisture barrier cream for a comprehensive skincare routine tailored to sensitive skin needs.

Step 2: Supplements for Rosacea & Blood Flow

These include natural antihistamine supplements, including vitamin C and vitamin B6..

Studies have looked at the effects of B vitamins on rosacea, and early research indicates that deficiencies in vitamins B2, folate, and vitamin B12 are associated with rosacea. More recently, researchers found that the severity of papulopustular rosacea (PPR) was linked to lower levels of vitamins B12 and folate. Additionally, nicotinamide and mecobalamin have shown potential for helping manage rosacea symptoms. Taking these nutrients together in an activated multi helps to relieve rosacea symptoms along with a low histamine diet. 

While some vitamins are good for rosacea, you might need to avoid other vitamins such as vitamin D (unless you are diagnosed with a deficiency). Researchers in one study found that high vitamin D levels in the blood is associated with rosacea and they suspect high vitamin D levels may even lead to the development of rosacea, although more research is needed. 

The same researchers found that people with rosacea had lower levels of calcium in their blood when compared to the “healthy” control group of people. So while more research is needed, low calcium may be linked to the appearance of rosacea, which is why we provide high quality calcium in our mild rosacea supplements. 

See our video testimonial from Heidi who had severe rosacea before finding relief using the Skin Friend rosacea creams and the AM and PM skin supplements. 

Whether you need a non-toxic rosacea cream, vitamins for rosacea, vitamins for dry skin & eczema or an itchy skin treatment, treating your issues at the root, with diet, skincare and supplements can be your answer. Shop the complete rosacea clear skin program here. 

References

https://www.aad.org/public/diseases/rosacea/what-is/symptoms

https://pmc.ncbi.nlm.nih.gov/articles/PMC7429105/

https://jsurgmed.com/article/view/428632#:~:text=Results%3A%20Serum%20vitamin%20D%20levels,dl%20in%20the%20control%20group

Step 3: Identify & Limit Histamine Reactions

What Causes Rosacea?

Understanding rosacea requires a closer look at the functional and structural changes that occur in the blood vessels of rosacea sufferers.

Normal Blood Vessel Function in Healthy Skin

Blood vessels play a critical role in maintaining skin health:

• Oxygen & Nutrient Delivery: Facial blood vessels transport essential nutrients, vitamins, minerals, fats, and oxygen to the skin, ensuring proper function.
• Waste Removal: Blood vessels help remove waste products produced by skin cells, much like household garbage collection.
• Temperature Regulation: When body temperature rises, blood vessels expand (dilate) to release heat, then return to normal size once the temperature is regulated.

Abnormal Blood Vessel Function in Rosacea

In rosacea, the normal blood vessel process is disrupted:

• Increased Sensitivity: Blood vessels dilate in response to ordinary substances that typically don’t cause a reaction.
• Excessive Dilation: Rosacea-affected blood vessels expand wider than normal.
• Prolonged Expansion: These vessels remain dilated for an abnormally long time, leading to persistent facial flushing.

These functional changes, if left untreated, can lead to permanent structural changes in the skin’s blood vessels.

Structural Changes in Rosacea-Affected Blood Vessels

Blood vessels are responsible for transporting oxygen-rich blood from the heart to the skin. In rosacea sufferers, these vessels undergo long-term damage:

• Loss of Elasticity: Dysfunctional endothelial cells cause blood vessels to stay permanently dilated—similar to a balloon stretched too many times.
• Vascular Damage: The smooth muscle cells responsible for blood vessel contraction weaken over time.
• New Blood Vessel Growth (Angiogenesis): The formation of additional tiny blood vessels near the skin’s surface makes rosacea-prone skin appear redder.

It’s important to recognize and minimize triggers to prevent these functional changes from developing into irreversible structural changes.

Rosacea Triggers

Rosacea symptoms can worsen due to various environmental and lifestyle factors. Identifying your specific triggers can help manage flare-ups.

*Although exercise may trigger rosacea initially, it should not be avoided, as it is crucial for long-term skin health.

Rosacea Treatment Plan

Limit Histamine Reactions

Since rosacea-related redness is linked to enlarged blood vessels, controlling histamine intake is essential.

Histamine Sensitivity Quiz

To determine if histamines contribute to your rosacea, take the following quiz:

Results:

• 20+ points: Possible histamine sensitivity.
• 30+ points: High likelihood of histamine intolerance.

Even if you score low, reducing histamine intake may still help manage rosacea symptoms.

Histamine Exposure: Internal vs. Dietary

• Internal: The body releases histamine in response to stress or allergens.
• Dietary: Many foods contain histamine, which can trigger inflammation and flushing.

Histamine-Related Symptoms

• Itchy nose, sneezing, congestion
• Burning or watery eyes
• Skin rashes, hives
• Headaches or migraines
• Breathing issues (wheezing, spasms)
• Digestive discomfort (cramps, diarrhea)
• Flushed skin or rosacea flare-ups

Histamine in Foods & Drinks

Certain foods contain high histamine levels, while others trigger histamine release in the body.

Low-Histamine, Amine-Free Foods

To support rosacea-friendly nutrition, incorporate more of these foods:

Step 4: Improve Gut Health

• Take probiotics – To support gut microbiome balance.
• Chew food properly – To aid digestion and nutrient absorption.

Step 5: Exercise to Support Circulation

• Exercise is essential for eliminating rosacea. I found this out the hard way ...

  My own personal experience is with mild rosacea. It wasn’t so bad because luckily I found a way to get rid of it before it had a chance to get worse. The first signs of rosacea began to appear twelve years ago; my chin was always red and I had to camouflage it with make-up, but my skin colour suddenly improved after I took dairy products out of my diet.

  I had a skin prick test and blood test for allergies and intolerances and modified my diet slightly so I enjoyed having a clear complexion for a while. However a few years later, even without having dairy in my diet, I started getting facial flushing.

  If the gas heater was on in winter I would flush. I was also overly sensitive to the summer heat and I couldn’t splash my face with warm water in the morning without my face being pink for the rest of the day. I also got patchy, red flushing during and after exercise. This was embarrassing so I used to apply make-up before going to the gym, just so I wouldn’t look like a blushing beetroot. Not that I ever exercised much! As I’ve mentioned before, I just never liked exercise; it always fatigued me and sometimes brought on cold and flu symptoms so I’d feel rotten for a whole week. However whenever I did stick to an exercise routine my rosacea would magically disappear. Then I would find another excuse to ditch the regime and my rosacea would soon return. So I did some extra research to see if this was a common reaction.

  The Rosacea Support Group website states that ‘Many rosaceans have noted that moderate (not strenuous) exercise seems to help alleviate their rosacea symptoms’.

  Other specialists have also said that many sufferers find the same success with exercise, which could be due to increased sympathetic constrictor tone to the facial blood vessels.15

  Other scientific reasons why exercise can improve rosacea:

  • Moderate exercise burns up the body’s lipid stores, which potentially leaves less fat available for the inflammatory response. However, excessive exercise, such as running a marathon, does the opposite and promotes inflammation in the body.(16)
  • Moderate exercise decreases blood levels of arachidonic acid (AA).17 AA from meat and dairy can be used to make inflammation in the body so it’s important to reduce AA levels by exercising and avoiding dairy if you suffer from rosacea.
  • Exercise enhances the amount of anti-inflammatory endorphins in the bloodstream.
  • Excess glucose in the blood can damage blood vessels and exercise reduces blood glucose levels.

  Regular exercise also improves blood circulation and good circulation is vital for healthy skin. An efficiently pumping circulatory system is necessary to carry nutrients and oxygen to your skin. If you have poor circulation, your skin literally becomes starved of nutrients because you are giving it an inadequate supply of essential fatty acids, antioxidants and oxygen.

   

  How does skin that is starved of nutrients survive?

  Think about it ... skin that lacks oxygen and nutrients will rot and die (as is the case with gangrene). So when your blood supply is sluggish or hampered in some way, the skin needs extra blood vessels to supply more nutrient-rich blood and it needs wider blood vessels to allow more flow with less effort.

  Poor circulation also means there is an inefficient removal of bodily wastes such as industrial toxins, pollution, dead cells and chemicals. Increased waste and skin cell turnover can cause the facial oil glands to become blocked and enlarged. This can eventually lead to nose and skin disfigurement seen in chronic rosacea.

   

  Exercise tips for rosacea

  • Initially when you exercise, you will get flushing and feel uncomfortable but bear with it as this reaction will eventually disappear.
  • If possible, exercise in air-conditioning or go swimming to avoid negative symptoms.
  • Exercise and sweat for at least fifteen minutes a day. However, keep your routines moderate and under one hour until your rosacea has cleared up.

  
  

  Step 6: Follow a Rosacea-Friendly Diet

Rosacea Treatment Plan: Key Takeaways

• Limit histamine in your diet – Avoid alcohol, chocolate, cheese, and spicy foods.
• Exercise regularly – Moderate workouts help circulation.
• Support gut health – Take probiotics and chew food properly.
• Use skincare wisely – Choose barrier-supporting creams.
• Take targeted supplements – Vitamin C, omega-3, and chlorophyll.
• Eat a nutrient-rich diet – Prioritize fresh foods and avoid processed options.

FAQ

Q: I get awful facial flushing, especially in summer. What can I do to quickly relieve the flush?

A: People with severe rosacea tend to produce excessive body heat, making them feel hot and uncomfortable. If you're experiencing facial flushing or excessive heat, try these methods for quick relief:

• Suck on an ice cube: This helps cool your body from the inside out.
• Apply cold water: Wet your skin with cold water or hold a plastic bag filled with ice cubes against the flushed area.
• Use visualisation techniques: If you don’t have access to cold water or ice, try visualising yourself in an icy-cold swimming pool filled with floating ice cubes. Studies suggest that the brain can’t distinguish between vivid imagination and reality. Pretending to shiver can even help trigger a cooling effect.

Q: I have rosacea, and my skin gets itchy all the time. Is there anything I can do to get some relief?

A: If your rosacea causes persistent itchiness, try these soothing remedies:

• Apply ice: Fill a plastic bag with ice cubes and gently hold it against the affected area.
• Take a soothing bath: Add 1/4 cup of bicarbonate of soda to a lukewarm bath and soak in it to calm irritation.
• Moisturise immediately after bathing: Before your skin is completely dry, apply a sensitive skin-friendly moisturiser or ointment to lock in hydration.
• Try supplements: Taking a supplement containing quercetin and vitamin C can help reduce inflammation and support skin health (see step five).

Key Takeaways

• Identify and limit histamine triggers.
• Support gut health with probiotics and proper digestion.
• Use skincare designed for rosacea-prone skin.
• Exercise regularly to improve circulation.
• Follow a low-histamine diet for symptom relief.

References

This is an edited extract from The Healthy Skin Diet, Chapter 18 (Exisle Publishing).