Tomatoes, shellfish, and other histamine-related foods
About 16 million Americans have rosacea, a chronic, inflammatory skin disease (with no known cause) that is characterized by slow-developing facial redness, flushing, and/or acne-like papules or pustules. Some sufferers may be sensitive to foods high in histamine, such as citrus fruit and nuts, and/or histamine-releasing foods, such as tomatoes and shellfish, because “histamine causes your blood vessels to swell, or dilate… contributing to a wide range of problems,” according to MindBodyGreen.com. Taking an antihistamine prior to a meal of histamine-containing foods may lessen skin-reddening side effects.
One of the most commonly reported triggers, alcohol is linked with rosacea flare-ups, according to patients surveyed by the National Rosacea Society; red wine seems to produce the greatest reaction. “Alcohol causes vasodilatation—increased blood to flow through the skin—which can make skin appear to be redder," explains John E. Wolf, Jr., MD, professor and chairman of the department of dermatology at Baylor College of Medicine.
Spicy foods, including hot peppers, Mexican-style foods, chili, and salsa, can provoke a rosacea flare-up, according to National Rosacea Society survey data. Some researchers believe that there is a correlation between spicy food-induced rosacea flare-ups and gastrointestinal upset.
Thirty-six percent of people surveyed by the National Rosacea Society agreed that hot coffee, tea, cocoa, and cider consistently aggravate their rosacea. A 2007 study of 24 patients conducted by researchers in the department of dermatology at Wake Forest University School of Medicine concluded that it is the thermal response of these drinks (not their caffeine content, a previous theory) that exacerbates rosacea. Simply drinking a slightly less steamy beverage of choice could help prevent a rosacea flare.
One in every five rosacea sufferers noted that chocolate was one of their food triggers, according to survey data from the National Rosacea Society. The theory: theobromine—the main alkaloid found in cocoa—dilates blood vessels and increases blood circulation, which contributes to skin flushing.
Sulfites, which can be found in marinated meats, “may contribute to chronic skin…symptoms,” reported a 2009 study by the National Center for Epidemiology and Population Health at The Australian National University.
“Some foods and beverages induce the blushing/flushing type of rosacea [while] others may induce the inflammatory papulopustular type,” says Richard Odom, MD, clinical professor of dermatology and former acting chairman of dermatology at the University of California, San Francisco. While food triggers are subjective, fermented foods, such as sauerkraut, kimchee, and certain aged cheeses (blue cheese, for example), have been logged as a rosacea trigger for some patients. Dr. Odom recommends keeping a food diary to monitor symptoms and then eliminating certain foods to see if that makes a difference. “Rosacea cannot be prevented, but it can be controlled with medication, avoidance of triggers, and proper skincare,” says Dr. Wolf.