Rosacea is a skin condition that causes redness. It often starts with the cheeks and nose, but it can spread to other areas. The first sign many people notice is the flushing of the nose and cheeks. As it progresses, other symptoms often develop as well.
The link between rosacea and alcohol abuse exists, but it’s more complex than most people realize. Before we get into the relationship between alcohol use and rosacea, let’s take a closer look at rosacea itself.
Types of Rosacea
- Erythematotelangiectatic rosacea: Redness, flushing of the skin, and visible or broken blood vessels
- Papulopustular rosacea: Redness along with swelling, acne-like breakouts
- Phymatous rosacea: Thickening skin, bumpy skin
- Ocular rosacea: Red, irritated eyes, eyelid swelling, stye
People with rosacea often develop symptoms of more than one type of this skin condition. It also progresses in stages. At first, blushing or flushing occurs frequently. In the second stage, the redness is persistent on the nose, cheeks, and forehead. The third stage is the appearance of blood vessels in the face and can be accompanied by acne-like bumps. The last stage includes bumps on the face and thickening of the skin. Thickening often occurs on the nose, which is known as Rhinophyma.
Women commonly develop vascular rosacea. This causes swollen blood vessels under the skin, which causes swelling and warmth in the area.
There are several risk factors for rosacea, and several suspected causes as well. Science continues to study the condition, but here’s what we know so far.
Fourteen million people in America get rosacea. Women are more likely to develop rosacea, but men are more likely to develop a severe case. Rosacea most often develops between 30 to 50 years of age, but it can occur at any time.
People of all ethnicities get rosacea, but some people are at a higher risk. If you are of Celtic or Scandinavian descent, you are more likely to develop the condition. Fair-skinned people with blonde hair and blue eyes are also at higher risk.
It’s also more common in people who have had severe acne. Lastly, it appears to run in families. If a family member had rosacea, you are more likely to develop it as well.
Causes of Rosacea
Since it runs in families, it’s believed rosacea has a genetic component. Certain genes may cause rosacea, or increase your risk of developing it.
Those who have the acne-like type of rosacea, Papulopustular rosacea, have a high amount of a specific bacterium. This can cause the immune system to overreact in an attempt to fight the bacteria. However, scientists haven’t determined if this is the cause of rosacea.
H. pylori is a bacterium found in the digestive tract. It is often found in those who have rosacea, but not everyone with H. pylori develops the condition.
Demodex is a type of mite that lives on the skin around the cheeks and nose. Many rosacea sufferers have high numbers of this mite, but not everyone with high levels of the mite develops rosacea.
A skin protein called cathelicidin helps prevent skin infection. It’s thought that those with rosacea may process this protein differently, leading to the disease.
It’s clear that rosacea is a complex skin condition that could be a combination of different factors. Like everything else regarding the condition, its link with alcohol use is complicated.
Rosacea is usually cyclical, with periods of remission and flares. It may appear to clear up and then reappear, or it may get worse when you encounter a trigger. While the symptoms come and go, the condition itself remains. There is no cure, but the symptoms can be reduced or controlled. Understanding your triggers is one way to reduce rosacea flare-ups.
Each individual will have their own triggers, but knowing the most common triggers is a good start. From there, keeping a diary can help you narrow down your specific triggers.
The most common triggers, according to Rosacea.org, are:
- Sun exposure – 81%
- Emotional stress – 79%
- Hot weather – 75%
- Wind – 57%
Unfortunately, exercise is a trigger for many people as well. The Rosacea.org survey found exercise to be a trigger for 56% percent of people. This was slightly higher than alcohol in the survey, with 52% reporting it as a trigger.
Food and drinks are common triggers. There are at least 20 different potential food-related triggers. After alcohol, spicy food was the most common, at 45%.
Alcohol: Cause or Trigger?
There’s no debate that there is some link between alcohol use and rosacea. The question is, what is the link? According to the American Academy of Dermatology Association, some studies suggest that women who drink are at a higher risk of developing rosacea. Studies also found that the risk increases with the amount of alcohol consumed. They also discovered that women who drank liquor or white wine had a higher risk than those who consumed other types of alcohol.
Other experts, including John E. Wolf, MD, chairman of dermatology at Baylor College of Medicine, told WebMD that alcohol does not cause rosacea. Instead, it’s believed to be a trigger for rosacea flares, which may be why it is so commonly thought of as the cause. Studies have shown that even one alcoholic drink can cause a flare in three out of four people with rosacea.
They’ve also noted that some drinks are more likely to cause rosacea than others. Red wine was the biggest culprit, with 76% reporting a flare after drinking. White wine came in at 56%, and beer was next with 41%. Ninety percent of people surveyed said that they limited their alcohol intake because of the condition, and 90% of these people believed it helped to reduce flares.
The Suspected Role of Vasodilation
Alcohol dilates the blood vessels, a process known as vasodilation. This will cause the face to look redder, even in those without rosacea. Red wine contains tyramines, which cause blood vessels to dilate more than other types of alcohol, which could explain why it triggers rosacea more often.
However, other triggers cause vasodilation as well. Spicy food contains capsaicin. This is what gives peppers their heat. It’s also a vasodilator. Exercise and even sun exposure also trigger vasodilation. Vasodilation is not, in itself, a problem. In fact, it’s essential for cardiovascular health.
Cardiovascular health, and activities that support it like exercise, are particularly important as you age. This puts women suffering from rosacea in a tough spot. Do you avoid the trigger, and lose the associated health benefits? Do you live with flareups from rosacea? The good news is there are things you can do to reduce flare-ups when you can’t avoid the trigger, or experience a flare despite your best efforts.
Rosacea Treatment Options
Rosacea treatment should begin with seeing a dermatologist. The sooner you are diagnosed, the easier the condition is to manage. If you’ve already had the condition for a long time, treatment can still provide effective options.
Topical medications can reduce vasodilation of the face to reduce redness. They can also reduce inflammation, particularly with acne-type rosacea. Topical and oral antibiotics are another first-line treatment that can help relieve rosacea symptoms.
Rosacea flares can be triggered by hot flashes during menopause. Estrogen treatment is a common treatment in these cases. Beta-blockers and alpha antagonists can help reduce flushing because they affect blood vessels. These drugs are not approved by the FDA for the treatment of rosacea but may be beneficial.
Laser treatment and surgery can be used to reduce the excess nose tissue associated with Rhinophyma.
There are home remedies for rosacea as well. While these shouldn’t take the place of medical treatment, they can be beneficial for rosacea management. Lifestyle changes include wearing sunscreen when outdoors, reducing stress, and eliminating triggers when possible.
Topical treatments include aloe, oatmeal, comfrey, and chamomile. These are known to soothe the skin, which can help reduce discomfort and redness associated with rosacea.
You’ll need to use a gentle facial wash that is fragrance-free. Avoid exfoliation and toners, because these can further irritate the skin. Rinsing with cool water is also recommended. You may find it helpful to choose skincare and makeup products designed for sensitive skin and are hypoallergenic.
Dispelling the Myth
It’s unclear whether drinking is a risk factor for rosacea itself, or a trigger for flare-ups when rosacea is already present. It is possible that both are true. What is known is that not everyone who drinks alcohol develops rosacea, and not everyone who develops rosacea drinks alcohol.
Alcohol use may increase the risk of developing rosacea, along with many factors mentioned earlier. It does appear to trigger a flare-up in the majority of rosacea patients.
However, many people assume that anyone with rosacea has an alcohol problem, and this can be embarrassing for those with the condition. It’s important to dispel this myth. Rosacea is a common condition, and many women are hesitant to seek treatment because of its association with alcohol use in popular culture. Treatment can help manage the condition and keep it from getting worse over time.
Rosacea is not a curable condition, but it is a highly treatable one. Don’t hesitate to seek treatment for this condition. Doctors and dermatologists are well aware of the potential causes of rosacea, as well as the treatments available.
nyulangone.com – Rosacea Types
aad.org – Rosacea: Who Gets It and Causes
hopkinsmedicine.org – Rosacea
aad.org – Does Drinking Cause Rosacea?
webmd.com – The Link Between Rosacea and Alcohol
health.harvard.edu – Rosacea A to Z