Rosacea triggers: common causes

Women with Rosacea querying the triggers of her symptoms

This blog post will explore the most common Rosacea causes so you can identify and priorities what changes are realistic for you to make to your lifestyle and skincare routine.

Identifying the root causes of Rosacea and making changes in these areas, is the fundamental key to successfully resolving the problem.

Rosacea is chronic skin inflammation that is often mistaken for Acne.  It causes redness, swelling, dryness and sometimes acne-like bumps.

Firstly, let's start with some clarification of what a trigger is vs. a cause.

  • Anything that causes your skin to flare up is a Rosacea trigger. UV light, heat, stress, alcohol, spicy foods, and medications are common Rosacea triggers.
  • Different people have different Rosacea triggers, so it's important to figure out what yours are.  Avoiding your triggers can help you keep your Rosacea under control.

Rosacea triggers affect the nervous, immune, and endocrine systems.

Damage to these systems leads to inflammation, skin barrier disorders and blood vessel abnormalities.

  • The cause is the root or origin that makes something happen.

Rosacea's cause is unknown, but it could be related to an overactive immune system, genetics, environmental factors, or a combination.

It’s not caused by poor hygiene. Actually, overly cleansing the skin can cause more harm than good as it leads to an imbalance in the skin’s pH level and balance of anti-inflammatory bacteria called the “microbiome.”

Despite there being no specific cure for Rosacea, the good news is that the condition can be effectively managed and the risk of seeing visible symptoms is therefore, greatly minimised.

If you want to keep track of your Rosacea triggers, check out our Rosacea diary HERE

Closeup of sensitised skin with a rash

Rosacea triggers that cause an inflammatory and immune response

Rosacea triggers can cause burning, constant redness, breakouts, and product sensitivity.

They do so by activating defence-related proteins such as histamine. Don't worry; this is your skin's natural way to protect against injury and bacterial infection.

An immune response occurs when these proteins interact with skin cells. It causes vasodilation, flushing, skin sensitivity, stinging, and itching.

What matters here is how the body processes these proteins:

  • Normal skin has a low immune response, therefore, a low protein level. Even if a reaction occurs once in a while (acute inflammation), we still refer to as normal skin.
  • Rosacea occurs when the immune system is overly sensitive and requires many proteins to protect itself. When this happens frequently, it leads to chronic inflammation.

Abnormal inflammation prevents the skin from acting as a protective barrier.

That weakens the immune system resulting in sensitive skin and Rosacea. 

Middle aged women with broken capillaries across cheeks 

Abnormal blood vessels dilation

Some Rosacea triggers such as heat, spicy foods, cigarette smoking, and alcohol dilate blood vessels. It’s normal for these responses to occur occasionally.

But when the blood vessels' walls dilate all the time, they lose elasticity resulting in flushing, swelling and redness.

Broken blood vessels called, “Telangiectasias,” form when they break and blood leaks out.  These are most likely to appear on the cheeks and part of the face where the skin is already thinning.

Cross section of skin to represent the cellular triggers that cause Rosacea

Genes and Rosacea triggers

According to the latest research, Rosacea sufferers are four times more likely to have a family history than non-sufferers.

This is partly due to shared genetic factors between family members.

However, the environment and other nongenetic factors that members of the same family share may also play a role.

Two gene groups in Rosacea skin change when exposed to Rosacea triggers.

  • A set of genes helps your immune system distinguish between self-proteins and invaders. Inflammation occurs when these genes fail to work correctly. 

  • Another set of genes protects cells from oxidative damage.

Oxidative stress happens when unstable molecules called reactive oxygen species (ROS) build up to levels that damage or kill cells.

Changes in these genes make it harder for the skin to fight off oxidative stress, which causes free radical damage and inflammation.

It remains unknown why some people's genes get altered while others don't.

Woman lying on a pillow that says Demodex mite

Hypersensitivity to certain mites (Demodex)

Rosacea may be caused by an overgrowth of Demodex folliculorum microorganisms. (Find out study HERE)

Demodex likes sebaceous gland-rich areas like the nose and cheeks. This is where Rosacea usually shows up. 

Because they live in the hair follicles, too many mites can block the sebaceous glands' entrance, causing irritation and swelling. 

Microscopic image of the demodex mite

The follicle inflammation causes an abnormal immune response and damages the skin barrier. 

Demodex is also found in normal skin and has no adverse reaction in most people. 

But Rosacea sufferers have more.

However, some non-Rosacea sufferers had as many as well. Therefore, some researchers doubt this theory. 

On the other hand, another study found high mites’ levels in all Rosacea patients. 

Moreover, the prevalence of Demodex increases with age (Rosacea is more likely in middle age). 

Also, long-term topical steroid treatment, another known Rosacea trigger, increases mite numbers.

Test tube with Helicobacter pylori positive written on it 

Food Rosacea triggers and Helicobacter pylori

This bacterium causes gut sickness.

The link between Helicobacter and Rosacea is unclear. More information HERE

Some studies show high bacteria levels in Rosacea skin.

However, other studies showed the same high level in large non-Rosacea patients, so there is no apparent connection.

Scientists are still unsure, and more research is required.

Middle aged woman with Rosacea


Is Rosacea also related to other illnesses?

Some authors have linked Rosacea to various pathologies.

These include cardiovascular disease, Type 1 Diabetes, Multiple Sclerosis, and Inflammatory Bowel Disease. It has also been related to Migraine, Parkinson's Hypertension, and Celiac Disease.

It is even associated with anxiety, depression, and increased risk of dementia in patients over the age of sixty.

Patients with Rosacea are more likely to have allergies (food and environmental) and respiratory diseases.

Hyperlipidaemia, metabolic diseases, urogenital diseases, and female hormone imbalance were significantly more common in Rosacea patients.

Other aggravating but non-causing Rosacea triggers

Alcohol can increase flushing and redness. But some people drink heavily and have other issues, but not Rosacea.

Other Rosacea activators include heat, strenuous exercise, and wind. But again, those factors only affect the most vulnerable immune systems.

The same goes for hot drinks, spicy foods, stress, hormones, and coughing.

Rosacea is a complex disease that has many potential triggers. While we can’t cover every single one of them, we hope that this comprehensive guide provides some valuable insight into what may cause Rosacea flare-ups for you.

If you suffer from Rosacea, be sure to download our free guide on, “The Top Causes of Rosacea,” so you can start switching to better alternatives today. 

Image of the Rosacea Triggers Check List

Leave a comment

Please note, comments must be approved before they are published

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.