Copyright 201o Brady Barrows

When discussing rosacea the subject of triggers always comes up. There is some confusion over what a rosacea trigger is because many misunderstand the difference between a rosacea flare up and flushing. A rosacea flare up is a pronounced erythma or redness which can be, but not always, accompanied by papules and pustules. Flushing is a when the skin, usually the face, becomes red and, or hot due to blood rushing to the face. Many confuse flushing with rosacea but actually flushing is a sign of rosacea just as papules and pustules are a sign. Not all rosacea sufferers exhibit pronounced or frequent flushing any more than exhibiting papules and pustules. Some rosacea sufferers may not exhibit any pustules and papules but simply have erythma. Erythma is the distinguishing hallmark of rosacea and flushing is usually the other distinguishing mark. But not all rosacea sufferers have pronounced flushing or flush any more than the general public just as not all rosacea sufferers exhibit papules and pustules. A rosacea sufferer may blush or flush and and the erythma or redness remains and aggravates the rosacea. Hence, rosacea triggers are broken down into two types:
Rosacea Flare Up Triggers and Flushing Triggers

For More Information on Rosacea Flare Up Triggers

For More information on Flushing Triggers

The other confusion about rosacea triggers is that when a rosacea newbie reads or hears about certain triggers should be avoided from reputable physicians and rosacea organizations they may think that these triggers are set in stone and have been clinically established as absolute triggers. This is far from the truth and actually there has been only one known clinical study on a rosacea trigger done on thermal flushing. All the other proposed rosacea triggers are purely anecdotal. What does ‘anecdotal’ mean?

anecdotal |ˌanikˈdōtl|
adjective
(of an account) not necessarily true or reliable, because based on personal accounts rather than facts or research : while there was much anecdotal evidence there was little hard fact | these claims were purely anecdotal.

When a doctor mentions rosacea triggers based upon a list compiled by the NRS or other source without explaining that triggers are anecdotal it implies to a rosacea newbie that these triggers are set in stone and surely must be true. The truth of the matter is that trigger avoidance isn’t an exact science except for the one trigger that was indeed investigated with the Wilkin report that concluded:

“It is concluded that the active agent causing flushing in coffee at 60 degrees C is heat, not caffeine.”

Oral thermal-induced flushing in erythematotelangiectatic rosacea.
Wilkin JK; J Invest Dermatol. 1981 Jan;76(1):15-8.

If every trigger was investigated as coffee was the list might be reduced. The first three on the NRS list, liver, yogurt and sour cream are an example of how anecdotal this list is:

http://www.rosacea.org/patients/materials/triggers.php

Another survey, which is anecdotal said the the most common triggers were:

Sun exposure
Emotional stress
Hot weather
Wind
Heavy exercise
Alcohol consumption
Hot baths
Cold weather
Spicy foods

http://www.rosacea.org/patients/materials/triggersgraph.php

The above survey listed this as ‘the most common factors’ by percentages and ‘spicy foods’ was the eighth most common. Maybe a clinical study will be done on spicy foods eventually.