A genetic predisposition to rosacea can turn a “happy hour” into a not-so-happy hour pretty quickly. Alcohol is a known rosacea flare trigger. But why?
Rosacea, a common skin condition that can cause redness and flushing of the face, affects roughly 16 million Americans. Those who deal with rosacea try pretty hard to keep their redness under control. This is often achieved by altering the diet (avoiding triggers), and using anti-redness medicated creams.
Alcohol is among the aforementioned triggers. While alcohol might not trigger all those with rosacea, it’s a common and well-documented rosacea trigger
Those of us who love to have a nightcap or a happy hour cocktail with friends might be asking “but why?”
In this article we’ll get into why alcohol can trigger rosacea, and what drinks to absolutely avoid.
There is a common misconception that rosacea, redness of the face or nose, is caused by alcoholism. This is not true. Rosacea is largely due to genetic makeup -- those who are of Celtic, Scandinavian, Scottish descent are more prone to rosacea than others.
While drinking alcohol is not the cause of rosacea, it might make matters worse as alcohol has been well documented as a rosacea trigger.
There is limited research on this but researchers have a few theories.
Alcohol is a vasodilator -- it causes the blood vessels to mildly dilate, allowing a heavier blood flow. This increase in blood flow can cause the skin to get red and flushed.
Alcohol content, by itself, can cause vessel dilation, but so can other components of an alcoholic drink -- such as histamines. (More on this later.)
To learn more about the link between rosacea and alcohol, The National Rosacea Society surveyed more than 700 people with rosacea about their experiences.
From this survey, it's clear that some drinks are more triggering than others.
According to that survey, these are the worst alcohol offenders for rosacea flare-ups:
From the list above you can see wine, and beer are at the top of the list and spirits are toward the bottom. This is likely due to the varying histamine contents.
A drink high in histamines can cause further vasodilation and result in a more intense flushing and redness reaction.
High histamine content
Red wine has the highest histamine content in the alcoholic drink world. Red wine has “60 to 3,800 micrograms per glass versus white wine, which has between 3 and 120.”
This is likely why red wine is considered the top alcohol trigger for rosacea.
Low histamine content
If you’re going to have a drink, stick to the lowest histamine content drink possible. These are generally clear spirits like gin and vodka. (Spirits with added flavorings are an exception to this.)
However, even with low histamines, the alcohol content alone might still cause a flare. Experiment with caution.
Roughly 21-33% of people with rosacea experienced a reaction with low histamine spirits -- versus 78% of those who drank red wine.
Rosacea is not caused by alcohol, so your rosacea is not likely to go away if you stop drinking alcohol cold turkey. However, if alcohol is a part of your regular routine, you might see that removing this trigger can reduce symptoms.
Dr. Diane Thiboutot says “While alcohol may exacerbate the signs and symptoms of rosacea, today it is well documented that this disorder can be just as severe in a nondrinker."
For redness control, a great course of action is the daily use of topical vasoconstrictor medications that constrict the blood vessels on your face and reduce redness. These medications can help control redness all day -- and perhaps dampen your happy hour redness.
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Yes, alcohol can cause rosacea flare-ups.
Those with rosacea have facial blood vessels that expand easily, which can cause varying degrees of face flushing. Alcohol can dilate the blood vessels even further, causing flushing reactions.
Additionally, some drinks have high histamine content which can cause additional vascular dilation and flushing. These high histamine drinks are considered “the top alcohol triggers.”
However, not everyone with rosacea is affected by alcohol.
Across the board, red wine seems to be a big “no-no” for those trying to control flares as it showed a flushing reaction in 78% of study participants.