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What you should know about rosacea

Dr. Adrian Weingart

What you should know about rosacea

Rosacea is a common, chronic skin disease that mainly occurs on the face. It is characterized by facial redness, bumps, and bumps that can become more severe over time. Rosacea usually develops after the age of 30. Age. In Germany, about 2-5% of all adults are affected.


Although rosacea can affect both sexes, it is more common and severe in women. Studies have shown that women between the ages of 30 and 50 are most likely to develop rosacea. Symptoms in women can be more pronounced and can result in a significant reduction in quality of life.


Symptoms of Rosacea


Rosacea particularly affects the face, especially the cheek and nose area. These areas in particular are often reddened. This redness usually occurs in flares at the beginning, until it eventually manifests itself. As the disease progresses, the vessels of the facial skin can be seen as a fine network on the affected skin areas. The vasodilatations become visible because they are widened by rosacea. The inflammation of the skin causes nodules (papules) and pustules (pustules) that are reminiscent of acne. In men in particular, a nodular thickening of the nose can occur, which is also colloquially known as a “bulb nose”.


Causes of rosacea


The exact causes of rosacea are not fully understood, but it is believed that a combination of genetic and environmental factors play a role. Possible environmental factors that can promote the occurrence of rosacea include:
  • Sunlight
  • Hot drinks
  • Hot baths
  • Stress
  • Hormonal changes
  • Certain foods such as coffee, alcohol, and spices
Even though purulent pustules can develop with rosacea, it is not a form of acne. In contrast to acne, the sebum production of the skin is not increased in rosacea. It is also suspected that certain microorganisms such as the Demodex mite in the face and intestines can play a role in the development of rosacea.


Diagnosis and treatment of rosacea


Treatment for rosacea depends on the severity of the symptoms and can range from topical medications such as corticosteroids or antibiotic creams to oral medications or light therapy. Lifestyle changes, including eating a balanced diet and reducing stress, may also help improve symptoms. Most of the time, however, rosacea cannot be cured, only improved. Regular check-ups with a dermatologist are important to monitor symptoms and adjust treatment if necessary. Overall, it is important to be active and take care of skin health when dealing with rosacea. Early diagnosis and treatment can help relieve symptoms and prevent serious complications from occurring.


Skin flora: Rosacea changes the skin microbiome


In addition to the known trigger factors, the role of the microbiome in the development and worsening of rosacea is of increasing interest. There is some evidence that the microbiome (i.e. all of the microorganisms that live on and in our body) can play a role in the development of rosacea. A disturbed microbiome, which shows an unfavorable change in bacterial types and numbers, can impair the immune system and thus increase the inflammatory reactions in the skin. Some studies have shown that people with rosacea have a different microbiome composition compared to people without the condition. A link has been observed between demodex mites and rosacea, as studies have shown that people with rosacea have a higher density of these mites on their skin. It is believed that the overpopulation of demodex mites can lead to inflammation on the skin, which is a symptom of rosacea.


Causes of rosacea: the intestines can also play a role


In addition to the influence of the skin microbiome, studies have shown that the development of rosacea is also related to the intestine. A disturbed intestine, especially a malfunction in the area of ​​the intestinal flora, can impair the immune system and thus lead to inflammation in the skin. Some studies have shown that people with rosacea have a dysfunctional gut barrier, suggesting that a dysfunctional gut may play a role in the development of rosacea.


Tip: Special foods to watch out for with rosacea


There is also evidence that diet may play a role in the development and worsening of rosacea. Some studies have shown that certain foods and drinks can trigger or worsen rosacea symptoms.
This includes, for example:

  • Dairy products such as yoghurt, cheese, sour cream
  • Special fruit : citrus fruits, bananas, red plums, figs
  • spicy food
  • Foods rich in histamine
  • Drinks: Alcohol, especially red wine, beer, bourbon, gin, vodka, and champagne.
  • Hot drinks like coffee.

It is important to note that the effects of diet on rosacea can vary from person to person. Some people can eat certain foods with no problem, while others are more sensitive to certain foods.


New solution: A healthy intestinal flora


Eating a balanced diet rich in high-fiber foods can help support the gut microbiome and maintain a balanced gut flora. Also, there are some studies showing that certain probiotic supplements can improve rosacea symptoms. New approaches to treating rosacea are therefore increasingly including pro- and prebiotics, as these have been shown to be beneficial for the intestinal flora and to rebalance them.
In this context we have developed our Dermabacs - a synbiotic that can also have a targeted effect against rosacea. Would you like to find out more? Then click here and take a closer look at Dermabacs!






  • Gallo, R. L, Granstein, R. D, Kang, S., Mannis, M. J, Steinhoff, M., Tan, J., & Thiboutot, D. (2018). Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee. Journal of the American Academy of Dermatology, 78(1), 148 -155. https://doi.org/10.1016/j.jaad.2017.08.037
  • Kim, H. S (2020). Microbiota in Rosacea. American Journal of Clinical Dermatology, 21(S1), 25-35. https://doi.org/10.1007/s40257-020-00546-8
  • Rebora A. Papulopustular rosacea. In: Williams H, Bigby M, Diepgen T, Herxheimer A, Naldi L, Rzany B (Ed). Evidence-based dermatology. London: Blackwell Publishing; 2008 S 105-110.
  • Van Zuuren, E. J (2017). rosacea New England Journal of Medicine, 377(18), 1754-1764. https://doi.org/10.1056/nejmcp1506630
  • https://www.rosacea.org/patients/rosacea-triggers/factors-that-may-trigger-rosacea-flare-ups

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