It is really frustrating that there are really no double blinded, randomized trials on rosacea triggers yet. However, these are the top ones that most rosacea patients say make their rosacea worse.
Likely time and research will show that one’s genetic profile and maybe even one’s previous environmental factors (how much sun your face was exposed to as a child; did you ever smoke, etc) will determine which triggers are worse for individual patients.
1. Sun: pretty much universal trigger: we know sun exposure increases VEGF (inflammatory protein) in the skin
2. Red wine or certain alcohols worse for some.
3 & 4. Gluten & Refined Sugar: this has not been studied thoroughly, but many MDs have heard that avoiding gluten and refined sugar helps with the rosacea
5. Spicy foods
6. hot drinks
7. ALWAYS avoid smoking
8. Extreme hot and cold temperatures,
Metrogel and other antibiotic creams or pills like Doxycycline (I like 20mg po per day for most patients: it is usually enough; some need 50mg po qd and others need 100mg qd or bid) do help.
See your MD for help.