As someone who has struggled with sensitive skin my entire life, my journey with rosacea began long before I was officially diagnosed. If you suffer from rosacea or sensitive skin, you’re not alone! So, get comfy, and grab a cup of tea, because we’re going deep on this topic today.

My Personal Experience

First off, if you’re new here, let me introduce myself properly—I’m Joy McCarthy, holistic nutritionist and founder of Joyous Health, a wellness hub I created 15 years ago. I’m the author of three best-selling cookbooks and co-founder of Hello Joyous. I’m all about science-backed holistic wellness, not trendy quick fixes or snake oil solutions (because let’s be real, there’s a lot of that in the wellness industry).

Being of Celtic descent, rosacea runs in my family. I’ve always blushed easily, my cheeks turn bright red when I’m hot or cold, and I’m highly sensitive to fragranced products and harsh ingredients. Basically, I’m the poster child for rosacea! You might think, well, that sucks, but honestly, it’s been a blessing in disguise. My skin has made me a skincare detective, leading me to research my condition extensively. By the time I finally saw a dermatologist five years ago, I had a strong suspicion about what he was going to prescribe which included the birth control pill, an oral antibiotic, and a topical antibiotic cream (metronidazole)—all common treatments for rosacea.

This is what my skin used to look like. :(

But after diving deep into research—reading personal experiences on forums, scrolling through Reddit threads, and reviewing clinical studies on PubMed—I realized these treatments were simply band-aid solutions. So, I made the decision to go a different route. Instead of conventional treatments, I chose a holistic, natural approach, and I’m so happy to say that I was able to heal my skin naturally. That doesn't mean I never have a flare-up. If I get sick and experience a fever, get exposed to too much sun, fall off the band-wagon of my health habits, or feel stressed, I can get a redness flare, but I can always get it under control within a couple of days - not chronic like it was before. 

Now, let me be clear: I’m not here to sway anyone away from conventional dermatology. I know that some people have found relief with prescription treatments. But after everything I learned, I knew that wasn’t the right path for me. Many people who took this route found their symptoms either persisted or worsened over time.

Now that we’ve got that out of the way, let’s dive into what rosacea actually is and what you can do from a nutrition, lifestyle, and skincare perspective to avoid flare-ups.

What is Rosacea?

If you’re here because you suspect you may have rosacea, it is worthwhile to get a proper diagnosis so you can move forward with confidence that you know what you’re dealing with. 

Rosacea is a chronic inflammatory skin condition that primarily affects the face, causing redness, heat, visible blood vessels, and sometimes small, acne-like bumps. It can flare up unexpectedly.  

Rosacea comes in four main types: ETR (redness, heat & visible blood vessels), papulopustular (acne-like bumps), phymatous (thickened, bumpy skin, often on the nose), and ocular (eye irritation & dryness). You may experience one or a mix of these subtypes. I had ETR and acne-like bumps. 

Rosacea is highly individual, meaning what triggers one person’s flare-ups might not be the same for someone else. That’s why getting to the root cause and finding a holistic approach that works for you is key to calming the skin naturally.

Root Causes of Rosacea

Like most skin conditions, the cause of rosacea is multi-factorial, meaning there is not typically one single cause (oh wouldn’t that be nice!). This is why there is a lot of trial and error when you’re on a skin-healing journey. Here are some of the causes:

Triggers & Lifestyle Factors - Certain foods (sugar, spicy foods, ultra-processed/nutrient-poor diet, high-histamine foods), alcohol, stress, temperature changes, skincare products, and even hormones can all play a role in worsening rosacea symptoms.

Identifying and managing your personal triggers is key to keeping flare-ups at bay. The best and most affordable way to do this is by following an elimination diet. Start with the big ones - gluten, dairy, soy, alcohol and sugar. Remove these from your diet for 14 days and then re-introduce them one by one every few days. If there is zero difference, move on to testing out other foods on an elimination diet, and choose the foods you consume the most often.

Gut-Skin Connection - About 50% of rosacea sufferers also have gut health issues, such as SIBO (small intestinal bacterial overgrowth), leaky gut or dysbiosis. Imbalances in gut bacteria can lead to systemic inflammation, triggering skin flare-ups. Additionally, histamine intolerance can be a major factor in rosacea. Are you someone who had a lot of digestive issues? Your gut health is the foundation of healthy skin. This is an area to investigate if you experience bloating, constipation or diarrhea. Check in with a Functional Medicine Doctor or a Naturopathic Doctor if you suspect you have SIBO or dysbiosis as there are tests to rule this out. 

Harsh Skincare Ingredients -  Conventional skincare ingredients such as SLS, synthetic fragrance, synthetic preservatives, alcohol, and chemical exfoliants like retinol can throw off the delicate balance of your skin barrier function and more specifically your skin's microbiome, disrupting the beneficial bacteria that help keep inflammation (aka rosacea) in check and keep your skin healthy and glowing. Even essential oils can be problematic for sensitive skin due to their potency.  Read more here. You can figure out yourself, is your skin just sensitive or has it been sensitized here. 

pH Balance - Your skin is slightly more acidic and thrives around 4.5 to 5.75. This subtle acidity creates magic in the form of a natural defence mechanism that helps the skin retain moisture while keeping pollution, microbes, viruses, and other potential contaminants out. If the pH levels get too high and start trending more towards a neutral or alkaline level, you may start to experience skin issues like rosacea and reactive or sensitive skin All soap and many foaming cleansers can be as high as a 9 or 10 on the pH scale. If you're not including a toner in your skincare routine, your skin is likely too alkaline. 

Immune System - The immune system plays a major role in skin health and I could write a whole post just about this topic. Some studies suggest that cathelicidins, a type of antimicrobial peptide in the skin, are overproduced in people with rosacea, contributing to redness and flare-ups. However, histamine intolerance can also be a contributing factor, particularly if flushing and heat is characteristic of your rosacea. Learn more about histamine intolerance here and what you can do about it here. 

Demodex Mites – These microscopic mites naturally live on everyone’s skin and play a role in a healthy skin microbiome. However, people with rosacea tend to have higher numbers—along with more mite waste—which may contribute to irritation and inflammation.

That said, an overgrowth of mites is usually a symptom, not the root cause. Simply eradicating them would be a band-aid solution. The real question to explore is: Why are they thriving in excess in the first place? Is your skincare carpet bombing your skin microbiome? 

Blood Vessel Dysfunction - Rosacea-prone skin tends to have hyperreactive blood vessels, meaning they dilate more easily in response to triggers like heat, spicy foods, alcohol, and stress. This leads to persistent redness and flushing.

You may have noticed I didn’t spend much time discussing spicy foods or extreme temperatures. That’s because these aren’t the root causes of rosacea—they’re simply triggers that can lead to a flare-up. The real issue lies in why your skin is so sensitive to heat or cold in the first place. Factors like a compromised skin barrier make the skin more reactive. After all, rosacea at its core is a sign of a weakened skin barrier.

Nutrition for Rosacea

As a nutritionist, this is an area I have researched extensively. I’ve written about it over at Joyous Health so I’m going to share the top things you need to know but I will share links so you can dive a little deeper.

Best Foods to Eat to Heal Rosacea

• Anti-inflammatory Foods: Fatty fish like salmon and sardines, turmeric, ginger, olive oil, dark berries. Here are 10 foods to reduce inflammation. If any of these are trigger foods for you, then of course, avoid them. 
• Gut-Healing Foods: Bone broth, fermented foods like kimchi and sauerkraut (as long as there is no histamine intolerance), ghee 
• Antioxidant-Rich Foods: Berries such as blueberries, blackberries, strawberries, dark leafy greens, pomegranate seeds
• Probiotic Foods: Coconut kefir, coconut yogurt 
• Healthy Fats: Avocados, olive oil, nuts and seeds, especially pumpkin seeds and more ideas here. 
• Herbs and Spices: Garlic, ginger, rosemary, turmeric, basil and mint

I go into further detail about nutrition for rosacea here.  

Skincare for Rosacea

As a nutritionist, I spent years trying to figure out what was going on from an internal perspective with my health that was causing my rosacea, and I completely overlooked the outside. For many people, it's the reverse - focusing on the outside and not the inside. They are both critically important and it's impossible to heal your skin if you only focus on one.

Once I realized that caring for the outside is just as important as caring for the inside, everything changed—it was the missing piece of the puzzle. That said, Hello Joyous skincare won’t cure rosacea if the underlying causes, like histamine intolerance, diet, and lifestyle choices, aren’t addressed. No skincare can compensate for that. But when I learned about the importance of pH balance, skin barrier function and the skin microbiome, I knew exactly what I needed to do and that created Hello Joyous. 

Hello Joyous is skincare designed to nurture your skin microbiome, support your barrier function, and let your skin do what it was meant to do. When given the right raw materials, your skin knows how to take care of itself. Hint: Less is more.

Your skin needs simplicity:

• Gentle cleansing, preferably only once per day, at night before bed
• Toning to balance pH while hydrating and providing the perfect dewy surface to absorb your serum
• Moisture and hydration to support the skin barrier function and protect the skin

The Essential Skincare Bundle is what I use and recommend whether you're 13 or 103 - your skin needs less than you think. Once you get your skin to a healthy state, continue using the Hello Joyous Skincare Bundle to keep your skin healthy and thriving. 

Natural Health Supplements

This post would not be complete without talking about natural health supplements as they can have a profound impact on your skin in a variety of ways from reducing inflammation, boosting antioxidants and supporting the barrier function of your skin which is essential for the prevention of rosacea.

It's important to note that you would not need all these supplements. It's always best to work with a natural healthcare practitioner to find out what is best suited to you

The top considerations to investigate are:

• Saccharomyces boulardii
• Zinc
• Omega 3s
• GLA
• Vitamin C
• Astaxanthin
• Vitamin D
• Quercetin

You can read more in-depth about some of these recommendations here. 

Additional Resources:

• Joyous Health Podcast: Managing Rosacea Naturally and Building Your Healthiest Skin
• Fix Your Period Podcast: How to Treat Rosacea Naturally 
• The Perimenopausal Podcast: Holistic Health For Rosacea + Hormonal Balance
• DNA Company Podcast: Finding the Best Solutions for Your Skin 
• Rosacea: Steer Clear of These Foods
• Rosacea: Best Foods to Eat
• Rosacea: Best Natural Makeup
• Glow from Within: How Gut Health Impacts Your Skin
• 3 Products to Support Your Skin Barrier Function
• Is Your Skin Sensitive or Sensitized?
• Your Skin Needs Less than you Think
• 10 Factors that Disrupt the Skin Microbiome 

And finally, meditation was a big part of my skin-healing journey to help me shift my mindset from "Why me and this isn't fair" to I CAN and WILL heal my skin. 

If you've come here because you are currently dealing with rosacea, my heart goes out to you. Please know that it is not a forever thing. I truly hope this information I have shared above helps you. You've got this!

Joy xo