Spicy foods, alcohol, and hot beverages may trigger flushing in patients with rosacea. However, evidence does not support dietary factors playing a central role in the pathogenesis.
Increased blood flow to the blood vessels of the face and increased numbers of blood vessels that are closer to the surface of the face are thought to be responsible for the redness and flushing associated with rosacea. Furthermore, vasodilatation, the normal response to hyperthermia, is thought to be more pronounced or exaggerated in individuals with rosacea. LL37, serine proteases, and other innate immune mediators have been found in increased amounts in rosacea-affected skin.
Demodex species (mites that normally inhabit human hair follicles) may play a role in the pathogenesis of rosacea. Demodex prefers the skin regions that are affected in rosacea, such as the nose and cheeks.
For more on the pathophysiology of rosacea, read here.
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Cite this: William James, Steven Brett Sloan. Fast Five Quiz: Can You Recognize and Properly Treat Rosacea? - Medscape - Jul 24, 2019.