Acne and rosacea

Reader stories
Scientific references
More information

Keywords: rosacea, acne, adult acne



Acne: after decades of denial, medical researchers now say that acne vulgaris is linked to the Western diet. It has been found that nearly all adolescents and an increasing number of young adults are affected by acne in westernised countries whereas acne is virtually unknown in nonwesternised populations such as the Kitavan Islanders of Papua New Guinea. The question is, which aspects of the Western diet cause the problem? So far, there have been some contradictory results, but overall, dairy products appear to be implicated as well as high fat and processed foods. In a Korean study, intake of instant noodles, junk food, carbonated drinks, snacks, processed cheeses, pork, chicken, nuts and seaweed were significantly higher in acne patients than in the controls. Since processed foods, takeaways and in some cases all dairy foods are avoided during failsafe eating, this could account for why some failsafers report an improvement in their acne.

Rosacea: is commonly linked to diet and a number of failsafers have reported improvements, see below for their stories and some scientific references showing why failsafe eating would work.

Sometimes called adult acne, rosacea is a common acne-like skin condition. The symptoms can include redness, flushing, small red bumps, sore red patches, broken veins, cysts, pus filled pimples, red nose and in some sufferers dry, irritated eyes. Unlike teenage acne, sufferers do not grow out of rosacea. The medical establishment generally regards rosacea as a chronic incurable skin condition that comes and goes. People with rosacea tend to have fair skin and especially English, Scottish or Irish heritage.

Foods commonly associated with rosacea (problematic food chemicals they contain are in brackets)
  • dairy foods (dairy foods are routinely avoided by people with severe symptoms when doing the RPAH elimination diet)
  • alcohol especially red wine (all alcoholic drinks contain high levels of salicylates, amines and glutamates except gin, vodka and whisky; red wine is particularly bad)
  • chocolate (amines)
  • soy sauce (MSG and/or natural glutamates that are the same as MSG)
  • yeast extract (natural glutamates - same as MSG)
  • eggplants, avocados, spinach (salicylates, amines, glutamates)
  • citrus fruits, including tomatoes, plums, raisins (salicylates, amines, last two also glutamates)
  • spicy foods (salicylates)
  • tea (salicylates)
Reader stories
Reader reports to the Food Intolerance Network confirm that rosacea and acne respond to diet.
[1351] Salicylate intolerance and acne rosacea: unable to take hot showers, have a hot drink, eat hot food, sit in a hot car or room or exercise without a painful, burning, deep red facial flush (August 2015)

I have suffered from acne rosacea for the past 5 years and from symptoms of rheumatoid arthritis for the past several months (I am 32).

In a desperate attempt to improve things, I have been gluten and dairy free for the past 2 months and have eaten nothing but vegetables for the past 2 weeks, but I have yet to see my symptoms resolve, although my acne certainly improved after removing dairy products from my diet. I suspect I may salicylate intolerant after coming across your website today, as many of my rosacea triggers seem to be high salicylate foods.

Update: Three days ago, I commenced a diet of red lentils, brussel sprouts and cabbage and have been able to stop taking my rosacea medication for the first time in the 5 years since my diagnosis. I am also free of joint pain!

Update on day 6 of low salicylates: I have a little stiffness in one of my finger joints today but still no rosacea flushes, and that's totally astonishing to me after so many years on medication. With the exception of one very good dermatologist in Sydney, I've rarely met anyone who knows more about rosacea than I do (GPs included!) and I have tried almost every known medication and procedure for it over the past 5 years. That the answer might be as simple as eliminating sals (and vasodilators, of course - alcohol in drinks and products, caffeine, certain medications and the theobromine in chocolate have always been my worst triggers) is a revelation! Eliminating dairy cured my hormonal acne but rosacea is another issue entirely.

I am very impressed with my results thus far and most grateful for your website. If it wasn't for that, I would never have tried this. I made an appointment with one of your listed dietitians so I can begin putting together a healthier diet for myself under her supervision. The appointment went well. She believes I may be on the right track in my avoidance of salicylates and has put me on the strictest form of the RPAH Elimination Diet for the next fortnight, and then I will be reviewed.

I will let you know how I go with the challenges. You can't begin to imagine how it will change my life if these good effects continue. Normally, without medication, I am unable to brush my teeth, take hot showers, have a hot drink, eat hot food, sit in a hot car or room, lie on my side on my pillow, exercise or face stressful situations without a painful, burning, deep red facial flush developing. I had forgotten, until now, what it feels like to just be normal!

Thank you for putting together such a comprehensive online resource. It appears it may be my way out of a lifetime of potentially harmful prescription medications - Amy, Qld

[1259] 202 sorbates: Rash reaction to potassium sorbate in Starbuck's cafe mocha (February 2014)
When I drink Starbuck's cafe mocha I get significant irritation on my face. It affects the skin between my eyes, my cheeks, the crevices of my nose and my chin. At times it has spread to my scalp. It can also affect the center of my chest. It mainly just looks bad but the affected skin can be tender and sting. Without further exposure the redness lasts a few days.  After researching the ingredients it seems likely the potassium sorbate ingredient is the cause, though it will take exposure to potassium sorbate through other products to be certain.

Starbuck's cafe mocha is made with Fontana Bittersweet Chocolate Mocha Sauce which contains this ingredient. The ingredients for the Fontana sauce can be seen here: - Rick, by email

Sue's comment:

I agree that potassium sorbate (preservative E202) seems the most likely cause of facial irritation.  It is well documented in the medical literature that sorbic acid and potassium sorbate can cause contact dermatitis but less well known that foods containing sorbates can cause erythema (reddening of the skin), most frequently on the face and back, worse in people with rosacea.  Reference: CRC Handbook of Food, Drug and Cosmetic Excipients, page 366

[295] Acne rosacea responds to failsafe (September 2003)

We started the failsafe diet in May 2002 after advice from a friend and it has had many interesting 'side effects', all of them good. We have had the usual wonderful behavioural changes in all members of the family and I don't know if any one else has reported this but if I stay 100% failsafe my acne rosacea goes (the scars don't but makeup covers them). I have taken many drugs for over the last 15 years for this condition and now I find that all forms of dairy give me pimples and cysts while flavour enhancers start up the vein ridden, red and sore rosacea. I am 34 now and don't want to look hideous in public any longer.- Viv, ACT

From [942] Another report of acne rosacea responding to failsafe (October 2010)

Over the past 15 years I have suffered from numerous things - CFS, IBS, Supraventricular Tachycardia, rosacea and itchiness. Post 2000, things were going along fairly okay CFS wise but I developed the SVT after the birth of my son in 2003. I had this corrected in 2007 (very long diagnosis!) but still continued to suffer the odd palpitation here and there. My IBS started in 1999 and I would swing from constipation to diarrhoea. My rosacea had been with me since 1997 and nothing would take it away. The itchiness started in 2008 and so did the headaches.

To cut a long story short, in January of last year I decided it was time to start looking into diet seeing no-one could work out what was wrong with me. So I went totally preservative, colour and sulphite free and purchased your book. Basically followed everything on the list of things to avoid. I did the same for my children. My rosacea disappeared! I also stopped itching and started to have less headaches and heart palpitations. I identified that sulphites affect my breathing, MSG affects my heart, something gives me headaches and 160b makes me itch. However, my diarrhoea and fatigue still remained. Eventually I looked more into salicylates (despite what the dietician thought!) and that was the final piece of the puzzle.

UPDATE 1 year later ... my rosacea is still doing well. I've tested my preservative theory on that one a few times and tried some pizza. I come out like rudolph! It's just so nice to have a white nose again, especially in photos! - Rachel, NSW

[1193] Avoiding salicylates, amines and additives reduces rosacea symptoms (February 2013)

I wrote to you quite some time ago regarding rosacea. My skin is still not 100% right, although avoiding salicylates, amines, preservatives and additives certainly reduces the symptoms of flushing, itching, and red pimples. - Lyn, NSW

[921] 282: Acne from bread preservative (June 2010)

Just looking over your website, you are missing one major side effect of 282 in adults - acne. I am a 50 yo adult and I always get a breakout if I eat a bread product containing 282, either because it was in fast food and not tagged (McDonalds use it, KFC and Hungry Jacks don't) or because the label did not show it. – Ric, NSW

From [148] I have lost my acne (February 2002)

After ten years of trying different diets - elimination, candida, vegetarian, allergy testing, you name it - I tried your diet after buying your book and the results were amazing. Convinced I was a chronic fatigue sufferer, I used to take more and more vitamins and health foods, only to find I was sicker and sicker.

But now, for the first time in 31 year, I feel normal. I have energy and have lost my coated tongue, mouth ulcers, acne and negative attitude. I am actually a nice person! I can't believe how even tempered and smiley I am when I stick to this diet. And my 9 year old daughter and 11 year old son are actually best mates. Before the diet, at times my daughter used to be IMPOSSIBLE, no matter what.

I can't thank you enough for having the insight, intelligence and love to dedicate so much time to this insane practice of adding chemicals and preservatives to food - and then trying (as the medical system does) to fix the resulting disorders with medication. - reader, Vic

[125] "To say I felt better would have been the understatement of a new millenium" (September 2001)

Around February of 2000 I was searching on the internet for some clues to my life long digestive problems, when I came across the food allergy section on the website. The featured food allergy topic happened to be salicylates ... just out of curiosity, and for the heck of it, I clicked on the link, and started to read about it ... I first off read the list of common symptoms. As I read it the list was all to familiar to me ... I answered Yes to every symptom. Needless to say, I started to follow a salicylate free diet. To say I felt better would have been the understatement of a new millenium...... ALL of my life I have suffered from very frequent urination, constipation, stomach bloating, short temper, irritability, inability to concentrate, memory problems, severe acne, dry skin (especially on my hands and feet), those restless legs, and more ...... The worst of it for me though was the constant urination, and constipation which led to a lot of gas ... Thank you so much for your work, and your book. Both have changed my life forever. I am finally free of a problem which has literally ruined my life. In case you're wondering, I'm 37 years old ... And yes, 36 years is WAY too long to suffer with this health problem. Sometimes I don't know how I made it this long with my sanity intact. - from the USA

    Scientific references

1. Cordain L and others Acne vulgaris: a disease of Western civilization.Arch Dermatol. 2002;138(12):1584-90.

ln westernized societies, acne has been found to affect, up to 95% of the adolescent population, about half of the population aged 25 years to 40 years and 12% of women and 3% of men in middle age. In nonwesternised societies, rates of acne are considerably lower, to non-existent, e.g. the Kitavan Islanders of Papua New Guinea and the Aché hunter-gatherers of Paraguay.

1a. Jung JY and others The influence of dietary patterns on acne vulgaris in Koreans. Eur J Dermatol. 2010;20(6):768-72.

1b. Ismail NH and others High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults.BMC Dermatol. 2012;12:13.

1c. Melnik, Bodo Dietary intervention in acne: Attenuation of increased mTORC1 signaling promoted by Western diet. Dermatoendocrinol. 2012;4(1):20-32.

This author suggests that dietary intervention in acne should reduce sugar and fat intake and limit intake of animal proteins e.g. in milk and meat, while increasing vegetable intake. See our factsheet: Failsafe weightloss

2. Keri JE, Rosenblatt AE. Diet and acne literature review J Clin Aesthet Dermatol. 2008 ;1(3):22-6.

Diet plays an important role in the pathogenesis of a variety of diseases. Recently, there has been an increasing interest in the role of diet in the development of common skin conditions such as acne and rosacea. The association of diet and acne has been controversial and unclear. Historically, it was thought that diet did not cause acne; however, recent studies reveal a potential role of diet in the pathogenesis of acne. Individuals that have a diet with a high glycemic load or increased milk consumption are reported to have a greater likelihood of having acne. This effect may be mediated by insulin-like growth factor-1 (IGF-1) since IGF-1 levels increase with milk consumption and with a high glycemic load and are known to contribute to the formation of acne. In contrast to acne, the association of diet and rosacea is much more accepted and established. There are a variety of foods that aggravate rosacea, including spicy foods, alcoholic beverages, and hot, caffeinated drinks. Patients are advised to avoid these triggers. Interestingly, omega-3 and omega-6 fatty acids may be beneficial in the treatment of rosacea, although further investigation is necessary. Full text

2a. Campbell TM and others Severe exacerbation of rosacea induced by cinnamon supplements. Drugs Dermatol. 2008 Jun;7(6):586-7.

An account of a case of a 68-year-old Caucasian female with type 2 diabetes mellitus who experienced an acute exacerbation of her rosacea 2 weeks after using cinnamon oil pills to lower her blood sugar levels. From the failsafe point of view, cinnamon is regarded as a salicylate challenge.

2b Lugovic-Mihic L and others Histamine intolerance--possible dermatologic sequences].[Article in Croatian] Acta Med Croatica. 2012 ;66(5):375-81.

A description of the effects of histamine intolerance on skin conditions including rosacea. From the failsafe point of view, we would call this amine intolerance.

3. Hodge L, Swain A, Faulkner-Hogg K. Food allergy and intolerance. Aust Fam Physician. 2009;38(9):705-7. Full text

    More information

Introduction to food intolerance

Fed Up by Sue Dengate

The Failsafe Cookbook by Sue Dengate

The information given is not intended as medical advice. Always consult with your doctor for underlying illness. Before beginning dietary investigation, consult a dietician with an interest in food intolerance. You can see our list of experienced and supportive dietitians 

© Sue Dengate 2024