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How To Reduce/Prevent Alcohol-Related Flare-Ups

Rosacea is a common trigger for patients. It produces flushing and worsening rosacea symptoms in the majority of rosacea patients.

Alcohol consumption triggers harmful episodes of flushing in approximately three quarters of all rosacea patients, making social periods like Christmas and New Year — where alcohol plays a central role in celebrations — potentially very damaging to the skin.

How Does Alcohol Harm Skin?

Excessive alcohol intake can lead to many health problems and has been implicated as a cause of several skin conditions.

In rosacea even small amounts of alcohol are often sufficient to produce extended periods of redness.

Alcohol induces vasodilation — a relaxing of the blood vessels which leads to a drop in blood pressure — which leads to facial flushing.

Contrary to advice in days gone by medical makeup for ocular rosacea can enhance quality  of life. Application technique can help protect against ocular rosacea symptoms.

The resulting chronic redness is more than a cosmetic annoyance.

Repeated episodes of flushing lead to more pronounced facial redness and telangiectasia (broken capillaries) and are associated with developing more advanced, treatment-resistant rosacea symptoms such as:

In short, for the majority of rosacea patients, alcohol consumption encourages and accelerates further failure and deterioration of their skin's functioning.

Confounding Aging Effects

Vasodilation producing lasting episodes of redness is alcohol's main negative effect in rosacea, however if your alcohol consumption is beyond moderate recommendations (a maximum of one drink per day for women and two for men) you will also experience aging effects on your skin (such as wrinkling from glycation, loss of elasticity and dehydration) which exacerbate the appearance and treatment of rosacea.

Red Wine — Alcohol Trigger #1

Red wine is reportedly the most common alcoholic rosacea trigger (affecting approximately 75% of patients).

Alcohol is generally a trigger, however surveys of rosacea patients have suggested that red wine — usually cited as the most beneficial alcohol due to resveratrol content — is more likely to cause flushing than other types of alcohol.

In some cases, switching to another drink, such as white wine, is enough to prevent redness.

Drugs To Prevent Alcohol-Induced Flushing

Antacids such as Zantac have been known to help prevent flushing due to alcohol in some patients, however the concurrent use of antacids and alcohol is not recommended due to potential damage to the stomach lining.

Strategies To Prevent Alcohol Flushing

As with other rosacea triggers, you should customize your approach to your own personal situation.

If your rosacea doesn't appear to worsen when you drink there's no need to make any changes.

Otherwise you may find the following suggestions useful.

Drink cool water between alcoholic drinks

Drinking at least as much water as you do alcohol will substantially dilute the alcohol you do drink.

Cool water also helps reduce skin temperature which is another cause of flushing.

Lemon and Water

Ice water in lemon can substitute for the appearance of gin and tonic or vodka. This drink's coolness helps dissipate redness due to overheating during social gatherings.

A glass of water (or another soft drink/soda) with a round or wedge of lemon has the appearance of vodka or gin and tonic and won't damage your skin.

Dry Ginger Ale

Ginger ale is frequently pale enough to pass for white wine or champagne.

Light dry ginger ale has an appearance close to white wine and champagne and won't leave you red-faced for hours afterwards.

Panaché, Shandy or Limondex

A very diluted alcoholic drink sometimes referred to as a Limondex or Shandy, popular throughout the world. Usually popular for teetotalers and designated drivers, it is useful for rosacea patients.

A mixture of half lemonade or club soda and half beer.

Spritzers

A wide variety of creative spritzers can cater as alternatives to full strength alcoholic beverages aimed at reducing the impact of alcohol on rosacea due to vasodilation.

Half or more soda combined with white or red wine substantially dilutes the alcohol.

Kalimotxo

A dilution of red wine by cola, which is the most prevalent alcoholic beverage known to trigger rosacea symptoms. The caffeine in cola is not a rosacea trigger as once thought so presents no risk to patients.

This drink is traditionally a mixture of half red wine and half cola served over ice.

Choose Cold Drinks

Apart from avoiding or reducing alcohol consumption, cool drinks help prevent flushing due to warm conditions.

Further Information and References

Australian Guidelines to Reduce Health Risks from Drinking Alcohol — Australian Government, Department of Health.

Alcohol Use (Keep It Moderate) — Mayo Clinic.

Alcohol Units and Guidelines (The Lower Risk Daily Guidelines) — NHS, UK.

Recommended Safe Limits of Alcohol — Patient.co.uk.

Alcohol and Public Health — Centers for Disease Control and Prevention.

Rosacea Flushing. Bernstein JE. Int J Dermatol. 1982 Jan-Feb; 21(1):24.

Alcohol-induced rosacea flushing blocked by naloxone. Bernstein JE, Soltani K. Br J Dermatol. 1982 Jul; 107(1):59-61.

Flushing in rosacea: an experimental approach. Parodi A, Guarrera M, Rebora A. Arch Dermatol Res. 1980; 269(3):269-73.

Flushing in rosacea: a possible mechanism. Guarrera M, Parodi A, Cipriani C, Divano C, Rebora A. Arch Dermatol Res. 1982;272(3-4):311-6.

Direct effect of ethanol on human vascular function. Tawakol A, Omland T, Creager MA. Am J Physiol Heart Circ Physiol. 2004 Jun; 286(6):H2468-73. Epub 2004 Feb 5.

Vasodilator properties of alcohol. J. A. Gillespie. Br Med J. 1967 April 29; 2(5547): 274—277.

Effects of Alcohol on Sympathetic Activity, Hemodynamics, and Chemoreflex Sensitivity. Philippe van de Borne, Allyn L. Mark, Nicola Montano, Decio Mion, Virend K. Somers. Hypertension. 1997; 29: 1278-1283.

Vascular Effects of Alcoholic Beverages: Is It Only Alcohol That Matters? Flávio D. Fuchs. Hypertension. 2005; 45:851-852.

Web MD — Zantac and Alcohol Don't Mix.

Ranitidine.

Vasodilation Image derived from Elizabeth2424 ([CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons.


Author: Peter Wilson.

Reviewed: Monday, 20 January 2014.


Further Information: How To Reduce/Prevent Alcohol-Related Flare-Ups : How To Reduce/Prevent Alcohol-Related Flare-Ups :




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