What causes Rosacea?

Common questions about rosacea 

What Causes Rosacea in Adults?

Rosacea in adults is caused by chronic inflammation that becomes visible in the skin. It often develops after years of internal stress, hormonal change, digestive imbalance, or skin barrier damage.

From a Traditional Chinese Medicine perspective, rosacea appears when internal heat, circulation issues, or nervous system stress can no longer be contained within the body and rise to the face.

Why Does Rosacea Start Later in Life?

Adult onset rosacea usually begins in the 30s, 40s, or 50s due to cumulative strain on the body.

Common contributors include:
• Long term stress or burnout
• Hormonal shifts such as perimenopause or menopause
• Years of active or aggressive skincare
• Digestive issues or food sensitivities
• Declining skin hydration and barrier strength

In TCM, this reflects depletion of Yin and fluids, allowing heat to surface through the skin.

Can Stress Cause Rosacea?

Yes. Stress is one of the most common rosacea triggers.

Stress activates the nervous system, increases blood flow to the face, and promotes inflammation. This leads to flushing, burning, and redness.

In TCM, stress affects the liver system, which plays a major role in circulation and skin inflammation.

Does Gut Health Affect Rosacea?

Yes. Digestive imbalance is strongly linked to rosacea.

Many adults with rosacea experience bloating, reflux, irregular digestion, or food reactions. Alcohol, sugar, spicy foods, and processed foods often worsen symptoms.

TCM views the gut as central to skin health. When digestion is impaired, internal heat and inflammation increase.

Can Hormones Trigger Rosacea?

Hormonal changes are a major cause of rosacea in adult women.

Fluctuating estrogen levels affect circulation, hydration, and temperature regulation in the skin. As hormones shift, the skin becomes drier, thinner, and more reactive.

This is why rosacea often worsens during perimenopause and menopause.

Can Skincare Cause Rosacea?

Over time, yes.

Frequent use of exfoliants, acids, retinoids, foaming cleansers, and alcohol based products weakens the skin barrier. Once the barrier is damaged, redness and sensitivity linger.

From a TCM perspective, this damages the skin’s protective layer, allowing internal heat to escape through the face.

Why Does Rosacea Flare With Heat and Alcohol?

Heat and alcohol increase circulation and inflammation.

In TCM, both contribute to internal heat, which rises upward and manifests as facial redness, flushing, and burning.

This is why rosacea often worsens with hot weather, exercise, spicy food, alcohol, and emotional stress.

Why Is Rosacea Different for Everyone?

Rosacea presents differently depending on the underlying imbalance.

Some people experience dryness and flaking. Others have flushing, bumps, or intense sensitivity. Many experience a combination.

TCM treats rosacea based on the individual pattern rather than a one size fits all diagnosis.

How Does TCM Explain Rosacea?

Traditional Chinese Medicine sees rosacea as a sign of internal imbalance rather than a surface condition.

Common patterns include:
• Heat in the blood
• Liver imbalance from stress
• Digestive weakness
• Declining skin hydration
• Nervous system overstimulation

Treating the root cause allows the skin to calm naturally.

Can Rosacea Be Managed Long Term?

Yes. When inflammation is reduced, triggers are understood, and the skin barrier is supported, rosacea often becomes quieter and more manageable.

This approach focuses on calming rather than forcing the skin to change.

When Should You Seek Personalised Help?

If rosacea appeared suddenly, worsens with stress or hormones, or feels unresponsive to typical skincare, personalised guidance can help.

Cynthia White offers video consultations to assess rosacea through a TCM lens and recommend supportive skincare, lifestyle changes, and tools tailored to each person.