People who have rosacea have long been told to avoid coffee, especially the caffeinated kind, if they wanted to avoid flare-ups of facial flushing and blemishes. Now new research may reverse that advice…welcome news for java-craving rosacea patients!

About 14 million Americans have rosacea, a common chronic skin disease that usually develops between the ages of 30 and 50 and causes flushing, blushing and acnelike breakouts. Women and people with fair skin are most prone to rosacea (though men can have it), and it tends to run in families. Skin redness usually occurs on the nose and cheeks but can extend to the forehead, chin, ears, chest and back—and over time can become permanent. Besides redness, the skin can also swell, thicken and develop a bumpy texture. Some well-known people have been afflicted with rosacea, perhaps most famously the comedian and actor W.C. Fields…and in more modern times, Bill Clinton and Diana, Princess of Wales.

Rosacea can be treated with laser therapy or medications, such as the topical gel brimonidine to constrict blood vessels and reduce redness…oral antibiotics to fight inflammation…or the acne drug isotretinoin. But even with these therapies, patients must still avoid triggers—such as exposure to sunlight, stress, spicy foods…and, it has long been thought, coffee.

For the new study, researchers from Brown University looked at about 15 years of health data on 83,000 nurses from the Harvard Nurses’ Health Study II, a large group of female nurses who have been followed and surveyed regularly since 1989. The nurses had been asked every four years about their food and beverage intake, including caffeine, and whether they had been diagnosed with rosacea. Over the course of the study, nearly 5,000 of them were diagnosed with rosacea.

Results: Surprisingly, the more caffeinated coffee the nurses drank, the less likely they were to be diagnosed with rosacea. Compared with nurses who drank less than one cup per month, nurses who drank four or more cups daily were 23% less likely to be diagnosed with rosacea.

Decaf coffee, on the other hand, was not associated with rosacea risk in any way, positive or negative. Nor was any other source of caffeine such as tea, soda or chocolate.

The researchers pointed out several ways that caffeine may help reduce risk for rosacea. One theory is that rosacea may be caused by an overactive immune system, and caffeine contains immune-suppressing antioxidants. Caffeine may constrict blood vessels so blood flow to the skin is reduced. Hormones may also be involved in the development of rosacea, and caffeine helps modulate the stress hormones adrenaline, noradrenaline and cortisol.

The researchers also pointed out that heat is thought to trigger rosacea flare-ups, but the fact that nurses who drank hot decaffeinated coffee were not at any higher risk for rosacea suggests that other components in coffee besides caffeine may be mitigating the effects of heat. Why other caffeine-containing foods and drinks had no association with rosacea risk, they believe, was likely because the amounts of caffeine they contained were too small to have an effect.

Note that this study does not prove that coffee prevents rosacea, it only suggests that coffee doesn’t seem to trigger rosacea. And while it’s true that the researchers looked only at women, the results still suggest that anyone who has the condition—or who is at risk for it, for instance because of family history—need not be so wary of coffee. In fact, a daily cup (or several) of joe might be a very good thing!

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