139: Can A High Histamine Diet Flare Rosacea?


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Did you ever notice that Rosacea trigger foods are also high histamine foods?

Apparently, research is showing more and more a connection between histamine and rosacea flares!

Though some people will find that following a rosacea diet can help lessen the redness in their skin, others will still get flares without explanation.

The connection to histamine may finally answer one of the reasons why.

And while it might make sense to try a low histamine diet if you’ve got rosacea, the issue at hand can be more complex than just food exposure.

See, hiding under the histamine issue is something called Mast Cells which is really the bigger issue IF histamines are one of your root causes.

In today’s episode, I’m going to share some new research coming out connecting rosacea with histamines and mast cells. Plus, I’m dishing on some hidden sources of histamine that are often overlooked (that have nothing to do with diet)!

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In this episode:

  • New research connecting high histamine foods to Rosacea flare-ups
  • What are Mast Cells + how are they connected?
  • What triggers Mast Cells to release histamine?
  • Specific gut bugs that produce histamine
  • List of symptoms associated with histamine issues
  • What are high histamine foods?
  • 3 potential antihistamine natural supplements to support Mast Cells


What if rosacea flare-ups are a sign of something else going on in your body and NOT the ultimate problem?

There’s more research coming out connecting the dots between mast cell destabilization with the various symptoms associated with rosacea.

Woman wondering about her high histamine diet triggering rosacea

Can A High Histamine Diet Flare Rosacea? (FULL TRANSCRIPT)

Welcome back to episode #139 of the Healthy Skin Show!

In today’s episode, I want to share with you some interesting research that I recently came across connecting what are known as Mast cells and Rosacea.

Just the other week, Dermatology Times published an article called “A new target for rosacea treatment: The mast cell.”(1) Towards the end of the article, the author specifically pointed out the most common food triggers identified by The National Rosacea Society include high histamine foods such as “yogurt, cheese, sour cream, soy, yeast extract and chocolate.”

In some people, this additional histamine from food exposure can trigger mast cells to degranulate and release histamine.

For people with rosacea, it seems to trigger an influx of mast cells as well as higher activity that’s found in facial skin.(1)

This appears to be in line with other research that suggests that rosacea flareups could be the result of neuropeptide production that in turn “induce[s] cathelicidin production” in mast cells.(2)

The more I dig, the more research that I find connecting the dots between the destabilization of mast cells to the various symptoms associated with rosacea.(3)

What’s really interesting to me is that I get alerts daily about new drug therapies for rosacea. It’s rare that those alerts point at research like this even though this information clearly exists in the literature and is being actively studied.

So then why aren’t we looking deeper than creams and medications to help people struggling with rosacea?

Especially given that mast cell issues typically have an effect throughout the body.

So what if rosacea flare-ups are a sign of something else going on in your body and NOT the ultimate problem.

I can’t say for sure, but it’s certainly interesting food for thought, right?

Microscope looking at mast cells

What Are Mast Cells?

Let’s hold up a moment… you’ve heard me say the phrase mast cells a few times now, but you might not know what they are.

A mast cell is a type of white blood cell that has a pretty big role to play in your body. A high concentration of the cells that ultimately create mast cells are found in your gut (specifically your small intestine).(4)

Mast cells are found in both mucus membranes and epithelial tissues and are involved in “allergy, asthma, anaphylaxis, gastrointestinal disorders, many types of malignancies, and cardiovascular diseases.”(4)

Inside mast cells, they have these granules that act as warehouses for a bunch of different inflammatory agents in your body that include “histamine, heparin, a variety of cytokines, chondroitin sulfate, and neutral proteases.”(4) These substances are released when the mast cell degranulates — essentially the granules open their doors to release what they hold within.

When mast cells become increasingly triggered, you can find that you’ve become intolerant to histamines or have developed a condition called Mast Cell Activation Syndrome (MCAS).

If you’ve never heard of mast cells before, it’s because this particular issue isn’t a very mainstream concept yet. There’s more research coming out on mast cells, but it can be difficult to find help.

I initially learned about Mast cells several years ago when I stumbled across the work of journalist Yasmina Ykelenstam at HealingHistamine.com. Though Yasmina passed away in 2018, her website survives and has a lot of information on it.

According to a presentation I sat in on at the Integrative Health Symposium 2020 in New York City by Dr. Ann Haiden, the following can trigger mast cells to degranulate:

  • Histamine exposure
  • Lectins
  • Gliadin (from gluten)
  • Stress (both external and internal)
  • Toxins
  • Certain drugs
  • Heat and cold
  • Lipopolysaccharides (LPS) which is produced in the gut by exposure to certain saturated fats such as coconut oil
  • IgE and other non-IgE triggers

Dandelion seeds

Mast Cell + Histamine Issues Are More Than Just Seasonal Allergies

It’s critical for you to know that mast cell issues go beyond just allergy symptoms (as the previous list of their involvement suggests).

Symptoms can be widespread and look like a very confusing constellation of random symptoms.

As an example, mast cells in the gut can cause diarrhea when they encounter something problematic by increasing fluid secretion and peristalsis.(4)

Other symptoms of histamine exposure from mast cells shared by Dr. Ann Haiden include:

  • Fatigue
  • Headache/Migraine
  • Nausea/Vomiting
  • Chills
  • Hives
  • GERD
  • Rashes
  • Abdominal pain
  • Diarrhea/Constipation
  • Anxiety
  • Tics or Tremors
  • Burning mouth
  • Depression
  • Memory Difficulty
  • Low blood pressure
  • Chest pain
  • Feeling cold
  • Having the sweats

And the list goes on and on.

You can see why this could be difficult for a doctor to piece together!

If you’ve listened to the Healthy Skin Show sequentially, you might recall Dr. Leonard Weinstock talked about the high incidence of Small Intestine Bacterial Overgrowth (SIBO) in rosacea patients.

To connect the dots between mast cells, a 2019 study published by Dr. Weinstock found that almost 31% of people with Mast cell activation had SIBO.(5)

While not everyone with rosacea has SIBO, it’s worth reiterating just how prevalent having SIBO is. A small study published in the Journal of American Academy of Dermatology found that “patients with rosacea were 13 times more likely to have SIBO compared with controls.”(6)

And sometimes the bugs in the gut happen to produce more histamine than others depending on your gut’s microbiome. It might surprise you to know that there are some friendly gut flora that naturally produce histamines (such as Lactobacillus acidophilus).

And there are other not-so-friendly bugs that make histamine too including Klebsiella oxytoca and Klebsiella ornithinolytica. These should not be confused with Klebsiella pneumoniae which does not produce histamines.(7)

These unfriendly bugs can pop up on stool testing. I’ve seen a number of clients that appear to have histamine intolerance, but it turned out that a major factor was gut dysbiosis with bugs that were also producing extra histamine as well!

One final interesting trigger — Yasmina mentioned that Demodex mites may also trigger mast cells on her website. Dr. Lio discussed them HERE on a recent episode at length in regard to resolving rosacea.

Avocados with high histamine content

Which High Histamine Foods Should You Look Out For?

Since I started out this episode mentioning that rosacea trigger foods also happen to be high histamine foods, I figured it was time to circle back on this point.

I don’t want to go too deep into the woods on this topic today because as I’m sure you can tell, this could be a very long discussion.

While I don’t consider myself to be a histamine expert, it is something that many of my clients struggle with on a daily basis — whether they’ve got rosacea or even eczema.

I’m going to be straight with you, a low histamine diet is really hard to follow for an extended period of time.

For some, it’s pretty difficult to follow PERIOD.

There are some foods that naturally contain more histamine — most of which are aged, pickled, dried, smoked, processed or fermented.

Canned foods are typically a problem too.

And there are fresh foods that just happen to have higher histamine like avocado, spinach, tomato, pineapple, and spices.

However, the bigger challenge is that cooked food increases in histamine concentration the longer it sits (even in the fridge).

Freezing a freshly cooked meal immediate helps to stop this histamine production.

So you can see why only addressing this from an elimination diet may not be truly practical. And given that other triggers are possible, it makes sense to look at this from a broader perspective!

In the meantime, it may be worthwhile to check out some natural histamine support:

  • Quercitin (helps stabilize mast cells and has antihistamine properties)
  • Nettles (an herb that has antihistamine properties)
  • Diamine oxidase (DAO) supplement (to help you breakdown histamine in the gut)

Just be aware that DAO supplements are not the same as typical digestive enzymes and would need to be taken with your other digestive support (not in lieu of it).

If you have an allergy to pork, be aware that DAO is typically derived from pigs.

Obviously these suggestions are for your information. Before trying any of them, discuss them with your practitioner to make sure that they’re right for you and will not negatively interact with something else you’re taking.

I think it’s important to point out that Mast cell issues can be complicated (to say the least) and it may not be as straight-forward as just following a diet to get Rosacea flare-ups to stop.

Unfortunately, there can be a number of triggers that cause Mast cells to degranulate. If you’ve already been avoiding the common trigger foods pretty religiously and still get flares, it’s time to dig deeper.

I hope this episode gives you some real food for thought about your rosacea.

It can be incredibly frustrating to deal with and equally embarrassing!

I’m excited to share more information coming up soon about histamine diets as well as rosacea episodes both from a clinical perspective, but also from people going through this just like you.

That’s why it’s important to share this episode with other rosacea warriors to help them find answers to what’s driving their flares.

If you’ve been struggling with rosacea, I’d love to hear your questions, comments or experience over at skinterrupt.com/139 so we can keep the conversation going!

And before you head out for the day, make sure to rate, review the show, and then hit the subscribe button so the next episode lands on your mobile device without you having to do a thing.

Thank you so much for tuning in and I look forward to seeing you in the next episode!

Woman looking at books in library


  1. https://www.dermatologytimes.com/rosacea/new-target-rosacea-treatment-mast-cell/page/0/1
  2. https://www.rosacea.org/blog/2019/may/new-study-further-clarifies-role-mast-cells-rosacea
  3. https://www.frontiersin.org/articles/10.3389/fmed.2019.00324/full
  4. https://www.frontiersin.org/articles/10.3389/fimmu.2015.00620/full
  5. https://journals.lww.com/ajg/Fulltext/2019/10001/Small_Intestinal_Bacterial_Overgrowth_Is_Common_in.1194.aspx
  6. https://www.jaad.org/article/S0190-9622(16)30014-7/fulltext
  7. https://www.ncbi.nlm.nih.gov/pubmed/12089029

What if rosacea flare-ups are a sign of something else going on in your body and NOT the ultimate problem?

Jennifer Fugo, MS, CNS

Jennifer Fugo, MS, CNS is an integrative Clinical Nutritionist and the founder of Skinterrupt. She works with women who are fed up with chronic gut and skin rash issues discover the root causes and create a plan to get them back to a fuller, richer life.

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