Alcohol consumption increases the risk for phymatous rosacea, according to study findings published in the Journal of Cosmetic Dermatology.

Researchers conducted a systematic review and meta-analysis to determine the association between alcohol intake and rosacea. They searched PubMed, Embase, and the Cochrane database from inception through February 16, 2021.

Eligible studies met the following criteria: case-control or cross-sectional study, was published in English, included analysis of alcohol consumption in rosacea patients and nonrosacea patients without region restriction, and provided odds ratios (ORs) with corresponding 95% confidence intervals (CIs) or raw data to calculate them.

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A total of 14 studies were included, all of which were case-control studies published from 2004 to 2020. The studies included a combined 152,381 participants (62.9% women)—76,383 patients with rosacea and 75,998 control individuals.

Pooled estimates for alcohol drinkers vs nondrinkers and occasional drinkers showed no evident difference in the risk for rosacea (OR = 1.22; 95% CI, 0.84 to 1.75; heterogeneity, I2 = 91.0%; P = .000).

Owing to significant heterogeneity of the studies, the investigators assessed the source of that heterogeneity in subgroup analyses. Among rosacea subtypes, the pooled ORs for erythematotelangiectatic rosacea (ETR), papulopustular rosacea (PPR), and phymatous rosacea were 1.15 (95% CI, 0.45 to 2.29; heterogeneity, I2 = 33.0%; P = .225), 1.36 (95% CI, 0.47 to 3.96; heterogeneity, I2 = 52.0%; P = .125), and 4.17 (95% CI, 1.76 to 9.91, heterogeneity, I2 = 54.4%; P = .067), respectively.

This suggested to the researchers that “the heterogeneity decreased distinctly in all subgroup analyses of rosacea subtypes and alcohol consumption is a risk factor for phymatous rosacea rather than for ETR and PPR.”

A significant difference was observed in a subgroup analysis of sex that compared the pooled estimates in men (OR = 1.79; 95% CI, 1.44 to 2.81; heterogeneity, I2 = 0.0%; P = .547) with those in women (OR = 1.13; 95% CI, 0.69 to 1.85; heterogeneity, I2 = 0.0%; P = .861) in 3 studies.

Some limitations to the results were noted, as in 2 studies the control groups were patients with other dermatologic issues and not healthy individuals, and in 3 studies the case groups excluded patients with phymatous rosacea. Also, the standards of alcohol consumption were varying and ambiguous in some studies, and the analysis included only studies in English, which might lead to a biased selection.

“More studies of rosacea investigating sex distribution, alcohol intake levels, and types of alcoholic beverages consumed are needed in the future,” the investigators commented.


Liu L, Xue Y, Chen Y, et al. Alcohol consumption and the risk of rosacea: a systematic review and meta-analysis. J Cosmet Dermatol. Published online September 28, 2021. doi:10.1111/jocd.14483

This article originally appeared on Dermatology Advisor