Rosacea and Associated Factors: A Comprehensive Analysis of Lifestyle, Dietary, and Treatment Patterns Using the NIH All of Us Database

Background: Rosacea is a chronic inflammatory skin disorder influenced by genetic, environmental, and behavioral factors. Despite increasing awareness of lifestyle and dietary contributors, comprehensive population-level analyses remain limited. Objective: To evaluate associations between rosacea and demographic, lifestyle, dietary, and treatment variables using the NIH All of Us database. Methods: We conducted a cross-sectional analysis of 410,361 participants, including 8,389 individuals diagnosed with rosacea. Two-sample tests of proportions, Fisher’s exact tests, and t-tests were used to compare rosacea and non-rosacea groups across variables including age, gender, BMI, physical activity, sleep, diet, environmental exposures, and medication use. Results: Rosacea patients were significantly older than controls (mean age 66.1 vs 55.9 years, p<0.0001) and showed higher prevalence in BMI categories 20–24 and 25–29. They exhibited reduced sleep duration, increased sedentary time, and lower daily caloric expenditure. Dairy allergies were more prevalent in the rosacea group (0.40% vs 0.09%, p<0.0001), alongside greater reported alcohol consumption, smoking, and UV exposure. Medication usage was markedly higher among rosacea patients, particularly for doxycycline (48.5% vs 11.3%) and metronidazole (57.4% vs 10.1%), reflecting current therapeutic practices. Conclusion: Rosacea is associated with distinct patterns in age, BMI, lifestyle behaviors, and treatment usage. These findings underscore the importance of integrating lifestyle and environmental assessments into rosacea management and support the need for longitudinal studies with matched controls to clarify causal relationships and optimize personalized care strategies.