It's the rosacea, it's a chronic, lifelong condition that Ralph has. The flareups can be caused by high temperatures (it's currently in the mid 90f range in Merida with very high humidity) and alcohol/drug abuse. He has mentioned before that he has to rub a lotion on his body to treat/maintain the flareups, obviously hasn't been doing that lately. Last time it was this bad was a couple of years ago when he was in his sasquatch arc and livestreaming himself getting shit-house drunk at different restaurants while Meigh and Rozie looked on in horror.