Rosacea is a chronic condition that typically causes facial skin, especially around the cheeks, to blush or flush more easily.
Along with discoloration, rosacea can also cause visible blood vessels, as well as swelling, skin thickening, and textural changes to your skin.
People living with rosacea may have a hard time building an effective skin care routine because this condition can make your skin more sensitive to many common ingredients, says Jeffrey Hsu, MD, a board certified dermatologist and founder of Oak Dermatology.
What’s more, since rosacea can cause a stinging and burning sensation, your skin may be more prone to irritation from certain skin care ingredients.
Ultimately, the best way to manage and improve rosacea involves working with a dermatologist, who can offer support with:
- identifying your triggers
- devising a customized skin care regimen based on your specific symptoms and skin type
- prescription medication treatment, if necessary
That said, if you don’t have the opportunity to consult a dermatologist, you might have some questions about caring for rosacea-prone skin. The guide below can help you develop a rosacea-safe skin care routine at home.
There’s no cure for rosacea, but Hsu says the right skin care products can help minimize symptoms.
Once you identify what ingredients trigger rosacea flare-ups and remove them from your routine, you may notice significant improvements in your skin.
Not only that, but after eliminating products with harsh ingredients, you can replace them with products that boost hydration and strengthen your skin barrier — two things particularly important in rosacea treatment, according to Cybele Fishman, MD, a board certified dermatologist with Advanced Dermatology PC.
Not taking care of your skin — which could mean under- or over-washing, neglecting to moisturize, or skipping sunscreen — can make rosacea worse, says Michele Green, MD, a cosmetic dermatologist in private practice.
It’s also important to consider your skin type when creating a custom skin care routine.
Green and Hsu offer a few basic tips to keep in mind for each skin type:
- Cleanse twice each day.
- Use a lightweight, oil-free moisturizer.
Get more skin care tips for oily skin.
- Use cleanser once daily with cool or lukewarm water.
- Moisturize 2-3 times per day.
- Opt for a moisturizer with humectant ingredients, like glycerin, tremella extract, and hyaluronic acid.
Get more skin care tips for dry skin.
- Choose a cleanser specifically formulated for sensitive skin.
- Avoid washing with hot water.
- Apply and distribute cleanser gently with your fingertips.
Choosing skin care products with these specific ingredients may help relieve and calm rosacea symptoms:
- Azelaic acid. This naturally occurring acid has antimicrobial and anti-inflammatory properties that make it helpful for calming rosacea flare-ups and treating severe acne, says Emily Wood, MD, a board certified dermatologist with Westlake Dermatology.
- Niacinamide. This B vitamin may help reduce redness and inflammation, says Green, while also helping strengthen your skin’s protective barrier and keep it hydrated. If you have oily skin, note that niacinamide can also help regulate oil production and minimize the appearance of pores.
- Alpha arbutin. This naturally occurring antioxidant is known for brightening skin, and Wood says it can help even out skin tone and improve discoloration.
- Ceramides. Wood highly recommends looking for moisturizers with ceramides, fatty acids that can help your skin retain moisture.
- Aloe. Aloe may have a temporary calming and soothing effect during a flare-up, says Green, thanks to its anti-inflammatory properties.
- Bisabolol. This active ingredient, which comes from the chamomile flower, may helpreduce redness and irritation during a flare-up, according to Hsu.
- Acetyl tetrapeptide-40. This peptide can reduce inflammation and redness while boosting skin barrier function, says Hsu.
- Camellia sinensis leaf extract. This extract, which comes from tea leaves, may protect the skin from sun damage while fighting inflammation, says Hsu. It can also reduce oil production.
If you have rosacea, or suspect you might have rosacea, you may want to avoid skin care products with the following ingredients:
- glycolic, lactic, or salicylic acid
- benzoyl peroxide
- physical exfoliants (like salt and sugar grains or jojoba beads)
- sodium lauryl sulfate
- witch hazel
These ingredients can irritate your skin and they might make rosacea symptoms worse.
According to Wood, retinoids like tretinoin may also worsen rosacea, causing increased skin dryness, flakiness, and discoloration. It’s always a good idea to check with a dermatologist before using retinoids.
What about CBD?
Cannabidiol (CBD), which is extracted from the cannabis plant, has also drawn attention as a potentially beneficial skin care ingredient, mainly due to its anti-inflammatory properties.
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Hsu notes that more studies are needed to confirm whether CBD can actually help treat rosacea — and if so, how much CBD you should apply to get these benefits.
The following signs might suggest that a skin care product is making your rosacea worse, according to Wood and Green:
- increased discoloration
- facial dryness
- a burning or stinging sensation when you apply the product
- swollen bumps that resemble pimples or acne breakouts
Whenever you introduce a new product into your routine, dermatologists strongly recommend doing a patch test first to check how your skin reacts.
How to do a patch test
Green suggests the following steps:
- Apply a dime-sized amount of the product to your inner arm, wrist, or neck once or twice a day (depending on the product’s instructions).
- Observe your skin over the next 24 hours for any signs of a negative reaction.
- Repeat this process every day for a week.
- If your skin shows no signs of irritation after one week of applying the product daily, it’s probably safe to use.
Important: “An allergic reaction might take a few days to develop and it’s important to be thorough, especially when it comes to rosacea or sensitive skin,” says Green. “If you experience any irritation, wash the product off as soon as possible and discontinue all further use.”
Just keep in mind that patch testing doesn’t offer a failproof way to test for sensitivity. Even if you don’t have a reaction in a patch test, the skin on your face may react differently to that product.
“The skin on the face is thinner and more sensitive than skin elsewhere on the body, like the inner arm where most patch testing is done,” says Green. “However, patch testing is still a great means to assess whether or not a skin care product will likely cause a reaction.”
What’s more, while patch testing can help identify allergies, it doesn’t always identify all possible unwanted reactions.
“You can have a negative patch test to an ingredient and experience irritation from it,” Fishman explains.
Overall, dermatologists agree that less is more when it comes to caring for rosacea-prone skin.
Using too many products, products with too many ingredients, or washing your face too frequently, can all damage your skin and increase sensitivity and irritation, says Hsu.
These general tips offer a place to start developing your skin care routine:
- Aim to cleanse your face twice a day, Green recommends.
- If you have especially dry skin, Fishman recommends washing with just water in the morning and then using a mild creamy or milky cleanser at night.
- Instead of using an abrasive washcloth, try gently rubbing cleanser into your face with your fingertips before rinsing off with lukewarm water.
- Avoid using toner or astringent, says Fishman. These products usually contain alcohol, acids, and other ingredients that can increase sensitivity and dryness.
- After cleansing, always follow up with a moisturizer. Green says a vitamin C serum can be helpful in the morning for brightening and evening out skin tone — just opt for a weaker formulation to avoid irritation. A richer moisturizing cream, like one containing hyaluronic acid, may be best for night, Green recommends.
Remember, sunscreen is essential
Sunscreen is a must for everyone. But if you have rosacea, you’ll want to take particular care to apply (and reapply) sunscreen each and every day.
According to the American Academy of Dermatology, just several minutes of sunlight exposure can trigger redness and flushing.
Green recommends using a fragrance-free, broad-spectrum sunscreen with an SPF of at least 30.
Mineral-based (physical) sunscreens, like those with zinc oxide or titanium dioxide, are less likely to cause irritation than chemical sunscreens, like those with avobenzone or oxybenzone.
Learn more about the difference between physical and chemical sunscreens.
What to avoid if you have rosacea
Study authors found that certain habits appeared closely linked to developing rosacea, including:
- excessive face washing
- using a facial mask more than four times a week
- wearing makeup more than six times a week
- having in-salon or spa treatments more than once each week
While the study focused on skin care practices that could lead to rosacea, these habits could worsen symptoms, too.
It’s not always possible to manage rosacea symptoms on your own.
If you notice your symptoms getting worse, even after you’ve made changes to your skin care routine, Wood recommends connecting with a board certified dermatologist.
A dermatologist can offer more support by:
- identifying symptoms of rosacea or other skin conditions
- pinpointing possible triggers
- determining whether prescription medications could help control rosacea
Learn more about what dermatologists do.
Telehealth for rosacea
Many dermatologists have adopted telemedicine platforms to better serve people searching for more accessible healthcare options.
Your insurance may cover a virtual visit, says Hsu, but if it doesn’t, or you don’t have insurance, some dermatologists offer a reasonable out-of-pocket cost for a consultation.
Managing rosacea starts with building an effective skin care regimen. Dermatologists advise keeping your routine as simple as possible: Use a gentle non-foaming cleanser once or twice a day, follow up with moisturizer, and apply SPF 30 (or higher) sunscreen daily.
As you adjust to your new skin care routine, pay attention to your rosacea symptoms. If they start getting worse or don’t improve within 2 to 4 weeks, consulting a dermatologist is a good next step.
Rebecca Strong is a Boston-based freelance writer covering health and wellness, fitness, food, lifestyle, and beauty. Her work has also appeared in Insider, Bustle, StyleCaster, Eat This Not That, AskMen, and Elite Daily.