Rosacea Treatment Guide
WHAT CAUSES ROSACEA?
One of the main reasons there have been such problems fnding a cure for rosacea is that no one knows, or at least not everyone agrees on, exactly what causes it. Many researchers think there’s a genetic component to the development of rosacea. Others believe that elevated levels of an inﬂammatory peptide called cathelicidin or high levels of an enzyme known as KLK5 in the skin’s uppermost layers play a role.
Let’s start with the lifestyle issues that can make rosacea worse. Basically, anything that causes a rush of blood to the face can be an issue. All of the following are triggers.
- Sun exposure.
- Hot climates.
- Heavy or strenuous exercise.
- Emotional stress (or just emotions in general).
- Specifc cosmetic ingredients, such as fragrant plant extracts or oils; various forms of mint and citrus; denatured alcohol, and witch hazel.
- Topical steroid creams and other topical medications that can thin the skin.
- Spicy foods, alcohol, coﬀee, or caﬀeinated teas, and hot beverages in general.
- Reactions to certain fabrics that might brush against your face, like wool or
textured, scratchy-feeling fabrics.
Rosacea Treatment Guide
That’s quite the lineup—and it’s not even the entire list. Although some triggers are more obvious than others, it’s hard to know what will spark a rosacea ﬂare-up for you, as it can diﬀer from case to case. What’s on the list above may or may not apply to you and there may be other things that do serve as triggers but that aren’t on our list. The variations of problems someone with rosacea may encounter is one of the stranger aspects of this disorder.
SKINCARE FOR ROSACEA
Because rosacea is an unpredictable skin disorder, with just about anything capable of setting it oﬀ or creating extreme sensitivity, it’s critical to assemble the most gentle skincare routine possible so as not to aggravate matters. All skincare products should be fragrance- and dye-free. “Fragrance-free” means avoiding fragrant plant oils, too, which surprisingly, and disturbingly, often show up in products labeled as being safe for sensitive skin. For example, lavender oil and citrus oils are definite no-nos due to the volatile fragrance components they contain!
A skincare routine for anyone with rosacea must do the following:
» Eliminate irritating or sensitizing ingredients, which may include otherwise benign ingredients not known to be irritating (but they are for your skin).
» Include calming products that reduce redness and soothe skin.
» Improve cell turnover to remove the buildup of dead skin cells.
» Protect from sun damage without causing irritation.
» Fight wrinkles with products containing antioxidants and skinrepairing ingredients.
» Absorb oil if skin is oily, but not to the point where skin becomes dried out.
» Provide a steady stream of barrier-repair ingredients to help skin become
more resilient, less reactive, and have a smoother surface.
As is true for everyone on the planet, using sunscreen is one of the most important steps in your skincare routine! Unprotected UV exposure makes rosacea worse, so be sure to apply a sunscreen every day that’s rated SPF 30 or higher to keep those damaging rays from harming your delicate skin.
Generally speaking, those with rosacea or sensitive skin should check the ingredient label when selecting a sunscreen. Ideally, you should use only sun-protection products whose active ingredients are titanium dioxide and/or zinc oxide. These mineral sunscreens are gentle and are the least likely to cause a stinging or burning sensation, both of which can worsen the redness and irritation you’re trying to minimize.
When it comes to enjoying time outdoors, don’t forget that sunscreen can’t do it all on its own. Consider sunglasses and wide-brimmed hats to further shield your face from UV radiation.
Here’s a step-by-step routine you can follow to try to get rosacea under control:
» Use an extremely gentle, non-drying, water-soluble cleanser that is appropriate for your skin type. Choose an emollient lotion or cream cleanser if you have dry skin and a thin-textured, gel, foaming, or soft lather cleanser if you have oily or combination skin. No soaps or bar cleansers!
» Soothe and reduce redness with a gentle, fragrance- and alcohol-free toner that’s loaded with anti-irritants and barrier-repair ingredients. This step may seem like extra work, but it can make a HUGE diﬀerence in the appearance and comfort of reddened, sensitized skin.
» During the day, apply a sunscreen with SPF 30 or greater whose only active sunscreen ingredients are titanium dioxide and/or zinc oxide, along with healing ingredients such as antioxidants and skin-repairing ingredients. If you have dry skin, choose a more emollient, creamy sunscreen; if you have oily or combination skin a more ﬂuid, lotion texture is optimal. If your combination skin has markedly dry areas, layer a regular cream moisturizer or richer serum underneath your sunscreen only on the dry areas.
» For extra sun protection (and we love extra protection), if you normally wear foundation and pressed powder, select those that have sunscreen.
Stick with makeup with sunscreen whose only active ingredients are titanium dioxide and/or zinc oxide as they present little to no risk of irritation.
Look for foundation and pressed powder with sunscreen rated SPF 15 or greater, and be sure your daytime moisturizer is rated SPF 30 or greater.
» If you have rosacea with oily or combination skin and breakouts, makeup with sun protection can be the only sunscreen you need (though in that case try to fnd makeup rated SPF 30). If you have dry skin and rosacea, you can wear a moisturizer with sunscreen under makeup to add a layer of protection or a moisturizer without sunscreen and then the foundation with pressed powder and SPF. There are many foundations and powders with mineral sunscreen actives, so you’ll have plenty of options!
» If you have oily or combination skin, in the evening apply a gel moisturizer or a light serum formulated with antioxidants and skin-repairing ingredients. A serum with retinol is fne because retinol has research showing it helps reduce the inﬂammatory factors that contribute to rosacea.
You’ll probably need a separate, more emollient moisturizer for around the eyes because a gel or light serum is usually not enough for that area.
If you have normal to dry skin, in the evening use a lotion or cream moisturizer formulated with soothing antioxidants and skin-repairing ingredients. It’s OK if it contains retinol. You can also use a serum over or under your moisturizer for extra hydration, redness reduction, and protection.
» Regardless of your skin type, you’ll want to consider using a BHA (salicylic acid) exfoliant once or twice a day. It takes experimenting to see what strength and frequency of application works best for you. BHA not only exfoliates skin, but also has anti-inﬂammatory properties that reduce redness and eliminate dry, ﬂaky skin. BHA also works amazingly well if you have rosacea and acne or blackheads!
» Check with your physician to see which prescription medication is best to treat your rosacea. Topical options include MetroGel®, MetroLotion®, Tazorac®, Renova, azelaic acid (brand names Azelex® or Finacea®), brimonidine, doxycycline, isotretinoin, and low-dose minocycline. Oral options include tetracycline and metronidazole. These are considered the most reliably researched medical options.
All of the topical medications should be applied as directed by your physician. Our strong recommendation is to apply any topical medication in the evening as the last step of your skincare routine, following your cleanser, toner, exfoliant, moisturizer, and/or serum. During the day, apply the topical medication before the sunscreen. Sunscreen is always the last skincare product you apply so as not to dilute its eﬀectiveness.
SUMMING IT UP
Although there’s no simple, works-for-everyone solution for rosacea, you can take action and control its most telltale symptoms. Through trial and error, rosacea can be brought under control—no more hiding, no more embarrassment. Male or female, if you have rosacea, see your dermatologist for medical treatments (they will be needed), and keep your skincare routine gentle, gentle, gentle!
RECOMMENDED PRODUCTS FOR ROSACEA:
The products below include various cleansers, toners, moisturizers, and mineral-based sunscreens that we feel strongly are worth trying if you have rosacea. Because rosacea-aﬀected skin can be incredibly fnicky and capable of reacting to the most benign formulas, coming up with a defnitive list is tricky and, unfortunately, not a sure thing. Therefore, please consider these recommendations knowing that, based on the frustrating nature of rosacea, your skin may respond unfavorably.
» Eucerin Redness Relief Soothing Cleanser
» First Aid Beauty Milk Oil Conditioning Cleanser
» Neutrogena Ultra Gentle Hydrating Cleanser, Creamy Formula
» Olay Foaming Face Wash, Sensitive Skin
Daytime Moisturizers with SPF
» Exuviance Sheer Daily Protector Sunscreen Broad Spectrum SPF 50
» MDSolarSciences Mineral Creme Broad Spectrum SPF 30 UVA/UVB Sunscreen
» Paula’s Choice Resist Super-Light Daily Wrinkle Defense SPF 30
» Paula’s Choice Skin Recovery Daily Moisturizing Lotion SPF 30
» Rodan + Fields Soothe Mineral Sunscreen SPF 30
Moisturizers and Serums
» Arbonne Calm Gentle Daily Moisturizer
» Dr. Dennis Gross Skincare Hydration Super Serum Clinical Concentrate Booster
» Elizabeth Arden Ceramide Capsules Daily Youth Restoring Serum
» Olay Regenerist Micro-Sculpting Serum, Fragrance-Free