Skincare tips for rosacea

There is no known cure for rosacea, but the right skincare can make a real difference to how sensitive and reactive the skin feels. Dr Sajjad Rajpar explains what to use, what to stop, and when it is worth seeing a dermatologist.

Many people mistake early rosacea for sunburn or hot flushes. Over time, persistent redness, visible blood vessels or acne-like bumps can develop. In the early stages the signs can often be camouflaged with makeup, but once the condition is more established, foundation is no longer enough and treatment is needed. Skincare will not clear rosacea on its own, but it is the foundation that every other treatment sits on.

1. Why skincare matters in rosacea: the skin barrier

There are a few basics to remember when it comes to skincare. First, it’s important only to use gentle formulations and avoid anything that may irritate the skin, because the bottom line is that rosacea-prone skin is very sensitive.

Research helps explain why. The skin barrier is the skin’s first line of defence: it keeps the outside out and water in. In rosacea it does not function properly. A poor skin barrier leads to:

• dehydration from increased water loss
• dryness
• sensitivity
• increased skin pH

A 2020 molecular study of papulopustular rosacea found barrier damage that was unexpectedly similar to eczema (atopic dermatitis). Sensitive skin needs to be treated really gently, which is why skincare is the starting point for everyone with rosacea, whatever other treatment is used. Read more about rosacea, redness and flushing.

2. Choose a gentle cleanser

A non-foaming formula doesn’t strip the skin of its natural oils, so it is kinder to your complexion. Use ones that are fragrance-free and labelled as suitable for sensitive skin.

• Cetaphil Pro Facial Wash
• CeraVe Hydrating Facial Cleanser
• Avène Tolerance Extremely Gentle Cleanser

3. Remove makeup and sunscreen gently

Similarly, use a very gentle product to remove makeup and sunscreen without disturbing the skin barrier. After removing makeup, consider double cleansing with a light moisturiser and water.

• Clinique Take the Day Off Cleansing Balm
• La Roche-Posay Toleriane Dermo-Cleanser
• La Roche-Posay Micellar Water for Ultra-Sensitive Skin

4. Use a light, soothing moisturiser

Lightweight, non-comedogenic products (that won’t clog or block the pores) help hydrate and soothe irritated skin. Use a moisturiser once or twice a day, depending on how dry your skin is.

• CeraVe Moisturising Lotion
• La Roche-Posay Rosaliac Anti-Redness Light Cream
• Avène Hydrance Aqua-Gel

5. Stick to one or two actives

Don’t over-complicate your routine; stick to one or two “hero” ingredients and keep it simple. If your rosacea is mild, start with a 10% azelaic acid product you can buy without a prescription. Other actives are best recommended on prescription.

• The Ordinary Azelaic Acid Suspension 10%
• The Inkey List Redness Relief Solution (10% azelaic acid)

6. Use green-tinted products to tone down redness

Green-based tinted products can help mask redness. They can be used alone or under foundation.

• Dr Jart’s Cicapair Tiger Grass Correcting Treatment
• Clinique Redness Solutions Day Relief Cream
• Eucerin AntiRedness Soothing Care Cream

7. Protect your skin from the sun

Sun exposure is one of the most common rosacea triggers, so protect your skin with a broad-spectrum sunscreen with an SPF of at least 30. Apply it every day, all year round, whatever the weather. Mineral (zinc oxide or titanium dioxide) formulas are often better tolerated on reactive skin.

• La Roche-Posay Anthelios UVMune 400 Invisible Fluid (plain or tinted)
• Heliocare 360° Oil-Free Gel
• Avène Antirougeurs Anti-Redness Soothing Day Emulsion SPF 30

8. Back away from the irritants

Certain skincare ingredients can worsen rosacea symptoms, so avoiding them is important. These include alcohol, fragrance and exfoliants. That means no exfoliating scrubs, pads or masks. At-home chemical peels and acid treatments are also best avoided. If a product stings or burns on application, stop it.

When should I see a dermatologist about rosacea?

Skincare alone controls only the mildest cases. It is worth booking a dermatology consultation if:

• the redness or spots are persistent, or keep coming back
• over-the-counter azelaic acid and gentle skincare have not been enough
• your eyes feel gritty, sore or red, or your eyelids are inflamed
• the skin on your nose is becoming thicker or bumpy
• you are not sure whether it is rosacea, acne, perioral dermatitis or eczema
• flushing or redness is affecting your confidence or quality of life

At Midland Skin you are seen by a consultant dermatologist who confirms the diagnosis, adjusts your skincare and discusses the options that may be appropriate for you, including prescription creams and tablets, BBL or vascular laser for persistent redness and visible vessels, and other treatments for flushing. The treatment plan is decided after assessment. Full details are on our rosacea, redness and flushing page.

If you are not sure the redness is rosacea at all, our article on the other causes of a red face may help.