Everything You Should Know About Managing Rosacea

Seeing red is never a good thing, especially when it comes to your complexion. Rosacea is an inflammatory skin condition that affects at least 14 million people in the U.S. I’ve seen many clients with rosacea over the past 30 years and understand what a frustrating and painful condition it can be. That said, I’ve also seen how much progress can be made when it’s managed effectively. Keep reading to learn more about how you can tweak your behavior, lifestyle, and skincare routine for clear, calm skin.

What Does Rosacea Look Like?

There are so many different signs and symptoms that can accompany a rosacea diagnosis that doctors have created four categories of rosacea. These are the two most common:

  1. Erythematotelangiectatic Rosacea: flushing; persistent redness or discoloration; visible, broken blood vessels; swollen, sensitive skin; burning or stinging; rough skin
  2. Papulopustular Rosacea: red, acne-like breakouts that come and go; oily skin; sensitive skin that stings or burns; visible, broken blood vessels; persistent redness

Though it’s rare, rosacea can sometimes cause the skin to become bumpy and thicken (especially on the nose). Some people also get it in their eyes, known as ocular rosacea. This can cause watery, swollen, or bloodshot eyes and blurred vision.

Who Gets Rosacea?

Rosacea is most commonly found in people with fair skin (think Northern European descent). This doesn’t mean other skin tones can’t experience rosacea, though. It’s a lot more likely to be misdiagnosed or missed entirely in patients of color because they don’t always present with classic redness. Other signs and symptoms to look for include warm-feeling skin; dry, swollen skin; a dusky brown discoloration; acne-like breakouts that come and go and don’t clear with treatment.

You’re more likely to develop rosacea if someone in your family has had it or if you’ve experienced lots of acne at some point. It’s not uncommon for rosacea to develop after the age of 30.

Tips for Managing Rosacea

The true root cause of rosacea is still unknown, and it’s likely more than just a single factor. Much like acne, rosacea is a systemic, inflammatory disease for which there is no known cure. The key is managing it successfully to be able to minimize flare-ups as much as possible. By working with a professional, identifying your triggers, and building the right skincare routine, you can get your skin to a much better place.

Work With a Dermatologist

Having worked with a lot of rosacea patients in the past, I’m full of tips and tricks for helping you manage rosacea at home. My first and foremost tip, though, is to work with a dermatologist. Rosacea is a medical condition that should be diagnosed by a board-certified dermatologist, especially since some of the signs and symptoms can be confused with other conditions (such as acne, eczema, or allergies). The first step is to confirm that you’re dealing with rosacea and not something else.

You may also need medications to help get your symptoms under control, and these can only be prescribed by a dermatologist. 

  • Azelaic acid. Azelaic acid has been shown to be very effective against rosacea, but only at 15% which is considered prescription strength. It’s anti-inflammatory, helps minimize redness, and exfoliates ever so slightly.
  • Sulfur-based medications. Sulfur has also been shown to help with redness and inflammatory lesions associated with rosacea.
  • Antibiotics. Dermatologists will sometimes prescribe low-dose antibiotics to help with inflammation

Know Your Triggers

When it comes to rosacea management, I can’t stress this enough: Know. Your. Triggers. While the underlying cause of rosacea may still be unknown, there are many well-known triggers. These are what set off an inflammatory response in rosacea patients and cause them to have flare-ups. Cutting out or reducing triggers is one of the most effective ways to manage symptoms of rosacea.

These are some of the most commonly known triggers for rosacea:

  • Sun exposure
  • Emotional stress
  • Wind
  • Heat (hot weather, hot baths or showers, saunas, hot tubs, etc.)
  • Alcohol
  • Spicy foods
  • Exercise 
  • Certain skincare ingredients
  • Certain medications

This list is by no means extensive, and it’s important to note that not all rosacea patients will have the same triggers. For example, one rosacea patient might react negatively to a skincare ingredient that another rosacea patient can use without issue. Because it’s so individual, you really have to be your own skin detective. 

I recommend keeping a journal as a way to help identify your personal triggers. This way, when you have a flare-up, you can go back to see if there was a skincare product, type of food, behavior, or environmental factor that could have contributed. I know it sounds tedious, and it can certainly take a while to identify patterns, but once you do you’ll be one step closer to clearer, calmer skin.

Build a Routine and Stick to It

If you have a condition like rosacea that makes your skin act sensitive, you’ll want to avoid product hopping. It’s important to build a consistent routine with the right products. Look for products that are soothing, hydrating, and support your skin’s barrier health. In other words? Baby your skin and keep it as comforted as possible. 

Here are some of my top tips for building a routine focused on managing rosacea:

  1. Cleanse gently, every day. This means both morning and evening! Cleansing can help remove dead skin-cell buildup from the skin (removing buildup can help keep flare-ups under control). Opt for a simple, sulfate-free cleanser. 
  2. NEVER skip sun protection. As I mentioned, sun exposure is one of the top triggers for rosacea. Use a broad-spectrum sunscreen every day in addition to wearing sun-protective clothing and avoiding direct sun exposure during peak daylight hours. Some people with rosacea are sensitive to “chemical” sunscreen filters, in which case I recommend trying a zinc oxide sunscreen. (Learn more about physical vs. chemical sunscreens.)
  3. Exfoliate (carefully). Removing dead cell buildup from the skin can help keep your moisture barrier balanced, which in turn can help mitigate rosacea flare-ups. Exfoliating is a great way to do this, but those with rosacea should proceed with caution. You may not be able to exfoliate as frequently as other people, and some traditional exfoliating ingredients like AHAs may just be too sensitizing for you. The good news is, there are other ways to exfoliate. It’s all about finding the right type for your skin. Just make sure you patch test anything you haven’t tried before. 
  4. Hydrate. It may seem obvious, but the importance of keeping rosacea-prone skin well-hydrated really can’t be overstated. As is the case with pretty much any skin condition, maintaining a healthy moisture barrier is key. This is achieved using products with oils and phospholipids. If you have oily skin and don’t want a heavy moisturizer everywhere, try using a heavier cream on the affected areas of your face (especially during flare-ups) and a lighter moisturizer everywhere else.

To learn more about building a routine, check out Skin Type 5 and Skin Type 9. I created these specifically for those who have rosacea and redness-prone skin. 

Always Patch-Test New Products

If you have rosacea, you’re more likely than the average person to have a negative reaction to a new skincare product. A negative reaction could trigger a flare-up, which might last anywhere from a few days to a few weeks. The best way to avoid this is to diligently patch-test new skincare products before applying them everywhere. It may seem like a pain, but trust me, it’s worth it!

Read more about how to patch-test for a negative reaction.

Skincare Ingredients to Avoid if You Have Rosacea (Plus, Ingredients That Can Help)

We’ve already talked about how there can be tons of different triggers for rosacea, but I want to touch on skincare ingredients for a moment. Yes, everyone is different, but these are ingredients I’ve noticed many rosacea patients react negatively to:

  • Fragrance (Both synthetic and natural, like high doses of essential oils.)
  • Drying alcohols (SD alcohol, denatured alcohol, isopropyl alcohol)
  • Sulfates (Found in some cleansers.)
  • Circulation-boosting extracts (This includes ingredients like mint, ginseng, and vitamin B12.)
  • L-ascorbic acid (This is a very potent form of vitamin C. Instead, try a no-sting form such as magnesium ascorbyl phosphate or ascorbyl phosphate.) 

Note: Be very careful with (or avoid) active facial treatments, such as microdermabrasion. Always check with your dermatologist first before getting any professional treatments. 

Ingredients to Help Soothe Rosacea

These are some of the ingredients I love to formulate with when I’m creating products for sensitive, redness-prone skin. They help soothe inflammation, calm irritation, boost hydration, and support a healthier moisture barrier. 

I know keeping rosacea under control can feel like an uphill battle sometimes, but I’ve seen many clients significantly improve their skin by diligently following these tips! Hard work pays off, and clearer, calmer skin is definitely possible.

Next, learn how to get rid of red, broken blood vessels on the face.

Renee Rouleau Author

Celebrity Esthetician & Skincare Expert
As an esthetician trained in cosmetic chemistry, Renée Rouleau has spent 30 years researching skin, educating her audience, and building an award-winning line of products. Trusted by celebrities, editors, bloggers, and skincare obsessives around the globe, her vast real-world knowledge and constant research are why Marie Claire calls her “the most passionate skin practitioner we know.”

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