As a dermatologist who has rosacea myself, I have a unique perspective on how to reduce redness on the face with skincare. Not only do I help rosacea patients in my Miami dermatology practice, but I also conduct research trials on the latest rosacea treatments. In this blog post, I will share my expert advice on the best skin care ingredients to effectively manage rosacea symptoms and discuss which soothing treatments have proven to be successful. I will make a point to discuss natural ingredients form plants to soothe irritated skin.

Rosacea is a chronic skin condition characterized by facial redness, visible blood vessels, and sometimes, acne-like bumps. While there is no cure for rosacea, there are several strategies and treatments that can help control flare-ups, reduce erythema, improve the appearance of your skin.

There are 16 Baumann Skin Types, and 8 of them are more susceptible to inflammation. You may be one of these. Take the skin type quiz to find out and get personalized recommendations of which rosacea products are best for your Baumann Skin Type.

There are prescription rosacea treatments, but in my experience they work best as part of a customized soothing rosacea skin care routine. In this blog I will discuss natural ingredients found in skincare that can help soothe the skin and improve the appearance of reactive rosacea skin. These soothing and calming ingredients can help reduce redness on the face. If you have mild rosacea, these ingredients may be enough to make your skin manageable without prescription education. If you have moderate or severe rosacea, you can combine these with prescription medications. If you have broken blood vessels  on the face, these will only go away with vascular laser treatments.

Lets look first at retinol and then what natural ingredients I like to use in my skin care routine to help soothe rosacea. I will also discuss which ingredients do not work on rosacea-prone skin.

Facial redness is a common concern for many people, particularly those with rosacea or sensitive skin. While there are several underlying causes of facial redness, such as inflammation, dilated blood vessels, and sun damage, various topical treatments and skincare ingredients can help reduce its appearance.

One class of topical medications used to treat facial redness is alpha-1 agonists, which work by constricting blood vessels. Oxymetazoline and brimonidine are two examples of alpha-1 agonists that have been approved by the FDA for the treatment of facial redness associated with rosacea. These medications are available by prescription and can provide temporary relief from redness, typically lasting for several hours.

Oxymetazoline is an alpha-1 agonist that is commonly found in over-the-counter products such as Afrin nasal spray and Visine eye drops. Afrin contains 0.05% oxymetazoline, while Visine contains 0.025%. In comparison, Rhofade, a prescription medication for the treatment of facial redness associated with rosacea, contains 1% oxymetazoline.

One of the main challenges with using oxymetazoline to treat facial redness is its poor absorption into the skin. (13) Oxymetazoline is a hydrophilic molecule, meaning it does not easily penetrate the skin's lipid barrier. Afrin was formulated to be absorbed through the thin nasal mucosa, while Visine was designed to penetrate the even thinner cornea of the eye. However, the skin on the face is much thicker and has a more complex structure, making it difficult for oxymetazoline to be effectively absorbed.

To overcome this challenge, Rhofade was developed with specific penetration-enhancing ingredients, such as:

• butylated hydroxytoluene
• anhydrous lanolin
• medium chain triglycerides
• diisopropyl adipate
•  oleyl alcohol
• polyethylene glycol 300
• PEG-6 stearate
• PEG-32 stearate
• ceteareth-6
• ceteareth-25

These ingredients help to temporarily disrupt the skin's barrier function, allowing the oxymetazoline to penetrate more effectively into the skin. Additionally, Rhofade's formulation includes other ingredients like citric acid, which helps to adjust the pH of the skin and further enhance absorption.

The inclusion of these penetration-enhancing ingredients, along with the higher concentration of oxymetazoline, makes Rhofade more effective in reducing facial redness compared to over-the-counter products like Afrin. While Afrin may provide some temporary relief from redness when applied to the face, its formulation is not optimized for skin penetration, limiting its overall effectiveness.

 Several skincare ingredients found in cosmetics have been shown to have vasoconstricting properties, which can help reduce facial redness. Caffeine, a common ingredient in many skincare products, is known for its ability to constrict blood vessels and reduce inflammation. When applied topically, caffeine can help improve the appearance of redness and puffiness, making it a popular choice for eye creams and serums.

Other skincare ingredients that may help reduce facial redness include:

1. Horse chestnut extract: This ingredient contains aescin, a compound that has been shown to have vasoconstricting and anti-inflammatory properties. It may help strengthen blood vessels and reduce the appearance of redness and swelling.
2. Green tea extract: Rich in polyphenols, particularly epigallocatechin gallate (EGCG), green tea extract has potent antioxidant and anti-inflammatory properties. It may help protect the skin from free radical damage and reduce inflammation, thereby minimizing the appearance of redness.
3. Vitamin K: This vitamin has been shown to help improve the appearance of bruising and dark circles, as well as reduce facial redness. It works by promoting the proper functioning of blood clotting mechanisms and helping to constrict blood vessels.
4. Plant Oils- several natural oils have been shown to have soothing and anti-inflammatory properties that may help reduce facial redness. Argan oil, derived from the kernels of the argan tree, is rich in vitamin E and essential fatty acids that can help nourish and calm irritated skin. Jojoba oil, which closely resembles the skin's natural sebum, is non-comedogenic and has anti-inflammatory properties that may help soothe redness and irritation. Evening primrose oil, extracted from the seeds of the evening primrose plant, contains gamma-linolenic acid (GLA), an omega-6 fatty acid that has been shown to have anti-inflammatory effects and may help improve the skin's barrier function, reducing sensitivity and redness.

Retinol, derivative of vitamin A, is renowned for its anti-aging properties. However, for individuals with sensitive or rosacea-prone skin, using retinol can be challenging due to its potential to cause irritation and inflammation. When introducing retinol into a skincare routine for rosacea patients, it is crucial to start with a gentle, holistic approach that focuses on hydrating the skin, repairing the barrier function, and reducing inflammation.
During the first month of a new rosacea skincare regimen, it is advisable to avoid using retinol and instead concentrate on nourishing and calming the skin with anti-inflammatory ingredients such as argan oil, azelaic acid, niacinamide, green tea and  jojoba oil. Once the skin has adapted to this soothing routine, a low-strength retinol can be gradually introduced, applied every third night over a moisturizer to minimize potential irritation. As the skin acclimates to the retinol, the strength and frequency of application can be slowly increased over several months, tailoring the rosacea routine to your tolerance level.

Gentle retinols that can be tolerated by rosacea prone skin should have one or more of these characteristics:

• Encapsulated
• Contain soothing ingredients
• Use retinaldehyde
• Have a low dose of retinol

You can shop our collection of gentle rosacea-safe retinols here.

Recent advancements in microencapsulation technology have made retinol more tolerable for sensitive, reactive skin. Microencapsulated retinol is retinol that is protected within a shell or matrix. This allows a slow, controlled release of retinol. the encapsulation also minimizes direct contact of pure retinol with the skin. 

Natural ingredient can help reduce skin redness by targeting various mechanisms involved in the inflammatory process.

Some natural ingredients, such as licorice extract and feverfew, may help reduce redness by acting on alpha-1 receptors or blocking beta receptors, leading to the constriction of blood vessels.

Other ingredients, like willow bark and green tea, can help reduce inflammation by inhibiting the arachidonic acid pathway and reducing prostaglandin production. Prostaglandins are lipid compounds that play a key role in the inflammatory response, and by blocking their production, these natural ingredients can help calm irritated skin.

Certain natural ingredients, such as chamomile and aloe vera, have antihistamine properties, helping to reduce the release of histamine, a compound that contributes to inflammation and redness. Additionally, some ingredients, like centella asiatica and colloidal oatmeal, may help inhibit the activity of natural killer (NK) cells, which are immune cells that can contribute to inflammation when overactive.

Many natural ingredients, such as green tea, licorice extract, and niacinamide, have potent antioxidant properties that help protect the skin from oxidative stress and free radical damage, which can exacerbate inflammation. These ingredients can also help strengthen the skin's natural barrier function, reducing transepidermal water loss and protecting against external irritants that may trigger rosacea flare-ups.

Here is a list of 10 natural ingredients that may help treat the erythema of rosacea:

1. Licorice extract: Contains glabridin, which has anti-inflammatory and skin-lightening properties that may help reduce redness and even out skin tone.
2. Willow bark: A natural source of salicylic acid, which has anti-inflammatory and exfoliating properties that can help unclog pores and reduce inflammation.
3. Aloe vera: Has anti-inflammatory, soothing, and moisturizing properties that can help calm irritated skin and reduce redness.
4. Chamomile: Contains apigenin, an antioxidant with anti-inflammatory effects that may help soothe rosacea-prone skin.
5. Colloidal oatmeal- has potent anti-inflammatory and skin-protecting properties that can help soothe and calm irritated skin, making it an excellent ingredient for managing rosacea symptoms. Its unique polyphenols, called avenanthramides, have been shown to reduce inflammation by inhibiting pro-inflammatory cytokines, such as interleukin-8 (IL-8) and nuclear factor kappa B (NF-κB). Additionally, colloidal oatmeal can regulate the activity of natural killer (NK) cells, preventing them from becoming overactive and contributing to inflammation. 
6. Niacinamide (Vitamin B3): Helps improve skin barrier function, reduce inflammation, and regulate sebum production.
7. Green tea: Rich in polyphenols, particularly EGCG, which has antioxidant and anti-inflammatory properties that may help reduce redness and inflammation.
8. Feverfew: Contains parthenolide, a compound with anti-inflammatory properties that may help calm rosacea-prone skin.
9. Cucumber: Has cooling and soothing properties that can help reduce redness and inflammation.
10. Centella asiatica (Gotu kola): Contains compounds like asiaticoside and madecassoside, which have anti-inflammatory and wound-healing properties that may benefit rosacea-prone skin.

 Oatmeal masks- 

One popular natural rosacea remedy is an oatmeal mask, which harnesses the soothing and anti-inflammatory properties of colloidal oatmeal. To create a simple oatmeal mask, mix 2 tablespoons of colloidal oatmeal with 1/4 cup of cool rice water until a smooth paste forms. Rice water, the starchy water leftover from soaking or cooking rice, is rich in antioxidants and has been shown to have skin-soothing properties. Apply the oatmeal and rice water paste to the face, avoiding the eye area, and leave it on for 10-15 minutes. Rinse off with cool water and gently pat the skin dry.

Other natural ingredients that can be added to the mask ingredients include aloe vera, which has cooling and anti-inflammatory properties, and honey, which has antibacterial and soothing effects. Incorporating these ingredients into a weekly mask may help calm rosacea-prone skin. These natural remedies combined with a soothing skin care routine can reduce the appearance of redness and inflammation. 

Cold water or ice-

Avoid using ice cubes, ice cycles, or ice water facials or exposing the face to extreme cold which can be harmful to rosacea-prone skin. If a cooling sensation is desired, using products that have been chilled in the refrigerator, but not ice-cold, products or applying a cool compress with a soft cloth is a safer alternative.

One option is to store products like hyaluronic acid serums in the refrigerator. Hyaluronic acid is a powerful humectant that helps hydrate and plump the skin, and when applied cold, it can provide a soothing, cooling sensation. Chilling hyaluronic acid serums in the refrigerator not only offers a refreshing feel but also helps to constrict blood vessels temporarily, reducing redness and inflammation without the risk of thermal shock or rebound vasodilation associated with direct ice application.

Cucumber Mask-

Cucumber, known for its soothing and cooling properties, is an excellent natural ingredient for calming rosacea-prone skin. To create a chilled cucumber paste, wash, peel, and cut a fresh cucumber into small pieces. Mash or blend the cucumber until a smooth paste forms, then transfer it to a bowl and refrigerate for 15-20 minutes.
Apply a thin layer of the chilled cucumber paste to the face, avoiding the eye area, and leave it on for 10 minutes. The cucumber's natural compounds, such as cucurbitacins and vitamin C, have anti-inflammatory properties that can help reduce redness and irritation associated with rosacea. Rinse the paste off with cool water and gently pat the skin dry. Use this soothing mask once or twice a week.

Oils that are good for rosacea should be rich in linoleic acid, antioxidants, and polyphenols. Linoleic acid is an essential fatty acid that helps maintain the skin's natural barrier, preventing moisture loss and protecting against irritants.Antioxidants, on the other hand, help combat free radicals that can contribute to inflammation and skin damage.

These are 5 oils that are good for rosacea:

1. Argan Oil
2. Chamomile Oil
3. Jojoba Oil
4. Squalane Oil
5. Sunflower Seed Oil

Natural plant-derived oils can help soothe and calm the skin. Oils rich in linoleic acid and antioxidants are particularly beneficial for those with rosacea.

Two oils that have shown promise in managing rosacea symptoms are coconut oil and jojoba oil. Coconut oil is rich in medium-chain fatty acids, which have anti-inflammatory and antimicrobial properties. These fatty acids can help reduce redness and soothe irritated skin. However, coconut oil is comedogenic and is not a good option if you get rosacea acne.

 Jojoba oil closely resembles the skin's natural sebum. It is non-comedogenic, and is rich in vitamin E. When applied topically, these oils can help calm and nourish the skin, reducing the stinging and burning sensations often associated with rosacea.

Argan oil, derived from the kernels of the argan tree, is another oil that may be beneficial for those with erythema. It is rich in vitamin E and essential fatty acids, which can help reduce inflammation and redness. Argan oil also has moisturizing properties that can help soothe and hydrate irritated skin. Its anti-inflammatory and antioxidant properties make it an excellent choice for those looking to manage rosacea symptoms naturally. I personally use PAORR Organic Argan Oil when my rosacea flares.

Argan oil, rich in linoleic acid, flavonoids, and vitamin E, may help soothe rosacea-prone skin. Linoleic acid strengthens the skin's barrier, reducing sensitivity and inflammation. Flavonoids, like quercetin and luteolin, inhibit pro-inflammatory mediators such as arachidonic acid and prostaglandins, thus reducing redness and discomfort. Vitamin E provides antioxidant protection and has anti-inflammatory effects. While more research is needed, argan oil's combination of compounds makes it a promising natural option for calming sensitive, rosacea-prone skin.

Coconut oil has potential benefits for managing rosacea due to its anti-inflammatory and soothing properties. It contains several components that may help reduce inflammation and calm irritated skin. One of these components is lauric acid, a medium-chain fatty acid with antimicrobial effects. Lauric acid can help combat acne-causing bacteria, which may be beneficial for those with papulopustular rosacea.

Additionally, coconut oil is rich in linoleic acid, an essential fatty acid that plays a crucial role in maintaining the skin's natural barrier function. Linoleic acid helps prevent moisture loss and protects the skin against irritants, which can be particularly helpful for those with rosacea-prone skin. Coconut oil also contains antioxidants, such as ferulic acid and p-coumaric acid, which can help protect the skin from free radical damage and reduce inflammation.

However, it's important to note that coconut oil is comedogenic and can clog pores, making it unsuitable for those with papulopustular rosacea, which is characterized by pimples and pustules. Clogged pores can exacerbate the symptoms of this subtype of rosacea, leading to increased breakouts and irritation.

One exception is VMV Hypoallergenics, a brand that uses a purified form of coconut oil high in lauric acid. They claim this formulation can kill acne-causing bacteria without clogging pores, making it potentially suitable for those with papulopustular rosacea. However, individual reactions may vary, and patch testing is always recommended. Consulting with a dermatologist for personalized advice is crucial for managing rosacea symptoms effectively.

While coconut oil may have potential benefits for some individuals with rosacea, it's essential to approach its use with caution and to consider individual skin type and rosacea subtype before incorporating it into a skincare routine.

Lavender oil, extracted from the flowers of the lavender plant, is known for its brain wave calming properties. While it may not directly target redness associated with rosacea, it can help reduce stress and promote relaxation, which may indirectly benefit those with the condition. Stress is known to be a trigger for rosacea flare-ups, so incorporating lavender oil into a skincare routine or using it in aromatherapy may help manage stress levels and, in turn, reduce the frequency and severity of rosacea symptoms. However, it's important to note that sensitive types can be allergic to essential oils. So this is an example of a natural ingredient that will help rosacea more off of the skin than on the skin.

Jojoba oil is known for its soothing properties and potential benefits for rosacea-prone skin. Rich in vitamin E, a potent antioxidant, jojoba oil helps protect the skin from oxidative stress and inflammation. It also contains linoleic acid, an essential fatty acid that strengthens the skin's barrier function, reducing sensitivity and transepidermal water loss. Jojoba oil is known to be non-comedogenic.

Looking for skincare products to trat rosacea? Here are some good resources:

• Blog on Rosacea Cleansers
• Collection of Rosacea Toners
• Collection of the best SPF for Rosacea
• Collection of Oils, Serums, and Creams to soothe skin
• YouTube playlist about rosacea skincare

1. Eat a healthy diet with fruits and vegetables and minimal sugar
2. Meditate or do stress relieving activities
3. Try and achieve your ideal weight which will decrease general inflammation. I have seen patients clear from weight loss alone!
4. Take the quiz and diagnose your Baumann Skin Type
5. Try the recommended products for 8 weeks and see if skin is beginning to improve.
6. If not improved, see a dermatologist to make sure you really have rosacea
7. Ask dermatologist about prescription medications.
8. If these do not work, talk to your dermatologist about vascular laser treatments

Hitting rosacea from all angles early is the best way to get rid of rosacea permanently.

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