Rosacea is a type of sensitive skin characterized by a pink or red face that flushes. If you have facial flushing, a red face, stinging face after cleansing, or you notice that your face feels hot often- you probably have rosacea.
Rosacea can coexist with the other 3 types of sensitive skin (acne, stinging and allergic), especially the Stinging and Burning Sensitive Skin Type.
Rosacea is a skin disorder in which capillaries in the face increase in size causing hot, red stinging skin known as facial flushing. With time, the blood vessels stay large resulting in spider veins on the face called telangiectasias (meaning dilated blood vessels).
How to Diagnose Rosacea?
Your dermatologist can diagnose rosacea. You can also take our quiz to see if you have Type 2 Rosacea Sensitive Skin.
Rosacea is progressive skin condition that gets worse if left untreated. It should be diagnosed early and treated as soon as possible to prevent an increase in severity. Most people do not realize that they have rosacea until they have a very red face most of the time . It is much better to start rosacea treatment early- when your face flushes from emotion, alcohol and exercise. There are many prescription medications for rosacea, but if you catch it early you can usually treat rosacea without a prescription using anti-inflammatory skincare ingredients. While there is no cure for rosacea, it can be prevented by using a rosacea skin care routine at the earliest signs of rosacea on the face or rosacea on cheeks.
How To Know If You Have Rosacea?
How do you know if you have rosacea? It is rare that for patient to ask me “Do I have rosacea?” because they usually do not suspect it unless the facial redness and pimples are moderate to severe. Most patients think that they have sensitive skin and do not realize that they have rosacea.
Look for these early signs that you are getting rosacea:
If your face gets red easily
Face flushes with emotion
Face gets hot, itchy and red during exercise
Alcohol, hot foods (temperature) or spicy foods make your face flush and feel hot
If you have these symptoms, it’s likely that you have early rosacea. It is hard for darker skin types to see the red face that is characteristic of rosacea so, if you have brown skin or black skin, you can tell if you have rosacea because your face will sting or feel hot even if it does not look pink. Yes dark skin types can have rosacea!
Get started on the best skin care for rosacea as soon as possible. We recommend trying one of our dermatologist developed skin care routines first and, if that does not work, consult one of our STS Approved medical providers to see if you need a rosacea prescription medication.
My face burns!
I often hear patients say, “My face burns when I put moisturizer on!” or, “Every moisturizer burns my face!” Rosacea skin tends to burn when it contacts low-pH skin care ingredients such as alpha-hydroxyacids (glycolic acid and lactic acid) and Vitamin C. Sunscreen ingredients, such as avobenzone, can cause a burning sensation on face after applying cream which is a characteristic sign of early rosacea. Preservatives in skin care, such as benzoic acid, can cause the face to sting and give you a red face. A personalized skin care routine can help calm and soothe your sensitive skin.
My face is red!
Rosacea is one of the most common causes of a red face that comes and goes. After years of facial flushing, you skin may turn permanently red. If that happens, you can do laser treatments to remove the facial redness.
Rosacea Skin Care
Using the wrong skin care products can worsen rosacea!
The best skin care products for rosacea have anti-inflammatory ingredients to soothe and calm inflammation like:
Best Rosacea Skin Care Ingredients To Soothe and Calm Skin
Ingredients To Avoid If You Have Rosacea
Alcohols (fatty alcohols are OK to use)
Ascorbic acid (Vitamin C) will irritate some rosacea prone skin types because it has a low pH that can cause the skin to sting.
Hydroxyacids like glycolic acid should not be used on rosacea prone skin IF your skin is stinging and irritated. Rosacea skin that has been treated with the correct skin care routine and is calm and not irritated may be able to tolerate low strength retinoids and hydroxyacids. however it is best if these are not added to the regimen at the same time. rather, begin the retinol first and if you are tolerating it every night for 2 weeks, then you can add a hydroxyacids. If you have oily skin, salicylic acid is ideal for rosacea because it has strong anti-inflammatory properties.
How To Wash Your Face If You Have Rosacea
If you have active rosacea, your face will sting when you wash your face- even if you only wash your face with water. Stinging when you wash your face is characteristic of rosacea.
During a flare-up, it is ok to skip washing your face in the am. However, you must wash your face at night. Regardless of when you wash your face, you must do it gently!!!
Cleansers should be applied with your hands- not with a loofa, facial brush or rough washcloth. Find a rosacea cleanser here.
Fill your palm with warm, but not hot, water. Learn more about what water to use to wash your face here.
Squeeze about ¼ teaspoon of a cleanser into your wet palm.
Apply cleanser first to cheeks and then forehead, chin and nose.
Swirl your fingers in a circular motion gently over each area for about 5 seconds
Rinse thoroughly with room temperature of slightly warm water. Not that the water you use to rinse with is very important.
These should contain soothing and calming ingredients and should not have ingredients that irritate sensitive skin. Salicylic acid is a great choice for a cleanser for oily skin types because it is in the aspirin family and is good at reducing inflammation in sensitive skin while clearing pores.
Many cleansers marketed to "sensitive skin" are not right because there are 4 different types of sensitive skin.
The way you apply skin care products is also important. You should not use:
Rough wash cloth
Anything that causes friction on the skin’s surface.
Friction worsens inflammation which causes the face to flush red.
The Best Soothing Cleansing Waters for Rosacea
Rosacea sufferers that live in cities with hard water such as New York City may get irritated from the calcium and magnesium in the water. We suggest rinsing off your cleanser with a soothing thermal spa water.
Rosacea Prescription Creams and Treatments for Dry Skin
While there are many prescription creams to treat rosacea, there are also many soothing anti-redness available without a prescription. Examples of prescription rosacea creams include Rhofade (oxymetazoline), Soolantra (ivermectin), and Azalea (azelaic acid) Cream. Aczone (dapsone) is an acne treatment product that is often used as a rosacea cream off label.
If you want to try a skincare products that target skin redness and does not require a prescription, here are some choices:
Rosacea Creams and Moisturizers for Dry Skin
Soothing moisturizers help control inflammation and can be used alone or with a prescription rosacea cream when you have mild to moderate rosacea. Here are our thoughts on skin calming moisturizers for rosacea.
You can find our dermatologists recommended moisturizers for rosacea sufferers with dry skin here:
Rosacea Oils for Dry Sensitive Skin
Essential oils do not contain soothing fatty acids- they are mostly fragrance which can irritate sensitive rosacea prone skin. Never use essential oils on a red face!!
Oils (not essential oils) have fatty acids with moisturizing and soothing activities that help rosacea. Choose oils with fatty acids like linoleic acid that soothe and calm the skin. Oils that target inflammation are wonderful for this concern. Argan oil is the best oil for redness. Do not use coconut oil for redness because it can cause acne. Jojoba oil is also an option, but jojoba oil is not as good as argan oil as a redness treatment. Avoid using olive oil for redness because it can impair the skin barrier. The best oils to use to soothe and calm the skin are:
How To Use A Rosacea Prescription Cream or Serum- Before or After a Moisturizer?
You should apply a rosacea cream treatment product twice a day, even if you do not wash your face in the morning. Apply the treatment before a moisturizer, as the moisturizer helps push the the cream or serum into the skin to get better results. The best skin care products for rosacea have ingredients to soothe inflammation like argan oil, niacinamide, fever few and green tea. Look for moisturizers that do not use benzoic acid as a preservative.
Rosacea Serums and Gels are Better for Oily Skin
There are many prescription rosacea treatment serums and gels. Prescription serums and gels include MetroGel (metronidazole), Mirvaso (brimonidine) and Finacea (azelaic acid). These rosacea serums and gels can be used on dry skin before a hydrating moisturizer or on oily skin before an anti-inflammatory moisturizer or a rosacea safe sunscreen. Nonprescription soothing serums that have been used to treat rosacea contain ingredients like caffeine, green tea and resveratrol.
How To Use A Rosacea Serum
Use rosacea treatment serums twice a day. If you wash your face in the morning, apply the rosacea serum after cleansing. If you do not wash you face in the AM, you still should apply the rosacea treatment serum. Follow with a moisturizer that is appropriate for your Baumann Skin Type® and a rosacea friendly sunscreen.
Toners are not the best skin care product for rosacea because they often have alcohol in them which can cause facial flushing and result in a red face. Witch hazel, which I found in many toners for sensitive skin, has some anti-inflammatory activity. However, most people with rosacea get a burning face or stinging face when they use skin care products containing witch hazel. If you insist on using a toner for rosacea, choose a gentle toner, to be applied before a rosacea cream or a rosacea serum. An essence is another word for a facial mist toner. Essences will not be as effective as rosacea serums and rosacea creams.
Rosacea sufferers often get a burning face or a stinging face when they use chemical sunscreens. The sunscreen ingredient avobenzone (also called Parsol) is the biggest culprit. However, oxybenzone, cinnamates like octinoxate (also called octyl methoxycinnamate or ethyl hexyl methoxycinnamate) and dibenzoylmethanes can also cause stinging. The bottom line: choose a mineral sunscreen (also called a physical sunscreen) if you have rosacea. The other problem with using sunscreen when you have rosacea is how to get sunscreen off without irritating your skin. Choose a gentle makeup remover to remove your sunscreen if you have rosacea.
Best Mineral Sunscreens for Rosacea
These are our favorite physical mineral sunscreens for rosacea with a tint to hide facial redness:
Best Gentle Makeup Remover for Rosacea
Getting sunscreen off when you have rosacea is not easy because you cannot scrub vigorously, use strong detergents or use scrubs. So how do you remove sunscreen when you have rosacea? We recommend a gentle makeup remover to use prior to cleaning the face with a rosacea cleanser.
Your aesthetician can design a rosacea facial for you based on your Baumann Skin Type®. Rosacea facials should not include scrubs. An enzyme exfoliator is a better choice to exfoliate rosacea prone skin. A scrub and microdermabrasion should not be used in a rosacea facial because the friction can cause inflammation. Your aesthetician should use rosacea creams and serums and a rosacea friendly toner. Rosacea facials are tricky. We recommend that you find a STS Approved medical provider with a well-trained aesthetician here.
Rosacea can be difficult to treat. You can usually keep it under control if you use the best skin care products for rosacea and your skin type. It all begins with knowing and shopping with your Baumann Skin Type®. Use your Baumann Skin Type to get educational advice that is right for YOU and read reviews from others with the same Baumann Skin Type,. You will get customized skin care routines for your skin type, and you can shop for products that match your Baumann Skin Type.