What’s the best skincare routine for rosacea?
Got rosacea? You’re not alone! This fun skin condition affects around 10% of Caucasians (including me!) as well as – to a lesser extent- Latin-American, African-American, African, and Asian people. Some of us get redness, some get pimples, most get irritated, sensitive skin. I get the lot.
What do you do about rosacea?
For all forms of rosacea, the best skin care, a good broad-spectrum sunscreen and avoidance of your specific rosacea triggers is essential. Choosing the right skincare can be fraught. The National Rosacea Survey from 1997, found that skin care products were big culprits when it comes to skin irritation- with toners and exfoliators the biggest offenders! Soap, cologne, sunscreens and makeup were also triggers. One in 4 even reacted to a moisturizer!
So what skincare should you use?
1. Gentle cleanser minus the soap. Go for soap free cleanser, ideally with emollients and humectants to protect the skin. In a couple of studies, any foaming cleansers, even soap free ones triggered flare ups. Using either very hot or cold water may trigger a flush while vigorous scrubbing or even a rough face cloth can irritate your already sensitive skin. Use your fingers to gently rub in the cleanser. Wash off with water and gently pat your skin dry.
2. A broad-spectrum sunscreen like Zinc Shade. UV Rays are often triggers for a rosacea flare. Making sure you use a sunscreen free of irritating ingredients and that protects you against both UVA and UVB rays will help prevent flares.
3. A moisturiser containing vitamin B3 (niacinamide). Niacinamide has been shown in studies to reduce trans-epidermal water loss, so preventing irritation and inflammation. Our B Quenched and B Calm moisturisers both have 5% niacinamide.
4. Vitamin A (retinoids). These have been shown in studies to reduce redness, pimples and those annoying dilated blood vessels (telangectasia). Beware some forms of vitamin A are more irritating than others. Retinal is the most effective and least irritating form of vitamin A.
Skincare ingredients to avoid with rosacea
This is simple; BIN soap, toners and exfoliators including scrubs, plus anything that causes a flare up for you. But the list might need to be extended! A 2020 study from China found that excessive facial cleanser use, using a face mask more than 4 times a week, frequent heavy makeup (more than 6 times a week) and regular skin care treatments in a beauty salon all contributed to worse rosacea! Food for thought!
One big problem with rosacea is that once the skin has become irritated and inflamed by a skincare or makeup ingredient or even by sunburn, some people with rosacea end up with “status cosmeticus”. This sets up a vicious cycle where you end up with a rapid flare up from even the mildest irritant to the skin. A tiny bit of a previously well tolerated sunscreen can trigger a very red face with irritation. This can be hard to manage.
The concept of priming
When starting a new rosacea regime, many doctors recommend starting slowly to help improve the skin barrier function and reduces the risk of irritation. With priming you would only use mild cleanser and gentle moisturizer for 3-5 days before introducing active ingredients.
If your rosacea is still bad despite these interventions, you should see a doctor for some additional treatments.
According to the American Acne & Rosacea Society, your doctor might try a combination of;
- A topical alpha agonist such as oxymetazoline
- Laser (like IPL or pulsed dye laser)
- Topical or oral antibiotics like Metronidazole or doxycycline
- Azelaic acid (15%)
- Topical Ivermectin (1%)
- Oral Retinoids
I know how irritating (literally) rosacea can be. So hand on heart, I wish you dewy skin -free of irritation!