If you have it, you likely know it. You might get flushing of the cheeks when you have a glass of wine, go out into the cold (or heat!) or eat spicy food. Perhaps you’ve seen little liquid filled ‘pustules’ around the nose and cheeks that you initially thought were pimples - only to observe that they didn’t disappear after a week or so as a blemish might.
I don't have rosacea myself, but I have several friends who do. And there's a good chance you or someone you know struggles with rosacea - it affects 10% of the adult population in America. While it can affect all races, it is most common in people with fair skin (people with Irish ancestors are particularly predisposed, as are people of Nordic, Scottish, Welsh and eastern European origin.)
*Penn Smith Skincare is a participant in the Amazon Services LLC Associates Program, an affiliate program. Many links are affiliate links, meaning I am compensated when you shop through these at no extra fee to you.
Rosacea is an inflammatory skin condition that affects both sebaceous glands and small superficial skin vessels. It typically shows up around the nose, nasolabial folds and cheeks. While we don’t completely understand the causes of rosacea, it seems that there are connections with the immune and vascular systems as well as some indication that the microbiome of the gut and skin are implicated.
Rosacea develops in these stages:
1. Prerosacea: which is essentially rosacea induced blushing (this redness is caused by the dilation of the superficial facial vasculature)
2. This stage is characterized by redness that comes and goes and mild superficial blood vessels start to show themselves (think broken blood vessels you see on the cheeks and nose)
3. The redness in the face gets worse and starts to stick around more permanently and this is when papules and pustules may start to develop.
4. Stage 4 is more and more inflammation and the eyes can be involved.
I want to stress that rosacea is a condition that, if suspected, warrants the attention of a dermatologist. Depending on the nature of the condition, your doctor may decide that a prescription strength treatment Is the best course of action.
Having said that, many people have seen a doctor and are looking for low cost accessible treatments to use in addition to, or instead of, recommended medications. Please use the information below as education but not to replace that of your dermatologist or other medical professional!
THE TREATMENTS - TOPICALS
As rosacea is primarily an inflammatory condition, all of the at-home topical solutions contain some anti-inflammatory properties. Additionally, some of them help modulate the vascular issues and manage the microbial environment that contribute to rosacea. Below are ingredients that may help the redness (whether or not you have rosacea) and inflammation. No matter what....These are great ingredients to see in your skincare!
COLLOIDAL OATMEAL
Anti-inflammatory, antibactirial. Soothing, helps with redness
Colloidal oatmeal is made by milling whole oat kernels into a fine powder which is then included in OTC skincare products. Because the whole oat kernel is used, colloidal oatmeal contains fats, proteins, vitamins and minerals. This nutrient-dense blend is what makes oatmeal not just a smart choice for breakfast (love me some overnight oats!!) but also gives the ingredient emollient properties that help soothe and soften the skin.
And this isn’t just your grandmother’s wives-tale-kind-of-ingredient - I was surprised to learn that the FDA officially added colloidal oatmeal to the ‘skin protectant’ category nearly twenty years ago! And more recent studies support the FDA’s vote of confidence - one study reported that colloidal oatmeal is actually able to diminish cytokines (signaling molecules that, when left unchecked, can wreak havoc and cause inflammation.) What’s more, colloidal oatmeal can act as an antioxidant combatting oxidative stress. And colloidal oatmeal is both inexpensive and unlikely to cause allergic reaction - opening it up as an ingredient to nearly everybody!!
How to use: So many ways. You can find it in serums and washes as well as a powder that can be added to a bath to soothe the body.
Good to know: Made from grains this natural remedy has been used for years and years. A fantastic rescue ingredient to keep in the house in powder form.
My picks:
Aveeno Oat Gel Moisturizer https://shop-links.co/1748093971665838701
Aveeno Oat Cleanser https://amzn.to/3rcrhjV
Aveeno Oat serum https://amzn.to/36psj3W
UK:
LICORICE
Anti-inflammatory, soothing, antioxidant, depigmenting / brightening
Licorice extract is a potent anti-inflammatory for rosacea. That’s because liquorice root (aka sweet root and glycyrrhiza glabra) has coumarins, flavonoids, plant sterols and glycyrrhizin, which all reduce rosacea's redness. Glycyrrhizin, one of the main ingredients in licorice, has been shown to help reduce inflammation and soothe irritation
How to use: AM and PM...licorice is good any time!
Good to know: Look for licorice in everything...It compliments nearly any ingredient deck.
My picks:
Procure Rosacare Soothing Sheet Mask (a great ‘treatment mask if your’e wanting to quell redness before, say, an evening out) https://amzn.to/392YcnE (currently unavailable-keep checking)
Another excellent licorice product is the Cetaphil Redness Relieving Light Moisturizer https://amzn.to/3fFRRyN
AZELAIC ACID
Anti-inflammatory, antibacterial, antioxidant, pigment inhibiting
I love Azelaic acid and am excited to incorporate it in to my routine to treat my pigmentation. In addition to pigment blocking qualities, Azelaic acid works to treat rosacea by decreasing the swelling and redness of the skin while also addressing bacterial issues that can contribute to rosacea. Azelaic acid is show to be good not only for the redness of rosacea but also the pustules. This acid also helps clear pores, turn over skin, help with acne scars....just incredible!
The prescription Azelaic acid products contain 15% for rosacea and 20% for acne, but effective 10% solutions can be found at your drugstore.
How to use: Combines with anything, it’s a bit thick so normally I prefer to layer in serum form at night. Since trying the Touch gel cream I am able to use that version in the AM also. It is preferable to use morning and night for best results.
Good to know: Azelaic acid can be drying so good to ensure the formulation contains hydrators - or pair with another that does. Start slow and asses your tolerance. Remember...It takes time to work. You have to give it a ample amount of time to see changes in your skin. Consistency is key!
My picks:
Paulas Choice Azelaic Acid 10% https://amzn.to/3PTDfMt
(in the video I said I would probably use this at night because of texture. After playing with it more it would definitely be an AM product for me because it has salicylic acid and I MIX it with moisturizer. Hence the "booster" aspect. Just FYI.
The Ordinary 10% Azelaic acid https://shop-links.co/1748094236326650396
Touch Brightening Cream (azelaic acid, tranexamic acid, kojic acid and niacinamide) https://shop-links.co/cfWEo5eVRDW (I have had time to play with this since filming and it is HANDS DOWN better than the other 2 in my opinion. I am trying to layer this in AM and PM right after my serums because it is a gel-cream.)
SULFUR
Anti-inflammatory, antibacterial, exfoliant
Sulfur has been around for such a long time (it’s an element, after all!!) But its use in skincare dates back to 1550 BC when it was cited in the Ebers Papyrus, an ancient Egyptian medical document. Medical history shows that sulfur has been used to treat rosacea at least since 1855 when it was described in the medical journal, Lancet. Today it’s more widely used in the treatment of acne but used judiciously (it can be drying) sulfur can be an invaluable tool in the treatment of rosacea. Beyond its anti-inflammatory and antibacterial properties, sulphur has been shown to kill emodex folliculorum mites 😬, which are thought to contribute to the pustules associated with the most stubborn forms of rosacea. Sulfur can also help with edema (swelling) associated with rosacea.
How to use: For the treatment of rosacea and redness, sulfur can be found in creams, serums and washes.
Good to know: Sulfur can be drying so take care in combining it with retinoids and other drying actives.
My picks:
Prosecea 10% sulfur https://shop-links.co/chNm1iCPuPZ
(this product could be great for acne too! Every skin is different but this could help!)
GREEN TEA
Antioxidant, anti-inflammatory
Green tea contains a component called Epigallocatechin-3-gallate (EGCG). EGCG is an antioxidant and anti-inflammatory agent and is thought to prevent the development of telangiectasias (dilated blood vessels), which occur with rosacea.
How to use: Layer in any time you can-I love to use green tea in essence and serum form.
My picks: Isntree green tea toner https://amzn.to/3mc5esS
ALLANTOIN
Moisturizer, exfoliotor antioxidant
Allantoin is typically derived from the comfrey plant but can also be found in a range of other plant and animal sources. Allantoin is a well-studied anti-irritant that helps manage the reactivity of rosacea.
Effectively Allantoin helps heal rosacea while also making skin more tolerant of ingredients that may cause irritation. It also works as an antioxidant, encourages the generation of new cells and speeds up the shedding of old, dead skin cells. I’m a huge fan of snail secretion which has been shown in studies to support the wound-healing process and stimulate new cell growth. Look for this ingredient in your skincare!
BETA GLUCAN
Hydrator, antioxidant, antibacterial and antiviral
Beta glucan is a humectant that, much like hyaluronic acid, attracts water to the top layers of skin. Beta glucan is an ingredient that soothes irritated skin and helps to calm redness. It’s is a polysaccharide derived from yeast or oats (!!) and is your skin's best friend if you struggle with skin barrier issues (redness, dehydration, itchiness, flakiness or acne).
My picks: Iunik beta gluten serum (a favorite for years) https://amzn.to/3PVk8Rv
Iunik Beta Glucan Moisture cream (such wonderful moisturizer!) https://amzn.to/3Q2LuG4
SUN PROTECTION
Solar damage can really exacerbate rosacea. UVB rays (the burning ones), in particular, can contribute to both skin cancer and redness. For people who struggle with rosacea I recommend mineral sunscreens as they tend to be less irritating than chemical SPFs. Look for zinc and titanium dioxide.
How to use: Morning before heading outside
Good to know: This is tinted-it is not universal but because there's no white cast it is more versatile than it would seem.
My picks:
US:
CeraVe Hydrating Sunscreen SPF 30 Tinted https://amzn.to/3me4L9N
UK:
THE TREATMENTS - AT- HOME TOOLS
INTENSE PULSED LIGHT
This is a modality that I recommend you consider if you have the broken capillaries (vascular superficial telangiectasia) associated with rosacea. I DO NOT recommend you use IPL at home to treat the papule and pustule form of rosacea - in fact that could do more harm than good. But for the typical ‘broken capillaries’ on the cheeks that create flushing, IPL can be a good option. IPL works by applying light energy to the skin, where absorbed by blood vessels, heating them to a point where they are destroyed. Sometimes several treatments can be needed and it may take a period of several weeks for the dead cells to be absorbed by the body. I’ve seen really impressive results. (pic below)
How to use: For at-home IPL (Faustina by Labotest), I recommend twice weekly sessions over a period of six weeks.
Good to know:
My picks: Faustina IPL https://amzn.to/3v42eDM
This photo is of one of my Facebook group members who used the Faustina IPL for four weeks 3x per week to treat broken capillaries related to rosacea (I realize there are differences in the quality of light of the photo, but the change in broken capillaries is undeniable)
HOT & COLD DEVICE
Can help constrict vessels to calm the effect of facial flushing. This device is excellent for hot flashes, headaches and alleviating puffiness. Not earth shattering tech but OH SO USEFUL!
How to use: I use this pressed on my temples, gently tap it from my tear trough to temple for lymphatic drainage and then....over a sheet mask to soothe like crazy. This device over the procure mask is a match made in soothing heaven. :)
Good to know: This device gets warm or cold, has red and blue light (not what I would be buying this for) and an option of sonic vibrations is so nice as well (but you can turn that option off, which I like).
My picks: Lift care fusion Skin Hot and cold facial massager (this has become one of my favorite little tools especially in the morning...especially for puffy skin, red skin, inflamed skin and also headaches!!) https://shop-links.co/cfCfUTt9j8s
Find more product options for redness & rosacea on Amazon
FAQ
Q. I've heard to avoid skincare products that contain alcohol. Does that also include the fatty acid types of alcohols found in skincare?
A. Avoid drying alcohols like SD Alcohol 40 and denatured alcohol. Fatty alcohols are not drying.
Q. I'm concerned that what I'm using in the shower on my hair/body may be exacerbating my rosacea. What do you recommend for hair care for rosacea, sensitive skin, or allergic skin?
A. Try to find products that have no fragrance. Avoid products with menthol and camphor. Keep your shower warm, not hot.
Q. Can I use vitamin C while having rosacea? Which type?
A. This is very personal. L-ascorbic acid is SO good for the skin but many people with rosacea get "hot" from vitamin C. I would suggest Magnesium Ascorbyl Phosphate as a great vitamin C derivative to try.
Q. Can I use retinoids with rosacea? Which type?
A. Yes but with extreme caution. Retinoids can be irritating and make rosacea worse. If you choose to try one be ready for trial and error. A great start is with retinaldehyde.
Q. Radio Frequency seems to exacerbate my rosacea. Is there anything I can do to keep using my RF device?
A. Unfortunately RF inherently causes heat in the skin. This is not your friend when you have rosacea. I have spoken to many people who are able to use RF on their neck but not their cheeks and they have no issues. But proceed with caution.
Q. Can I use LED with rosacea? Do any particular colors exacerbate or help eliminate? What about infrared?
A. LED is great for rosacea. I would avoid NIR (near infra red) because there is some heat. Otherwise LED is anti inflammatory and can be helpful. Green LED works on vascularity and may be helpful with redness and hyperpigmentation. Blue LED could help with pustular rosacea. Be careful with LED masks that sit close to the face and make you warm just by covering your face....That warmth (not the LED) may flare rosacea (and melasma FYI!).
I hope this blog post helps you! The subject is huge and I intend to expand this post with additional ingredients and graphics so please check back!
XOPenn
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Disclaimer: This post is not intended to provide diagnosis, treatment or medical advice. Content provided on this blog is for informational and entertainment purposes only. Please consult with a physician or other healthcare professional regarding any medical or skin related diagnosis or treatment options. Information on this website should not be considered as a substitute for advice from a healthcare/skin professional. The statements made about specific products throughout this website are not to diagnose, treat, cure or prevent disease. It is important that you check labels to determine if a product is right for you. Before starting any treatment at home consult a health care or skin care professional to determine if it’s right for you.