I thought my rosacea was stubborn acne for most of my adult life. There were cystic spots that were caused by hormones, but I was also dealing with small, angry papules and redness around my nose, chin, and cheeks that even the best skincare routine couldn’t fix. I was surprised to find out that I really have rosacea after seeing a dermatologist recently. (Fun fact: patients often think they have acne when they really have rosacea.) Since then, I’ve been determined to learn more about the skin condition. It looks like my current skin care routine was probably making things worse.
You probably have a lot of questions about rosacea if you’ve made it this far. Dr. Emma Craythorne, a dermatologist and the founder of Klira, is helping me explain what rosacea is, how to treat it, and the best products to use in a skincare routine for rosacea.
What Is Rosacea?
Dr. Craythorne says, “Rosacea is a very common, long-lasting condition that can cause a number of changes to the skin.” He goes on to say that it mostly affects the middle of the face and can show up as redness, papules (small, hard spots that don’t come to a head), pustules (spots with a pus-filled head), and flushing. It can also show up as visible veins and sometimes thick skin.
“Although generally considered common, assessment of the true prevalence of rosacea is challenging because of the variable clinical manifestations, the existence of other skin disorders with overlapping features, and underdiagnosis is highly likely,” explains Dr Craythorne. “Rosacea can show up in a lot of different ways, and a lot of the time people won’t go to the doctor to get a diagnosis. This is likely to happen more often in the UK because skin problems are easier to get care for.”
Dr. Craythorne says that rosacea mostly happens to adults over 30, and it happens more often in women than in men. “Sometimes it happens in teens, who often confuse rosacea with acne vulgaris. Rarely, it happens in kids,” she says.
Dr. Craythorne says that rosacea can happen to people of all skin tones, but it’s harder to see the symptoms in people with darker skin tones because they can hide some of the more obvious ones, like redness. This means that it can often be underdiagnosed. “Rosacea is a broad term that covers a lot of different conditions, so diagnosis and treatment can be different.”
What Makes Rosacea Happen?
It’s not clear what causes rosacea, but there are a few main things that make it worse. Dr. Craythorne says that genetics plays a big role, so if rosacea runs in your family, you might be more likely to get it too. Rosacea is also affected by our immune systems. People with rosacea often have an immune system that works too hard and reacts too strongly to things like microorganisms, UV light, and physical or chemical trauma. This causes long-term inflammation and problems with blood vessels in the skin.
Demodex mites, tiny creatures that live in sebaceous (oil) glands, are another factor that makes the problem worse. Everyone has these mites on their skin, but people with rosacea usually have more of them or their immune system doesn’t react normally to them, which can make symptoms worse. Dr. Craythorne says that vascular hyperreactivity, which is when the blood vessels in the face are too sensitive to things in the environment, is another important sign of rosacea. This causes redness and flushing that doesn’t go away. It is thought that very hot or cold weather, as well as some spices, can make rosacea symptoms worse.
Dr. Craythorne suggests keeping a flare log to help you learn more about your rosacea flares and what might cause them. “Get to know your skin well,” she says. “Think about your genes and what your flares are. For three months, keep a flare diary to see if there are certain things that set them off. Don’t decide on a whim what a trigger is, because you’ll get it wrong. Be patient and keep the diary for real results.”
How Do Doctors Treat Rosacea?
There is no cure for rosacea, but medical treatments can help a lot with the symptoms. A good skincare routine can also help (more on that in a minute). Dr. Craythorne says that when it comes to medical, prescription formulas, it’s best to start with topical treatments that have been shown to work. Some of the best ways to treat it are:
- Azelaic Acid (15%): Helps with redness and swelling.
- 1% Ivermectin: This drug fights inflammation and may help lower the number of demodex mites.
- Tretinoin (0.05%): This is a prescription form of vitamin A that helps with skin turnover and managing symptoms. When treating rosacea, Dr. Craythorne suggests tretinoin over other retinoid forms like retinol.
It can take weeks for treatment to show real results, so it’s very important to be patient and stick to your routine. If topical treatments don’t work after 12 weeks, doctors may give you antibiotics or isotretinoin to take by mouth.
Which Skincare Ingredients Can Help with Rosacea?
If you can’t see a dermatologist, don’t worry; there are a lot of over-the-counter skin care products that can help with rosacea. Dr. Craythorne says to focus on skincare products that have been shown to help with rosacea. “Keep your skincare simple and focused—only use products that have a lot of proof,” she says. Some good skincare ingredients that you can buy without a prescription are:
- Azelaic Acid: This anti-inflammatory ingredient soothes the skin and makes it less red.
- Niacinamide is known for its ability to reduce inflammation. It can help make the skin barrier stronger and less red.
- Ceramides are important for keeping the skin barrier healthy, which can stop flare-ups.
- Sunscreen: You must use broad-spectrum SPF every day because UV light is a common cause of rosacea flare-ups. You should also stay away from sunbathing and sunbeds.
“Once you find a routine that works, stick to it. The skin will behave differently at different times, but don’t switch routines too quickly. It takes at least eight weeks for real results to make a difference,” says Dr. Craythorne.
What ingredients should you stay away from?
You should stay away from some ingredients in your skincare routine. These include:
- Fragrances: These can make redness worse and irritate the skin.
- Products that contain alcohol: These dry out the skin, which makes it more likely to get inflamed.
- Harsh scrubs and exfoliants can hurt the skin barrier and make it more red and sensitive.
- Foaming cleansers: These often have surfactants in them that take away the skin’s natural oils, which can make it irritated.
Use products that are made for sensitive skin to keep your skin care simple and gentle.
How We Picked the Best Rosacea Products
What are the expert-approved products for rosacea, then? We talked to Dr. Craythorne and makeup artist Rose Gallagher. Rose Gallagher has rosacea, two types of it, and she uses her social media to share pictures of her real skin and recommend products to others who have the same diagnosis. I’ve also added the products that people have told me to use since I found out I had rosacea. For our suggestions, scroll down.
