How to reduce redness from rosacea

What kind of redness are you treating?

Rosacea can cause flushing that comes and goes, redness that stays, visible blood vessels, or bumps that look like acne. On lighter skin, redness often looks red; on darker skin, color can look brown or violet and may be harder to see. The visible signs do not always tell the whole story.1

A brief flush often clears within a few hours, while rosacea color can last longer and flare when something triggers it. Rosacea can resemble acne or dermatitis, so ask a doctor or dermatologist if you are unsure what is causing ongoing facial redness. Earlier treatment can help keep rosacea from worsening.1

What to do every day

Keep the routine simple and gentle. A practical daily sequence is to cleanse, moisturize, then protect your skin from the sun.3

1. 1Cleanse with a gentle cleanser. A mild synthetic cleanser is less irritating than traditional soap.
2. 2Moisturize frequently and choose skin care products made for sensitive skin.
3. 3Use sunscreen every day with SPF 30 or higher. Physical sunscreens containing zinc oxide or titanium dioxide may be better tolerated.

Avoid exfoliants and alcohol based products, which can irritate rosacea prone skin. Topical steroids can aggravate rosacea, so ask the prescriber before changing a medicine you already use.3

What triggers rosacea redness?

Common triggers include sunlight, hot or cold temperatures, hot drinks, alcohol, spicy food, exercise, stress, some skin products and certain medicines. A trigger for one person may not affect another, so the useful list is the one your skin helps you build.3

Keep a daily note of redness, warmth or stinging and what happened beforehand. Change one suspected trigger at a time and watch for a pattern, rather than cutting out every food or activity on a broad list. Hot drinks can trigger flushing for some people.14

Which treatments can reduce rosacea redness?

For persistent facial color, a clinician can prescribe topical brimonidine or oxymetazoline. These medicines can fade color quickly: the best effect is usually seen 3 to 6 hours after application, and the fading can last up to 12 hours before color starts to return. They manage color for a time rather than curing rosacea. Using them persistently can cause rebound flushing when you stop, so they are often used only occasionally.13

Treatment depends on the signs you have. Topical azelaic acid is an option for mild to moderate rosacea with inflammatory bumps; prescription creams or gels and a course of oral antibiotics are other options a doctor may discuss. Antibiotics may be prescribed for 6 to 16 weeks. Persistent redness or visible vessels can also be treated with intense pulsed light or vascular laser. A dermatologist can help choose among these options when treatment is not working.34

What skincare ingredients may calm rosacea prone skin?

Zinc oxide and titanium dioxide are used in physical sunscreens that protect against ultraviolet light and may be better tolerated than chemical sunscreens. Azelaic acid is different: it is a medicine used for mild to moderate rosacea, particularly inflammatory bumps. It is not a quick cover for flushing or persistent color.35

For prescribed azelaic acid gel, apply a thin film to the affected area at the same time each day, following the prescription directions. Use the full course unless your care team tells you to stop early, and do not use other acne products on the same area unless they approve. Tell the care team before use if you are pregnant, trying to become pregnant or breastfeeding.5

Contact your care team promptly if treated skin burns, itches, crusts or peels. Mild irritation, redness or dryness can also occur. Keep the gel away from your eyes; rinse with cool tap water if it gets into them.5

How to care for sensitive skin with rosacea

If water or skin care products sting or burn, keep to gentle cleansers and moisturizers instead of adding several new products at once. If you use makeup, water based or powder makeup is usually less irritating. A green tinted concealer can camouflage visible redness, which is a cover up in the literal, unglamorous sense.13

How to reduce facial flushing?

Start by avoiding triggers you have identified. Limit exposure to heat, sunlight and humid conditions where possible, cover your face in cold weather, manage stress and avoid doing too much aerobic exercise if it brings on flushing. If flushing is becoming more frequent or the redness lasts longer, arrange a medical assessment rather than treating every episode as an ordinary brief flush.4

When should you get medical help?

See a doctor if you have symptoms that could be rosacea or if you are not sure what is causing them. Get urgent medical advice if you have rosacea and your eye is painful, your vision is blurred, you are sensitive to light or your eye is red. These can be signs of an eye complication that needs urgent care.4