What is a good skincare routine for rosacea?

Use this routine morning and night

1. 1Wet your face with warm or lukewarm water. Use a mild cleanser with your fingertips, then rinse gently. Pat dry without rubbing.
2. 2Let your face dry completely before applying topical rosacea medicine. Damp skin is more likely to sting.
3. 3Apply your topical medicine before moisturizer, following the schedule your clinician gave you.
4. 4After medication, wait five to 10 minutes before applying moisturizer, sunscreen or makeup.
5. 5Moisturize after your face is dry. In the morning, also apply sunscreen to skin not covered by clothing.

Choose a cleanser for your skin type

Choose a mild cleanser and avoid traditional soap if it irritates your skin. Cream or milk cleansers, low foaming cleansers and micellar water are options for dry, normal or combination skin. A creamy, low foaming cleanser can suit very dry skin. For very oily skin, a mild soap is an option, but wash without scrubbing. Micellar water does not need rinsing, so the sink gets to clock out early on that step.14

Moisturize even if your skin is oily

Moisturizer matters whether rosacea leaves your skin dry or oily. It helps trap water and restore skin lipids, which can make skin feel more comfortable. Applying it to dry skin is less likely to burn or sting. If you use topical medication, apply that first, then moisturizer after the wait time in the routine above. In one small study, people used metronidazole gel twice daily and applied a gentle moisturizing cream to one side of the face twice daily. After 15 days, that side had less dryness, peeling and roughness and felt more comfortable. That study result is not a promise that every moisturizer will change your skin in 15 days.3

Protect your skin from the sun every day

Sun exposure is a common rosacea flare trigger throughout the year. Use a gentle, broad spectrum, water resistant sunscreen with SPF 30 or higher on exposed skin every day, including cloudy days. If sunscreen irritates you, try a fragrance free mineral sunscreen with zinc oxide, titanium dioxide, or both. Physical sunscreens may be better tolerated. If a mineral sunscreen leaves a white cast, a tinted or micronized formula can reduce it, especially on darker skin tones.234

Add shade and sun protective clothing when you are outdoors. A wide brimmed hat and sunglasses with UV protection help cover areas sunscreen does not. Staying out of the midday sun can also reduce exposure.2

Keep the product list simple

Look for fragrance free products made for sensitive skin and labeled noncomedogenic. Choose fragrance free rather than unscented, and favor a cream over a lotion or gel. Skip astringents and toners. More products do not equal healthier skin, and a smaller shelf is a surprisingly reasonable design brief.35

Ingredients to avoid with rosacea

Commonly reported irritants include the ingredients below.3

• Alcohol, camphor, fragrance, glycolic acid, lactic acid, menthol, sodium lauryl sulfate and urea.
• Alpha hydroxy acid, beta hydroxy acid and salicylic acid.
• Witch hazel, peppermint and eucalyptus oil.

Avoid exfoliating products, scrubs and rough rubbing or massaging. Use your fingertips instead of a facial sponge or abrasive washcloth. Sodium lauryl sulfate is common in some shampoos and toothpastes, so check products used near your face as well as products meant for your face.234

Test new products before using them on your face

Try a small amount on a patch of skin at your neck or jawline and wait at least a few hours. If you react, avoid the product and note its ingredients in a rosacea diary. Burning, stinging, itching or dry, scaly skin can be signs that a skin or hair care product is irritating you. Stop using products that cause these reactions. A diary also helps you track which products or ingredients seem to trigger your own flares.25

Makeup can be part of the routine

If you wear makeup, try fragrance free products. Water based or powder makeup may be less likely to irritate. A light liquid foundation that spreads easily and can be set with powder is another option. Avoid waterproof makeup and heavy foundation that is hard to spread or needs makeup remover. Green tinted concealer can camouflage redness, which is a rare day of work for a color wheel.23

What skin care can and cannot do

Rosacea is a chronic condition with symptoms that can flare and settle. There is no cure, but general skin care, lifestyle measures and medical treatment can help manage symptoms. Skin care can improve comfort, reduce flare ups and support treatment results; it is not a substitute for a treatment plan. If you think another medicine is triggering a flare, do not stop taking it on your own. Ask the clinician who prescribed it whether it could be responsible. If you have ocular rosacea, follow your doctor's directions for eyelid scrubbing and medication. A dermatologist can help with diagnosis, treatment and product recommendations if gentle products are difficult to find.124