Dermatologist’s Rosacea Skincare Routine & Treatments

Understanding Treatment Options and Products for Managing Rosacea

Throughout more than three and a half decades of practice, I have assisted countless patients in discovering reliable methods to manage rosacea, a condition that has personally affected me as well. In this detailed resource, I will outline my established, comprehensive strategy for keeping rosacea under control. This approach integrates a precise skincare regimen, carefully chosen products, and, where necessary, appropriate medical interventions. You will gain insights into the processes for alleviating redness, mitigating flare-ups, and establishing a solid base for sustained skin wellness.

Individuals under my care have directly observed how my regimen and selected products, which emphasize repairing the impaired skin barrier and combating inflammation, effectively reduce flushing and stinging sensations. This makes the skin far less reactive to common rosacea triggers.

Rosacea management demands a thorough, skin-friendly skincare protocol that supports the restoration of the compromised skin barrier and actively counters inflammatory responses. It is imperative not to overlook any part of this process when dealing with rosacea.

Employ solely products that are compatible with rosacea in each of the four vital skincare phases:

CLEANSE – The cleansing phase eliminates accumulations of skin microorganisms that can intensify rosacea symptoms.
CORRECT – Here, the focus is on soothing active rosacea manifestations.
HYDRATE – Without adequate moisturization, the damaged skin barrier cannot recover effectively.
PROTECT – Exposure to ultraviolet rays can provoke rosacea flare-ups, making protection essential.

All necessary compatible items for these phases are available in a specialized kit designed for rosacea therapy. Below, we delve into each step in detail. For those incorporating prescription topical medications or specialized cleansers, I will describe integration methods I have successfully used with patients over the years.

Once rosacea achieves a state of remission, cautious exfoliation or incorporation of age-defying products becomes feasible. I provide guidance on this further along in the article.

Complete Holistic Skincare Routine for Rosacea Control

4-Step Rosacea Skincare Routine

1. Cleanse

In the morning, begin by cleansing the skin using a 2% pyrithione zinc fortified calming soap from the rosacea therapy kit.

This cleanser, which I formulated specifically for patients with sensitive skin and rosacea (detailed notes on sensitive skin management follow later), is exceptionally gentle while being enhanced with pyrithione zinc. This ingredient has been clinically shown to diminish skin yeast and bacterial populations that may worsen rosacea.
As an alternative, a prescription cleanser combining sodium sulfacetamide and sulfur—a sulfa antibiotic paired with sulfur—proves highly beneficial when medical intervention for rosacea-prone skin is warranted.

In the evening, cleanse using a pH-balanced, soapless extremely gentle foaming facial cleanser included in the kit.

From my extensive clinical observations, pH-balanced synthetic detergent cleansers like this one are the most reliably tolerated. Other options include Vanicream Cleansing Bar or Toleriane Cleanser.

The majority of rosacea-affected skin exhibits unusually heightened sensitivity owing to a weakened skin barrier. Consequently, irritating products or treatments, including those for anti-aging or acne, are often not suitable. – Dr. Bailey

2. Correct

To address imbalanced skin inflammation, patients apply green tea antioxidant skin therapy immediately after cleansing and gentle towel drying. This product, part of the rosacea therapy kit, aids in calming inflammatory responses. This forms a cornerstone of the rosacea treatment routine for my patients.

The formulation boasts a potent concentration of green tea antioxidants, caffeine, and hyaluronic acid, which replenishes the skin’s depleted antioxidant reserves resulting from ongoing rosacea-related inflammation.

For oily pustular rosacea and associated inflammation, consider applying benzoyl peroxide cream twice daily to affected regions. Although it may cause irritation initially, it can be particularly suitable and may target mites effectively. Further details on managing oily skin appear later.
Facial dandruff, frequently accompanying rosacea, requires targeted care. The calming zinc soap from the cleansing phase combined with green tea antioxidant skin therapy often suffices to manage both issues. If symptoms persist, apply clotrimazole cream twice daily until control is achieved.
When using prescription topicals, layer them over the green tea cream.

Explore additional medical treatment possibilities in a comprehensive guide covering rosacea medical treatments, including creams, topical and oral medications, and procedural options.

3. Hydrate

Moisturizers play a pivotal role in repairing and sustaining the impaired skin barrier characteristic of rosacea. Proper hydration is indispensable for skin recovery.

Apply daily moisturizing face cream (included in the kit) over the correct step products. It is enriched with ceramides and squalane to bolster the skin barrier.
Incorporate a few drops of omega enriched face booster oil (not in the kit) into the moisturizing face cream in your palm, blend, and apply to the face.

The skin gains advantages from essential oils like sea buckthorn and castor seed oil.
This addition proves especially valuable for dry skin types and in arid environments.

At night, consider substituting the moisturizing cream with direct application of the omega oil to the face.

Select only non-irritating moisturizers suited to your skin type, steering clear of AHAs, BHAs, vitamin C, and similar irritants. Additional guidance on product selection and avoidance follows later.

Note for Individuals with Papulopustular Rosacea

Those with oily papulopustular rosacea might prefer skipping traditional moisturizers. Non-oily hydrators like hyaluronic acid in the green tea antioxidant skin therapy can elevate skin moisture levels, often providing ample hydration for oily areas, particularly the T-zone.

4. Protect

Ultraviolet radiation from the sun significantly contributes to rosacea triggers, notably in the erythematotelangiectatic subtype. I advocate for sunscreens composed exclusively of mineral physical blockers, containing at least 5% zinc oxide and titanium dioxide.

Daily application of non-irritating sheer strength physical matte tinted SPF 50+ sunscreen (included in the kit) is recommended to avert UV-induced rosacea flares.

It delivers broad-spectrum, high-SPF protection in a hypoallergenic, non-irritating formula tailored for sensitive skin like that prone to rosacea.

Be aware that numerous sunscreens mix mineral and chemical filters, potentially including brightening agents that irritate sensitive skin.

One Comprehensive Kit for All Rosacea Treatment Products

I have assembled a skincare kit tailored for my patients, encompassing all essential rosacea skincare steps with the rosacea therapy kit. This kit provides the optimal complete routine proven to manage rosacea effectively.

For over 35 years, I provided handwritten skincare instructions to my patients. Eventually, I recognized the consistent foundation prescribed for rosacea cases. We integrate prescription topicals as needed, but this routine serves as the core. Every compatible product required is within this kit.

Anti-Aging Skincare Routine

Exercise caution when introducing anti-aging products into a rosacea skincare regimen. Even the most potent anti-aging formulations can provoke irritation in sensitive skin. I recommend initiating them only after rosacea remission and allowing several months for skin barrier recovery.

Your Step-by-Step Anti-Aging Skincare Guide

The following outlines incorporating retinoids into your routine:

Maintain the foundational rosacea skincare routine outlined earlier.
Restrict retinoid use to nighttime, as they degrade upon light exposure.
Commence with minimal frequency: 1-2 applications weekly at bedtime, gradually increasing to nightly over 2-3 months.
Retinol anti-wrinkle night cream is far gentler and less irritating than tretinoin, featuring pharmaceutical-grade green tea antioxidants for skin calming.

Dilute by blending with moisturizing face cream (from the rosacea kit) in the palm prior to application.
This method, employed successfully for years with patients, enables a gradual “low and slow” introduction of this powerful anti-aging agent.

Should dryness emerge, pause use until skin normalizes, then resume progressively.

For an in-depth walkthrough of a full rosacea anti-aging routine, including options and recommendations, refer to detailed resources on using retinol, Retin-A, and tretinoin for rosacea as the premier anti-aging approach.

Your Anti-Aging Rosacea Skincare Kit

Utilize the rosacea therapy kit for foundational treatment, then incorporate retinol ultra-intensive anti-wrinkle night cream following the outlined steps.

Using Tretinoin?

If prescribed tretinoin, find protocols and layering tips with other products in guides on applying tretinoin cream effectively.

Other Anti-Aging Skincare Products

The acidic pH of many anti-aging items, such as vitamin C and AHAs (e.g., glycolic acid), renders them challenging for sensitive skin, particularly erythematotelangiectatic rosacea. However, those with controlled papulopustular rosacea may tolerate them well.

Preferred over-the-counter anti-aging choices include retinol and glycolic acid anti-wrinkle cream. Always begin with the mildest strength 1-2 times weekly, advancing to daily use of the strongest tolerable concentration.

Treating Highly Sensitive Skin Associated with Rosacea

Patients frequently inquire about managing extreme skin sensitivity stemming from rosacea, seeking relief from this distressing issue. For instance, a 59-year-old woman with 20 years of diagnosed rosacea described intolerance to sunscreens and moisturizers, relying solely on Aquanil for cleansing (to which she began reacting) and minimal concealer, amid very dry skin.

When sensitivity leads to broad product rejection and dryness, I investigate coexisting conditions alongside rosacea. My protocol ensures addressing any contributing barrier-disrupting factors through precise diagnosis and a phased, personalized plan—though challenging, a targeted routine for sensitive skin yields substantial improvements.

Conditions mimicking or complicating rosacea-induced redness and sensitivity include allergic or irritant contact dermatitis, photosensitivity from medications, facial dandruff (seborrheic dermatitis), and intense inflammation from demodex mites.

Rosacea Cool Down Phase Before Full Treatment

If barrier impairment stems purely from rosacea, implement a “rosacea cool down” period. This also aids healing from aforementioned conditions post-identification and resolution.

Prior to standard rosacea treatment, conduct a 2-month cool down to rebuild barrier integrity across key healing stages: quell inflammation, regenerate the epidermal living cell layer, renew the stratum corneum dead cell layer, then proceed to the four-step rosacea routine. All required products are in the rosacea therapy kit.

Cool down protocol for rosacea-sensitive skin:

Cleanse with extremely gentle facial cleanser, pH-balanced and hypoallergenic. After 2-4 weeks, if tolerated, alternate with calming zinc bar soap at night.
Apply green tea antioxidant skin therapy post-drying to replenish depleted skin antioxidants.
Select a moisturizer immediately following green tea.

Occlude with a thin layer of plain oil as a secure moisturizer.

Essential for dry skin barrier recovery.
Opt for non-stinging oils like canola, extra virgin coconut, or ideally hypoallergenic jojoba mimicking natural sebum. Ensure purity without additives.

For severe inflammation, substitute with tolerable non-halogenated cortisone like Locoid Ointment.

May sting some; alternatively, compound hydrocortisone in a familiar base.
Critical for inflammation control but short-term to avoid dependency in rosacea; physician oversight essential, prioritizing non-halogenated options.

Occasionally, antibiotics such as oral tetracycline or doxycycline for months may be required.
Avoid sun rigorously with sun protection hats and mineral zinc oxide matte tinted sunscreen.

Apply pure mineral makeup powder to camouflage redness. Avoid liquid foundations until barrier repairs; mineral powders preferred for rosacea skin. Makeup details follow later.
Steer clear of known rosacea triggers.
Adopt an anti-inflammatory diet and lifestyle modifications. Comprehensive advice available in guides on food and lifestyle impacts on rosacea.

Oily Skin and Rosacea

Oily skin often coexists with blackheads, clogged pores, and rosacea, complicating treatment as standard oily/acne products can exacerbate rosacea.

Skin Care Regimen for Rosacea and Oily Skin Types

Initiate with “rosacea cool down” to soothe inflammation without worsening pores. Products in rosacea therapy kit.
Address clogged pores and blackheads subsequently.

Optimal: sonic cleansing devices like Foreo or Clarisonic.

Cautiously test on rosacea areas (cheeks, forehead) starting low with delicate brush.

For blackheads: retinoid like retinol night cream.

Challenging but feasible selectively; application instructions on product page.
Alternative: alcohol-free benzoyl peroxide acne treatment cream on nose, chin, brows only—test gingerly for flares.

Natural Treatment Approaches for Rosacea

Natural rosacea management acknowledges the inherent sensitivity and barrier weakness, emphasizing internal and external nurturing. This encompasses rosacea-aware dietary and lifestyle shifts, guided by dermatological expertise, alongside gentle botanical skincare to curb redness and acne-like symptoms.

Core elements of natural strategies include:

Embracing a trigger-avoidant rosacea-friendly diet.
Implementing inflammation-reducing lifestyle changes.
Incorporating gentle herbal and botanical products safe for sensitive skin.
The rosacea skincare kit facilitates natural skin healing processes.

This holistic framework empowers long-term rosacea control by addressing root sensitivities comprehensively, fostering resilience against triggers while promoting overall skin vitality.