What are the Best Treatments for Rosacea?

Personal/Inspirational, Skin Care
You can have great skin while you have rosacea – just know what to use and what to avoid. No matter what, this will require some trial and error, but hopefully our guidelines will help.

Do you have a rosy tinge to your cheeks?  Accompanied by dilated blood vessels around your cheeks and nose?  But otherwise pale skin?  Chances are, you have rosacea.  An inherited condition, rosacea typically presents in patients 25-60 years of age (Cosmetic Dermatology, 2002).  In men, symptoms show on the nose, but in women, cheeks and chin are more common (National Rosacea Society).

To treat these symptoms, do the following:

1.)  See a dermatologist immediately.

Typically, this is not the advice that people reading a beauty blog (even a scientific one) want to hear.  But it is the best advice.  Check out the treatments only a dermatologist can give you:

  • Prescription sulfur-containing treatments, such as Novacet.  Sulfur has drying properties, which help the skin to heal.  Numerous studies have found sulfur to be effective against fighting rosacea, including a 1997 study in the Journal of Dermatological Treatments.
  • Topical antibiotics like metronidazole, or oral antibiotics like tetracycline or minocycline.  How exactly these antibiotics control rosacea is officially undefined, since antibiotics kill bacterial cells.  However, they have been found to definitively treat rosacea and to control exacerbations (Journal of Drugs in Dermatology, 2007).
  • Electrocautery or laser treatments, like a pulsed dye laser or IPL.  These treatments tone down redness within the skin and reduce spider veins.  Electrocautery uses a tiny needle to zap the entire length of the blood vessel.  As for the laser treatments, they usually require up to 12 treatments and cost upwards of $1500 -but are well-worth it.

2.)  Select the right skin care products.

For cleansing, it’s hard to beat the anti-inflammatory Aveeno Natural Colloidal Oatmeal Cleansing Bar.

When selecting skin care products, think anti-inflammatory, first and foremost.  My favorites for rosacea are:

Cleansers:  Think oil-free, non-foaming, and anti-inflammatory.  Between flare-ups, I like Vanicream Cleansing Bar ($9.90, Amazon.com), which cleanses with little or no irritation; or Aveeno Natural Colloidal Oatmeal Cleansing Bar ($2.21, Amazon.com), with soothing colloidal oatmeal.  During a flare-up, the sulfur-rich Coral KAVI Bar ($8.00, Amazon.com) is a dream.

Yes, the packaging could use some work. But I’ve never known anyone with acne or rosacea who has tried this sulfur treatment and not liked it.

Daytime treatment product:  If your skin is oily or you are having a flare-up, sulfur has been shown to have great effects.  Please see your dermatologist for a prescription!  If this is not an option, De La Cruz Sulfur Ointment ($3.13, Amazon.com) has 10% sulfur, and some of my friends with rosacea have had sensational results using it.

For an anti-inflammatory sunscreen, I really like Topix Replenix SPF 50, with concentrates of anti-inflammatory EGCG (the active component of green tea).

Daytime sunscreen:  Again, you want oil-free and anti-inflammatory. Replenix Antioxidant Sunscreen Moisturizer SPF 50 ($29.90, Amazon.com).  Most green tea moisturizers contain straight green tea extract, but Topix Replenix actually extracts the active component of green tea – EGCG – and concentrates it.  What’s more, EGCG has antioxidant and soothing effects.  So I love it for rosacea.

If you’ve tried everything for rosacea and nothing has worked, DermaDoctor Calm, Cool, and Corrected 2n1 Rosacea Cream contains two unusual anti-inflammatory agents, NDGA and oleanolic acid.  It also works well with other treatments, including sulfur.

Nighttime moisturizer:  DermaDoctor Calm Cool and Collected 2n1 Rosacea Cream ($85.00, Amazon.com).  This cream contains two unusual ingredients, nordihydroguaiaretic acid (NDGA) and oleanolic acid.  NDGA reduces inflammation by reducing inflammatory factors, as well as the activity of the hormone necessary for converting testosterone to its active form, DHT (European Journal of Pharmacology, 2009).  The enzyme 5-alpha reductase is also inhibited with treatments for hair loss, like Rogaine.  On the other hand, oleanolic acid reduces sebum levels in the skin, and hence places for bacteria to proliferate.  The idea is, if antibiotics control rosacea by eliminating bacteria, so should oleanolic acid.  Good theory.  Truth be told, I think DermaDoctor Calm Cool and Collected 2n1 Rosacea Cream is best if used in conjunction with laser therapy, oral and topical antibiotics, and sulfur.

3.)  Avoid all of the following. 

According to the National Rosacea Society, each of the following cause rosacea, in the following percentages of patients with rosacea:

  • Sun (61%)
  • Emotional stress (60%)
  • Hot weather (53%)
  • Alcohol (45%)
  • Spicy foods (43%)
  • Strenuous exercise (39%)
  • Hot baths (37%)
  • Cold weather (36%)
  • Hot drinks (36%)
  • Skin care products (24%)

4.)  Use matte skin powders.

Iridescent or shiny powders contain mica, which has rough-edged particles that can cause irritations for those with rosacea, according to Dr. David E. Bank, M.D., Director of the Center for Dermatology, Cosmetic and Laser Surgery in Mount Kisco, NY.  Instead, Dr. Bank recommends using a matte finish for powder and foundation.  We like Make Up For Ever Mat+ Foundation ($25.00, Amazon.com), which gives a great polish.  I mean, lack of polish.  I mean, lack of shine…

5.)  If all else fails, use the right green-toned concealer. 

For under $10, Physicians Formula Green/Natural Duo is pretty spectacular.

On the color wheel, red is right across from green, meaning that your best chance at achieving neutrality is to use a green-toned concealer on blemishes, followed by a superb flesh-colored concealer.   I like Physicians Formula Green/Neutral Duo ($6.41, Amazon.com) followed by Laura Mercier Perfect Camouflage ($22.00, Amazon.com).  While the Laura Mercier product is not green, it is amongst the best concealers I have ever used, and mica-free (see #4, above).

Bottom Line

Rosacea can be difficult to live with, but it is not the end of the world.  With oral and topical antibiotics, sulfur, laser treatments, oil-free/anti-inflammatory skin care products, and avoidance of the certain environmental stressors and products, you can simultaneously have rosacea and great skin – promise!

What works for your rosacea?  Tell us!


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  • an

    Can retinol be used for rosacea?

  • Alice

    Thanks for the article! I am always wary about new products and how they will react to my skin but will have to try a sulfur product. I tried Aquanil cleanser a few months ago and love it. Very gentle. And it comes as a liquid which I like better than bars.

  • Lucas

    Great post!
    I’ve never tried sulfur products with fear they would be too harsh. Is it okay for combination skin types to use it? Won’t the dry parts of my face get irritated?
    And if I’m having a flare up in the middle of the day, should I just put the sulfur product over sunscreen or do I have to wash my face first?
    Maybe I will give it a try.

    Gentle cleansing was an important part, skin care wise, of getting my rosacea under control as well as oral antibiotics for the first two months and topical metronidazol, which I still use every night, and sunscreen in the morning.
    Diet and lifestyle changes also made a difference, but took a little longer to show results.
    Anti-inflammatory products are helpful, like green tea extract, chamomile extract and antioxidants in general. Niacinamide works for me too. I apply the CeraVe PM lotion at night and it helps control the redness. Also, careful use of tretinoin has helped my skin greatly; it was tricky at first, but over time it made my skin more resilient.
    Recently I started using a zinc based sunscreen, which I hope will be a positive addition.

  • Leah

    Have you ever tried glominerals redness reducing powder? I’ve heard some interesting things about it for rosacea. Not as a long term fix but to help cover up flare ups.

  • Sophie

    I found that CeraVe AM w/ SPF 30 moisturizer works really well at calming my flare ups during the day. They also make a PM version without the SPF, but I don’t like that as much. Another great thing about this product is it’s cruelty-free. I think the Vanicream is, also. ^^

  • OMG! Thank you so much for sharing this! It is a wealth of information!

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