Retinol for rosacea

Rosacea skincare routine: your complete step-by-step guide

Rosacea is a chronic inflammatory skin condition, characterised by flushing redness (often spread over the nose and cheeks) as well as bumps, breakouts and visible blood vessels. Rosacea primarily affects adults and particularly women over 30 with fair skin.

What you can expect:
Rosacea skincare routine
Things to avoid with rosacea
Is retinol good for rosacea?
Is niacinamide good for rosacea?
Is azelaic acid good for rosacea?
Salicylic acid and rosacea
Hyaluronic acid and rosacea
Vitamin C and rosacea

Rosacea skincare routine

To help with inflammation (as well as wrinkles, blackheads, pimples and oiliness), the best face routine for rosacea is:

1. Use a gentle, non-drying cleanser: if you have rosacea, it’s important to avoid washing your face with bar soap, drying cleansers, harsh scrubs or stiff bristled cleansing brushes, because they damage and inflame the skin
2. Use a skin-soothing BHA exfoliant: BHA reduces redness & dry flakiness as well as helping with spots and blackheads, note that if you have skin prone to rosacea you may want to start using a BHA exfoliant every other day & build up to once every day
3. Use SPF 30+ with titanium dioxide and/or zinc oxide in the AM: these two mineral sunscreen agents are exceptionally gentle & effective which is best for rosacea prone skin
4. For oily/combo skin with rosacea, use a lightweight lotion, gel moisturiser or even a light serum in the PM: a serum with retinol is also a good option, as it helps reduce inflammations
5. For dry/normal skin with rosacea, use a lotion or cream with sufficient antioxidants & skin-repairing ingredients in the PM: it may also contain retinol
6. Prescription medication: discuss with your GP whether this is an appropriate choice for you & ask for advice, you’d apply this topical medication to cleansed skin before applying your SPF / moisturiser

Things to avoid with rosacea

Skincare ingredients to avoid for rosacea are alcohol, essential oils and/or witch hazel . Cinnamon, rosemary, lavender and rose are typical natural fragrances that can severely irritate skin. Avoid these, as well as synthetic fragrances. Skincare products that contain lemon, lime, menthol/peppermint, pine or cedar can all cause significant irritation. And do not use rough facecloths, face brushes or abrasive scrubs with a coarse grain. Rosacea often starts as a mild issue, with some redness here and there on the cheeks and nose, but if you don’t adapt to its needs, then you will most likely continue to see redness.

Is retinol good for rosacea?

Cosmetic retinoids (eg. retinol and retinaldehyde) are not the first recommendation during active rosacea flare-ups, but in many cases retinol and rosacea can be helpful for breakouts and/or signs of ageing, so long as the rosacea is under control at that moment.

Retinol is good for rosacea because it works to normalise cell renewal and potentially minimise any triggering factors of rosacea symptoms, via the modulation of inflammatory pathways within skin.

Because rosacea-prone skin often comes with dryness and sensitivity, retinol side effects might be magnified, especially if the product contains irritating ingredients or if the retinol content is too strong for your skin. That’s why it’s more important to find a gentle, controlled-release retinoid formula, starting with low potency and low frequency of use and working up to application every other night. The rest of the skincare routine should include a gentle cleanser and a replenishing, calming moisturiser, as well as a broad-spectrum SPF 30 of higher for daytime.

What about systemic retinoids? Both oral and topical isotretinoin have been proven to help reduce some signs of rosacea, especially in case of papules and pustules, thanks to their anti-inflammatory effects and their work to promote skin remodelling and to reduce the overproduction of sebum (oil). Controlling sebum production is important because inflammatory microorganisms feed on excess sebum, which can lead to vasodilation and redness.

Is niacinamide good for rosacea?

over the years have proven its anti-inflammatory effects for atopic dermatitis, psoriasis, rosacea and acne, while more specific barrier-protective effects were also proven in a study with 50 rosacea-prone patients. Because of these benefits and an exceptional tolerance profile, niacinamide and rosacea is a seriously recommended match.

Is azelaic acid good for rosacea?

This ingredient has proven soothing, antioxidant and antibacterial action that can play a role in visibly reducing the redness, bumpy texture and general discomfort associated with rosacea.

While prescriptions at a 15% concentration is the gold standard for rosacea, the use of topical 10% azelaic acid is proven to be effective as well in reducing redness and breakouts in acne-prone skin, thanks again to its anti-inflammatory properties, and for that it might also play role in visibly reducing rosacea papules and pustules.

Salicylic acid and rosacea

As an exfoliant for rosacea, salicylic acid (aka BHA) has well-established skin-renewing properties, as well as soothing effects that help to reduce breakout-prone skin, redness and discomfort. So yes, BHA has been proven affective on rosacea papules and pustules.

Properly formulated, at the right pH and concentration and without irritating ingredients such as fragrance and the drying kinds of alcohol (primarily SD or isopropyl alcohols), salicylic acid can be used regularly to visibly improve rosacea-prone skin and help reduce discomfort.

Hyaluronic acid and rosacea

Hyaluronic acid is both safe and highly effective for rosacea-prone skin. It is first and foremost a potent and effective hydrator, which can relieve the dryness that often accompanies rosacea flare-ups (without worry about adding more oil). Moreover, its anti-inflammatory properties make it a great candidate to help alleviate redness and discomfort, whilst also improving skin barrier function.

Vitamin C and rosacea

Vitamin C serums and other formulas are good for rosacea because of their ability to boost collagen production, as well as helping improve skin barrier function and smoothing rough texture.

While more specific or extensive research is limited, topical vitamin C preparations have recently been studied and the results were encouraging. The research says that the potent antioxidant action of ascorbic acid might be responsible for the observed reduction of the erythema of rosacea, in which free-radical production plays a role in the inflammatory response to triggers.

Simply put, people with rosacea should tolerate vitamin C skincare well because of its anti-inflammatory effects. However, it is advised to incorporate formulations with a lower percentage of L-ascorbic acid or its derivatives (eg. ascorbyl glucoside & tetrahexyldecyl ascorbate) and keep an eye on how your skin is feeling.

References for this information

  • Anais Brasileiros de Dermatologia, November–December 2020, Pages 19-38 and 53-69
  • Annals of Dermatology. June 2020, pages 189-196
  • Antioxidants, January 2024, pages 1-10
  • Cosmetic Dermatology- Cedar Knolls, January 2001, pages 35-40
  • Cutis, August 2005, pages 135-41
  • Cutis, December 2013, pages 306-317
  • Dermatologic Clinics, Volume 36, April 2018, Pages 151-159
  • Experimental Dermatology, July 2019, pages 786-794
  • Experimental and Therapeutic Medicine, August 2020, pages 1048-1052
  • International Journal of Biological Macromolecules, September 2018, pages 572-584
  • International Journal of Dermatology and Venereology, December 2021, pages 199-209
  • Journal of the American Academy of Dermatology, June 2003, pages 836-845
  • The Journal of Clinical and Aesthetic Dermatology, July 2017, pages 14-17
  • Journal of Drugs in Dermatology, June 2013, pages 664-667
  • Journal of Drugs in Dermatology, September 2015, pages 964-968
  • Journal of Drugs in Dermatology, April 2021, pages 384-392
  • The Journal of the European Academy of Dermatology and Venereology, December 2022, pages 2,499-2,503
  • Journal of Medical Sciences, January 2014, pages 87-91
  • Skin Pharmacology and Physiology, June 2014, pages 311-315
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