How to Create a Rosacea Skincare Routine and Things to Avoid with Rosacea

Hi, tribe! I’m thrilled to welcome back my husband, Dr. Eddy, back to the show! It’s been a while since he’s been on, but I know you all love to hear from him too! 

Did you know that April is Rosacea Awareness Month? Maybe you have rosacea yourself or know someone who suffers from it, but it’s a skin condition that causes redness, inflammation, and irritation. 

Both Dr. Eddy and I see patients every day with rosacea — it’s a common skin condition, so I wanted to have an entire episode dedicated to its symptoms and potential methods of treatment. Let’s get started! 

What Is Rosacea? 

As Dr. Eddy explained, rosacea is an inflammatory skin condition which people usually associate with redness or blushing around the face, particularly around the cheeks and the nose. However, rosacea can present in different ways for different people — someone else’s rosacea may have different symptoms than yours! 

Because of this, rosacea is often confused with other skin conditions, so if you’re unsure if you have rosacea, definitely consult your dermatologist for a diagnosis. 

“There are some auto-immune diseases that could mimic something like rosacea. There are, again, forms of rosacea that we may want to treat differently, depending on how the patient presents . Even things as far as an eczema or a contact eczema that may show up on the face due to some makeup can mimic rosacea.” – Dr. Eddy Prodanovic

If you have rosacea, you should definitely seek treatment from your dermatologist — your skin is very sensitive, and your rosacea can worsen if exposed to certain topical solutions or even based on your diet! 

What Are the Four Subtypes of Rosacea?

Within rosacea, there are four main subtypes that you need to aware of:

#1: Erythematotelangiectatic Rosacea

This rosacea is characterized by persistent redness or rosiness on the face. Without treatment, this type of rosacea can have permanent effects on the skin. 

#2:  Papulopustular Rosacea 

Papulopustular rosacea is characterized by red, swollen bumps that appear on the cheeks, chin, and forehead. This type of rosacea is often confused with acne due to the whitehead pustules.

#3: Phymatous Rosacea 

Phymatous rosacea is characterized by bumpy, swollen skin, commonly around the nose, due to inflammation causing excessive scar tissue. It’s typically more frequent in men than women.

#4: Ocular Rosacea

Ocular rosacea affects the eyes, causing irritation, sensitivity, burning, or even cysts. With ocular rosacea, your eyes may look red and watery while feeling dry and gritty.  

What Are Signs of Rosacea? 

Now that we’ve covered the four main types of rosacea, let’s discuss some of the most common signs of rosacea. Remember — if you are experiencing any of all of these symptoms, please consult your dermatologist for diagnosis and treatment. 

Sign #1: Trigger-Based Flushing

Trigger-based flushing happens when you’re exposed to certain environments, foods, or emotional stress. 

For example, some people complain that they get more flushed when eating spicy foods or drinking red wines — even if those things haven’t bothered them in the past. Others claim that they become more flushed during times of emotional stress or hormonal cycles.

If you’ve been experiencing trigger-based flushing recently, it may be a sign of erythematotelangiectatic rosacea.  

Sign #2: Textural Changes on the Skin

Textural changes on the skin include bumps, rashes, and other abnormal conditions. However, keep in mind that acne is not the same as rosacea. Acne is caused by clogged pores, excessive oil production, and bacterial infection, while papulopustular rosacea is due to inflammation. 

“The location of these pimple-like … bumps are typically around the chin, nose, cheeks and eyes.” – Dr. Eddy Prodanovic

If you’re unsure if your skin’s texture changes are due to acne or rosacea, consult your board-certified dermatologist for a diagnosis — we’ve been trained to notice the difference and treat your symptoms! 

Sign #3: Broken Capillaries

Capillaries are little blood vessels throughout our skin, and sometimes, those tiny vessels can pop. Some people call those broken blood vessels “spider veins,” but the official term is “telangiectasias,” which can be a symptom of rosacea. 

If you’re seeing red patches on your skin, those could be a result of broken capillaries due to rosacea. 

Sign #4: Watery, Gritty Eyes

Have you been constantly scratching or rubbing your eyes? Are your eyes constantly red, no matter how much care you give them? Do they feel somehow watery and gritty at the same time?

If so, that may be a sign of ocular rosacea! When I see a patient who has ocular rosacea, I’ll often work together with an ophthalmologist to ensure the rosacea doesn’t cause corneal abrasions or other long-term side effects. 

Each type of rosacea requires a nuanced treatment plan from a dermatologist, but there are some things you can do yourself to lessen the symptoms! 

#1: Use a Gentle Skincare Routine

If you have rosacea, treat your skin like baby skin. Use a gentle, hydrating cleanser and avoid any product with a harsh, physical scrub. In addition, don’t use homemade soaps:

“A lot of these homemade soaps, for example, will contain a lot of lye in them, … and that actually increases the pH, but the skin itself should be a tiny bit on the acidic side, and that can really irritate the skin.” – Dr. Eddy Prodanovic

#2: Exfoliate Your Skin with a Beta Hydroxy Acid Chemical Peel 

Beta hydroxy acids are less irritating on the skin, and they also help to minimize large pores that often come along with textural changes of the skin due to rosacea. I’d recommend choosing a chemical peel that contains salicylic acid.

However, before you apply the entire peel to your face, test a little portion of your skin to make sure it won’t cause irritation.  

#3: Moisturize Your Skin 

No matter your skin type or skin condition, moisturization is absolutely essential. However, for rosacea skin, it’s even more important to apply moisturizer every day. 

Look for moisturizers that contain ceramides (emollient), as well as glycerin and hyaluronic acid — as these humectants do a great job of attracting moisture from the environment into your skin.

#4: Apply Sunscreen Every Day and Limit Sun Exposure

This is the number #1 tip Dr. Eddy and I tell our rosacea patients — UV rays, heat, and humidity often cause flare ups with rosacea, so during the warmer months, make sure that you limit your exposure to the sun and ALWAYS wear sunscreen. 

I absolutely love the EltaMD UV Clear Sunscreen. It blends easily with any skincare routine, and it has a very special ingredient called niacinamide, which helps reduce inflammation. 

How Do You Get Rid of Fine Lines and Wrinkles When You Have Rosacea?

Because rosacea causes your skin to become extra sensitive, it’s important to know what types of products are safe to use to stimulate collagen production and reduce fine lines. 

In Episode #34 and #35, we discussed how retinols and retinoids can help with collagen production and reduce fine wrinkles. However, retinoids that contain concentrated amounts of retinoic acid can be extremely harsh on rosacea skin.

Instead, opt for a gentler retinol — we recommend Avène Retinol, which typically won’t irritate rosacea skin. Remember just to use a pea-sized amount for the entire face — a little bit goes a long way! And if you’re looking for something even gentler, there’s a plant-based retinol derivative called bakuchiol. It really helps restore radiance to your skin and increase collagen production — plus, it’s super gentle on sensitive skin. 

We’ve touched on this a little bit already, but definitely avoid sun exposure and products that are harsh on the skin. In addition, you should avoid extreme cleansing routines with mechanical brushes. Once a week is okay, but every day will cause damage and irritation. It’s best just to use your fingers to manage the cleanser into your skin. 

And when you’re looking for cleansers, moisturizers, or other skincare products, be sure to not trust the branding at face-value:

“ anything that says it’s natural, it’s plant-based, it’s organic, just be careful. I mean, poison ivy is plant-based, natural, and organic, but if you put that on your face, you know what type of reaction your skin would have. If you … to try something , do a test a small portion of your skin and see how your skin reacts. If it gets really irritated, … know that not appropriate for you.” Dr. Eddy Prodanovic

As always, ask your dermatologist for their expertise regarding the products and treatments you should pursue when it comes to your skin type or skin condition.

How Can a Dermatologist Treat Rosacea?

In addition to recommending gentler skincare products, dermatologists can perform a number of treatments and prescribe medications to lessen the effects of rosacea. 

Depending on your type of rosacea, an Intense Pulse Light (IPL) or a V-Beam laser treatment may be right for you. Usually, you’ll have to undergo multiple laser treatments to reduce the broken capillary damage rosacea can have on your skin.

If you’re experiencing blushing or redness due to rosacea, there are a few prescription creams, such as Rhofade and Mirvaso, that can help reconstruct those weakened blood vessels, which helps the redness fade.  

For bumps and pustules, we commonly prescribe a topical product called metronidazole — an old-school product that’s been out for a while now! There are some newer treatments, such as ivermectin, that are also extremely effective.

Lastly, there are some antibiotic-based oral medications that work as an anti-inflammatory for the skin. These oral medications can help with bumps and even redness! 

If you’re interested in receiving any of these treatments, consult your dermatologist for advice! And if you don’t currently have a dermatologist, you can find one here. 

Rosacea Doesn’t Determine Your Skincare Success!

Tribe, even if you suffer from rosacea, I want you to know this — you can still have healthy skin! Rosacea doesn’t have to defeat you — with the right treatments, products, and expertise from your dermatologist, rosacea doesn’t have to determine your skincare success! 

And even if you don’t have rosacea, I think this information is applicable to you! It’s Rosacea Awareness Month, so why not show our friends who suffer from rosacea some support and extra love? 

If you enjoyed this episode, be sure to let me know on Instagram! You can tag me, @drnikoleta, with a screenshot of the episode and your greatest takeaways. I’d also really appreciate it if you would subscribe and leave a five-star rating on Apple Podcasts — that helps us share the podcast with more people like you who are looking to achieve the skin of their dreams! 

And if you want to get even more plugged in, check out the podcast Facebook Community! This is an exclusive group of like-minded individuals who prioritize skincare, self-care, and healthcare — we’d love to have you join us!

Until next time, Step Out with Confidence®, take care of yourself, and know that rosacea doesn’t have to defeat you!