Dealing with red, reactive skin and rosacea — a chronic condition where skin is overly sensitive, often with visible blood vessels and raised bumps on the face — usually means tiptoeing around anything that could trigger a flare-up. The problem is that virtually “anything that makes the face flush can cause a rosacea flare,” says dermatologist Joshua Zeichner, the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital.
Common triggers include stress, extreme temperatures, spicy foods, fragrance, alcohol in skin care, and alcoholic drinks (especially wine) says dermatologist Debra Jaliman, an assistant professor of dermatology at Mount Sinai’s Icahn School of Medicine. Even hot showers and skin-care acids can worsen symptoms. Constant rubbing and friction (like from frequent mask wearing) can also cause a flare-up says Skin Wellness Dermatology founder and dermatologist Dr. Corey L. Hartman, who has noticed an uptick in flare-ups since the beginning of the pandemic. But there are ways to tame outbreaks and lessen their effects, so we asked 11 dermatologists and estheticians for their advice. They all recommend avoiding products with fragrances or alcohols and to be careful with potential irritants, like acids and physical exfoliants. Instead, look for products suited for sensitive skin and rosacea, and stock up on skin care that contains hyaluronic acid, azelaic acid, and niacinamide. Below are some specific products — from creams and cleansers to tinted primers and sunscreen — that might calm and camouflage inflamed skin.
If you have reactive skin, you know that even the cleansing process has to be gentle. Zeichner and David Lortscher, a board-certified dermatologist and CEO of Curology, both recommend this foaming Neutrogena face wash for its extra-gentle ingredients. “The technology in this cleanser prevents the cleansing ingredients from compromising the integrity of the outer skin layer,” says Zeichner.
Another foaming cleanser Zeichner suggests is this one from Aveeno because it contains feverfew, a calming ingredient associated with chamomile, which has been clinically proved to reduce redness and irritation. Other perks: It’s free of fragrances and hypoallergenic, too.
Another gentle option is EltaMD Foaming Facial cleanser, an oil- and paraben-free face wash that’s formulated without additives. Miami-based dermatologist Roberta Del Campo of the Del Campo Dermatology and Laser Institute likes this one because it also gently removes makeup and oils.
Dermatological nurse and celebrity aesthetician Natalie Aguilar recommends this cleanser as she looks for gentle, calming, and hydrating ingredients when it comes to rosacea. “It cleanses facial skin while preserving hydration and decreasing inflammation,” she says. “It’s cooling, revitalizing, and protective.” The key ingredient, chamomile, is a favorite of Dr. Farhaad Riyaz, board-certified dermatologist and Docent’s medical advisor, because “it’s antibacterial and anti-inflammatory and soothes, calms, heals, de-stresses, and reduces swelling associated with rosacea.” Other key ingredients, like calendula and sunflower oil, add to the formula’s creamy consistency, which Aguilar adds is great for removing makeup.
Hartman is a fan of this cleanser from Restorsea, which uses natural actives like songyi mushroom and Aquabeautine XL, which comes from the hatching fluid of baby salmon. “This potent, yet gentle cleanser is naturally derived and chemical free,” he says. He also likes that it’s good at removing dirt and oils and makeup but won’t irritate skin, key for someone with an already compromised skin barrier.
The general rule with red, rosacea-prone skin is “the less ingredients, the better,” so Lortscher also suggests this Free & Clear liquid cleanser, which is noncomedogenic (so it won’t clog pores) and free of common dyes, fragrances, preservatives, and chemicals.
Dr. Smita Ramanadham, a plastic surgeon who also has a skin-care brand, Skin by Dr. Smita, recommends this gentle cleanser, which uses oat amino acids that don’t strip the skin and supports the skin barrier. It also contains glycerin for hydration and botanical antioxidants that help to protect skin from the elements.
Certain ingredients found in cleansers (menthol or eucalyptol, specifically) can throw off the skin’s PH level, says Zeichner, making rosacea worse. His go-to recommendation is Dove’s Sensitive Skin Beauty Bar. It’s a favorite of dermatologist Dr. Hadley King as well. It’s a simple, skin-barrier-supporting, ultraaffordable option that you can use to cleanse both your face and body. “It uses a gentle cleansing agent and is particularly moisturizing,” Zeichner says.
It’s common for people with rosacea to also deal with acne, but it can be difficult to find a cleanser that’ll clear out pores without further irritating or drying out the skin. If you’re hoping to deal with both simultaneously, look for something that gently exfoliates, like this cleanser, which comes recommended by aesthetician Candace Marino. “This cleanser does an excellent deep clean without foaming up and drying out the skin,” she says. It uses botanical-derived lactic, glycolic, and salicylic acid, which work together to gently exfoliate without further irritating the skin. “It’s so gentle it’s recommended for clients post-laser or peel,” she says.
SkinSpirit aesthetic nurse practitioner Shawna Jones likes this pH balanced toner from ZO Skin Health, which she says will help soothe the skin and support the skin-barrier function. The formula has allantoin, which Dr. Riyaz says is an “anti-inflammatory that soothes, calms, heals, and reduces the irritation, redness, and sensitivity seen with rosacea.” It also has sodium hyaluronate to improve hydration, which is key for people with rosacea as they tend to have a dehydrated compromised skin barrier.
For some additional soothing after you tone, Jaliman suggests this serum specifically formulated for rosacea-prone skin from La Roche-Posay. “This visible redness-reducing serum does what it says. What’s nice about it is that it’s free of parabens, it’s oil-free and fragrance-free, so it’s really good for sensitive skin. It’s made with an ingredient called ambophenol, which soothes skin.”