I first experienced rosacea in 2019, when I noticed redness, soreness and small swollen patches appearing across my face. As anyone who has suffered from a skin condition will know, flare-ups or periods of misbehaving skin can be ruinous for self-esteem as well as incredibly frustrating. Frustratingly, my GP misdiagnosed me with eczema and recommended products that were either totally ineffective or, worse, aggravated the condition. After a year of struggling to understand my skin, I saw a different doctor who correctly diagnosed my rosacea. Following this diagnosis, I was able to investigate my skin condition properly, with the help of experts and a renewed focus on how to treat it topically, factoring in the ingredients to look for and those to avoid.

Skin expert Debbie Thomas is the beauty insider’s go-to for many skin conditions including redness and rosacea. She explains the most obvious indicators: “If you are getting regular flushing that leaves prolonged areas of redness, mainly on the cheeks and nose, then you are likely to have mild rosacea. Add in spot-like lumps, burning skin and dry, sore eyes and this could be more advanced rosacea.”

After years of struggling with rosacea, these are the biggest lessons I’ve learned. 

Skincare routine: keep it simple, opt for ceramides and azelaic acid

Keep it simple: the more products you use, the higher the chance of applying something that contains an ingredient that may aggravate your skin and cause a flare-up. Thomas says: “Because rosacea is not just about how the skin looks, it’s also dealing with sensations of burning, stinging and tightness, people often think they should be using thick, calming moisturisers to smother the skin in protection, but rosacea is often worsened by rich or oily products. 

“You are better off using lighter weight products that let the skin breathe and support the skin barrier combined with some active ingredients to address the rosacea symptoms. My top two ingredients are ceramides (lighter lotions or gel formations) for barrier support and azelaic acid (15-20% strength) to help with the rosacea symptoms. Another ingredient worth a try is a prescription medication that reduces inflammation: metronidazole can be helpful when the skin is flared up.”

In terms of products to avoid, Dr Catriona Maybury, consultant dermatologist and Dermatica medical lead explains: “We recommend avoiding products containing alcohol, menthol and fragrances because they contain compounds that can irritate the skin and exacerbate rosacea symptoms. All Dermatica products have been specifically designed with dermatologists to make them fragrance-free, making them suitable for all skin types, and particularly those with rosacea skin.”

Because triggers can vary from one rosacea patient to another, your skin’s individual response to an ingredient is the best indicator of whether that product is suitable for you or not. Patch-testing products is a good habit. 

Dr Maybury stresses the importance of cleansing delicately twice daily: “An emollient-based cleanser will help maintain the skin barrier without stripping away the essential oils you find in other types of cleansers. Dermatica’s emollient-based Caring Squalane Cream Cleanser, £12.95, helps prevent moisture loss and removes make-up, dirt and SPF without irritating and inflaming skin.”

Dr Justine Hextall, dermatologist and Fellow of the Royal College of Physicians, explains why rosacea skin often feels dehydrated: “There is a skin barrier issue with rosacea, so the skin is very sensitive and dry and loses moisture easily.”

Proper moisturisation acts as a protective shield, locking in hydration while keeping out impurities and potential irritants that can worsen rosacea skin.

An effective at-home skincare routine and regular facials can be really helpful and cause instant improvements in terms of hydration and texture. The hydrafacials available at clinics such as Therapie and Debbie Thomas offer a thorough cleanse followed by replenishing vital nutrients deep into the skin. Skinwork’s Clean + Contour Facial, £145, will gently cleanse, exfoliate, polish and brighten skin, avoiding delicate areas such as broken capillaries while preventing and calming inflammation and redness with red and blue LED light therapy.

Dr Maybury warns to avoid harsh exfoliators and astringents. “They remove oils and strip the skin, which can disrupt the skin barrier and make rosacea patients even more vulnerable to triggers causing flare-ups.”

Some gentle exfoliators can be effective. Fjör’s hydrolytic enzyme is a targeted exfoliator that is recommended for those with rosacea. Mats Clarsund, Fjör scientific lead, explains: “Target exfoliation means that the enzyme acts as a pair of scissors that snips off only dead cells from the skin, leaving alive cells to continue their natural lifecycle. Other exfoliation methods are not targeted so they do not distinguish between what is dead skin and what is alive skin, which can leave your skin damaged, exposed to external pathogens and often with a red appearance.”

Environment: sunlight, alcohol and stress are big triggers

Sunlight is the biggest environmental trigger for rosacea, with 80% of rosacea patients having light sensitivity. 

Dr Maybury explains: “Just a few minutes in the sun can cause flushing and redness in rosacea patients because they are particularly susceptible to the sun’s powerful rays.”

Dr Hextall adds: “Sun protection is crucial for rosacea patients, as sun exposure can lead to flare-ups and worsen symptoms. La Roche Posay Anthelios UV 400 SPF 50, £19.90, with its broad spectrum protection, is a great daily SPF.”

In terms of our diet and the effect that can have on rosacea, Dr Thivi Maruthappu, author of SkinFood says: “Common trigger foods are spicy food, hot drinks and alcohol. It is the histamine in alcohol that is particularly problematic and can cause flushing symptoms. Try clear spirits over wine and beer. For some people, probiotic supplements can help to calm the skin. Try to follow an anti-inflammatory skin-supporting diet with plenty of nuts, seeds and oily fish rich in omega fatty acids that support the skin barrier.”

Stress

Stress is another common cause of rosacea flare-ups and can perpetuate a negative cycle of stress, flare-ups and even more stress. However, a recent National Rosacea Society survey showed over 67% were able to reduce symptoms and flare-ups by having effective stress management systems in place. 

Many dermatologists recommend prescription skincare programmes offered by brands such as Dermatica and Dr Emma Craythorn’s Klira 

If you’re keen to look for professional treatments for rosacea, this can help both the appearance of skin and rosacea symptoms such as flushing and itching. Professor Firas Al-Niaimi from the Taktouk Clinic offers an effective six-to-eight-week tailored programme, but encourages people to do their research: “It’s important to understand the skin history and tailor the treatment accordingly. I often see patients who have had suboptimal treatment from lasers.”

Debbie Thomas offers several effective options for rosacea treatment: “We assess each client at an initial consultation and work out which option or combination of options would work best for their skin. From the newest AdvaTx laser and cold plasma device to the tried and tested IPL, Fotona laser and dedicated peels.”

Images: Kitty McGee; Skinwork; courtesy of brands