A derivative of vitamin A, retinol is highly regarded for its transformative ability to rebuild, smooth and repair the skin’s surface. It does this by increasing the rate of skin turnover, amplifying collagen production and protecting against free radicals.

But finding the right retinol is notoriously tricky, even without the added hurdle of sensitive skin. It can cause irritation, dryness and flakiness if it’s used incorrectly, or the formula isn’t right for your skin type – which is one reason why those of us with rosacea may steer clear of the active. 

But can retinol ever be good for rosacea? Three experts explain everything you need to know.

The answer is yes, but only if you follow these three rules. 

Use retinol with caution

Dr Catriona Maybury, a consultant dermatologist and medical director at Dermatica, says that whether someone with rosacea can use retinol varies on a case by case basis. Take a slow, gentle approach to see if your skin can tolerate it or not. 

“Using retinol with rosacea requires extra precaution. Retinol can be harsh on sensitive skin types and this is especially true for people with rosacea, as their skin is prone to irritation and inflammation,” she says.

“While retinol can help unclog pores and smooth skin, it does so by speeding up skin cell turnover. For people with rosacea, this can disrupt the skin barrier and trigger redness, stinging and flares. 

“Retinol can be very drying which can be counterproductive if you have rosacea, because hydration is key for soothing flare ups, so low-dose retinol is recommended. Start with a low concentration of retinol and pay attention to how your skin reacts. Always do a patch test first and go slowly and focus on hydration. If you can tolerate it, then you can continue.”

Remember that your type of rosacea should dictate your retinol use

Dr Maryam Zamani, oculoplastic surgeon and founder of MZ SKIN, says that whether retinoids are appropriate for your skin will depend on the type of rosacea you have. She explains that there are four subtypes of rosacea (talk to a doctor or dermatologist to check which kind you have):

1. Erythematotelangiectatic rosacea. This is characterised by flushing and persistent redness, and may also include visible blood vessels
2. Papulopustular rosacea. If you experience persistent redness with transient papules and pustules (bumps and pimples), you may have this rosacea subtype 
3. Phymatous rosacea. Symptoms include skin thickening, often resulting in an enlargement of the nose from excess tissue
4. Ocular rosacea. This subtype is characterised by ocular manifestations such as dry eye, tearing and burning, swollen eyelids, recurrent hordeolum (styes) and potential vision loss from corneal damage

“Retinols or retinoids can be used for types one and two,” Dr Zamani says. This is because these products have anti-inflammatory properties at lower percentages, which can help decrease acne and redness. However, if you have subtype three or four, retinol is a no-go.

Overall, says Dr Zamani, successful retinol use is more about sticking to a consistent routine than it is about the percentage of retinol in a product. “For topical retinoids, I recommend to start low at 0.025% and then increasing as needed.”

Consider your skin barrier

Founder of the award-winning D.Thomas clinic, skin and rosacea expert Debbie Thomas is known for her transformative results. She explains that it is essential to repair the compromised skin barrier often associated with rosacea before using retinol. “You must build up retinol use slowly; don’t jump in with a strong formula or over-use.” 

While some retinols are designed for sensitive skin with rosacea, Thomas warns that “even these can still cause irritation if your skin is not supported with the right ingredients”, or “if you start using retinol on a broken skin barrier”. As a result, “it is a good idea to prepare your skin with barrier repairer ingredients like ceramides”.

Once your skin barrier is healthy, “introducing a low dose of retinol should be well tolerated,” Thomas says. “Start with a [product containing a] low percentage of retinol, such as Medik8 Crystal Retinal 1 or PCA Skin Retinol Treatment For Sensitive Skin – they are gentler options you could try with caution. Start using every two to three nights, then after three to four weeks see if you can tolerate more frequent use. If the skin becomes irritated, reduce use further – for example, every fourth day for a month – then up the use gradually.”

Remember, too, to never mix retinol with water – this increases its potency, which makes it harsher on sensitive skin. Retinol and other acids also make skin more susceptible to damage from UV rays, so it’s even more important to use a broad spectrum SPF during the daytime if you incorporate retinol into your routine.

Imagery: courtesy of brands