How To Treat Rosacea, According To A Leading Skin Expert

“Rosacea is a chronic skin condition that’s more common in women than men – and if you have fair skin, you’re particularly susceptible, but any skin type can develop it,” says Dr. Stefanie Williams, medical director at London’s Eudelo skin clinic. “Your genetics, hormones, environmental factors, diet, skincare, as well as stress and emotional wellbeing, can all have an influence.” What’s more, rosacea frequently appears in mid-life (but it can appear earlier or later, too). “My patients often report being clear-skinned teens yet, now they’re in their forties, they’re seeing not only lines and wrinkles appearing, but also breakouts – a common rosacea symptom.” Other symptoms include excessive flushing of the skin, irritation, inflamed bumps (that are often confused with acne) and even sore, red eyes – as well as persistent redness and broken blood vessels – as the condition progresses.

“In most cases, rosacea is hereditary, so you need prescription creams like ivermectin, metronidazole and azelaic acid,” says Dr. Williams. “But triggers such as sun, heat, cold wind, spicy food, coffee and red wine may make it worse.” Which means you can ease symptoms by identifying and avoiding those triggers, where possible (hot flashes during menopause – another potential trigger – are inherently unavoidable). Begin recording your rosacea flare-ups in your diary: make notes about what you’ve eaten, what you were doing and what products you were using when your skin behaved badly. You should be able to recognize a pattern. If, for example, alcohol is the common denominator, try eliminating it for a month and monitor how your skin responds.

“What I’ve found in my practice is that rosacea sufferers tend to use the wrong skincare (ie, that for dry skin) because their skin feels dry – but the issue is often micro-inflammation, as opposed to dryness,” says Dr. Williams. “So they often use rich creams, oils and calming balms, which might feel soothing at first but actually aggravate rosacea breakouts. Instead, you need to treat the micro-inflammation with anti-inflammatory prescription creams, or skincare products that are specially formulated with breakout-prone skin in mind – or, most often, a mix of both,” she advises. “Essentially, any non-prescription products should be lightweight in consistency and ultra-low in oils and silicone derivatives.”

Married to your retinol? “If you adjust the type and concentration of your retinoids and hydroxy acids to your individual skin tolerance, then yes, you can still use these ingredients with caution,” says Dr. Williams. “However, you will have to be more careful with them, as rosacea skin is often more sensitive and reactive.” She advises using less-irritating ingredients from the same ingredient family to keep skin in check: “For example, use PHAs – such as lactobionic acid and gluconolactone – instead of AHAs like glycolic acid, which are more irritating. I pair these in my Delo Rx Active hydrator with multiple calming ingredients and non-pore-clogging, hydrating ingredients, such as hyaluronic acid, for the best soothing effect. With retinoids, I use a well-tolerated combination of four different types – retinol, retinaldehyde, retinyl linoleate and hydroxypinacolone retinoate – at 0.5% in total.”

There are different types of rosacea – most commonly, the vascular type with redness and broken vessels, and the inflammatory type with breakouts – although, according to Dr. Williams, these often overlap, and all types can range from mild to severe. While inflammatory bumps, pimples and spots respond well to a product treatment plan, vascular rosacea needs laser or IPL treatment to calm down. “You’ll get longer-lasting relief of facial redness and broken blood vessels,” says Dr. Williams. “But before starting any laser or IPL sessions, it’s very important that all breakouts are cleared first,” she warns. “Otherwise, the inflamed lesions will absorb part of the light, which makes the treatment less effective for your broken vessels and often worsens the breakouts. It’s a common mistake made in many beauty salons and aesthetic clinics alike.”

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