Spot the rosacea irritants on a label
Paste an ingredient list. What often irritates rosacea lights up, with sources. Then build your trigger watch list.
- 1Label
- 2Marked
- 3Watch list
Tap to add or remove.
Rosacea is a medical condition: skincare supports treatment, it doesn’t replace it.
Three colors, from what rosacea sources name
The AAD, Mayo Clinic, DermNet or the National Rosacea Society names it as an irritant or trigger.
It belongs to a group those sources advise against, like exfoliants, or a source says to avoid it in some cases.
A rosacea source suggests it. Prescription medicines are marked as such.
26 ingredients and medicines, each with its sources. Your own skin may react differently, so test new products first.
Rosacea is a medical condition: skincare supports treatment, it doesn’t replace it.
Often irritates rosacea: the AAD, Mayo Clinic, DermNet or the National Rosacea Society names it as an irritant or trigger. Use with care: it belongs to a group those sources advise against, like exfoliants, or a source says to avoid it in some cases. Generally rosacea-friendly: a rosacea source suggests it. Prescription medicines are marked as such. Your own skin may react differently, so test new products first.
Which ones have you noticed before a flare?
Share of 1,066 people with rosacea naming each triggerNRS survey · several answers each
Rosacea-friendly skincare: check your products
Paste a label or tap ingredients. Each one gets a stamp from what the AAD, the National Rosacea Society and DermNet say, then your triggers build a watch list. Rosacea is a medical condition: skincare supports treatment, it doesn’t replace it.
- Often irritates rosacea
- Use with care
- Generally rosacea-friendly
Checking a whole product? The skincare ingredient checker adds pore grades, fragrance allergens and active clashes to the same list.
What the sources agree on
Three stamps, from what rosacea sources name
Often irritates rosacea: the AAD, Mayo Clinic, DermNet or the National Rosacea Society names it as an irritant or trigger. Use with care: it belongs to a group those sources advise against, like exfoliants, or a source says to avoid it in some cases. Generally rosacea-friendly: a rosacea source suggests it. Prescription medicines are marked as such. Your own skin may react differently, so test new products first.
AAD: rosacea skin careNRS survey 2005DermNet: rosaceaMayo Clinic: treatment
Skincare supports, it doesn’t cure
Rosacea is a long-term skin condition. Cleveland Clinic calls it lifelong, with no cure, though it can go into remission, and the NHS says treatment can control it. The AAD calls skin care an essential part of every treatment plan: a gentle cleanser, a moisturizer and sunscreen, next to the medicine your dermatologist prescribes. It isn’t caused by poor hygiene and isn’t contagious (Mayo Clinic).
Cleveland ClinicNHSAAD: diagnosis and treatmentMayo Clinic: symptoms
The first-line treatments are prescribed
For bumps and pimples, the AAD lists azelaic acid, metronidazole and ivermectin. A Cochrane review found high-quality evidence for azelaic acid and ivermectin, moderate for metronidazole. For lasting redness, oxymetazoline cream and brimonidine gel fade it for up to 12 hours. Expect a slight improvement in 3 or 4 weeks and a noticeable one in 2 to 3 months (AAD).
Eye symptoms? See a doctor
Gritty, dry, itchy, red or watery eyes, swollen eyelids or light sensitivity can be ocular rosacea. The AAD says about half of people with rosacea have an eye flare, and Mayo Clinic says it can start before any skin signs; problems with the cornea can lead to vision loss. The NHS says to get an urgent appointment for a painful eye, blurred vision, light sensitivity or a red, gritty eye. Skincare can’t treat this.
AAD: symptomsMayo Clinic: ocular rosaceaNHSAAD: eye problems
Redness doesn’t always look red
On darker skin, the AAD says flushing may only feel warm, redness can look brown or violet, blood vessels are harder to see, and bumps may be the first sign. Mayo Clinic says lasers might cause long-term or permanent color changes on brown or Black skin, so ask for a provider experienced with your skin tone.
Even water can sting
The AAD says burning or stinging can happen with any product on the face, even water. In a National Rosacea Society survey of 1,023 people with rosacea, astringents and toners were the products women most often found irritating (49.5%). The NRS advises as few products as possible: each one adds a chance of irritation.
Rosacea triggers, ranked by the people who have them
In a National Rosacea Society survey, 1,066 people with rosacea named what sets off their flares. Next to each one, the AAD’s tip. Your list may be shorter: the NRS says you don’t need to avoid triggers that don’t affect you.
Also reported: certain fruits 13%, marinated meats 10%, certain vegetables 9%, dairy products 8%. NRS survey 2002
Food triggers are mostly self-reported. A 2017 review groups them into hot drinks, alcohol, spicy foods, and foods with cinnamaldehyde like tomatoes, citrus, chocolate and cinnamon, and says more research is needed. Weiss 2017
Rosacea skincare: dos and don’ts
The AAD calls skin care an essential part of every rosacea treatment plan. Building a whole routine? See the sensitive-skin routine.
Cleanse twice a day with a mild, soap-free cleanser, using your fingertips and warm water, then pat dry with a clean cotton towel.
AAD: rosacea skin careMayo Clinic: treatmentDermNet: rosaceaWait for your face to dry, apply any rosacea medicine first, then a moisturizer.
AAD: rosacea skin carePick a cream rather than a lotion or gel, labeled fragrance-free (not “unscented”), for sensitive skin and non-comedogenic.
AAD: rosacea skin careWear broad-spectrum SPF 30+ every day, even when it’s cloudy. If it stings, switch to zinc oxide, titanium dioxide or silicone. Find yours.
AAD: rosacea skin careMayo Clinic: treatmentTest a new product first: the AAD suggests the inside of your arm, twice a day for 7 to 10 days; the NRS suggests your neck or jawline for at least a few hours.
AAD: testing productsNRS: skin careUse as few products as possible.
NRS: skin careTo cover redness, try a green-tinted concealer, and water-based or powder makeup.
AAD: rosacea skin care
Use astringents or toners.
AAD: rosacea skin careAAD: preventing flare-upsExfoliate, scrub or rub, or wash with a washcloth or sponge.
AAD: rosacea skin careAAD: 8 things to knowNRS: skin careUse products with alcohol, camphor, fragrance, glycolic or lactic acid, menthol, sodium lauryl sulfate or urea. Check yours.
AAD: rosacea skin careTreat it with regular benzoyl peroxide acne products.
AAD: bumps and pimplesPut steroid creams on rosacea unless your doctor prescribed them.
DermNet: rosaceaNRS: trigger listWear waterproof makeup or a heavy foundation.
AAD: preventing flare-upsRinse with hot water or take hot baths: warm is better.
AAD: rosacea skin careAAD: preventing flare-ups
Every ingredient, sourced
26 ingredients and medicines: 14 that often irritate rosacea, 3 to use with care, 6 generally rosacea-friendly and 3 prescribed for rosacea. When sources disagree, the row says who says what.
| Ingredient | Stamp | Why, and who says so |
|---|---|---|
| Common label irritants | ||
| Alcohol (the drying kind)Alcohol denat., SD alcohol, ethanol | Often irritates rosacea | The AAD puts alcohol first on its list of ingredients dermatologists recommend avoiding with rosacea, and Mayo Clinic names it as an irritant. In a National Rosacea Society survey of 1,023 people with rosacea, 66% said alcohol irritated their skin: the most of any ingredient. This is ethyl alcohol (alcohol denat., SD alcohol). Fatty alcohols like cetyl or cetearyl alcohol aren’t flagged: the FDA says their effect on skin is quite different. AAD: rosacea skin careMayo Clinic: treatmentNRS survey 2005DermNet: rosaceaFDA: alcohol |
| FragranceFragrance, parfum, perfume | Often irritates rosacea | The AAD lists fragrance among the ingredients to avoid, and says to pick “fragrance-free” rather than “unscented”. In the National Rosacea Society survey, 29.5% said fragrance irritated their skin. Mayo Clinic and Cleveland Clinic also point to fragrance-free products. AAD: rosacea skin careNRS survey 2005NRS: skin careMayo Clinic: treatmentCleveland Clinic |
| Witch hazelHamamelis virginiana, in toners | Often irritates rosacea | The National Rosacea Society names witch hazel among the skin care ingredients that can trigger a flare, and 30% of people in its survey said it irritated their skin. It’s typical of toners and astringents, which the AAD says never to use with rosacea. NRS: trigger listNRS survey 2005AAD: rosacea skin care |
| MentholCooling ingredient | Often irritates rosacea | The AAD calls menthol a common rosacea trigger and lists it among the ingredients to avoid; Mayo Clinic does too. In the National Rosacea Society survey, 21% said it irritated their skin. AAD: preventing flare-upsAAD: rosacea skin careMayo Clinic: treatmentNRS survey 2005 |
| CamphorCinnamomum camphora | Often irritates rosacea | The AAD calls camphor a common rosacea trigger and lists it among the ingredients to avoid. Mayo Clinic names it as an irritant too. AAD: preventing flare-upsAAD: rosacea skin careMayo Clinic: treatment |
| PeppermintMentha piperita oil or extract | Often irritates rosacea | In the National Rosacea Society survey of 1,023 people with rosacea, 14% said peppermint irritated their skin. The NRS lists any substance that causes redness or stinging as a possible trigger. NRS survey 2005NRS: trigger listNRS: skin care |
| Eucalyptus oilEucalyptus globulus leaf oil | Often irritates rosacea | In the National Rosacea Society survey, 13% of people with rosacea said eucalyptus oil irritated their skin. NRS survey 2005NRS: skin care |
| Sodium lauryl sulfateA foaming cleanser (SLS) | Often irritates rosacea | The AAD calls sodium lauryl sulfate a common rosacea trigger, often found in shampoos and toothpaste. A review of cleansers for rosacea says it has a high potential to irritate, and prefers mild synthetic cleansers. Sodium laureth sulfate is a different ingredient and isn’t on these lists. AAD: preventing flare-upsAAD: rosacea skin careLevin 2011 |
| AcetoneRare in skin care | Often irritates rosacea | The National Rosacea Society lists hydro-alcoholic and acetone products among skin care triggers. NRS: trigger list |
| Acids & actives | ||
| Glycolic acidAHA exfoliant | Often irritates rosacea | The AAD lists glycolic acid among the ingredients to avoid with rosacea, and says: if you exfoliate your skin, stop. DermNet says exfoliants may aggravate rosacea. AAD: rosacea skin careDermNet: rosaceaNRS: skin care |
| Lactic acidAHA exfoliant | Often irritates rosacea | The AAD lists lactic acid among the ingredients to avoid with rosacea. A review of cleansers and moisturizers for rosacea notes that it can sting and irritate. AAD: rosacea skin careLevin 2011 |
| Salicylic acidBHA exfoliant | Use with care | An exfoliating acid. The AAD says to stop exfoliating if you have rosacea, and DermNet says exfoliants may aggravate it, but none of the rosacea pages we read names salicylic acid itself. Ask your dermatologist before using it where you have rosacea. AAD: rosacea skin careDermNet: rosaceaNRS: skin care |
| Retinol & other retinoidsRetinol, retinal, tretinoin, adapalene | Use with care | In the AAD’s guide to retinoids, a dermatologist says people with a lot of redness or inflammation should avoid retinoids and ask a dermatologist about rosacea treatment. Another advises the least-intense formula, every other night to start. AAD: retinoids |
| Benzoyl peroxideAcne washes and gels | Often irritates rosacea | The AAD calls regular benzoyl peroxide an unacceptable treatment for rosacea, because it can irritate sensitive skin. The exception is a prescription 5% encapsulated cream made for rosacea, usually applied once a day (AAD). AAD: bumps and pimples |
| Azelaic acidPrescription 15% gel or foam | Generally rosacea-friendly | A first-line rosacea medicine. The AAD says azelaic acid gel or foam, applied twice a day, can treat the bumps and pimples of rosacea and may reduce lasting color. A Cochrane review found high-quality evidence that it works. Expect some sting at first: on the 15% gel label, 29% had burning, stinging or tingling, mostly in the first few weeks. The rosacea evidence is for prescription strengths. AAD: bumps and pimplesAzelaic acid 15% labelCochrane 2015Cleveland Clinic |
| NiacinamideVitamin B3, in moisturizers | Generally rosacea-friendly | DermNet says moisturizers with niacinamide improved the skin barrier of people with rosacea in at least two studies. In one, 50 women with rosacea used a 2% niacinamide moisturizer twice a day for 4 weeks: the treated skin held water better, and facial redness scores fell. That study was small, funded by a skin care company, and had no untreated comparison on the face. The AAD lists vitamin B3 among things that can trigger a flare, without saying which form. DermNet: nicotinamideDraelos 2005AAD: preventing flare-ups |
| Sunscreen & moisturizer | ||
| Zinc oxide & titanium dioxideMineral sunscreen filters | Generally rosacea-friendly | If sunscreen irritates your rosacea, the AAD suggests one with zinc oxide, titanium dioxide or both. DermNet also recommends these physical sunscreens, SPF 30 or higher. They can leave a white cast on darker skin; a micronized or tinted one may help (AAD). AAD: rosacea skin careDermNet: rosacea |
| Chemical sunscreen filtersAvobenzone, octocrylene, homosalate… | Use with care | Not on any rosacea avoid list we read. But if a sunscreen stings, the AAD suggests switching to zinc oxide, titanium dioxide or silicone. Don’t skip sunscreen: sun was the most common trigger (81%) in a National Rosacea Society survey. AAD: rosacea skin careNRS survey 2002 |
| Silicone (dimethicone)Dimethicone, cyclomethicone | Generally rosacea-friendly | The AAD names silicone, listed as dimethicone or cyclomethicone, as a sunscreen ingredient to look for if your rosacea reacts to sunscreen. AAD: rosacea skin care |
| GlycerinA humectant in moisturizers | Generally rosacea-friendly | A review of cleansers and moisturizers for rosacea calls glycerin a widely used, effective humectant, and found that mild moisturizers eased dryness, burning and stinging in people with rosacea. Levin 2011 |
| CeramidesBarrier lipids in moisturizers | Generally rosacea-friendly | A review of moisturizers for rosacea expects lipid-rich moisturizers with ceramides may help, though it says most of that evidence comes from eczema. Levin 2011 |
| UreaIn rich moisturizers | Often irritates rosacea | The AAD lists urea among the ingredients to avoid with rosacea, and Mayo Clinic names it as an irritant. Diazolidinyl and imidazolidinyl urea are different ingredients and aren’t flagged. AAD: rosacea skin careMayo Clinic: treatment |
| Medicines | ||
| MetronidazolePrescription cream, gel or lotion | Prescribed for rosacea | The AAD lists it, once or twice a day as directed, for the bumps and pimples of rosacea; the 0.75% gel label says twice a day after washing. A Cochrane review rates the evidence as moderate. Its label says to use it less often or stop if irritation occurs. AAD: bumps and pimplesMetronidazole labelCochrane 2015 |
| Ivermectin creamPrescription 1% cream | Prescribed for rosacea | A once-a-day prescription cream for the bumps and pimples of rosacea. In its two 12-week trials, about 38% to 40% were clear or almost clear, against 12% to 19% on the plain cream. A Cochrane review found high-quality evidence. Ivermectin labelAAD: bumps and pimplesCochrane 2015 |
| Redness creamsOxymetazoline cream, brimonidine gel | Prescribed for rosacea | Prescription creams for persistent redness in adults. They narrow blood vessels, so redness fades for up to 12 hours, at its best 3 to 6 hours after applying, then comes back (AAD). A Cochrane review found high-quality evidence for brimonidine. The oxymetazoline label asks for caution with heart disease, low or uncontrolled high blood pressure, and narrow-angle glaucoma. Sources split. Mayo Clinic says overuse might lead to worse flushing, and DermNet warns of rebound flushing after stopping; the Cochrane review found no rebound with brimonidine. Ask your dermatologist how often to use it. AAD: rednessOxymetazoline labelCochrane 2015Mayo Clinic: treatmentDermNet: rosacea |
| Steroid creamsHydrocortisone and other topical steroids | Often irritates rosacea | DermNet says topical steroids may aggravate rosacea, and the National Rosacea Society lists them among the drugs that can trigger a flare. If a doctor prescribed one, ask them before you stop: the AAD gives that advice for any medicine you suspect. DermNet: rosaceaNRS: trigger listAAD: preventing flare-ups |
The four types of rosacea
Many people have more than one. A 2019 global expert panel recommends diagnosing and treating by the features each person has, and combining treatments when there are several (expert consensus). ROSCO 2019DermNet: rosacea
Erythematotelangiectatic
Lasting redness in the center of the face, with small visible blood vessels. Symptoms flare and fade.
Papulopustular
Red bumps and pimples, some with pus, that look like acne.
Phymatous
Thick, bumpy skin, most often on the nose (rhinophyma). More common in men, usually after years without treatment.
Ocular
Irritated, dry, watery or bloodshot eyes, light sensitivity and styes. See a doctor: it can affect your vision.
Rosacea or acne?
Four clues it may be rosacea. Only a dermatologist can tell for sure.
- 01No blackheads
Rosacea bumps can look like acne, but rosacea doesn’t cause blackheads.
Cleveland Clinic - 02Redness underneath
Redness in the center of the face that lasts, often starting as easy flushing, is the core sign.
AAD: symptomsDermNet: rosacea - 03Products sting
Burning or stinging when you put something on, even water.
AAD: symptoms - 04
Acne products can make rosacea worse
The AAD calls regular benzoyl peroxide an unacceptable rosacea treatment, and rosacea sources advise against exfoliating acids. Mayo Clinic says rosacea can be mistaken for acne or dermatitis, so let a dermatologist tell them apart. Not sure what your bumps are? Try the acne face map or the pimple identifier.
AAD: bumps and pimplesAAD: rosacea skin careMayo Clinic: symptoms
What a dermatologist may prescribe
Skincare can’t replace these. The AAD says to expect a slight improvement in 3 or 4 weeks and a noticeable one in 2 to 3 months; Mayo Clinic says 2 to 6 weeks for azelaic acid and metronidazole. Rosacea needs long-term care: once it’s under control, a dermatologist may switch you to a maintenance plan, often a single treatment. AAD: bumps and pimplesMayo Clinic: treatmentAAD: diagnosis and treatmentROSCO 2019
| Medicine | For | What the label or the AAD says |
|---|---|---|
| Azelaic acid 15% gel or foamTwice a day | Bumps and pimples | Burning, stinging or tingling in 29% on the gel label, mostly in the first weeks. Reassess after 12 weeks without improvement. AAD: bumps and pimplesAzelaic acid 15% labelCochrane 2015 |
| Metronidazole cream, gel or lotionOnce or twice a day | Bumps and pimples | Its label says it can make eyes water, and to use it less often or stop if it irritates. AAD: bumps and pimplesMetronidazole labelCochrane 2015 |
| Ivermectin 1% creamOnce a day | Bumps and pimples | In two 12-week trials, about 38% to 40% were clear or almost clear, against 12% to 19% on the plain cream. Ivermectin labelAAD: bumps and pimplesCochrane 2015 |
| Oxymetazoline cream, brimonidine gelOnce a day or as needed | Lasting redness (adults) | Temporary: up to 12 hours, best 3 to 6 hours after applying. Mayo Clinic says overuse might worsen flushing. AAD: rednessOxymetazoline labelMayo Clinic: treatment |
| Low-dose doxycycline pillsOne pill a day | Bumps and pimples | The dose is too low to work as an antibiotic, so it can be used long term (AAD). Pregnancy and breastfeeding: The AAD lists doxycycline among the medicines that should not be used during pregnancy. The 40 mg capsule label says to avoid it in the second and third trimesters, when it may cause permanent tooth discoloration and a reversible slowing of bone growth in the baby, and not to breastfeed during treatment and for 5 days after the last dose. Pregnant or breastfeeding? Tell your dermatologist. AAD: bumps and pimplesCochrane 2015AAD: pregnancy skin careDoxycycline 40 mg label |
| Lasers and intense pulsed lightIn-office sessions | Redness and visible vessels | Only with an experienced dermatologist: burns, color changes or scars are possible, and Mayo Clinic says they might change the color of brown or Black skin. AAD: rednessMayo Clinic: treatmentROSCO 2019 |
Keep your routine gentle
One face scan. Your whole routine, sorted.
This page answered your question. MySkincare starts from your own skin, and the products you already use.
- 1Scan your face3 photos: front, left profile, right profile.
- 2See your skin scoreFree6 zones scored separately: forehead, eye area, T-zone, both cheeks, chin.
- 3Scan your productsIt reads each ingredient list and says: keep it, watch it or replace it.
- 4Follow your routineMorning and night, checked so your products work together. With reminders.
Questions people ask
What skincare ingredients should I avoid with rosacea?
The AAD lists alcohol, camphor, fragrance, glycolic acid, lactic acid, menthol, sodium lauryl sulfate and urea, and says never to use an astringent or toner and to stop exfoliating. The National Rosacea Society adds witch hazel, peppermint and eucalyptus oil, which people with rosacea reported as irritating in its survey. Paste your product’s ingredient list in the checker above to find them.
Is azelaic acid good for rosacea?
Yes, it’s a first-line treatment. The prescription 15% gel is FDA-labeled for the bumps and pimples of rosacea, applied twice a day, and a Cochrane review found high-quality evidence that it works. Expect some burning, stinging or tingling at first (29% on the label), mostly in the first few weeks. The AAD says to expect a slight improvement in 3 or 4 weeks and a noticeable one in 2 to 3 months. More in the azelaic acid guide.
Does niacinamide help rosacea?
It may help the skin barrier. DermNet says moisturizers with niacinamide improved barrier function in people with rosacea in at least two studies. One was a 4-week study of 50 women using a 2% niacinamide moisturizer, funded by its maker and without an untreated comparison on the face. The AAD lists vitamin B3 among things that can trigger a flare, without saying which form, so test it first. More in the niacinamide guide.
What is the best moisturizer for rosacea?
No brand suits everyone, but the AAD describes what to look for: a cream rather than a lotion or gel, fragrance-free (not “unscented”), made for sensitive skin and non-comedogenic, applied after any rosacea medicine. Skip urea and lactic acid, which the AAD lists among irritants. A review of rosacea moisturizers points to glycerin and ceramides, and DermNet to niacinamide.
What is the best face wash for rosacea?
A mild, soap-free cleanser. Mayo Clinic suggests a nonsoap cleanser twice a day and DermNet mild synthetic cleansers rather than soap. The AAD says to use your fingertips, rinse with warm water and pat dry. Skip sodium lauryl sulfate, which the AAD calls a common rosacea trigger.
What sunscreen is best for rosacea?
Broad-spectrum, SPF 30 or higher and water-resistant, every day. If sunscreen stings, the AAD suggests zinc oxide, titanium dioxide or silicone (dimethicone), labeled “fragrance free”, not “unscented”. Mineral sunscreen can leave a white cast on darker skin; a micronized or tinted one may help. Find yours.
What triggers rosacea?
In a National Rosacea Society survey of 1,066 people with rosacea, the most common were sun (81%), stress (79%), hot weather (75%), wind (57%), exercise (56%) and alcohol (52%). Triggers differ from person to person: the AAD suggests a daily diary for at least 2 weeks to find yours, and the NRS says there’s no need to avoid the ones that don’t affect you.
Does coffee trigger rosacea?
Hot drinks are the trigger the sources name. The AAD suggests iced coffee or tea, or letting drinks cool until they’re warm, and a 2017 review groups hot drinks with heat-related triggers. In a survey cited by that review, 33% of people with rosacea named hot coffee and 30% hot tea.
Is it rosacea or acne?
Rosacea bumps can look like acne, but rosacea doesn’t cause blackheads (Cleveland Clinic). Rosacea usually comes with redness in the center of the face, flushing, and burning or stinging when products go on (AAD). Mayo Clinic says the two can be confused, so let a dermatologist tell them apart: acne products like regular benzoyl peroxide can irritate rosacea.
What is ocular rosacea?
Rosacea that affects the eyes: gritty, dry, itchy, red or watery eyes, swollen eyelids or light sensitivity. Mayo Clinic says it can start before skin signs and that problems with the cornea can lead to vision loss. See a doctor; the NHS says to get an urgent appointment for a painful eye, blurred vision, light sensitivity, or a red, gritty eye.
Can rosacea be cured?
No. Cleveland Clinic calls it lifelong, and the NHS says it can’t be cured but treatment can control it. It can go into remission, and once it’s under control, the AAD says a dermatologist may switch you to a maintenance plan, often a single treatment.
Do Demodex mites cause rosacea?
They may play a part. Cleveland Clinic lists too many of these normally harmless skin mites among possible causes, and DermNet links rosacea inflammation to more Demodex on the skin. Mayo Clinic says the exact cause is unknown.
Is witch hazel good for rosacea?
Usually not. The National Rosacea Society lists witch hazel among skin care triggers, and 30% of people with rosacea in its survey said it irritated their skin. It’s typical of toners and astringents, which the AAD says never to use with rosacea.
Can I use retinol if I have rosacea?
Ask your dermatologist first. In the AAD’s guide to retinoids, a dermatologist says people with a lot of redness or inflammation should avoid retinoids and ask about rosacea treatment instead. If you do use one, another suggests the least-intense formula, every other night to start.
Is rosacea contagious?
No. Mayo Clinic says rosacea isn’t contagious and isn’t caused by poor hygiene.
American Academy of Dermatologyaad.org
- 7 rosacea skin care tips (updated April 3, 2024)
Avoid alcohol, camphor, fragrance, glycolic acid, lactic acid, menthol, sodium lauryl sulfate and urea; fragrance-free, not “unscented”; sensitive-skin, non-comedogenic; a cream rather than a lotion or gel; never an astringent or toner; stop exfoliating; medicine first, then moisturizer; SPF 30+, zinc oxide, titanium dioxide or silicone; green-tinted concealer; water-based or powder makeup.
- How to prevent rosacea flare-ups
A tip for each trigger (sun, heat, hot drinks, alcohol, spicy food, stress, wind and cold, exercise, hot baths); menthol, camphor and sodium lauryl sulfate are common triggers; stop astringents and toners; don’t stop a medicine without asking; vitamin B3 can trigger a flare.
- Triggers could be causing your rosacea flare-ups
Common triggers (sunlight, heat, stress, alcohol, spicy foods, some skin and hair care products, makeup, wind and cold, some medicines, exercise); triggers differ between people; keep a diary every day for at least 2 weeks.
- Rosacea, signs and symptoms (updated April 3, 2024)
Flushing, lasting redness, acne-like bumps, visible blood vessels, thickened skin, burning or stinging with any product (even water), dryness; on darker skin, flushing may only feel warm and redness can look brown or violet; about half of people with rosacea get an eye flare.
- Rosacea treatment, acne-like breakouts (updated April 3, 2024)
Azelaic acid twice a day, ivermectin once a day, metronidazole once or twice a day; regular benzoyl peroxide is an unacceptable rosacea treatment (except a prescription 5% encapsulated cream); slight improvement in 3 or 4 weeks, noticeable in 2 to 3 months.
- Rosacea treatment, redness (updated April 3, 2024)
Brimonidine gel and oxymetazoline cream for adults: temporary, up to 12 hours, best 3 to 6 hours after applying; IPL and lasers for redness and visible vessels, only by an experienced dermatologist; skin care is essential.
- Rosacea treatment, eye problems (updated April 3, 2024)
Treatment is essential when rosacea affects the eyes; warm compresses and gentle lid cleaning, artificial tears, prescription eye treatments; eyesight-threatening cases go straight to an ophthalmologist; skin antibiotics can harm the eyes.
- Rosacea, diagnosis and treatment (updated April 3, 2024)
No single test; skin care is “an essential part of every rosacea treatment plan”; plans combine trigger avoidance, gentle skin care, sun protection and medicine; a maintenance plan once rosacea is controlled.
- Just diagnosed with rosacea? 8 things you should know
More than half of people with rosacea develop an eye problem at some point; contact a doctor for irritated or red eyes; skip washcloths and products with fragrance or astringents; flares can happen even when you avoid triggers.
- Retinoid or retinol? (updated May 25, 2021)
A dermatologist: people with a lot of redness or inflammation should avoid retinoids and ask about rosacea treatment; another: the least-intense formula, every other night to start.
- How to test skin care products (updated August 10, 2021)
Apply to the inside of the arm or elbow twice a day for 7 to 10 days; red, itchy or swollen skin means wash it off and don’t use it.
- Dermatologist-approved pregnancy skin care (updated June 26, 2025)
Tetracycline, doxycycline and minocycline are among the ingredients that can put a baby at risk of birth defects and should not be used during pregnancy.
DailyMed, US National Library of Medicinedailymed.nlm.nih.gov
- Azelaic acid gel 15%: FDA label (DailyMed, revised May 2022)
Bumps and pimples of mild to moderate rosacea; a thin layer twice a day after a very mild cleanser; avoid alcoholic cleansers, astringents, abrasives and peeling agents; reassess after 12 weeks; burning, stinging or tingling 29%, itching 11%.
- Metronidazole gel 0.75%: FDA label (DailyMed, 2022)
Bumps and pimples of rosacea; a thin film twice a day after washing; can cause watery eyes; use less often or stop if irritated; cosmetics after applying.
- Ivermectin cream 1%: FDA label (DailyMed, revised May 2025)
Inflammatory lesions of rosacea; once a day, a pea-size amount per area; two 12-week trials: clear or almost clear 38.4% and 40.1% vs 11.6% and 18.8% on vehicle; burning and irritation in 1% or fewer.
- Oxymetazoline hydrochloride cream 1%: FDA label (DailyMed, revised November 2018)
Persistent facial redness of rosacea in adults; once a day, pea-sized amount; caution with heart disease, blood pressure problems and narrow-angle glaucoma; success at hours 3 to 12 on day 29: 12% to 18% vs 5% to 9% on vehicle.
- Doxycycline 40 mg capsules (Oracea): FDA label (DailyMed, revised April 2025)
Bumps and pimples of rosacea in adults, one 40 mg capsule a day; avoid in the second and third trimesters of pregnancy (permanent tooth discoloration, reversible slowing of bone growth); breastfeeding not recommended during treatment and for 5 days after the last dose.
National Rosacea Societyrosacea.org
- Factors that may trigger rosacea flare-ups
Weather, heat, drinks (alcohol, hot drinks), spicy and hot foods, stress, exercise, topical steroids and other drugs; skin care with alcohol, witch hazel or fragrance, hydro-alcoholic or acetone products, anything that causes redness or stinging; keep a diary.
- New survey pinpoints leading factors that trigger symptoms (Rosacea Review, Summer 2002)
1,066 people with rosacea: sun 81%, stress 79%, hot weather 75%, wind 57%, exercise 56%, alcohol 52%, hot baths 51%, cold 46%, spicy foods 45%, humidity 44%, indoor heat 41%, skin care products 41%, hot drinks 36%, cosmetics 27%, medicines 15%.
- Ingredients may aggravate rosacea (Rosacea Review, Spring 2005)
1,023 people with rosacea: alcohol 66%, witch hazel 30%, fragrance 29.5%, menthol 21%, peppermint 14%, eucalyptus oil 13%; astringents and toners were the products women most often found irritating.
- Rosacea skin care & cosmetics
Ingredients that commonly irritate; avoid astringents and exfoliating agents; fragrance-free products; test on the neck or jawline and wait at least a few hours; use as few products as possible.
Mayo Clinicmayoclinic.org
- Rosacea, symptoms and causes (October 17, 2023)
Flushing, visible veins, bumps, burning, eye problems, enlarged nose; triggers; not caused by poor hygiene and not contagious; risk factors; can be mistaken for acne or dermatitis.
- Rosacea, diagnosis and treatment (October 17, 2023)
Redness creams work within 12 hours and overuse might worsen flushing; azelaic acid and metronidazole take 2 to 6 weeks; lasers may change skin color on brown or Black skin; nonsoap cleanser, fragrance-free products, avoid alcohol, camphor, urea and menthol; mineral SPF 30+.
- Ocular rosacea, symptoms and causes (April 2024)
Red, burning, itchy, gritty or watering eyes, blurred vision, light sensitivity, swollen lids; can start before skin signs; corneal complications can lead to vision loss; no cure, but treatment controls it.
DermNetdermnetnz.org
- Rosacea (Kuo, 2022; updated September 2024)
About 5% of adults; Demodex, blood vessel and immune factors; 2017 diagnostic features; keep a symptom diary; mild synthetic cleansers; exfoliants, alcohol-based products and topical steroids may aggravate; physical SPF 30+; green-tinted cosmetics; redness creams may cause rebound flushing on stopping.
- Nicotinamide
Moisturizers with nicotinamide improved skin barrier function in people with rosacea in at least two studies; well tolerated.
Cleveland Clinicclevelandclinic.org
- Rosacea (updated April 12, 2023)
Four types; more than 14 million people in the US; usually after 30; possible causes including Demodex mites; a lifelong condition without a cure that can go into remission; rosacea doesn’t cause blackheads; azelaic acid, ivermectin, metronidazole, brimonidine; fragrance-free products.
NHSnhs.uk
- Rosacea (reviewed March 17, 2023)
Rosacea can’t be cured, but treatment helps; SPF 30+ daily; avoid heat, sun and humid conditions; get an urgent appointment for a painful eye, blurred vision, light sensitivity or a red, gritty eye (possible keratitis).
US Food and Drug Administrationfda.gov
- “Alcohol free” (cosmetics labeling, 2022)
“Alcohol” on a cosmetic label means ethyl alcohol (SD alcohol, alcohol denat.); fatty alcohols like cetyl, stearyl and cetearyl alcohol have quite different effects on skin.
Studies and other sources
- van Zuuren et al., Interventions for rosacea, Cochrane Database of Systematic Reviews, 2015 (CD003262.pub5; abstract)cochranelibrary.com
106 trials, 13,631 people: high-quality evidence for azelaic acid, ivermectin and brimonidine (no rebound after stopping), moderate for metronidazole; ocular rosacea needs more study.
- Schaller et al., Recommendations for rosacea diagnosis, classification and management: global ROSacea COnsensus 2019 panel, Br J Dermatol, 2020 (repository copy)escholarship.org
Expert consensus: diagnose and treat by features (persistent redness, flushing, bumps, visible vessels, thickening, eyes) rather than fixed types; a chronic disease needing long-term care; some eye problems need an ophthalmologist; IPL and lasers can change skin color on darker skin.
- Levin & Miller, A guide to the ingredients and potential benefits of over-the-counter cleansers and moisturizers for rosacea patients, J Clin Aesthet Dermatol, 2011 (publisher copy)jcadonline.com
Mild synthetic cleansers over soap; sodium lauryl sulfate irritates; avoid toners, astringents and abrasives; lactic acid can sting; glycerin is an effective humectant; ceramide-rich moisturizers may help (evidence mostly from eczema); mild moisturizers eased dryness, burning and stinging.
- Draelos, Ertel & Berge, Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea, Cutis, 2005cdn.mdedge.com
50 women with rosacea, 4 weeks, 2% niacinamide moisturizer twice a day: better barrier and hydration on the treated arm, lower facial redness scores; no facial control group; funded by the maker.
- Weiss & Katta, Diet and rosacea: the role of dietary change in the management of rosacea, Dermatol Pract Concept, 2017dpcj.org
Food triggers fall into heat, alcohol, spicy (capsaicin) and cinnamaldehyde (tomatoes, citrus, chocolate, cinnamon) groups; in a survey, hot coffee 33%, hot tea 30%; the evidence is mostly self-reported.