Rosacea

Overview

Rosacea is a long-term condition that causes facial redness and flushing, and sometimes bumps and pimple-like spots. It affects about 5% of adults and most often shows up in fair-skinned people between 30 and 60. It used to be sorted into four "types," but doctors now tend to treat it feature by feature instead: flushing, lasting redness, visible blood vessels, bumps, thickened skin, and eye irritation. We reference both approaches below since both are still used in practice.

Evidence anchors

• guideline

  Thiboutot D, Anderson R, Cook-Bolden F, et al. Standard management options for rosacea: the 2019 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2020;82(6):1501-1510.

  PMID:32035944View source ↗
• guideline

  Schaller M, Almeida LMC, Bewley A, et al. Recommendations for rosacea diagnosis, classification and management: update from the global ROSacea COnsensus 2019 panel. Br J Dermatol. 2020;182(5):1269-1276.

  PMID:31392722View source ↗
• systematic review

  van Zuuren EJ, Fedorowicz Z, Tan J, et al. Interventions for rosacea based on the phenotype approach: an updated systematic review including GRADE assessments. Br J Dermatol. 2019;181(1):65-79.

  PMID:30585305View source ↗
• systematic review

  van Zuuren EJ, Fedorowicz Z, Carter B, van der Linden MMD, Charland L. Interventions for rosacea. Cochrane Database Syst Rev. 2015;(4):CD003262.

  PMID:25919144View source ↗
• epidemiology

  Gether L, Overgaard LK, Egeberg A, Thyssen JP. Incidence and prevalence of rosacea: a systematic review and meta-analysis. Br J Dermatol. 2018;179(2):282-289.

  PMID:29478264View source ↗

Ingredients that help

• Azelaic Acidstrong

  Calms the inflammation behind rosacea bumps and pimples, fights the microbes involved, and keeps pores from clogging. It is approved as a 15 percent gel and a 15 percent foam for the bumpy, pimple-like type of rosacea. It works by dialing down two of the main inflammation triggers in rosacea skin. In trials (Thiboutot 2003), applied twice a day it cleared 50 to 70 percent more bumps than a dummy cream. A 2025 analysis ranked 20 percent azelaic acid the most effective topical, ahead of ivermectin, metronidazole, and minocycline.

  PMID:12789172
• Zinc Oxidestrong

  Shields your skin from the full range of UV rays. Sun is the most common rosacea trigger and a big reason it sticks around. Rosacea guidelines prefer mineral filters like zinc oxide (with or without titanium dioxide) over chemical ones, because they do not irritate reactive skin and do not create the heat that brings on flushing.

• Titanium Dioxidestrong

  Shields your skin from UV rays, almost always paired with zinc oxide so you get full UVA and UVB cover. Same reasoning as zinc oxide: mineral sunscreens are the first choice in rosacea care.

• Niacinamidemoderate

  Strengthens the weak skin barrier that comes with rosacea, so your skin holds onto water better and loses less of it. It calms inflammation and helps your skin make more of its own barrier fats (ceramides). In a 2005 trial of 50 people, a niacinamide moisturizer clearly improved the barrier and eased rosacea signs over 4 weeks. It is pregnancy-safe and gentle.

  PMID:16209160
• Centella Asiaticamoderate

  Calms redness and the sting that comes with rosacea, and helps strengthen your skin barrier so it loses less water. It is a plant extract whose natural compounds (asiaticoside, madecassoside, asiatic acid) quiet inflammation in skin cells. Studies of centella products report less facial redness and discomfort in sensitive, rosacea-prone skin within 4 weeks.

• Madecassosidemoderate

  Soothes irritated skin and helps it heal. It is the single most-studied compound pulled from centella for calming inflammation and repairing skin. A useful add-on to the gentle routine that rosacea guidelines recommend for every type of rosacea.

• Ceramidesmoderate

  Refill the natural fats your skin barrier is missing, so it holds water better and feels less reactive. Rosacea skin is low on these fats (ceramides) and loses water too fast. Replacing them is a core recommendation in the 2020 rosacea management update for every type of rosacea, and a key partner to any medical treatment.

• Hyaluronic Acidmoderate

  Draws water into your skin to hydrate it, without the heavy, sealing feel that can set off flushing. Recommended as part of the gentle rosacea routine.

• Glycerinmoderate

  Pulls water into your skin to keep it hydrated, with very little risk of irritation. It shows up in most rosacea-friendly moisturizers.

• Panthenolmoderate

  Hydrates your skin and speeds up barrier repair. This form of vitamin B5 is often combined with centella and ceramides in sensitive-skin products, which studies have linked to less facial redness.

• Colloidal Oatmealmoderate

  Calms inflammation and itch, thanks to natural compounds in oats. It is an officially recognized skin protectant and shows up in many rosacea-friendly moisturizers (for example, the Aveeno Calm + Restore line). Studies show it helps your skin hold water better and feel less dry.

• Petrolatummoderate

  Seals moisture into your skin, cutting water loss by about 99 percent, and helps your skin build up its own barrier proteins. A useful top layer in the gentle rosacea routine the guidelines recommend. It is tolerated in rosacea because it does not clog pores or irritate.

• Dimethiconemoderate

  Forms a light, breathable film that slows water loss and protects against irritants, without clogging pores or trapping heat. That matters in rosacea, where heavy sealing can bring on flushing. It is an officially recognized skin protectant and common in rosacea-friendly moisturizers.

• Bisabololmoderate

  Calms skin inflammation. It is a compound from chamomile that quiets the inflammatory signals in skin. It turns up often in sensitive-skin and rosacea products because it soothes without much risk of triggering an allergy.

• Allantoinemerging

  Soothes skin and gently smooths away flakiness. It is often paired with panthenol and centella in sensitive-skin products, and it appears in rosacea-friendly skincare reviews (Del Rosso 2022).

• Chamomileemerging

  Calms reactive, inflamed skin. Its natural compounds (apigenin and bisabolol) quiet the inflammation in skin cells. One caution: if you are allergic to daisy-family plants (like ragweed or marigold), you may react to it too.

• Lactobionic Acidemerging

  Exfoliates very gently while also holding water in your skin. Many people with rosacea tolerate it when stronger acids like glycolic acid make them sting. It appears in rosacea-friendly exfoliants made for sensitive skin.

• EGCG (Green Tea)emerging

  Calms inflammation and acts as an antioxidant. Small studies show green tea extract used on the skin can reduce redness and bumps in rosacea. The way it works is promising (it quiets inflammation and the sun-driven signals behind rosacea), but the big trials are not there yet, so the evidence is early.

Suggested routine

Watch out for these on labels

Specific irritants from our watchlist that the research pack identifies as aggravating for rosacea.

Products from our catalog

• La Roche-Posay · Toleriane Hydrating Gentle CleanserCleanser

  Fragrance-free, gentle on your skin's natural acidity, with ceramides, niacinamide, and glycerin. A textbook gentle cleanser for rosacea-prone skin.

  View retailer ↗
• CeraVe · Hydrating Facial CleanserCleanser

  Does not foam, no fragrance, with ceramides and hyaluronic acid. Easy on the weakened barrier that comes with rosacea, where foaming cleansers leave skin tight and stripped.

  View retailer ↗
• Anua · Heartleaf 77% Soothing TonerToner

  Heartleaf and panthenol. It calms inflammation, has no alcohol, and follows the classic K-beauty calming-toner style used in sensitive and rosacea routines.

  View retailer ↗
• Skin1004 · Madagascar Centella AmpouleSerum

  Centella plus madecassoside. This is the strongest single-plant pick we carry for calming rosacea redness. Pregnancy-safe.

  View retailer ↗
• The Ordinary · Niacinamide 10% + Zinc 1%Serum

  Niacinamide 10%. Draelos 2005 found barrier and rosacea benefits at strengths in this range. A cheap way to start. One catch: some people with rosacea sting at 10 percent, and a 4 to 5 percent version may feel better.

  View retailer ↗
• Naturium · Azelaic Topical Acid 10%Serum

  Azelaic acid 10%. The closest non-prescription match to the approved 15 percent gel and foam for the bumpy, pimple-like type of rosacea. Pregnancy-safe, and the best-backed non-prescription active on this list.

  View retailer ↗
• The Ordinary · Hyaluronic Acid 2% + B5Serum

  Hyaluronic acid plus vitamin B5 (panthenol). A lightweight hydration step that does not trap heat or set off flushing.

  View retailer ↗
• CeraVe · PM Facial Moisturizing LotionMoisturizer

  Ceramides, niacinamide, and hyaluronic acid. A repeat pick in dermatologist recommendations for supporting the skin barrier in rosacea.

  View retailer ↗
• KraveBeauty · Great Barrier ReliefMoisturizer

  Squalane, niacinamide, and ceramides. Built for weakened barriers and reactive skin, which makes it a good fit for the flushing-and-redness type of rosacea.

  View retailer ↗
• La Roche-Posay · Anthelios Mineral Tinted SPF 50SPF

  All-mineral (zinc oxide and titanium dioxide), tinted to cancel out rosacea redness, and fragrance-free. Mineral filters are the first choice in rosacea guidelines.

  View retailer ↗
• Beauty of Joseon · Relief Sun: Rice + Probiotics SPF 50+ PA++++SPF

  A mostly-mineral SPF 50+ PA++++ with rice and probiotics. A nice-feeling option if the white cast of pure mineral sunscreens puts you off.

  View retailer ↗
• Round Lab · Birch Juice Moisturizing UV Lock Sunscreen SPF 45SPF

  Mineral SPF 45 with birch sap. A hydrating, non-greasy base that suits daily rosacea use.

  View retailer ↗

Ingredients to consider adding

Not yet in our catalog. Surfaced here as editorial backlog.

• MetronidazoleRx only

  An approved first-choice cream for the bumpy, pimple-like type of rosacea (0.75 percent cream, gel, or lotion twice a day, or 1 percent cream or gel once a day). In rosacea it works mainly by calming inflammation, not by killing germs. The evidence is moderate-quality.

• IvermectinRx only

  An approved 1 percent cream, used once a day for the bumps and pimples of rosacea. It targets the tiny skin mites (Demodex) tied to rosacea and calms inflammation. In two large trials (Stein Gold 2014, PMID 24595578), clear or near-clear skin reached 38.4 percent and 40.1 percent at 12 weeks, versus 11.6 percent and 18.8 percent on a dummy cream. Reviews rank it among the top three creams for this type of rosacea.

• Brimonidine TartrateRx only

  An approved gel (0.33 percent, labelled in the US as 0.5 percent of the active) used once a day. It is the only topical made specifically for the lasting facial redness of rosacea. It narrows the small blood vessels in your skin, starting within 30 minutes and peaking around 3 to 6 hours. In two trials (Fowler 2013), 57 percent saw their redness improve versus 30 percent on a dummy gel. One catch: about 10 to 20 percent of users get a rebound where the redness comes back worse.

• Oxymetazoline HydrochlorideRx only

  An approved 1 percent cream used once a day for the lasting facial redness of rosacea. It narrows the small blood vessels in your skin to fade redness. In two trials (Stein Gold 2018, pooled PMID 30500142), clearly more people improved on it than on a dummy cream at every hour after applying (P<0.001). It causes less rebound flushing than brimonidine.

• Minocycline Foam 1.5%Rx only

  An approved 1.5 percent minocycline foam (Zilxi) used once a day for the bumps and pimples of rosacea. In two trials (Stein Gold 2020), more people reached clear or near-clear skin than on a dummy foam (52.1 percent vs 43.0 percent; 49.1 percent vs 39.0 percent) at 12 weeks, with fewer bumps. Very little of the antibiotic gets into your bloodstream.

• Encapsulated Benzoyl Peroxide 5%Rx only

  An approved 5 percent benzoyl peroxide cream (Epsolay) for the bumps and pimples of rosacea. The benzoyl peroxide is wrapped in tiny silica shells that release it slowly, which cuts the irritation that used to rule benzoyl peroxide out for rosacea. In two trials (Bhatia 2023), bumps dropped 68.2 percent versus 38.3 percent on a dummy cream at 12 weeks.

• Sodium Sulfacetamide 10% + Sulfur 5%Rx only

  A long-used topical for the bumps and pimples of rosacea. In a double-blind trial (Sauder), bumps dropped 78 percent at 8 weeks (versus 36 percent on a dummy) and redness improved 83 percent. Handy if you cannot tolerate ivermectin, azelaic acid, or metronidazole. Two catches: skip it if you are allergic to sulfa drugs, and it has a sulfur smell.

• Doxycycline 40 mg Modified-ReleaseRx only

  An approved low-dose pill (Oracea) for the bumps and pimples of rosacea. The dose is too low to act as an antibiotic, so it calms inflammation without breeding resistant bacteria. It is also the first oral choice for rosacea that affects the eyes. Over the long run (Del Rosso 2021), it cut the relapse rate to half that of placebo (13.8 percent vs 27.7 percent).

• Isotretinoin (low-dose)Rx only

  A low-dose pill (0.3 mg per kg of body weight a day) recommended by the 2019 and 2020 expert panels for severe or stubborn bumpy rosacea and for early skin-thickening. The evidence for it working is moderate-certainty.

• Cyclosporine 0.05% Ophthalmic EmulsionRx only

  A first choice for moderate-to-severe rosacea that affects the eyes, used alongside lid cleaning, artificial tears, and the low-dose doxycycline pill. In trials it improved how well the eyes make and hold tears and eased dry, irritated eyes. It is an eye drop, prescribed by an eye doctor.