A goal of cleansing is to remove excess oil, dirt, dead skin cells, makeup, and sunscreen.

Cleansing helps remove and reduce organisma that are triggers of rosacea, most notably P. acnes – the bacteria that can cause acne and rosacea flares – and Pityrosporum – a yeast found normally on the skin but can stimulate reaction in some patients with rosacea.

The challenge is achieving these goals but not overcleansing and stripping necessary, healthy components from the skin. The advice below discusses cleansing based on skin type.

Use a cream cleanser or mildly foaming cleanser. Avoid soap as this is too drying and irritating for your skin. Use your fingers to wash your face – use of a washcloth is not recommended for rosacea prone or sensitive skin. If you have really dry skin think about using a wipe off, water free cleanser such as Avene’s extremely gentle cleanser no rinse formula.

Some patients with rosacea have numerous and overactive oil glands that create a lot of oil on the skin surface. Often the best option is using a gentle foaming cleanse, and, if you are very oily, do a cleansing cycle twice. Cleansing twice will remove more of the unwanted materials from the surface of the skin and less of the components that are essential for moisture.

A salicylic acid containing cleanser is great for cleansing pores and removing oil, but may be drying especially in rosacea prone skin. Alternating with a gentle cleanser can reduce dryness and irritation.

For the most part, your cleansing routine can be similar to the oily skin but no more than one cleansing cycle. If you are prone to dry areas, following the advice for dry skin will probably work best for you. Also seasonal variations in your skin may guide your cleansing routine – dry routine in fall and winter and the oily skin routine in the summer.

In rosacea, it is very important to maintain the barrier function of facial skin. Dry skin has small cracks in the surface of the skin and thus the barrier is not fully intact. These small cracks can trigger blood vessel, immune and nerve responses that result in a rosacea flare – redness, flushing, burning, bumps, and swelling.

Daily application of a gentle, fragrance-free moisturizer can be essential to maintaining control of rosacea. New moisturizers feature ingredients such as ceramides and natural lipids that replenish elements in the upper layer of skin that help your skin function as a barrier.

Examples include Cerave, Elta Barrier Renewal Complex and PM Therapy, and Charlotte Skin & Laser’s Fortified Moisturizer and Moisture Balm (staff and patient favorites!).

• + Physical exercise outdoors when it is windy and cold can really strip the skin of its natural moisture and trigger a flare of rosacea or dermatitis.
• + Get ahead of this potential dryness and damage to your skin’s barrier with application of a thick occlusive moisturizer prior to outdoor activities to protect the skin.
• + These thick moisturizers can act like a protective mask. Elta Intense moisturizer, Skin Ceuticals Hydrabalm, Theraplex emollient and even plain Vaseline or Aquaphor are great protective, occlusive moisturizers.
• + They are also very hydrating and soothing thus help calm and heal extremely dry, cracked skin.

One of the most common and frequent triggers for rosacea flare is sunlight or ultraviolet radiation. Daily sun protection is essential to treat and prevent progression of rosacea.

A sun screen product whose main active ingredient is a physical agent such as zinc or titanium is recommended for sensitive skin patients and patients who suffer from rosacea.

Chemical sun screens can cause sting and burn and are more likely to irritate the eyes. Chemical sun screens work by absorbing the ultraviolet rays of sunlight.

This is then converted to heat energy in the skin which can cause a flush or flare of rosacea skin. Zinc works by reflecting the sun’s rays and thus does not produce heat in the skin. Zinc is also anti-inflammatory which is ideal for the sensitive skin of rosacea.

Sun protection also includes avoidance of sun exposure during peak hours of the day. Wear a sun protective hat and seek shade when possible. During physical activity, sun screen should be re-applied every 2-3 hours.