If you have rosacea, you likely know that not every ingredient is suitable for your sensitive skin. One class of skincare ingredients that often raises questions for folks with rosacea is alpha hydroxy acids (AHAs). AHAs are known for their exfoliating properties and are commonly found in many skincare products. But are they too harsh for your rosacea-prone skin?

The short answer: It depends! Here, we’ll look at the use of AHAs for rosacea and share insights into whether they can be safely incorporated into your skincare routine.

Understanding rosacea 

Rosacea is a chronic skin condition that primarily affects the face, causing redness, acne-like bumps, and visible blood vessels. It commonly appears on the nose, chin, cheeks, and forehead.¹ Sometimes, it can also affect the eyes, leading to dryness and irritation.

There are four main types of rosacea, each with distinct symptoms: 

• Erythematotelangiectatic (redness and blood vessels)

• Papulopustular (acne-like breakouts)

• Phymatous (thickened skin, especially around the nose)

• Ocular (eye-related symptoms)

The exact cause of rosacea isn’t fully understood, but it’s believed to be a combination of genetic and environmental factors.² Triggers for rosacea flare-ups can include sun exposure, stress, extreme temperature (hot or cold), alcohol consumption, and spicy foods.³

Managing rosacea involves a combination of medical treatments, gentle skincare, and lifestyle changes. Guidance from a healthcare provider or dermatologist is important for an accurate diagnosis and tailored treatment plan.⁴

One particular treatment option you may come across alpha hydroxy acids (AHAs).

The role of AHA in skincare 

Alpha hydroxy acids are organic acids found in certain foods and milk sugars.⁵ They have become popular ingredients in cosmetic and dermatological products due to their ability to improve various skin conditions. 

AHAs, including glycolic acid, citric acid, malic acid, tartaric acid, and lactic acid, can help address issues like:⁶

• Acne

• Scars

• Hyperpigmentation

• Rough skin texture

• Signs of aging

The main way AHAs work is by exfoliating the top layer of the skin, which promotes the growth of new and smoother skin cells.⁷ They can also contribute to improved skin firmness and thickness. However, it’s important to use AHAs with caution as they can cause side effects such as redness, swelling, and itching.⁸ Overuse or incorrect usage can potentially harm your skin.

The effectiveness of AHAs depends on factors like their concentration, pH, and duration of application.⁹ Follow the instructions provided by your healthcare professional or the product itself. Some studies suggest that AHAs may increase skin sensitivity to sunlight, which can lead to skin damage—so remember to use sun protection when using products containing AHAs.¹⁰

AHA for rosacea: What does the science say?

Research suggest that incorporating AHA peels and lotions into standard skincare regimens for acne and rosacea can help treat the condition and improve results.¹¹

Yet, it’s important to approach AHA treatment with caution and care. Traditional AHAs like glycolic acid can potentially cause irritation, which may be problematic if you have sensitive skin or rosacea.¹² However, newer variations such as polyhydroxy and bionic acids offer similar benefits to AHAs but reduced irritation. These milder alternatives may be better suitable if you have sensitive skin, rosacea or if you have undergone cosmetic procedures.¹³

PHA for rosacea

Polyhydroxy acids (PHAs) are a newer generation of exfoliating compounds that offer similar benefits to AHAs without causing the same sensory irritation.¹⁴ This makes them particularly suitable for sensitive skin or rosacea. PHAs also have moisturizing properties, helping to retain moisture in your skin and improve its natural barrier function. This can enhance your skin's resistance to chemical irritants.¹⁵

Additionally, PHAs possess antioxidant properties, protecting your skin from damage caused by free radicals. Research also suggests that PHAs, such as gluconolactone or lactobionic acid, can provide significant improvements in photoaging, which refers to aging caused by sun exposure.¹⁶

How to use AHA in your rosacea skincare routine?

A dermatology provider can assess your skin condition and determine if AHAs suit you. While PHAs are considered a safer alternative for rosacea patients, your dermatology provider can provide personalized advice on the best products, concentrations, and application frequency.

3 lifestyle changes to manage rosacea

Managing rosacea involves adopting certain lifestyle changes and following a consistent skincare routine. Here are three steps you can take for better skin health:¹⁷

1. Skincare: Protecting your skin from the sun is a must for managing rosacea. Avoid excessive sun exposure and use broad-spectrum sunscreen daily. Choose a gentle facial cleanser that does not irritate your skin and follow with a moisturizer or barrier repair product to keep your skin hydrated and reduce irritation. Consider using cosmetic products specifically formulated for rosacea, such as those with a green tinge that can help camouflage redness.

2. Avoid triggers: Identify and avoid triggers that can worsen your rosacea symptoms. Common triggers include extreme temperatures, UV radiation, spicy foods, hot or alcoholic drinks, wind, intense exercise, and stress. By minimizing exposure to these triggers, you can help prevent flare-ups and reduce the severity of symptoms.

3. Medication: Topical treatments are commonly used for rosacea management. These may include metronidazole, azelaic acid, or ivermectin creams or gels, which can help reduce inflammation and control symptoms. Sometimes, your dermatology provider may recommend laser therapy or intense pulse light (IPL) to target redness and visible blood vessels. Oral antibiotics may be prescribed for papulopustular rosacea, especially if topical treatments are insufficient. Antibiotics like minocycline, doxycycline, erythromycin, clarithromycin, or clindamycin may help reduce inflammation associated with this form of rosacea.¹⁸ In severe cases that do not respond to other treatments, low-dose isotretinoin may be considered under specialist supervision.

Treat your rosacea with Curology

If you’re looking for an effective solution to manage your rosacea, consider signing up for a personalized prescription formula from Curology. Our online platform connects you with licensed dermatology providers who will create a custom treatment plan specifically tailored to your skin needs.

Get your personalized skincare routine with Curology

Get your personalized skincare routine with Curology

Start your skin quiz

With Curology, you’ll have access to prescription-strength ingredients to help reduce redness, inflammation, and other symptoms associated with rosacea. Our formulas include proven ingredients like azelaic acid, metronidazole, and other dermatologist-recommended compounds.

To get started, visit our website and sign up for our offer.* You’ll answer a few questions about your skin and medical history, and upload photos of your skin concerns, and a dermatology provider will review your information to create a personalized formula just for you.

P.S. We did the homework so you don’t have to:

1. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. (2023, April 19).

2. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

3. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. (February 2018).

4. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

5. Tang, S.C. and Yang, J.H. Dual Effects of Alpha-Hydroxy Acids on the Skin. Molecules. (2018, April 10).

6. Tang, S.C. and Yang, J.H. Dual Effects of Alpha-Hydroxy Acids on the Skin. Molecules. Ibid.

7. Tang, S.C. and Yang, J.H. Dual Effects of Alpha-Hydroxy Acids on the Skin. Molecules. Ibid.

8. Tang, S.C. and Yang, J.H. Dual Effects of Alpha-Hydroxy Acids on the Skin. Molecules. Ibid.

9. Tang, S.C. and Yang, J.H. Dual Effects of Alpha-Hydroxy Acids on the Skin. Molecules. Ibid.

10. Tang, S.C. and Yang, J.H. Dual Effects of Alpha-Hydroxy Acids on the Skin. Molecules. Ibid.

11. Tung, R.C., et al. alpha-Hydroxy acid-based cosmetic procedures. Guidelines for patient management. Am J Clin Dermatol. (March-April 2000).

12. Tung, R.C., et al. alpha-Hydroxy acid-based cosmetic procedures. Guidelines for patient management. Am J Clin Dermatol. (March-April 2000).

13. Green, B.A., et al. Clinical and cosmeceutical uses of hydroxyacids. Clin Dermatol. (September-October 2009).

14. Grimes, P.E., et al. The use of polyhydroxy acids (PHAs) in photoaged skin. Cutis. (February 2004).

15. Grimes, P.E., et al. The use of polyhydroxy acids (PHAs) in photoaged skin. Cutis. Ibid.

16. Grimes, P.E., et al. The use of polyhydroxy acids (PHAs) in photoaged skin. Cutis. Ibid.

17. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. (February 2018).

18. Rivero, A.L. and Whitfeld, M. An update on the treatment of rosacea. Aust Prescr. (February 2018).

19. Tung, R.C., et al. alpha-Hydroxy acid-based cosmetic procedures. Guidelines for patient management. Am J Clin Dermatol. Ibid.

Meredith Hartle is a board-certified Family Medicine physician at Curology. She earned her medical degree at Kirksville College of Osteopathic Medicine in Kirksville, MO.

*Cancel anytime. Subject to consultation. Results may vary.

Written by

Curology Team

Medically reviewed by

Meredith Hartle, DO