If you deal with rosacea—a chronic skin condition that gives your skin an unwanted “flush” or redness —you probably know the importance of a good skincare routine. While there’s currently no cure for rosacea, the right care can help you manage your symptoms. 

But what does a skincare routine for rosacea look like? Generally speaking, you’ll want to be gentle with your skin if you’re dealing with this condition (we’ll get into why in a bit). That also means that exfoliation can be tricky. Ultimately, everyone’s skin is unique and your licensed dermatology provider can help you figure out what’s right for you. That said, our experts are here to help you understand what you need to know about exfoliating with rosacea, so you can make an informed decision for your skin. 

What is rosacea and what causes it?

Rosacea is a chronic inflammatory skin condition characterized by:¹

• Recurrent flushing.

• Erythema (redness).

• Telangiectasia (visible blood vessels).

• Papules, or pustules (acne-like bumps). 

Generally, these symptoms arise on your nose, chin, cheeks, and forehead. The symptoms of rosacea tend to come and go. Many people report that factors such as sun exposure or emotional stress can trigger flare-ups. The exact cause of rosacea remains unclear, but scientists believe that both genetic and environmental factors contribute to its development. 

Inflammation plays a key role in some of rosacea’s primary symptoms, such as redness and rash, but the underlying reasons for this inflammation are not yet fully understood. Genetics, immune reactions, microorganisms, environmental factors, and neurovascular dysregulation are among the known factors that contribute to the development of rosacea.²

Demodex mites have also been found in higher numbers on rosacea-affected skin, but it’s unclear whether this is a cause or consequence of the condition.³

The importance of gentle skincare for rosacea 

Gentle skincare is essential if you have rosacea, as anything that irritates your skin can worsen the condition. To prevent irritation, avoid rubbing or scrubbing your face, which means refraining from using washcloths, facial sponges, or exfoliating products. 

It's also crucial to choose rosacea-friendly skincare products and test them before incorporating them into your daily routine if you have concerns about potential reactions. A study found that 82% of rosacea patients reported irritable skin with a burning or stinging sensation when using cosmetic products, especially those with the greatest potential to interfere with the skin barrier, such as exfoliants, soaps, and tonics.⁴

It’s important you understand your skin type so you know how often to exfoliate your face for optimal results.

Why is exfoliating beneficial for some skin types? 

Exfoliation can be a beneficial part of a skincare routine because it helps to remove dead skin cells, dirt, and debris from the surface of your skin. Exfoliation can either be chemical or mechanical. Both methods help improve skin texture and enhance skin cell turnover.

However, over-exfoliation or using harsh exfoliants can lead to skin irritation, especially if you have sensitive skin conditions like rosacea. Therefore, it’s crucial to choose gentle exfoliating products and methods that are suitable for your skin type.⁵

How to exfoliate with rosacea

If you have rosacea, exfoliating your skin requires extra care and gentleness. It’s important to avoid mechanical scrubs, as they can be too harsh and aggravate your condition. Instead, if you choose to exfoliate, consider using gentle chemical exfoliants such as polyhydroxy acids (PHAs) or beta hydroxy acids (BHAs).

Alpha-hydroxy acids (AHAs) can also be beneficial for those with rosacea. However, polyhydroxy acids offer the benefits of AHAs without irritation, making them suitable for use on sensitive skin, including rosacea-prone skin, and even after cosmetic procedures.⁶ 

PHAs provide additional humectant and moisturization properties compared to AHAs and can enhance your skin barrier function, increasing your skin's resistance to chemical challenges.⁷ Most PHAs also possess antioxidant properties.⁸

Rosacea treatments 

To properly treat rosacea, it’s essential to consult a medical provider who can guide you and prescribe specific treatments. 

Common treatments for rosacea include:⁹

• Identifying and avoiding triggers: Some common triggers for rosacea flare-ups include UV light, spicy food, weather changes, and alcoholic beverages. By recognizing and avoiding these triggers, you can better manage your condition.

• Skincare recommendations: Using pH-balanced skin cleansers instead of soaps, applying a broad-spectrum sunscreen with SPF 30 or higher, and regularly using moisturizers can help improve your rosacea-prone skin.

• Avoiding topical steroids: Although they have anti-inflammatory properties, topical steroids should be avoided in rosacea treatment as they’re associated with rebound flaring or induction of rosacea-like dermatitis.

• Topical treatments: Your doctor may recommend topical treatments such as azelaic acid 15% gel, foam, or 20% cream. Custom skincare products containing topical ivermectin and metronidazole are also effective in treating rosacea.

3 exfoliators to try if you have rosacea 

As mentioned earlier, the best exfoliating options for rosacea are those that contain polyhydroxy acids (PHAs) due to their gentle and non-irritating nature. Let's take a closer look at some of the PHA-containing exfoliators recommended by our team of licensed skincare providers — each helping improve your rosacea-prone skin.

1. PCA Skin Hydrating Face Serum

The PCA SKIN Hydrating Serum is a lightweight, fast-absorbing serum that provides hydration to your skin. Enriched with hyaluronic acid, gluconolactone (PHA), and sodium PCA, this powerful formula helps to retain moisture, soothe irritated skin, and strengthen your skin's barrier, making it a good choice for rosacea-prone and sensitive skin.

2. Neostrata Bionic Face Cream

The NeoStrata Bionic Face Cream is an emollient cream designed to address the needs of sensitive and rosacea-prone skin. Formulated with 8% polyhydroxy acid (PHA) gluconolactone and 4% lactobionic acid, this gentle cream can provide hydration, reduce redness, and strengthen your skin's barrier.

3. Neostrata Facial Cleanser

The NeoStrata Restore Facial Cleanser Gel with PHAs is a gentle cleanser formulated to meet the needs of sensitive and rosacea-prone skin. Enriched with 4% polyhydroxy acid (PHA) gluconolactone, this gel helps remove impurities, makeup, and excess oils while maintaining your skin's natural balance. 

Curology can help treat rosacea 

Curology offers a unique, personalized approach to treating rosacea, focusing on customized skincare formulations tailored to your specific needs. By understanding the complexities of rosacea, our licensed dermatology providers create individualized prescription formulas that target inflammation, redness, and other symptoms associated with this skin condition.

With Curology, you'll receive a custom-formulated cream containing a blend of active ingredients that work synergistically to help manage your rosacea. In addition to topical treatments such as azelaic acid, ivermectin, and metronidazole, our custom formulas also include other proven, skin-friendly ingredients to ensure your skin gets the help it needs.

Get your personalized skincare routine with Curology

Get your personalized skincare routine with Curology

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Take the first step towards clearer, healthier skin by exploring our personalized prescription formula designed specifically for rosacea. Experience the difference that Curology products can make in managing your skin condition and achieving a more confident you.

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

1. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. (2022, September, 30).

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

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

4. Addor, F.A. Skin barrier in rosacea. Anais Brasileiros de Dermatologia. (January-February 2016).

5. Rodan, K., et al. Skincare Bootcamp: The Evolving Role of Skincare. Plastic and Reconstructive Surgery – Global Open. (2016, December 14).

6. Green, B.A., et al. Clinical and cosmeceutical uses of hydroxyacids. Clinical Dermatology. (September-October 2009).

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

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

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

Donna McIntyre is a board-certified nurse practitioner at Curology. She obtained her Master of Science in Nursing at MGH Institute of Health Professions in Boston, MA.

* Subject to consultation. Subscription is required. Results may vary.

Written by

Curology Team

Medically reviewed by

Donna McIntyre, NP-BC