Hello! My name is Shannon Gunderson and I am a Board Certified Family Nurse Practitioner.

My passion is dermatology and I am an active member of the Dermatology Nurses Association and the American Academy of Dermatology Association. I have an extensive 25-year nursing background in ICU, ER, trauma, pediatrics, plastic surgery, hair transplant surgery, and dermatology. 

I currently work as an aesthetic nurse practitioner performing and teaching cosmetic procedures and I have worked in telemedicine, seeing patients for Curology for the past 4 ½ years. I discovered my passion for dermatology when I was stricken with severe cases of Norwegian scabies while caring for patients in ICU, and during international medical mission trips. Those infections left me with terrible acne and skin issues that made me determined to find and share skincare solutions to ensure no one else had to endure such an experience.  

I have been passionate about learning and treating rosacea because it is so common and can be one of the most frustrating conditions to treat. Treating rosacea has been a frustration of mine because for many years the available solutions, prescription medications, lasers, peels, etc., were far too expensive for the average person to afford and it was difficult watching my patients suffer needlessly. I am so thrilled that we are now able to treat rosacea here at Curology and patients from all demographics have the ability to access affordable medication tailored just for them!

What is rosacea? 

Rosacea is a skin condition that can affect all skin types, characterized by flare-ups and followed by remissions. This means there are periods where it’s worse followed by periods where it’s better. It most often affects the central face (cheeks, chin, nose, and central part of forehead).¹

Although rosacea is a common condition, it is more than skin deep and can wreak havoc on self-confidence and self-esteem. There’s no cure, but it is treatable! When left untreated, rosacea often results in facial redness that becomes more prominent with time. You might also see an increase in the number of visible blood vessels (aka telangiectasias). Inflammatory bumps (papules and pustules) may develop. 

In severe cases of rosacea, the nose grows bumpy and swollen from the excess tissue. This is called rhinophyma and is most often seen in men. And keep an eye on those eyes! About half of rosacea patients also report irritated, watery, and bloodshot eyes.²  

How common is rosacea?

Rosacea is more common than you may expect. More than 16 million Americans³ are estimated to be affected, and over 415 million people worldwide.⁴ Recent epidemiologic data estimates that approximately 5.5% of the global population struggles with rosacea.⁵ So you’re not alone! 

Common factors include being between 30-50 years old, having a Scandinavian or Celtic ancestry, having a family history of rosacea, having fair skin, and being female:⁶ Children can be affected by rosacea but it is most commonly diagnosed in adults. Interestingly, it isn’t uncommon for people with rosacea to not even know they have it!

What is an effective skincare routine for rosacea? 

The most effective skincare for patients with rosacea is a routine that incorporates gentle consistency. Those afflicted with rosacea generally have skin that is more sensitive than average, so having a gentle routine is critical to maintaining the integrity of the skin barrier while also avoiding irritation.⁷ This can be achieved through a daily skincare routine that emphasizes a steady, long-lasting approach versus sporadic instances of aggressive exfoliation. 

Cleanser

Begin by choosing a gentle cleanser that is fragrance-free. Consider a non-soap version, which is made without the fats and alkaline by-products often found in regular soap cleansers. Non-soap cleansers tend to be easier to rinse off and they have a pH similar to our skin’s natural pH.⁸  

Once you have identified the proper cleanser, try following these simple steps:

• Get rid of that harsh sponge or cleansing brush and use your fingers to gently rub the cleanser into your skin.

• Rinse with lukewarm water.  Avoid irritating your skin with water that is too hot, or too cold.

• Use a cotton towel to gently blot your face dry—do not rub!

• In order to avoid a stinging sensation, your skin should be completely dry before applying any topical medication.  

Pro tip: In order to ensure your skin is dry, begin by waiting 30 minutes, and then gradually reduce the time each day until you find the perfect balance between your routine not taking too long and your skin not stinging.

Product recommendations:

• The Curology cleanser 

• Neutrogena Ultra Gentle Daily Cleanser

• Vanicream Free & Clear Liquid Cleanser 

Once your skin is cleansed and dried, you can apply a topical medication (like your Curology Custom Formula). This might include a prescription medication for rosacea such as azelaic acid, metronidazole, or ivermectin. When it comes to in-office procedures, laser and light therapies (e.g., KTP lasers, pulsed dye lasers, and intense pulsed light)⁹ can often help certain symptoms of rosacea. This includes thickened skin and visible blood vessels.¹⁰ 

Keep in mind that there is no cure for rosacea. These therapies are often considered cosmetic procedures that likely won’t be covered by insurance. There are many different treatment options for rosacea depending on your specific symptoms. You can talk to your medical provider to learn more about what’s best for you!

Moisturizer

Five to ten minutes after applying your treatment, it’s time to apply a soothing moisturizer (like the Curology moisturizer!).  Ideal moisturizers for people with rosacea are made to calm and smooth your skin.¹¹ Look for hydrating ingredients like hyaluronic acid, glycerin, and ceramides. Keep in mind that moisturizers can, and should, be applied on top of topical medication. It is not necessary to remove topical medication prior to applying a moisturizer!  

Product recommendations:

• The Curology moisturizer

• The Curology rich moisturizer 

• EltaMD AM Therapy

• Neutrogena Hydro Boost Gel Cream

Sunscreen

Did you know that sun exposure is a common trigger for rosacea? One of the best ways to minimize the effects of rosacea is to be diligent with sun protection. Just remember that when it comes to sunscreen, not all types are created equal.

Patients experiencing rosacea should seek out sunscreens that contain zinc oxide or titanium dioxide. Those minerals are known to provide physical protection from the sun and tend to be less irritating than ingredients commonly found in chemical sunscreens.¹² And remember to always use a broad spectrum sunscreen with at least SPF 30.

Product recommendations:

• The sunscreen by Curology SPF 30

• EltaMD UV Clear Untinted SPF 46

• Neutrogena Sensitive Skin Sunscreen Lotion Broad Spectrum SPF 60+

• MD SolarSciences Mineral Crème 

What ingredients are safe for rosacea? 

Just as with sunscreens, mineral makeup is often an excellent choice for folks with rosacea. Choose fragrance-free products in order to avoid additional unnecessary ingredients that have the potential to irritate your skin. Always keep an eye out for products that contain zinc oxide and titanium dioxide. Other preferred ingredients include allantoin, bisabolol, willow bark, and aloe vera.¹³

What ingredients should be avoided? 

Persons suffering from rosacea should generally avoid astringents and toners!¹⁴ These may cause irritation for sensitive skin. Additionally, to reduce the chance of irritating your skin, avoid products with potentially irritating ingredients¹⁵ such as:

• Lactic acid

• Glycolic acid

• Menthol

• Sodium laurel sulfate

• Camphor

• Fragrance

• Alcohol

Curology is here to help!

Thank you for taking the time to share some of your day with me and improve your knowledge of rosacea. If you, or someone you love, are suffering from rosacea, know that I and many other medical providers like me are here at Curology to provide you the support and treatment you need to get better.

Get your personalized skincare routine with Curology

Get your personalized skincare routine with Curology

Start your skin quiz

The team at Curology has devoted countless hours to developing skincare products designed to be tailored to your individual skin type. We specialize in rosacea and a variety of other common skincare ailments. Before trying off-the-shelf products designed to treat the average person, give Curology a try and receive prescription medication that is customized for your specific skincare regimen. 

P.S. We did our research so you don’t have to. 

1. Gallo, R. L., et al. Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee. Journal of the American Academy of Dermatology. (2018).

2. National Rosacea Society. All about rosacea.

3. National Rosacea Society. Rosacea Now Estimated To Affect At Least 16 Million Americans.

4. National Rosacea Society. New Study Finds 415 Million People May Suffer From Rosacea Worldwide.

5. Thiboutot, D., et al. Standard management options for rosacea: The 2019 update by the National Rosacea Society Expert Committee. Journal of the American Academy of Dermatology. (2020).

6. American Acadmey of Dermatology. Rosacea: Who gets and causes. 

7. Thiboutot, D., et al. Standard management options for rosacea: The 2019 update by the National Rosacea Society Expert Committee. Ibid.

8. National Rosacea Society. Facial cleansing for rosacea.

9. Oge', L. K., et al. Rosacea: Diagnosis and Treatment. American family physician. (2015).

10. American Academy of Dermatology. Lasers and lights: How well do they treat rosacea?

11.  National Rosacea Society. Moisturizer for rosacea.

12. Thiboutot, D., et al. Standard management options for rosacea: The 2019 update by the National Rosacea Society Expert Committee. Ibid.

13. Gallo, R. L., et al. Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee. Ibid.

14. Thiboutot, D., et al. Standard management options for rosacea: The 2019 update by the National Rosacea Society Expert Committee. Ibid.

15. American Academy of Dermatology. 6 rosacea skincare tips dermatologists give their patients.

*Subject to consultation. 

Written by

Shannon Gunderson, NP

Medically reviewed by

Nicole Hangsterfer, PA-C