Dermatologists Say These Ingredients Will Make Your Rosacea Worse
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Fact checked by Michelle RegaladoReviewed by Blair Murphy-Rose, MD, FAADFact checked by Michelle RegaladoReviewed by Blair Murphy-Rose, MD, FAAD
If you've ever struggled with redness, inflammation, irritation, and/or acne-like breakouts, you may have the chronic skin condition known as rosacea. Although there is no permanent cure, rosacea flare-ups can be better managed by understanding what is causing them. Genetics, hormones, diet and environmental factors can all be a trigger. The ingredients present in cosmetics and skincare products can also play a major role. “One of the hallmarks of rosacea is that the skin’s barrier protection is somewhat weak, therefore many ingredients that are fine for use on normal skin will be very irritating to rosacea-prone skin,” dermatologist, Elizabeth Tanzi, MD, tells Byrdie.
To help keep flare-ups at bay, we asked Dr. Tanzi along with three other board-certified dermatologists about which ingredients you should avoid and how they may interact with your skin. First, they recommend keeping a simple makeup and beauty routine. The fewer ingredients present in moisturizers, cleansers, and makeup, the better. They also advise anyone with rosacea to patch test any new skin product on a small section of the neck or forearm before applying it on the face. This will help you determine how your skin is susceptible to react. Keep reading for a list of ingredients you should avoid from if you have rosacea.
Meet Our Experts
Dr. Elizabeth Tanzi, M.D., is a board-certified dermatologist as well as the founder and director of Capital Laser & Skin Care in Chevy Chase Maryland.
Dr. Patricia Ceballos was a double board-certified dermatologist at Schweiger Dermatology Group in New York City.
Dr. Rachel Nazarian, M.D., F.A.A.D., is a board-certified dermatologist at Schweiger Dermatology Group in New York City.
Dr. Michele Green, M.D., is a board-certified cosmetic dermatologist based in New York City.
Tretinoin
While tretinoin (or retinoids) are sometimes used to treat rosacea to help reduce the appearance of pustules and bumps, Dr. Tanzi warns against it. Individuals with rosacea have hypersensitive skin and retinoids, which are potent and potentially irritating in nature, may trigger redness and spider veins.
Alpha-Hydroxy Acids (AHAs)
Alpha-hydroxy acids are not recommended for people with sensitive skin. This includes individuals who have rosacea. The most common AHAs include glycolic, lactic, citric and malic acids. Dr. Tanzi warns against glycolic acid for those who have rosacea as it acts as an exfoliator. Glycolic peels often makes non-sensitive skin tingle so you can only imagine what it would do to already existing irritation.
Beta-Hydroxy Acids (BHAs)
It is best to avoid BHAs if you have rosacea. These oil-soluble chemical exfoliants can trigger rosacea. Potential side effects may include rashes, peeling or blisters. A commonly used BHA is salicylic acid, an acne treatment that works by dissolving cell buildup, which may be too irritating and drying for those with rosacea.
What type of products contain AHAs/BHAs?
AHAs and BHAs can be found in a variety of products—from peels to creams and cleansers. Looking at the label and ingredients list before using a new product is highly recommended.
Benzoyl Peroxide
Benzoyl peroxide is another common ingredient used to treat acne and is a foe to rosacea, according to Dr. Tanzi. It increases the skin's oxidative stress, increasing inflammation and premature aging.
Ingredients
Benzoyl peroxide is an organic acid in the peroxide family that has been used to treat acne because of its keratolytic, moderate comedolytic, and antibacterial properties, which include the reduction of P. acnes and Staph. aureus on the skin.
Hydroquinone
Hydroquinone is a skin-lightener used to treat dark spots and hyperpigmentation. Dr. Tanzi recommends staying away if you have rosacea. It can easily inflame or burn the skin.
Toners containing alcohol
Toners containing alcohol are used to achieve a deeper cleanse of the skin and remove all oils, which is not appropriate for those with rosacea. Toners such as witch hazel do not pose an issue themselves but the alcohol it may contain does. Many drugstore commercial toners are a bit misleading and actually contain 15-30% ethanol, dermatologist, Patricia Ceballos, MD, says.
Some Alcohols Can Be Beneficial
Emollients and emulsifiers such as cetyl alcohol can help ward off irritation. Cetearyl alcohol is a fatty alcohol that can help lock in moisture, Dermatologist, Rachel Nazarian, MD, notes. Naturally derived from plants, it is used in the formulation of skincare products to help them spread better and thicken their consistency. The type of alcohol that is drying and irritating—and that people with rosacea should avoid—is ethyl alcohol or ethanol.
Menthol, Eucalyptus Oil and Peppermint
You know that minty-tingle feeling you get after applying face masks or using a refreshing cleanser? That sensation is actually harmful to individuals with rosacea, according to Dr. Ceballos. This sensation usually manifests itself in ingredients like menthol, eucalyptus and peppermint, which could provide more of a burning, itchy feeling than the "cooling" sensation it's usually marketed as for individuals with rosacea.
Harsh Soap
Dr. Ceballos says regular soaps can be extremely irritating for people with rosacea. They often contain harmful chemicals such as formaldehyde releasers or detergent like sodium lauryl sulfate. Dr. Nazarian adds that the latter is a very effective cleansing ingredient in that it does good job at stripping oils from the skin. "Those who have rosacea should steer away and look for more gentle cleansers that don’t strip too much of the natural oils from the skin," she says.
Ingredients
Sodium lauryl sulfate (aka SLS) is a surfactant that has many different functions, but it primarily acts as a cleansing agent in skincare. It's a type of sulfate and is derived from coconut oil, palm kernel oil or petroleum oil. As a foaming agent, sodium lauryl sulfate can help a product cleanse better or more thoroughly by sudsing up and creating a foamy lather.
Parabens
People with rosacea should avoid products containing parabens, which are known skin irritants, says dermatologist, Michele Green, MD. Commonly used as preservatives in cosmetic products, they can be found in makeup, moisturizers, hair care products, shaving lotions and more. The most common parabens are methylparaben, propylparaben, butylparaben and ethylparaben.
Phtalates
Phtalates are chemical compounds used to make plastics more durable. They often serve as solvents and stabilizers in perfumes or fragrance. They can be found in many cosmetics products such as aftershave lotions, cleansers, hair sprays and nail polish. Phthalates are known skin irritants and individuals with rosacea should stay away, according to Dr. Green. They are often included in the ingredients list under dibutylphthalate, dimethylphthalate and diethylphthalate. If a product contains “fragrance” or “flavor”, there is a high probability it contains phthalates.
Fragrance and dye
As a rule of thumb, individuals with rosacea should avoid products containing fragrance or dye as it may trigger irritation.
Frequently Asked Questions
Which ingredient is best for rosacea?
Dr. Ceballos recommends products that contain glycerin. This ingredient works as a humectant, meaning it helps moisturize the skin by sealing water into skin cells. “Choose a gentle and hydrating cleanser, such as La Roche Posay Toleriane Dermo Milky Cleanser or Neutrogena Ultra Gentle Hydrating Facial Cleanser,” Dr. Ceballos says. “Toleriane Fluide or Toleriane Riche moisturizers are excellent options in this scenario as well.”
Does hyaluronic acid make rosacea worse?
As hyaluronic acid is an ingredient naturally found in our own skin, it won’t disrupt the skin’s pH and won’t have a negative effect on rosacea. Dr. Nazarian notes the importance of looking at the label when purchasing a product, as hyaluronic acid is often combined with other ingredients.
What are the ingredients to look out for in makeup?
"When shopping for makeup, remember the irritating ingredients mentioned above," Dr. Cebellos says. "Since acne rosacea patients often have eye involvement, choose mineral eye makeup with low pigment content and mascaras, which have been allergy-tested and ophthalmologist-tested and easily removable with warm water."
What about homemade remedies?
Although it can be tempting to turn to homemade remedies and ingredients for urgent relief, Dr. Nazarian warns against them. "Most of the ingredients we are surrounded by vary from our skin in terms if pH," she says. Those with rosacea should stick to pH-balanced skincare specifically made for sensitive skin.
Read the original article on Byrdie.
