Whether you realize it or not, your skin is constantly adapting to everything happening in the environment around it, and these changes can manifest themselves in many ways. For some, that means rosacea flare-ups. Rosacea is a common skin condition known for its visible blushing and facial redness. You can’t cure rosacea, but fortunately, there are facial treatments for rosacea that can help prevent and reduce flare-ups. 

Here, we’ll show you some insightful ways to help prevent rosacea flare-ups by identifying triggers and suggesting rosacea creams (and other treatments!) that can work.

What is rosacea?

It’s estimated that more than 14 million people in the United States experience rosacea—a chronic skin condition with symptoms that commonly include persistent redness and frequent flushing across the nose, cheeks, chin, and forehead. In some instances, rosacea symptoms appear on the ears, neck, scalp, and chest. Many people with rosacea have dry skin or sensitive skin, and while rosacea is usually not harmful in itself, for some people, it can negatively affect their mental well-being. The exact cause of rosacea is still unknown, but scientists are working to find better ways to manage rosacea flare-ups and will hopefully one day find a cure. For now, researchers have identified a few commonalities among rosacea patients that may play a role in its development:

• Genetics. Research from Stanford scientists identified a genetic basis for rosacea.¹ Studies of twin siblings have also shown a possible genetic connection with rosacea.²

• Immune response. A peptide called cathelicidin typically protects skin from infection—but people with rosacea may process this peptide differently, which can result in redness and swelling.³,⁴

• Face mites. It may sound gross, but skin mites are a natural part of the human microbiome that live on the body. A type of mite known as Demodex folliculorum lives in the hair follicles on the face and eyelids. A greater number of these skin mites have frequently been found in rosacea patients, which may trigger an immune or inflammatory response.⁵

• Bacteria. Certain types of bacteria—like Helicobacter pylori, a common intestinal bacterial infection—can stimulate the immune system, which may aggravate rosacea inflammation. Oral antibiotics to treat H. pylori may reduce the effects of rosacea.⁶

What does rosacea look like?

Some of the most common characteristics of rosacea flare-ups are frequent flushing or persistent redness spreading from the nose across both cheeks. If you’re experiencing redness, it’s not necessarily because of rosacea. Several things can cause your face to turn red. Here are some symptoms people may experience with rosacea: 

• Stinging and burning on the skin’s surface. 

• Persistent redness of the skin.

• Frequent flushing and blushing. 

• Dryness and rough patches on the skin. 

• Thick, uneven skin (most commonly across the nose).

• Acne-like lesions (often referred to as acne rosacea).

• Dilated and visible blood vessels.  

• Vision problems. 

What can I do about it?

The best treatment for rosacea is the treatment that works for your unique skin. There are certain things you may want to avoid, like salicylic acid, which can be great for treating acne, but not rosacea with acne-like lesions. 

Oral medications, like ivermectin and metronidazole, have been approved by the Food and Drug Administration (FDA) for the treatment of rosacea. FDA-approved topical medications for the treatment of rosacea include azelaic acid, ivermectin, and metronidazole. These ingredients help reduce redness, inflammation, papules, and pustules associated with rosacea.⁷ Facial treatments for rosacea aim to limit or prevent symptoms; remember, there is no cure—yet. 

Here are four that work:

1. Metronidazole. This is an antibiotic that helps stop the growth of certain bacteria and parasites. The FDA recommends 0.75% to 1% metronidazole cream for the treatment of rosacea. It’s available by prescription only. 

2. Azelaic acid. Azelaic acid is a topical anti-inflammatory treatment that reduces erythema, papules, and pustules related to rosacea. Clinical studies demonstrated that eight weeks of topical 15% azelaic acid cream significantly reduced acne-like inflammatory lesion count and erythema.⁸ You can find creams with up to 10% azelaic acid over the counter, but it’s best to consult your dermatology provider first. 

3. Ivermectin. Used to treat parasites, ivermectin (1%) is a prescription cream that has been shown to reduce papules and pustules associated with rosacea.

4. Light therapy. For some, laser treatments for rosacea can be effective in reducing visible blood vessels (telangiectasia) and erythema. Intense pulsed light works to reduce flushing and improves some of the eye-related symptoms associated with rosacea⁹

Some changes in your lifestyle may go a long way

Along with a gentle skincare routine¹⁰ that includes rosacea cream, the American Academy of Dermatology recommends lifestyle changes to minimize or prevent flare-ups.¹¹ This starts with identifying what triggers rosacea symptoms for you. After all, it’s your life, which means lifestyle management: little things or habits you implement in your daily routine.

Here are a few lifestyle choices you can make to help prevent symptoms:

• Protect your skin from the sun. “Sun protection plays a vital role in maintaining healthy skin and helping prevent rosacea flare-ups. It includes using a broad-spectrum sunscreen with at least SPF 30,” says Meredith Hartle, a board-certified physician at Curology. But don’t stop there! Wearing sun-protective clothing, a large-brimmed hat, and sunglasses can also go a long way to help prevent sun exposure. 

• Limit hot beverages and alcohol consumption. No one likes to hear they’ll have to skip happy hour with friends. Just try limiting your alcohol intake, and identify exactly what triggers flare-ups. Try iced coffee over a piping-hot brew. And while you’re at it, take a hard pass on spicy food if this is a trigger for you. 

• Curb your stress. Let’s be real—stress happens. Learn techniques that work for you to manage emotional fluctuations. Deep breathing, meditation, and working in the garden can all help. Try different tactics to find what works best for you.

• Check the ingredients. Not all skincare products, creams, and lotions are good for all skin types and conditions. Watch out for products containing potentially irritating ingredients like alcohol, witch hazel, or added fragrance. Check the ingredient list before purchasing over-the-counter skincare products. 

• Change the weather. Okay, you can’t really do that—but what you can do is change with the weather. Use a humidifier during the winter to increase moisture in the air. Cover your face in cold, dry, windy climates when you go outside. Avoid hot and humid conditions when you can. Dress in layers and drink icy beverages to cool off.  

Treating rosacea with Curology

Remember, the most effective rosacea treatment options depend on your symptoms. Curology is a full-service customized skincare brand and our licensed dermatology providers have more than 100 years of combined experience treating skin conditions like rosacea. We can help you develop an effective and comprehensive rosacea skincare routine that works for you. Our dermatology providers are experienced in treating rosacea and helping to prevent flare-ups by using what’s best for you and your unique skin. 

Get your personalized skincare routine with Curology

Get your personalized skincare routine with Curology

Start your skin quiz

To become a member, just answer a few questions and snap a few selfies.If Curology is right for you, we’ll pair you with one of our licensed dermatology providers who will create a personalized prescription formula that can include rosacea-specific ingredients like ivermectin, metronidazole, and azelaic acid. And if you don’t have rosacea, we can also help with acne or anti-aging concerns. We’ll be there every step of your journey toward healthier skin to answer questions, offer advice, and recommend products targeted at getting results. 

Your first 30 days are on us. Just pay $4.95 (plus tax) to cover shipping and handling.*

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

1. Stanford Medicine. Genetic basis of rosacea identified by researchers. (2015, March 12).

2. National Rosacea Society. Researchers report interim results of studies funded by NRS members. (2013).

3. Yamasaki K, et al. Increased serine protease activity and cathelicidin promotes skin inflammation in rosacea.Nature Medicine. (August 2007). 

4. American Acadmey of Dermatology. Rosacea: Who gets and causes. (n.d.).

5. National Rosacea Society. Causes of rosacea: Demodex mites and microbes. (n.d.). 

6. Yang, X. Relationship between Helicobacter pylori and rosacea: Review and discussion.BMC Infectious Diseases. (July 2018). 

7. Thiboutot, D., et al. Standard management options for rosacea: The 2019 update by the National Rosacea Society Expert Committee. Journal of the Academy of Dermatology. (2020, February 6).

8. Dall’Oglio, F., et al. A novel azelaic acid formulation for the topical treatment of inflammatory rosacea: A multicenter, prospective clinical trial.Journal of Cosmetic Dermatology. (2021, May 1).

9. Zhang, H., et al. Rosacea Treatment: Review and Update. Dermatology and therapy. (2021).

10. American Academy of Dermatology. 6 Rosacea skin care tips dermatologists give their patients. (n.d.).

11. American Academy of Dermatology. How to prevent rosacea flare-ups. (n.d.).

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

Written by

Curology Team

Medically reviewed by

Kristen Jokela, NP-C