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Can you treat rosacea with salicylic acid? What you need to know

Spoiler: This ingredient isn’t typically recommended for rosacea prone skin. Here’s what to use instead.

Curology Team Avatar
by Curology Team
Updated on Jan 23, 2024 • 5 min read
Medically reviewed by Camille Dixon, PA-C
Close up woman face with rosacea
Curology Team Avatar
by Curology Team
Updated on Jan 23, 2024 • 5 min read
Medically reviewed by Camille Dixon, PA-C
We’re here to share what we know — but don’t take it as medical advice. Talk to your medical provider if you have questions.

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Summary

  • Rosacea is a chronic skin condition that causes facial redness, irritation, and sometimes acne-like lesions.

  • Salicylic acid is an exfoliant that is very effective for acne but may be too harsh for rosacea-prone skin.

  • Other lifestyle changes, topical treatments, and oral treatments may be more effective for treating rosacea.

  • Curology’s Custom Formulaᴿˣ is a personalized treatment that may contain proven ingredients like metronidazole, azelaic acid, or ivermectin to help calm and treat rosacea.

Along with redness, broken blood vessels, and dry skin, one of the possible symptoms of rosacea is acne-like lesions.¹ So, it may seem logical to use over-the-counter acne treatments—many of which contain salicylic acid—to help treat it. But that’s not the case!

Acne and rosacea are different skin conditions, and what you use to treat one may not work for treating the other. People who experience rosacea also often have skin that’s too sensitive to be treated with many salicylic acid products. That’s why salicylic acid and rosacea typically aren’t a good match.

We asked Curology’s licensed dermatology providers to let us know the best uses for salicylic acid and explain why rosacea isn’t one of them. They’ve also shared insightful tips for identifying possible rosacea triggers to help prevent flare-ups.

Understanding rosacea and salicylic acid

Rosacea is a chronic skin condition that causes symptoms such as persistent redness, which usually appears across the cheeks and nose, and frequent flushing and blushing. Acne-like lesions (pustules and papules) and dilated or broken blood vessels (telangiectasias) can also occur.² A burning or stinging sensation is sometimes associated with rosacea flare-ups, and in more severe cases, the skin can also become thicker, most commonly on the nose. Dry or rough patches can also occur. 

While effective treatments can help control the symptoms, currently, there’s no known cure. The exact cause of rosacea is yet to be determined, yet we do know of specific triggers that can cause flare-ups³ (more on that in a bit).

What is salicylic acid?

Salicylic acid is a beta-hydroxy acid (BHA) that works as a chemical exfoliant to clear pores of dead skin cells and excess sebum. For many people, salicylic acid creams, cleansers, lotions, and gels can help reduce inflammation and redness from acne. It’s also used to help reduce certain signs of aging. Thanks to its exfoliant and anti-inflammatory properties, products with salicylic acid often give the skin a more even, brighter appearance.⁴ 

While salicylic acid is often used to treat acne, using products that contain salicylic acid for rosacea is a different story, as they can be drying and too harsh for people with sensitive skin.

How should you treat rosacea instead?

The first step in treating rosacea is identifying and avoiding your triggers. This can vary from person to person but often includes factors like certain foods, weather conditions, and stress.⁵

For daily skincare, use pH-balanced skin cleansers instead of traditional soaps that can be too harsh for rosacea-prone skin.⁶ It’s also crucial to protect your skin from the sun. Use a broad-spectrum sunscreen* with SPF 30 or higher every day, even when it’s cloudy. Regularly applying a good quality moisturizer will also help keep your skin hydrated and reduce irritation.⁷

Treatment choices are tailored to your specific symptoms and the severity of your rosacea.⁸ Most therapies aim to reduce inflammation.⁹ Common topical ingredients include metronidazole, azelaic acid, and ivermectin.¹⁰ These are applied directly to your skin and can help control your symptoms. They’re also ingredients that may be included in Curology’s Custom Formulaᴿˣ. 

In some cases, oral medications might be necessary. These include doxycycline, erythromycin, or isotretinoin (for severe cases).¹¹ Sometimes, a combination of topical treatments and oral antibiotics is most effective.¹²

Procedures like laser and intense pulsed light (IPL) therapy can benefit certain types of rosacea.¹³ These treatments target visible blood vessels and can reduce redness and other symptoms.

Remember, managing rosacea is a personalized process. It’s important to work closely with your dermatology provider to find the treatment plan that works best for you.

What can trigger rosacea flare-ups?

Knowing exactly what can trigger your rosacea symptoms can help you avoid flare-ups. Triggers vary from person to person, but some common ones include:¹⁴

Vigorous exercise: This isn’t your “pass” on working out! Exercise is essential to keeping your body healthy. But if heavy exercise is a flare-up for you, consider skipping that sweaty HIIT class and take a long walk instead.¹⁵ 

Weather: This includes extreme heat and humidity in the summer or intense cold and wind in the winter. Identify the specific climatic conditions that seem to trigger flare-ups for you. If possible, use humidifiers to help reduce dryness in the air during winter and air conditioning to keep things cool during warmer months.¹⁶

Stress: Research shows that emotional stress triggers a nerve pathway that can exacerbate rosacea symptoms,¹⁷ so learning to manage stress may help prevent rosacea flare-ups. Do whatever works for you: mindfulness, breathing exercises, meditation, yoga, or simply going for a relaxing stroll outdoors.  

Certain skincare products and ingredients: Products that contain alcohol, witch hazel, and added fragrance can also trigger rosacea flare-ups for some (more on these in the next section).¹⁸

Some alcoholic beverages: Potential culprits include red wine, beer, bourbon, vodka, and gin. Since alcohol can trigger rosacea in some people, mocktails can be a delicious alternative!¹⁹

Spicy food: This doesn’t mean you have to avoid spices altogether. On the contrary, you can still use many spices to add delicious flavor to your food—just avoid the ones that add heat if this seems to be a personal trigger. Try using herbs like thyme, oregano, and rosemary instead.²⁰

Ingredients to watch out for if you have rosacea

People with rosacea often have sensitive skin, so you need rosacea-friendly cleansers and other rosacea-friendly products that don’t contain potentially irritating ingredients. Along with salicylic acid, here are some other potential irritants to keep an eye out for:²¹

Menthol: Menthol is a naturally occurring alcohol extracted from peppermint. It has a cooling and analgesic effect on the skin but can cause irritation. It’s found in products such as cleansers, lotions, scrubs, and washes.²²    

Glycolic acid: This ingredient is used to exfoliate the skin, but like salicylic acid, it may be too harsh for sensitive skin. Glycolic acid can be found in various products, including cleansers, creams, lotions, gels, masks, toners, and serums.²³

Added fragrance: Natural and artificial fragrances can also cause irritation—and they’re often unnecessary in the first place. We typically recommend passing on products that contain added fragrance, regardless of the source.²⁴  

Alcohol: A common irritant in cosmetics, alcohol²⁵ is commonly listed among the ingredients as ethyl alcohol, alcohol denat, or SD alcohol (followed by numbers like 23-A, 40, and 40-B).²⁶ Other “fatty” alcohols include cetyl, stearyl, cetearyl, or lanolin alcohol, and they’re often included in products labeled alcohol-free. Their effects are much different than denatured alcohol and may be good for your skin.²⁷

Here are some additional dermatologist-approved skincare tips and products for rosacea-prone skin.

Always keep in mind what works for you

Everyone’s skin is unique, which is why it’s important to know which products work for you and which don’t. Led by dermatologists, Curology offers full-service skincare subscriptions that include customized solutions formulated for your unique skin. At Curology, we can address not only rosacea but also acne, signs of aging, and hair loss.

Get your personalized skincare treatment for rosacea.

Get your personalized skincare treatment for rosacea.

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As a Curology member, you’re paired with a licensed dermatology provider who will be with you every step along your skincare journey. Curology uses ingredients such as ivermectin, metronidazole, and azelaic acid to create a personalized prescription formula—a rosacea treatment by dermatology providers that’s just for you.

Stop fearing rosacea flare-ups, and sign up** today by taking a quick skin quiz and snapping a few photos of your skin. If Curology is right for you, you can get started with our prescription-strength Custom Formula for rosacea.***

FAQs

Which acid is best for rosacea?

While some types of acids can be too harsh for people with rosacea, azelaic acid has been proven to help treat rosacea.²⁸ It’s available over-the-counter or by prescription and has anti-inflammatory, anti-keratinizing, and antibacterial properties.²⁹ These effects help make it a beneficial option for your skincare routine.

What ingredient calms rosacea?

The most calming ingredients for rosacea can vary, but commonly, topical treatments like metronidazole, azelaic acid, and ivermectin are effective.³⁰ They help reduce inflammation and redness. In some cases, oral medications like doxycycline, erythromycin, or isotretinoin (for more severe rosacea) might also be beneficial for you.³¹

What is the best treatment for rosacea?

The best treatment for rosacea is personalized to your specific needs. Options include topical treatments like metronidazole, azelaic acid, and ivermectin.³² For some, oral medications like doxycycline, erythromycin, or isotretinoin are appropriate.³³ Additionally, laser and intense pulsed light (IPL) therapy can be effective.³⁴

Is salicylic acid good for rosacea?

Salicylic acid might not be the best choice for rosacea, as it can be irritating. Rosacea often causes the skin to become sensitive, so it's important to use gentle skincare products that don’t exacerbate your symptoms.³⁵

What causes rosacea?

The exact cause of rosacea isn’t fully understood, but it’s thought to involve a combination of factors.³⁶ Genetics, immune reactions, microorganisms, environmental influences, and neurovascular dysregulation all play a role in its development.³⁷ It’s a complex condition influenced by both internal and external factors.

• • •

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

  1.  Farshchian, M. and Daveluy, S. Rosacea. StatPearls. (2023, August 8).

  2.  Oge', L.K., et al. Rosacea: Diagnosis and Treatment. American Family Physician. (2015, August 1).

  3. National Rosacea Society. Factors That May Trigger Rosacea Flare-Ups. (n.d.).

  4. Arif, T. Salicylic acid as a peeling agent: A comprehensive review.Clinical Cosmetic and Investigative Dermatology. (2015, August 26).

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

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

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

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

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

  10. Rivero, A.L., and Whitfeld, M. An update on the treatment of rosacea. Australian Prescriber. (February 2018).

  11. Abokwidir, M., and Feldman, S.R. Rosacea Management. Skin Appendage Disorders. (September 2016).

  12. Rivero, A.L., and Whitfeld, M. An update on the treatment of rosacea. Australian Prescriber. Ibid.

  13. Zhang, H., et al. Rosacea Treatment: Review and Update. Dermatology and Therapy. (February 2021).

  14.  National Rosacea Society. Factors That May Trigger Rosacea Flare-Ups. Ibid.

  15.  National Rosacea Society. Factors That May Trigger Rosacea Flare-Ups. Ibid.

  16. National Rosacea Society. Factors That May Trigger Rosacea Flare-Ups. Ibid.

  17. Buddenkotte, J., et al. Recent advances in understanding and managing rosacea. F1000 Research. (2018, December 3).

  18. National Rosacea Society. Factors That May Trigger Rosacea Flare-Ups. Ibid.

  19. National Rosacea Society. Factors That May Trigger Rosacea Flare-Ups. Ibid.

  20. National Rosacea Society. Factors That May Trigger Rosacea Flare-Ups. Ibid.

  21. American Academy of Dermatology Association. 6 rosacea skincare tips dermatologists give their patients. (n.d.).

  22. American Academy of Dermatology Association. 6 rosacea skincare tips dermatologists give their patients. Ibid.

  23. American Academy of Dermatology Association. 6 rosacea skincare tips dermatologists give their patients. Ibid.

  24. American Academy of Dermatology Association. 6 rosacea skincare tips dermatologists give their patients. Ibid.

  25. American Academy of Dermatology Association. 6 rosacea skincare tips dermatologists give their patients. Ibid.

  26. National Center for Biotechnology Information. PubChem Compound Summary for, Denatured Alcohol. (n.d).

  27.  U.S. Food and Drug Administration. “Alcohol Free”. (2000, March 7).

  28. Rivero, A.L., and Whitfeld, M. An update on the treatment of rosacea. Australian Prescriber. Ibid.

  29. Rivero, A.L., and Whitfeld, M. An update on the treatment of rosacea. Australian Prescriber. Ibid.

  30. Rivero, A.L., and Whitfeld, M. An update on the treatment of rosacea. Australian Prescriber. Ibid.

  31. Abokwidir, M., and Feldman, S.R. Rosacea Management. Skin Appendage Disorders. Ibid.

  32. Rivero, A.L., and Whitfeld, M. An update on the treatment of rosacea. Australian Prescriber. Ibid.

  33. Abokwidir, M., and Feldman, S.R. Rosacea Management. Skin Appendage Disorders. Ibid.

  34. Zhang, H., et al. Rosacea Treatment: Review and Update. Dermatology and Therapy. Ibid.

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

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

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

Camille Dixon is a certified Physician Assistant at Curology. She received her Master of Medical Science in Physician Assistant Studies from Midwestern University in Downers Grove, IL.

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• • •
Our medical review process:We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.
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Camille Dixon, PA-C

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