This Could Be The Reason Your Acne Won't Go Away


acne rosacea

Treating acne can be pretty frustrating; sometimes it can feel like no matter what you do, nothing changes. Well, this might be because you have acne rosacea… If you’re hella confused and thinking acne rosacea-what? You’re not alone, as very few people know about this form of acne. Acne rosacea often looks almost identical to normal pimples, but it’s not caused by the same bacteria, so treatment methods are very different – typical acne-improving ingredients might actually make acne rosacea worse.

To help you identify a rosacea breakout and treat it like a pro, we spoke to celeb dermatologist and author of Beyond Beautiful, Dr. Doris Day, for her guidance. Here’s everything you need to know about this rare form of acne:

What is Rosacea?

To understand how to treat acne rosacea, it’s helpful to know what rosacea is. Rosacea is a skin condition that appears as redness and inflammation. Dr. Day says that “There are four different types of rosacea,” which she outlines below:

Acne rosacea: We’ll explain all later…
Telangiectatic Rosacea: This appears as broken blood vessels and overall redness.
Rhinophyma: This is a fullness of the nose. It’s more common in men than women, and worse in those who drink alcohol.
Ocular rosacea: This is rosacea of the eyes and can lead to blindness. It feels like a gritty feeling in the eyes, also known as blepharitis.

Dr. Day adds, “You can have an overlap and have more than one type at a time. All types of rosacea may be triggered or exacerbated during times of stress or after exposure to heat and alcohol, and some spices and foods. You may also have your own personal triggers.”

What is Acne Rosacea?

“Known as acne rosacea or a rosacea breakout, these are red bumps and pustules that appear usually in the center of the face, the forehead, and the mouth. It can look like acne, but without blackheads and whiteheads,” Dr. Day told us.

What Causes Acne Rosacea & How is it different?

According to Dr. Day, the cause of acne rosacea is unknown. Although she does explain; “We know what we see: we know things that can exacerbate it, and we know things that can make it better. But, there are some theories: one is the mite theory which is that there’s an overgrowth of a mite called Demodex in the skin of those with rosacea. The mites may also carry bacteria that could be part of the problem and could be causing inflammation in the skin.” The most common form of acne is caused by an overgrowth of bacteria called p.acnes, which stimulates an immune response that creates redness, swelling, and sometimes pus. Dr. Doris explains, “The bacteria that’s believed to be an underlying issue in acne, called p. acnes bacteria, is NOT an issue in rosacea.”

This is why identifying acne rosacea is so important as the method of treatment is completely different. If you treat acne rosacea with ingredients and formulas that are targeted for acne, you could exacerbate the rosacea breakout as they’ll be too harsh on the skin. For example, lactic acid, which is recommended for acne-prone skin, shouldn’t be used if you have rosacea as it’ll dry out the skin and damage the skin’s defensive barrier further.

Acne rosacea Source: National Rosacea Society

While the exact cause of acne rosacea is unknown, here are some common triggers:

  • Alcohol
  • Spicy foods
  • Strong skincare products, like retinol or AHAs
  • Extreme temperatures (hot or cold, including baths and saunas)
  • Stress or anxiety
  • Menopause
  • Sunlight
  • Hot foods and drinks
  • Chronic coughing
  • Some medications

To help determine your personal rosacea triggers, Dr. Day recommends documenting your flareup patterns; “It can be helpful to keep a diary and see if you can identify your unique triggers. Usually, you’ll see a flare within a day of exposure to the particular cause or groups of triggers.”

How Should You Treat Acne Rosacea?

Topical treatments: Dr. Day recommends her patients use “Over-the-counter products that contain sulfa or azelaic acid.”

The American Association of Dermatology revealed: “Findings from six research studies show that between 70% and 80% of patients have had noticeably less rosacea with azelaic acid. Some patients saw a complete clearing.” For those of you wondering where this miracle ingredient comes from, Azelaic acid is found in grains and is formed organically by yeast that lives on the skin. It’ll help brighten and improve the texture of the skin while reducing the appearance of pimples.

The Ordinary’s, Azelaic Acid Suspension 10%, $13, is a great affordable option. Another highly recommended topical treatment is metronidazole, which is available as a gel or cream. The American Academy of Dermatology says that “Research studies show that it can effectively reduce both the redness and the acne-like rosacea breakouts.”

Alternatively, Dr. Day prescribes “prescription-strength versions of azelaic acid and sulfa. These medications can be used alone or in combination with other prescriptions, such as oral antibiotics that are used more for their anti-inflammatory than antibiotic effect, and topicals such as metronidazole or ivermectin.”

In clinic treatments: “There are also chemical peels specifically designed for treating rosacea-prone skin. They can help with breakouts, restore the water balance, and repair the skin barrier that’s often damaged in the skin with rosacea” explains Dr. Day. Pictured above, you can see the amazing impact of chemical peels. This patient had three peels (which are typically performed at two-to-three-week intervals) while also using Alumier Labs skincare products that are formulated for rosacea-prone skin. Laser or light therapy is also suggested as an effective treatment of acne rosacea as it’ll treat redness and help reduce the size of the pimples.

Daily Skincare Tips for Rosacea-Prone Skin

Use a gentle cleanser: f you worry that cleansing will irritate your skin further, then rest assured that the right cleanser won’t! It’s important to cleanse twice a day to wash away any impurities, dirt, or oils, you just need to find a gentle cleanser – stay clear of soap, or any harsh ingredients. Instead, look for a fragrance-free formula that contains soothing and hydrating ingredients, like the Aveeno Ultra-Calming Foaming Cleanser, $9, which is infused with calming chamomile and moisturizing glycerin.

Moisturize daily: Moisturizing is an essential step in any skincare routine, but it’s especially important if you have acne rosacea as it can help strengthen the defensive barrier of the skin, which is typically weak. The Clearogen Acne Lotion, $32, is ideal as it features sulfa to help keep breakouts at bay, green tea extract to soothe and brighten, as well as other hydrating ingredients.

Protect your skin: The sun is a common trigger for acne rosacea, so it’s super important to protect your skin from the sun’s harmful UVA and UVB rays. This means you need to apply sunscreen daily with SPF 30 and 5-star uva rating, even on cloudy days! The Block Island Organics Natural Face Moisturizer SPF 30 with Clear Zinc is perfect, $30, as it contains anti-inflammatory zinc, which is commonly used to treat and soothe rosacea.


Use rosacea-friendly products: While curing rosacea entirely isn’t possible, there are tons of products that you can use to improve redness and help soothe your skin. Check out these nine skincare products you should know about if you have rosacea.

Let us know if you have rosacea in the comments below and what products you use to treat it.