Expert Q&A: The Best Skin Care Routine for People With Acne and Rosacea

An Interview With Diane S. Berson, MD

Medically Reviewed by Laura J. Martin, MD on February 04, 2011
From the WebMD Archives

Feb. 4, 2011 (New Orleans) -- If you have acne or rosacea, adding skin care products and cosmetics into your daily routine can pose a challenge.

At the American Academy of Dermatology annual meeting, Diane S. Berson, MD, discussed how proper skin care and appropriate choice of skin care products can improve the skin of acne and rosacea patients. Berson is an assistant clinical professor of dermatology at Weill Medical College of Cornell University in New York City.

What's the best way to clean your skin if you have acne or rosacea?

Gently wash with cleansing products with mild surfactants to remove surface oil and dirt without compromising the skin’s barrier function. And be sure to thoroughly rinse cleansers from the skin as the residue can be irritating.

Scrubbing the skin will worsen acne, as it can remove protective skin lipids and increase irritation. Harsh cleansers, alkaline bar soaps, and alcohol-based products may also further irritate the skin.

The medications used to treat acne and rosacea can leave the skin red, dry, or inflamed.

Should I use a moisturizer?

It's a common myth that people with acne should not use moisturizers, when in fact the opposite is true. If they do not use a daily moisturizer, the skin can become red and peel easily due to the drying effect of acne medications. Adding moisture back into the skin can counter the effects of these medications.
People with acne should use a light, oil-free moisturizer that is non-comedogenic, meaning it won’t clog the pores. Moisturizers containing heavy mineral oils should be avoided, though products containing silicone oils such as dimethicone are good choices.

In people with rosacea, the skin is more sensitive and can react with ingredients in both prescription medications and skin care products. Look for moisturizers that contain ceramides, glycerin, or hyaluronic acid. They're usually well tolerated and will help hydrate sensitive skin.

What about sunscreen?

Ultraviolet (UV) radiation from sunlight and artificial light sources can aggravate both acne and rosacea, so I recommend daily use of a broad-spectrum sunscreen that protects against both UVA and UVB light.

Newer sunscreens with microfine zinc oxide are smoother, lighter textured, and more cosmetically appealing than the physical blockers zinc oxide and titanium dioxide used in the past.

For those with acne or oily skin, spray and gel-based sunscreens work well.

Will cosmetics harm my skin?

You can't always control flare-ups, but you can camouflage the redness and pimples of acne and rosacea with cosmetics. Fortunately,  cosmetics are continually improving and can be found in formulations that are non-greasy and non-comedogenic.

Mineral-based cosmetics, which contain powdered formulas of silica, titanium dioxide, and zinc oxide that absorb oil and camouflage redness, are non-irritating for acne and rosacea patients. The ingredient dimethicone creates a smooth, matte finish and can camouflage breakouts while protecting the skin from ultraviolet light.

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69th Annual Meeting of the American Academy of Dermatology, New Orleans, Feb 4-8, 2011.

Diane S. Berson, MD, assistant clinical professor of dermatology, Weill Medical College of Cornell University, New York.

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