The best products for rosacea, oily skin and blackheads are not easy to find. The skin problems often happen together. Treatment is tricky because rosacea makes the skin sensitive and the best products to fight skin oil and blackheads can be irritating. I received a great question about the topic of rosacea and blackheads from a reader and I wanted to share my answer.
Dear Dr. Bailey,
I read your blog series on rosacea and I have a question. I have been diagnosed with rosacea. I mainly have it on the apples of my checks and my forehead (right in the middle). My problem is that I have an oily t-zone and I have blackheads and other break outs on my chin. I would love to know what products will work. I want something gentle as to not upset my rosacea but I need oil and blackhead control for my chin and nose as well.
I was going to buy the Calming Zinc Soap along with the Green Tea Cream in your Redness Relief Kit. Will these control my clogged pores?
This is a great question. To best answer this, I'm going to share with you some general information from my dermatology practice.
First off, you're not alone. It's really common to have a combination of oily skin, blackheads, clogged pores and rosacea! However, treatment can be tricky since the products that we use to treat blackheads, and our first-choice products for oily skin, may aggravate rosacea.
When working with my dermatology patients, I begin with what I call a "rosacea cool down skin care routine". This routine involves doing whatever it takes to quiet down the inflammation that drives the rosacea.
Dermatologist Dr. Bailey's Rosacea Cool Down Skin Care Routine to Calm the Inflammation of Rosacea.
First, it is important to stop all irritating skin care products or procedures.
Second, use products that sooth and calm the inflammation that drives rosacea. In my practice I use:
- Calming Zinc Soap alternating with a pH balanced gentle cleanser such as my Extremely Gentle Foaming Facial Cleanser. We start using the Calming Zinc every other day and gradually increase to daily. Some people can eventually use it twice a day, but there is a small potential for Calming Zinc to dry out ultra-sensitive complexions.
- Green Tea Antioxidant Skin Therapy is the best product to calm the inflammation of rosacea without a prescription. It combines an ultra-concentrated pharmaceutical formulation of active green tea polyphenol antioxidants, resveratrol from grapes and caffeine. This magic combo gets the red out. My patients use this twice a day right after washing and before applying anything else. I've used it myself for years to control my own rosacea and I never travel without it!
The two key products to calm rosacea (Calming Zinc and Green Tea Cream) are included in my Redness Relief Kit.
I have patients use these products on the entire face. Although neither of these products will make blackheads or clogged pores worse, they don't treat them either. They are, however, essential to the overall strategy for unclogging the pores since they help soothe the rosacea, allowing us to work on the competing pore and oily skin problems.
During the rosacea cool down, if the rosacea is really flaring up, I would also prescribe topical (and possibly oral) medicines until we control the rosacea. Some of my prescription approaches to rosacea are outlined in my post Prescription Medicine and Cosmetic Procedures to Treat Rosacea
It's also important that rosacea-prone skin stay well hydrated if it's going to heal.
Rosacea-prone complexions have weakened barrier integrity and must remain well hydrated - even when skin is oily. For this, I typically recommend a soothing facial moisturizer such as Daily Moisturizing Face Cream for Oily to Normal Skin, which is perfect for oily skin. It also contains squalane, an important lipid component of skin, and glycerin to bind water for optimal skin hydration. Get all 3 of these key rosacea fighting products in my Facial Flaking and Redness Solutions Kit!
Sun exposure triggers the inflammation of rosacea.
Yes, sun can trigger your rosacea. This means that daily wearing of a broad spectrum sunscreen on facial skin is essential as part of our rosacea cool down. I always recommend sun protection with mineral zinc oxide sunscreen. The most loved oil-free mineral zinc oxide sunscreens by my oily complexion patients are,
Sheer Strength Pure Physical Matte Tinted SPF 50+ Sunscreen, which uses iron oxide as tinting technology to also block visible light that can contribute to pigment problems. The tinting blends well into all skin types and the base is weightless on the skin. I wear this sunscreen every day and my complexion loves it!
Sheer Strength Pure Physical Invisible SPF 50 Sunscreen for those who don't want to use a tinted product.
Sheer Strength Pure Physical Spray SPF 50+ Sunscreen which is an untinted weightless sunscreen that is moderately water resistant and rubs in easily on hairy skin such as the top of the scalp! It's a men's favorite and the product I wear on my neck and chest every day.
After the inflammation of rosacea has subsided from the "rosacea cool down", then we're ready to tackle clogged pores!
I have found that the best way to unclog pores for rosacea-prone complexions is with the Clarisonic Sonic Brush System and Retinol.
We work gingerly, but deliberately with the complexion and the Clarisonic. We start with once daily use. The sonic brush oscillation helps to deliver cleanser deep into the pores to help remove pore clogging oil and debris. We use a brush head designed for sensitive skin.
This well-loved sonic skin-cleansing system usually can be used by most rosacea patients at least on the nose and chin (where clogged pores are the worst). It also helps the other treatment products, including the Calming Zinc and the Green Tea Cream to penetrate skin better. However, it is important to note that there is no guarantee that the rosacea-prone areas of the cheeks or forehead will react well to sonic cleansing.
To treat blackheads in rosacea-prone complexions retinoids are my first choice.
I can usually coax a person's rosacea-prone skin into letting me use a retinoid on certain parts of the face. Retinoids include prescription Retin A (tretinoin) and retinol. I start with my Retinol Night Cream twice a week at night. As the skin gets use to the retinol we gradually increase to nightly. There may be areas of the face that don't tolerate the retinol, such as the cheeks. It's easy to avoid applying the Retinol Night Cream to these areas.
My Retinol Night Cream comes with the same high concentration of green tea antioxidants as my Green Tea Antioxidant Cream. This helps fight irritation from retinol, making this the ideal retinoid for rosacea skin suffering from blackheads. Apply Retinol Night Cream after washing and apply my Daily Moisturizing Face Cream on top. It's the perfect night treatment to fight blackheads and it also fights skin aging.
Of course, rosacea, being a capricious gremlin, will resurface from time to time even if you're being "nice" to your skin. Flare-ups always happen when they're most inconvenient. When a flare-up occurs, it's an "all stop" on the products that could wake up the beast, and back to the rosacea cool down regimen. When the inflammatory phase is once again quiet, then resumption of the blackhead and clogged-pore treatment can be gingerly restarted.
Phew, it sure will be nice when we have a cure for rosacea. It's such a cranky skin problem and requires patience, delicate care and stewardship.
Thanks for a great question. This is a combination of skin problems that I see every day in my dermatology practice and that I'm sure tons of readers can relate to your experience.
Cynthia Bailey MD, Dermatologist
If you have questions about skin care or skin health please send them to me using the Contact Dr. Bailey button at the top of the page.
Disclaimer: Please realize that availing yourself of the opportunity to submit and receive answers to your questions from Dr. Bailey does not confer a doctor/patient relationship with Dr. Bailey. The information provided by Dr. Bailey is general health information inspired by your question. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Bailey has provided in her office for existing patients of her practice). Never ignore your own doctor’s advice because of something you read here; this information is for general informational purpose only.