The Seven Best Ingredients for Rosacea and How They Work

Here are the seven best ingredients to treat rosacea and how they work. Yes, we’re talking about both prescriptions and OTC products!

What is rosacea?

A lot of people struggle with it without realizing that they have it.

Rosacea is a long-term inflammatory skin condition that causes reddened skin and a rash, usually on the nose and cheeks.

It is a medical condition that needs to be diagnosed by a doctor or dermatologist. It’s characterized by red flushing of the skin, especially when you come into contact with something that’s a trigger. For instance, hot or cold foods like alcohol, wine, changes in weather, or even sun exposure can trigger rosacea. For some people, like those of Celtic backgrounds, rosacea can even be genetic. Likewise, it’s most seen in Fitzpatrick photosensitivity types 1-3 even though it can happen to anyone. Also, it usually happens to people who are over 40. 

There are different types of rosacea, and some people confuse rosacea with acne when the rosacea is papulopustular. So, it’s important to see a dermatologist and get diagnosed so you won’t use ingredients for acne on rosacea.

What are the best ingredients for rosacea? 


Starting with the ingredients doctors recommend, topical ivermectin has been used for years, and it’s well tolerated by the majority of skin types, meaning people don’t normally have irritation or redness when they use it. Topical ivermectin is also known to be anti-inflammatory and anti-parasitic. 

Given that demodex mites are known to be related to rosacea, ivermectin is helpful to rosacea since it’s been shown to keep them under control. Demodex mites are a part of our natural biology, but an overpopulation of them has been linked to rosacea flare-ups. 

Moreover, Ivermectin can help with papulopustular rosacea and inflammation. But, it needs to be prescribed by a doctor.

You can get prescriptions and custom-blended formulas from Dermatica. Cassandra has a formula from Dermatica for her acne. But, they have other ingredients too for rosacea like metronidazole. 

Dernatica Custom Blended Formulas 


Metronidazole is another ingredient commonly used for rosacea. It’s an antibiotic, and if you see a doctor, they might prescribe it orally. Whether it’s used topically or orally, metronidazole helps with erythema, redness, or inflammation. 

Vitamin A

Vitamin A is the gold standard in dermatology. Retin A and tretinoin are types of vitamin A, and they can be used for rosacea.

Because tretinoin helps to speed up skin cell proliferation and tells your body to create new skin cells at a faster rate, it allows the skin to thicken at the dermis and slough off the top layers of the skin's surface. This can be helpful for people who have acne, rosacea, or a combination of both. 

You have to see a doctor or dermatologist to get tretinoin. But fortunately, Dermatica makes this process very accessible. Cassandra has been using Dermatica for a while, and she receives a custom blend for acne and subclinical rosacea.

Dermatica has a multitude of rosacea options. They have topical Ivermectin and metronidazole. They can even blend them together for a custom treatment. They have doctors online who can asses your skin digitally and provide you with a custom blended prescription. Cassandra received a customized formula blended with actives like niacinamide and other great ingredients. Her prescription comes every 28 days, and it's $25 a month. 


When used topically, brimonidine is helpful for rosacea. It works as a vasoconstrictor, meaning it constricts blood vessels. For those who have redness or flushing with rosacea, brimonidine can truly help. This has to be prescribed as well. 

Azelaic Acid

This is a dicarboxylic acid, and it’s amazing for rosacea, especially when there are pustules and redness. It’s very good for acne as well. Azelaic acid tells the skin to calm itself down, and it’s very soothing on the skin. You can even get a prescription with a higher dose. As for OTC options, The Ordinary is great. But, Dr. Sam also has a fantastic one. This is the neutralizing gel. It has azelaic acid, but it’s combined with the BHA, salicylic acid. 

Dr Sam's Neutralizing Gel | For Breakouts + Blemishes – $39

For rosacea and acne, this is one of the best products Cassandra has ever used. You can use it as a spot treatment, or you can smooth it all over. 



The Ordinary Azelaic Acid Suspension 10% - $11.10

This one is more price-conscious. It can feel a little grainy, but azelaic acid is the active ingredient, and this formula is still effective for redness and pustules. 



Another good OTC option is vitamin B3 or niacinamide. Niacinamide brightens the skin, helps the skin create ceramides, strengthens our skin barrier, and regulates oil production. It also helps with hyperpigmentation, but a lot of people don’t realize that it helps with rosacea as well. Cassandra has a Dermatica formula with niacinamide for her subclinical rosacea and acne. The formula controls oil, and Cassandra uses it on her T-zone. Overall, niacinamide is great because it’s very stable, meaning it combines well with other ingredients

The sun is one of the biggest triggers for rosacea. Sun exposure can cause rosacea to flare and worsen over time. The sun can also lead to hyperpigmentation and degrade collagen, which in turn, causes wrinkles and fine lines. So, sunscreens are some of the best products you can use to prevent and treat rosacea.

Instree Hyaluronic Watery Sunscreen - $16.99

This is one of Cassandra’s favorites. It’s super hydrating, and it’s a great option. However, it's a chemical sunscreen. And for people with pustular rosacea, some chemical sunscreens can sting.

Zincscreen from Supergoop - $44

SPF is one of the best things for rosacea. For physical options, this is one of Cassandra’s favorites. Mineral formulas are made with things like zinc oxide or titanium dioxide. Zinc oxide is a little more gentle on the skin, especially if you’re someone who has sensitive skin. 

If you use some of these recommendations together, not only can you create a great routine that treats rosacea, but you can create one that prevents future flare-ups.