Finding cleansers for rosacea can be one of the most challenging parts of treatment, but with careful attention and patience, good choices are available. The main idea is to apply cleansers that are as close to pH neutral as possible.

Understanding pH

Any substance that dissolves in water will have a pH. Acids (think car batteries and lemon juice) range from 0 to 6; bases (think bathroom scrubbing powders) have pH from 7 to 14. Distilled water is pH neutral. The best cleansers for rosacea will be as close to pH neutral as possible.

Be careful, though, because pH only applies to substances that dissolve in water. Oils and alcohol do not dissolve in water, so they can’t have pH. Having no pH is not the same as having neutral pH. So, watching pH and keeping an eye on some basic chemistry, your rosacea cleaning strategy needs to include three different paths to success.

Dealing with Makeup, Lotions and Skin Care Products

While your rosacea may tempt you into leaving makeup or lotions on your skin, you do need to keep your skin clean and your pores open. Some rosacea sufferers use a green-tinted makeup to hide the redness. When selecting a cleanser that removes makeup, be careful not to be enticed into buying acne treatment products. Rosacea is not acne and the alcohol in acne medications will cause discomfort. Gentle makeup remover is your best bet.

study reported by The National Institutes of Health shows that Cetaphil Gentle Skin Cleanser, applied with fingertips and without scrubbing, effectively cleaned makeup, lotions and other products without causing transepidermal water loss (TEWL). The cleanser is nonalkaline (not harsh; close to pH neutral) and many patients report their skin feels hydrated using it.

Dealing with Sunlight

Your dermatologist has probably reminded you politely to avoid sunlight and to always use sunscreen. That’s good advice, so long as you use one with a sun-protecting factor (SPF) of 15 or higher and pick a product that blocks ultraviolet-A and ultraviolet-B (UVA, UVB) rays.

Help yourself further by limiting your activity in hot weather. This prevents a lot of moisture loss, salt deposits left on your skin, and the need for extensive cleansing. Of course, wash the sunscreen off each evening. Gentle cleanser, fingertips only.

Dealing with Skin Types

  • Oily Skin–Synthetic detergents (as opposed to true soaps) can be used, if diluted, to deal with troublesome oily spots. Cleansers with sulfacetamide 10 percent and sulfur 5 percent are doctor-recommended—talk to your dermatologist about prescription products. As with any skin type troubled by rosacea, gentleness is preferred to vigorous scrubbing.
  • Dry Skin–Transepidermal water loss (TEWL) is especially pronounced in rosacea patients with dry skin. Here your challenge is to keep moisture locked in, so avoid excessively hot or cold water for showering and hand or face washing. Use a creamier synthetic detergent cleanser, or apply a thin film of alcohol-free lotion after showering and washing to retain a thin film on your skin to hold in moisture. The National Institute of Arthritis and Musculoskeletal and Skin Diseases recommends using a mild lubricant if this soothes your skin. Increase your water consumption (other organs besides your skin will benefit, too).
  • Combination Skin–Still avoiding saponified products (soaps), look for cleansers that have surfactants that will not pull lipids (fats) and proteins from the skin. Synthetic detergent cleansers that leave behind emollients or humectants can help, too. As always, fingertips only, and blot dry with a 100 percent cotton towel.

Reducing spicy foods, avoiding hot liquids and asking your dermatologist about antibiotics may make your skin cleansing regimen easier.