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What kind of skin care is suitable for the rosacea prone skin?


Cases of rosacea, couperose and perioral dermatitis are on the rise in the cosmetic practice - despite or possibly even because of a more intense skin care. 

Reliable statistical data are not yet available though.

Causes of rosacea

  • Disorders of the immune system caused by cathelicidin splitting proteases. The rosacea skin usually shows an increased number of these signalling molecule fragments, a condition that encourages facultatively pathogenic bacteria.
  • In spite of an increased expression, the inflammatory type involves a decrease in antimicrobial peptides (cathelicidins) due to corresponding serine proteases.
  • A fat-enriched skin care offers ideal habitat conditions for anaerobic bacteria strains, in other words, bacteria strains that can cope without atmospheric oxygen such as propionibacterium acnes and staphylococcus epidermidis.
  • UV stress is a cofactor in the development of rosacea.
  • Demodex mites can provoke inflammatory reactions.
  • Rosacea patients frequently complain that they cannot tolerate hypertonic skin care products that often are oil-in-water emulsions. In analogy, they cannot tolerate sweat and particularly dried up sweat. The skin cannot compensate an imbalance in osmotic pressure.

Comparison rosacea - couperose


  • vascular dilatations
  • instable capillaries
  • weakness of the connective tissue
  • inflammatory (so-called "open skin" with papules or pustules)
  • augmented osmotic sensitivity


Besides a very minimal amount of a fatty cream, the following active agent concentrates are appropriate for the care of the rosacea prone skin:

  1. Complexion skin care liposomes Plus: Tranexamic acid (antifibrinolytic) reduces redness and supports the recovery.
  2. Liposome concentrate Plus: As a 5-alpha-reductase inhibitor, azelaic acid has antibacterial effects; linoleic acid forms an anti-inflammatory metabolite due to the natural 15-lipoxygenase.
  3. Boswellia nanoparticles: Boswellia acids inhibit the natural proteases of the skin and the inflammation-triggering 5-lipoxygenase.
  4. Butcher's Broom serum: Saponins stabilize the superficial blood vessels and the connective tissue.
  5. Echinacea extract: Echinacea soothes redness in the case of couperose.
  6. Vitamin B liposome concentrate: Niacinamide (Vitamin B3) supports the recovery of the skin and has anti-inflammatory properties.

It is nearly impossible to predict what specific combination will be the best skin care solution for the individual rosacea case. In case of doubt, use (1), (2) and (3) in pure form and gradually test the active agents (4), (5) and (6). It is less recommended to use the mentioned active agents at the same time since the particular dosages are pretty low in this way. After a skin analysis, further active agents are individually applicable as already described in the above-mentioned publications.


  • Peelings based on abrasive bodies, fruit or other acids, herbal extracts ("herbal peelings") or microdermabrasions generally are counterproductive.
  • In individual cases, massages can be helpful in conditioning the connective tissue, provided that they are professionally performed.


Dr. Hans Lautenschläger


Addendum (October 22, 2018)

Since 2017 skin care products based on oleogels, free of mineral oils, with 5-α-reductase inhibitors (e.g. azelaic acid; up to 1% in cosmetics) and protease inhibitors (e.g. boswellic acids) are available (patent application DE 10 2017 002 125) - optionally with tranexamic acid (stabilizing capillaries) and betulinic acid (antiparasitic efficacy). They contain physiological lipids, which are absorbed in a short time and inhibit the specific anaerobic skin flora of rosacea.


Please note: The contribution is based on the state of the art at the revision date.

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