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Rosacea for the Esthetician: A Comprehensive Guide—Part II

Cynthia Bailey, MD August 2013 issue of Skin Inc. magazine
Facial distribution of rosacea

Image courtesy of Cynthia Bailey, MD

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In Part I of this article, which appeared in the July 2013 issue of Skin Inc. magazine, the different types of rosacea were described and explained, and tips were provided to help skin care professionals identify rosacea versus acne, dermatitis and facial dandruff. Part II will discuss how to design a skin care program for clients with rosacea, as well as how to work with these specialized clients.

Designing a skin care program for rosacea

The first and most important step is to decide if clients are suffering from the exquisitely sensitive skin of the erythematotelangiectatic type of rosacea, or the tougher skin of papulopustular rosacea—or if they fall somewhere in between. In general, the facial skin barrier strength in rosacea is abnormal, making any irritating products or treatments—such as those for anti-aging or acne—much more aggravating to rosacea-prone skin.

What’s the best way to begin working with clients who you believe might have rosacea?

  • Ask what products and procedures they have used before. What have they tolerated or not tolerated? Use this history as a guide.
  • When in doubt, start cautiously by using nonirritating products.

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Related Content



Facial Distribution of Rosacea

Facial distribution of rosacea

Calming Facial Results


Before the facial











After the facial

In this series of photos using a facial imaging system, it is evident that this client has both erythematotelangiectatic rosacea and a papulopustular flare. Notice the degree of skin inflammation and redness before and after the facial. Following the treatment, the skin shows less intense redness both in the normal lighting photo and in the exposure designed to detect redness. Also, notice how well her skin tolerated the facial in spite of the fact that it was very reactive in the midst of a rosacea flare up.

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