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I am in my mid 30’s and starting to see some aging in my skin. Also, I have rosacea and my skin is very sensitive/reactive. Is it possible for me to use an exfoliator to remove facial dead skin, which is making my face look dull and dry? Also, would using a buf puf with my facial cleanser be too harsh?

Thank you for your time, Ames

Hello Ames,

Rosacea makes skin very sensitive, which you’ve noticed! That said, I’m often able to help my rosacea patients find anti-aging skin care options and create an effective anti-aging skin care program that works with their rosacea. Gentle exfoliation with something like a Gentle Facial Buf Puf is one of the options I use for my rosacea patients. Because rosacea skin is so easily triggered it’s important to use only the gentlest pressure and a very mild cleanser with the Facial Buf Puf. I like the Buf Puf used in the morning so that a person can enjoy the bright, exfoliated skin texture during the day. My rosacea patients may only be able to use the Buf Puf twice a week, but that’s still a nice exfoliation to remove the dull dead cells.

I also have good luck treating most of my rosacea patients with tretinoin cream (Retin A Cream) as their primary anti-aging skin care product. In my experience, patients with rosacea are much more able to tolerate tretinoin cream than an acid pH product like AHA’s or vitamin C. I find that the trick to getting rosacea prone skin to tolerate the tretinoin cream is to use supportive products to calm the rosacea such as Replenix CF Cream or Green Tea Antioxidant Skin Therapy – Replenix Power of Three Cream, and Calming Zinc Soap (formerly Noble Zinc). I control the rosacea first for a few months then sneak up on their skin with the tretinoin cream. We start it once or twice a week and slowly advance to nightly. If the rosacea starts to flare up we stop the tretinoin, calm down the rosacea then resume. It’s not easy, but it is worth it because tretinoin cream has such wonderful anti-aging properties, which I’ve discussed in the past.

I also find that calming facials can help soothe rosacea prone skin into tolerating the gentle exfoliation with the Buf Puf and the tretinoin cream. The ideal interval between facials is every 6 weeks. The skin always looks great after a facial and it’s another way to keep rosacea prone skin looking its best. It’s important to find an aesthetician that understands what a calming facial is because some professional facial products can provoke rosacea.

Each patient’s skin is unique and I customize the approach based on what they can tolerate. Rosacea is easy to provoke and so there is no way to predict how a person will do. I of course can’t say if your skin would tolerate this anti aging options and I recommend that you see a dermatologist for specific recommendations and treatments.

For more information on how I coach my patients on the use of tretinoin cream you may want to read my post How To Correctly Use Retin A (tretinoin) For Acne and Anti-Aging Skin Care. For more information check out my in depth series of posts on rosacea. The first post of the series is titled What Is Acne Rosacea?

I hope that helps. Best of luck!

Warm Regards,

Cynthia Bailey MD, Dermatologist

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