Rosacea Sunscreens
Patient guide by Dr. Cleckley, Dermatologist, FACD.

"Sunscreen is amazing for rosacea – if you get it right!"

Rosacea Sunscreens

New 2016 — Public Proof About Zinc

The Basics of Real Sunscreen Therapy

Sunscreen Selection Guide

Suggested Sunscreens

Application Suggestions

About Dr. Cleckley and This Site

Choices in rosacea sunscreen for effective treatment and ongoing therapy of rosacea.

The sun has its benefits, however for rosacea patients it is the #1 trigger of their symptoms and therefore the most prevalent factor in worsening skin disease.

My rosacea patients who successfully avoid incremental, incidental sun damage and exposure year-round have demonstrably better outcomes than those who fail to protect themselves from the sun, irrespective of any other factors contributing to their rosacea.

Optimal sunscreen use contributes to the success of all other rosacea treatments: topical and systemic drugs, laser, IPL (intense pulsed light) and general skin care.

Although the cause of rosacea is not known and likely extremely complex, dermatologists can say with certainty that it is a photosensitive disorder.

Accordingly, if we choose the sunscreens we use carefully, and use them daily, we already have an extremely effective treatment for rosacea, and it is one which works by the superior method of prevention.

In addition, when patients use sunscreens daily to treat their rosacea, they also prevent the most obvious signs of skin aging (wrinkling, fine lines, colour and textural changes) by the most effective means currently available.

What Is Optimal Sunscreen Use in Rosacea Treatment?

Optimal use results in prevention of rosacea flare-ups, the prevention of blood vessel damage and great reductions in skin's reactivity, sensitivity, inflammation, redness and the prevalence of papules, pustules and broken capillaries.

Over the years I have refined a criteria for selecting an effective sunscreen for rosacea treatment, the technical details of which are elborated elsewhere on this website.

By following these criteria and making a careful selection of the sunscreens you use you'll reach the relatively inexpensive truth of what can really be meant by the generic recommendation that "sunscreen benefits rosacea" and radically alter the future of your skin.

Choose sunscreens on the basis of their ingredients and not jut their SPF, a figure which pertains only to visible skin burning, and not overall protection against all the sun's rays (UVA, UVB, UVC and infrared).
Similarly, for daily routine use, choose sunscreens specifically formulated for (and not just marketed for) daily facial use. Avoid sunscreens which are very water-resistant or intended for outdoor/beach use. These are difficult to remove, leading to irritation from the zealous cleansing they require, or (if not removed entirely) hamper absorption of beneficial skin care and medications.

Sunscreen packaging highlighting UVA protection aspect of the sunscreen, relevant to rosacea treatment.

Choose sunscreen chemicals which provide high levels of prolonged UVA protection at low doses. Careful selection in this regard prevents exposure to irritating levels of sunscreen chemicals, either through high initial dose or necessitating repeat application during the day to provide a good treatment response. The FDA has failed to approve a single new sunscreen agent since 1996 (citing a "backlog") and creating a situation where the US now has the most inferior sunscreens in the developed world. For more information about this conundrum see my US sunscreen fiasco references and the 2016 public proof about zinc.
Order your sunscreen in from Europe, Japan or Australia where the sunscreens contain newer and safer ingredients which provide higher protection (particularly UVA protection) at much lower chemical exposure and don't look, feel or smell like the dated and inadequate sunscreens we're used to in the US.

For further information, refer to my list of suggested rosacea sunscreens or the selection guide.

Avoid sunscreens based on microfine zinc or titanium dioxide. It's a little known fact that the "clear" or nanoparticle versions of these sunscreens do not provide anywhere near the protection of their traditional, opaque versions. For further information, refer to the chart under the section "Effectiveness of Various Sunscreens Against Light" found in the Solar Wavelengths Section.
Don't depend on sunscreen in makeup for protection. Unfortunately, the protection offered by makeup products is regulated identically to sunscreen products, however patients don't apply nearly as much makeup as they do sunscreen. Studies have shown that sunscreens in makeup provide negligible sun protection and should therefore only be used in addition to a sunscreen product.
If possible, choose a sunscreen which contains a significant concentration of at least two antioxidants. Known effective topical antioxidants for rosacea are polyphenolic grape seed extracts, catechin green tea extracts, caffeine and ferulic acid. When used in combination, the effectiveness of each antioxidant is generally magnified. Refer this example of an antioxidant sunscreen (Kinerase Pro+ Therapy Daily Defense Lotion).
If possible, avoid preservatives in sunscreens. I like Attend SPF 50+ because it is preserved with an antioxidant, rather than parabens or alcohols.
Rosacea-specific sunscreens are the ultimate in rosacea treatment. These specialty products maximize the benefits of sunscreens to rosacea and eliminate tripwires in skin care. These products generally contain beneficial levels of ingredients impossible in mass-produced products, although they have much shorter shelf-lives. For examples, see my list of some suggested sunscreens.

Clarity in Purpose of Sunscreen

I believe the most peritent point about UV exposure which patients fail to adequately grasp is that it is incremental exposure to daylight (including through glass, for example while making brief trips in the car), over months and years, and not just prolonged warm or hot direct sun, which augments lasting, negative changes to skin's biological age, and increasing severity of increasingly treatment-resistant rosacea symptoms.

Recommended Rosacea Sunscreens

Sunscreen formulations have been changing more frequently than usual as maximum marketable SPF numbers have been revised and as the FDA has mandated changes to labels.

I do not mandate the use of any particular brand or product, but direct patients to this selection guide.

Update: 09/13 — By request, I have compiled a list of suggested sunscreen options. If you would like to suggest a sunscreen or provide feedback you are welcome to contact me through my Google Plus Profile.

Sunscreen chemicals and ingredients are common to many brands across different markets, in large part because there are only a few manufacturers of sunscreen chemicals, and because large cosmetic companies often own several brands.

I have noticed that L'Oreal replicates identical sunscreen formulas under different brand names.

Other sections of the website provide more technical and academic sunscreen information.

Rosacea Sun Protection References

My findings and recommendations are based on clinical experience and academic research.

Below are some references which may be of interest and assistance to pharmacists, medical students and other medical professionals.

Nichols K, Desai N, Lebwohl MG: Effective sunscreen ingredients and cutaneous irritation in patients with rosacea. Cutis. 1998;61:344-346.

Neumann E, Frithz A: Capillaropathy and capillaroneogenesis in the pathogenesis of rosacea. International Journal of Dermatology. 1998;37:263-266.

Kosmadaki MG, Yaar M, Arble BL, Gilchrest BA. UV induces VEGF through a TNF-alpha independent pathway. Federation of American Societies for Experimental Biology Journal. 2003;17:446-448.

Millikan L: Recognizing rosacea. Postgraduate Medicine. 1999;105:149-158.

You can also see this complete list of references for rosacea and sunscreen.

Author: Jeremy Cleckley

Rosacea Sunscreens Patient guide by Dr. Cleckley, Dermatologist, FACD.