Allergic and sensitivity reactions may be categorized as clinical (obvious to the patient themselves or to the dermatologist treating the patient) and subclinical (invisible to the naked eye, however able to be confirmed by tests or the presence of indirect side effects).

Damage from subclinical irritation and inflammation in rosacea tends to be associated with a more insidious course of disease as the patient is unaware of the harm they are doing.

Burning, redness, stinging, itching and prickling sensations are the most common manifestations of reactions reported by rosacea patients in the course of using cleansers, serums, moisturizers and sunscreens.

Rosacea patients are astounded to find that many of their skin care concerns resolve by permanently avoiding certain ingredients.

Through extensive trials over more than a decade, The Clinic has determined the relative harm of hundreds of ubiquitous ingredients which are either useless to skin or for which superior alternatives and formulations exist.

Sodium laureth sulphate (and variations thereof including sodium lauryl sulphate and sodium pareth sulphate) top the list for their capacity to dry, irritate and compromise the barrier integrity and function of skin, potentiating environmentally-provoked rosacea symptoms as well as any side effects from subsequent skin care or rosacea medications such as azelaic acid and metronidazole.

Other ingredients best avoided include:

• artificially fragranced and "fragrance-free" products (the latter usually contain masking scents and are therefore fragranced);
  
  
• tea tree, lavender, ylang ylang and propolis — however all purportedly natural and organic skin care is more-or-less relatively harmful to skin, however pleasant its use may be;
  
  
• preservatives (evidence thus-far implicates parabens in particular) — for further information, refer paraben preservatives and skin deterioration.

To avoid allergic reactions from skin care, we propose the following minimum clinically-tested and refined protocol, which meets the above criteria for extremely low hypoallergenicity in rosacea patients:

AM

Apply a moderate quantity of Rosacea Oil-Free Purifying Gel Cleanser or De-Sensitizing Cleansing Emulsion to dry skin. Massage gently and thoroughly for 30 seconds or longer (longer for makeup removal or if skin is normal to combination/slightly oily). Rinse thoroughly with cool to tepid water. Pat skin dry, ideally by pressing soft tissues flat against skin. Apply any rosacea medication (if prescribed) followed by Rosacea Hydrating Serum applied underneath Rosacea Treatment Fluid or Rosacea Treatment Cream. Follow with sunscreen and makeup (if used).

PM

As per AM, minus sunscreen and makeup. Rosacea Cooling Lotion is an evening/night-time alternative to Rosacea Treatment Fluid and Rosacea Treatment Cream.

For closely related topics, see (Non)Comedogenicity of Skin Care Ingredients in Rosacea Skin Care Products and New Larger Size Packaging and Formulas Eliminate Preservatives/Enhance Rosacea Treatment.