When it comes to skincare for rosacea, patient preferences are nearly as important as whether it works, according to Dr. Cheri Frey, assistant professor of dermatology at Howard University College of Medicine, at the 2025 Science of Skin Summit in Austin, TX in September.
“It’s not just important what we see from an objective standpoint, it’s also important what patients think,” Dr. Frey said. “Do they like it? Are they satisfied? They need to like how it feels on their skin, because if they don’t like how it feels, they’re not going to use it.”
She explained that people want an “experience” from their skincare products — for example, many people prefer cleansers that foam when used, and want to feel like the cleanser is really working to strip everything off the skin. However, she warned that although alkaline cleansers remove oils from the face, they can also cause swelling in the outermost layer of the skin and damage the skin’s moisture barrier, leading to dryness and irritation. A cleanser containing a polymeric surfactant may be a safe and gentle alternative for patients with sensitive skin who still want a foaming product.
Dr. Frey also discussed moisturizers and the skin’s natural moisturizing factor (NMF), as well as the processes of transepithelial electrical resistance (TEER) and transepidermal water loss (TEWL). TEER measures how ions move across the skin cells, giving a better idea of how tightly connected they are, while TEWL measures how much moisture evaporates from the skin surface. High-TEER moisturizers aid in keeping the skin barrier intact and reducing inflammatory markers, such as interleukin 8, and the erythema associated with rosacea.
Dr. Frey noted that there are a number of skin care products that contain prebiotics and postbiotics, and that considering the research into the beneficial effects of the microbiome on skin, the concept is sound. She shared a study examining the effects of an extract from Aquaphilus dolomiae, a bacterium isolated from Avène Thermal Spring Water, on expression of Substance P, a neuromodulator involved in neurovascular inflammation. When applied to cultured human skin cells in a lab, the extract inhibited Substance P production and reduced mast cell activation, reducing inflammation.1 She recommended that healthcare providers incorporate such products into regimens for their rosacea patients.
Reference:
1. Lestienne F, Viodé C, Ceruti I, et al. Cutaneous sensitivity modulation by Aquaphilus dolomiae extract-G3 on in vitro models of neuro-inflammation. J Eur Acad Dermatol Venereol. 2020 Aug;34 Suppl 5:43-48. doi: 10.1111/jdv.16641. PMID: 32870552.
Photos courtesy of AEK Solutions