Choosing An Effective SPF For Rosacea or Acne

AUTHOR - DR. DAVID JACK

If you’re suffering from an inflammatory skin condition - such as rosacea or acne - you may find that choosing a daily sunscreen is somewhat difficult. Your skin might feel clogged and oily with heavier mineral SPF filters, and might feel a bit sensitive with some of the more aggressive chemical filters, so it can be difficult to navigate the choice of this important skincare step. In this article I’m going to explain why it’s still essential to use sunscreens when you have rosacea or acne, and how to choose a good sunscreen product.

Why should I use a daily sunscreen if I have Rosacea or Acne?

sunscreen

Sunscreen is the single most important part of anyone’s skincare routine - it has been estimated that 80% of skin damage and ageing can be attributed to of sun exposure, particularly exposure in youth. The significant link between UV exposure and skin cancers and skin ageing generally has been shown consistently throughout the medical literature, as well as the vital role of sunscreens in prevention of skin cancers. UV exposure is strongly linked to the development of all types of skin cancers and all attributes of ageing including collagen/elastin loss, pigmentation and volume change. Of note, the incidence of melanomas (one of the most aggressive skin cancer types) increasing by 140% in the UK since the 1990s, highlighting further the importance of daily sunscreen use.

Prevention is simple and proven - avoid UV exposure and protect your skin with SPF on a daily basis, throughout the year. For most people, this is not an issue, but if you have rosacea or acne, or indeed any other inflammatory skin condition, SPF products can occasionally exacerbate oiliness and irritation. So what to do? My advice is that whilst you must use a sunscreen on a daily basis, there are many new and advanced formulations that are available that provide significant cover to reduce the significant risk that UV light poses, but which also help to reduce inflammation and treat these conditions at the same time. Since the skin will already be compromised in any inflammatory skin condition, with a higher risk of collagen breakdown anyway - using a broad-spectrum sunscreen that also moisturises the skin and provides antioxidant and anti-inflammatory support is particularly important.

When it comes to choosing an SPF for rosacea and acne, the major consideration on the type of SPF filter is that is broad spectrum, meaning it covers against the two forms of UV light reaching our skin: UVA and UVB. In the summer, UVB levels creep up, whilst UVA levels are pretty constant throughout the year. UVA accounts for about 95% of the light reaching our skin and tends to penetrate very deeply (causing DNA damage, volume change and collagen damage), whilst UVB tends to penetrate more superficially and causes more irritation and redness in the form of sunburn. The skin’s barrier function may also become compromised following sun exposure, worsening inflammation in those with acne and rosacea, and pigmentation changes often develop in the aftermath.


The key message is to use a high factor, broad spectrum screen that covers both UVA and UVB, year round. The amount used depends on the type - for inorganic sunscreens, two tablespoons for the face is a suggested guide, for organic screens it may be slightly less that is required. So please don’t rely solely on a few drops of sunscreen added to a moisturiser to provide enough cover - the product you select are be certified in the form they are delivered - blending products may reduce efficacy.

What should I look for when choosing a sunscreen for acne or rosacea?

Rosacea-Ingredients

When looking for a sunscreen we should consider a couple of different things, firstly, the SPF number - this relates to the amount of UVB cover it provides:

SPF 15 protects against 92% UVB rays
SPF 30 protects against 97% UVB rays
SPF 50 protects against 98% UVB rays

The cover for the deeper penetrating UVA rays will be about 1/3 of the level for UVB, so ensuring you have a sunscreen that says ‘broad spectrum’ meaning that it covers for a broader spectrum of light is really important. UVA cover is denoted on sunscreens by the presence of a circled UVA symbol and the level of UVA cover related to a either a ‘PA’ rating or star rating, with a higher number of stars providing the most cover.

Sunscreens are notoriously difficult to formulate at higher levels so getting a good screen covering both UVA and UVB with a high SPF rating and good UVA cover can be difficult. This is particularly so if the formula is expected to do other things, e.g. moisturising, antioxidant support and other forms of protection. As with any product, the formulation is key so better formulas will provide more than just sun protection.

Which SPF should I use if I suffer from acne?

Acne is a common inflammatory skin condition that results in breakouts and irritation. It often affects the face and other areas of the body and is commonly associated with changes in hormones, such as during puberty. There are different forms of acne - more information can be found on the NHS’s website about this condition and its management.

Increased temperatures, moisture and UVB levels during the summer can cause changes to the skin’s function. Often in summer, the skin can become more oily, which for some can help improve barrier function, but for others might result in breakouts. If you’re someone who has acne and this happens to you then you probably won’t feel like using a thicker mineral-based sunscreen product. I developed my All Day Long SPF 50 moisturiser to help combat this issue for my patients who suffer from acne. It includes a very lightweight SPF 50 filter, as well as a hyaluronic acid and vegan snail-slime moisturiser to hydrate the skin but not to clog. It also contains Niacinamide which is a potent antioxidant and anti-acne ingredient.

Essentially with acne, you should look for an SPF that is not clogging, provides a high level of sun protection and also has additional antioxidant benefits. I usually would suggest using a thinner (but advanced) chemical filter with additional ingredients.

My acne improves in the sun, should I not be getting more of it?

If you have acne, then you might have noticed that your skin improves when you’re in the sun. This is thought to be related to UV light killing the P. Acne bacteria that drives the acne process. Whilst this is a short term benefit, the much bigger risk of UV damage to the skin in other ways far outweighs this transient effect, so I’d never advise unprotected sun exposure for this purpose.

What about rosacea?

Rosacea is a relatively common inflammatory skin condition, characterised by redness, facial flushing and sometimes breakouts, similar to acne. As the condition progresses, it can even affect the nose (rhinophymia) and eyes. Inflammation related to rosacea can cause thinning of the skin due to collagen and elastin breakdown over time, enhancing natural ageing processes and making the skin more susceptible to other ageing processes. There are often particular triggers that exacerbate rosacea. These can include things like:

  • Stress
  • Spicy foods, alcohol and hot drinks
  • Caffeine
  • Exercise
  • Changes in temperature - cold or heat
  • Menopause
  • Particular medications

Rosacea may also be worsened by sun exposure so here are a few tips on how to manage rosacea in the summer time:

  • Avoid direct sun exposure
  • Keep your skin cool by staying in the shade and using hydrating masks during the summer time
  • Daily use of a good quality sunscreen moisturiser
  • Make sure you stay hydrated
  • Avoid dietary triggers, such as spicy foods and alcohol
  • Avoid scrubbing the skin with rough cloths/harsh exfoliators
  • Use a gentle, nourishing cleanser twice per day (e.g. La Roche Posay Tolerane cleanser)

Which SPF should I use if I suffer from rosacea?

For those with Rosacea, the situation is ever so slightly different than with acne - not only can mineral sunscreens clog pores, certain chemical sunscreens can irritate the skin and exacerbate redness. This is thought to be partly due to existing inflammation and also low levels of the skin’s natural moisturiser, squalene, in the skin in rosacea sufferers. To avoid these effects, it’s important to use sunscreens that also contain anti-inflammatory ingredients, and which also function as SPF moisturisers. With this in mind, my All Day Long SPF moisturiser is also formulated with azelaic acid, Panthenol (vitamin B5) and a vegan form of snail slime, which is deeply moisturising.
For rosacea sufferers, choosing an SPF product is difficult - mineral filters often are clogging and uncomfortable, but chemical filters may risk irritation. My personal preference is to use a thin chemical filter, but one with a built-in moisturiser and anti-inflammatory ingredients, particularly vitamin B5 and azelaic acid.

Useful Resources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344124
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3709783
Cancer Research UK
NHS Acne
NHS Rosacea
La Roche-Posay Toleraine Dermo Cleanser