Of all the skin conditions your clients may present to you, rosacea may be the hardest to fully understand and treat. This is because rosacea is frequently mis-diagnosed as acne, as sensitive skin, and a host of combinations. Misunderstanding can lead to improper treatments that can only exacerbate the skin’s condition.
Estheticians cannot diagnose or treat skin diseases such as rosacea. However, it is crucial that estheticians recognize and provide skin care services that help to alleviate the condition and provide an ongoing holistic program to manage it.
To provide insights into the proper recognition of this skin condition, as well as proper treatment, Repêchage CEO and Founder Lydia Sarfati, CIDESCO diplomate, partnered with Dr. Natalya Fazylova DNP, Doctor of Nursing Practice and an Associate Professor at the City University of New York as well as co-founder of NYC’s ReBalance Aesthetics & Wellness Medical Center, for an online Master Class, Soothe Sensitive Skin: Repêchage® Hydra 4® Red-Out® Facial.
Here are some of the key points discussed to dispel rosacea myths, help in recognition and proper treatment, and focus on creating a holistic program to benefit your clients to create real loyalty for the long run.
What is Rosacea?
The Rosacea market size reached to $2.14 billion in 2025 and is expected to grow to $3.34 billion in 2030. This growth may be attributed to increasing prevalence of chronic inflammatory skin conditions, rising dermatology consultations, wider availability of topical antibiotics, growing awareness of rosacea symptoms, and improved access to care.
It could also be attributable to increased disruptions in the skin microbiome due to environmental factors, improper diet and lifestyle habits, improper skin care usage and treatment and increased stress.
Rosacea is a chronic inflammatory skin condition influenced by environmental, dietary, genetic and lifestyle factors that play a critical role in its onset and exacerbation. Genetic factors play a significant role in rosacea, with studies estimating that heritability accounts for 46% of the risk.
Immune dysregulation, microbiome alterations, hormonal influences and psychosocial stress can also be exacerbators as well as extrinsic triggers like ultraviolet radiation, air pollution, dietary factors, alcohol consumption, smoking, skin care practices and climate. These diverse factors converge on shared neurovascular and immune pathways, resulting in characteristic rosacea symptoms.
Rosacea is a disease that is still misunderstood and consistently underdiagnosed. The root cause is not fully understood. Rosacea presents itself as symptoms such as sensitivity to the skin, papules and pustules, follicular scales, redness and itching. It advanced cases, it can cause an enlarging of the nasal area called rhinophyma.
Predisposition for rosacea tend to be people between the ages of 30-60, fair skinned, Fitzpatrick skin type 1,2 with a genetic predisposition, although we are finding that higher Fitzpatrick skin types such as 3 and 4 or higher can also be genetically predisposed, but it may be missed or underdiagnosed. Women are more likely to get rosacea, however cases in men can be more severe.
Besides genetic predisposition, possible causes can be disruptions in the digestive tract caused by celiac disease, Crohn’s, ulcerative colitis, helicobacter pylori infection, and irritable bowel syndrome (IBS).
There are complex reasons as to why individuals with rosacea are more likely to develop gut health issues such as IBS. The digestive tract, like the skin, is exposed to environmental factors, and the complex interplay between exposure and a person’s genetic risk is believed to cause changes in the immune system that may cause the immune system to mistakenly target both the gut in IBS and the skin in rosacea.
Researchers also find rosacea sufferers may have an increased number of demodex mites, tiny mites that live in the hair follicle on the face. These microorganisms live on everyone’s skin, but there are often more of them in people with rosacea. Demodex is found on facial skin, especially the forehead, cheeks, sides of the nose, eyelashes and external ear canals. It sometimes causes a condition called demodicosis.
What Can Estheticians Do?
“As estheticians, you know that you are not allowed technically to diagnose the skin,” says Sarfati. “You can analyze it, but only medical doctors can diagnose skin diseases. You must stay within your license. When you speak to the client, remember the language that you use, how you position your recommendations, how you analyze the skin, and what do you say to your clients is very important. Be professional and have integrity. “
There is a lot that estheticians can do to help alleviate symptoms of the condition. “When a rosacea patient sees an MD, the doctor might not be looking at the patient in a holistic manner,” says Sarfati. “They are looking at a specific symptom and trying to fix that. But our body is a wonderful complex of many different organs put together, and if we don’t have a holistic approach, we’re usually worse off because we’re not treating the body as a whole. We’re just focusing on one element of what the particular symptom is.”
As for early diagnosis, the esthetician can note what state and stage of rosacea their client is currently presenting. There are three types of rosacea:
Vascular rosacea manifests as a butterfly rash on the center of the face, caused by vasodilation of the capillaries and increased cortisol production. This can be exacerbated by heat exposure, drinking alcohol and stress.
Inflammatory rosacea has the vascular component, but there is the addition of inflammatory exacerbation which is related to GI health.
Ocular rosacea is when you not only have symptoms of inflammation but also have outbreaks of pustules and papules which may be itchy, leading to infection, acne scars and hyperpigmentation.
Dr. Fazylova notes that unfortunately, clients may come to your skin care salon or spa after having undergone treatments that made the condition worse, including chemical peels, improper skin care products and acne treatments that disrupted the skin’s important microbiome.
It is for this reason that educating your client on the importance of holistic treatments at the earliest sign of outset is of vital importance.
Comprehensive skin analysis and consultation are key to creating a plan for helping to manage the skin symptoms of rosacea. Once the client is onboard with the lifestyle changes as well as treatments provided, they will see that their rosacea eruptions will decrease or at least become more manageable.
These recommendations can include dietary recommendations, stress reduction techniques, as well as proper in salon treatments with proper at home maintenance. These interventions can not only help improve the appearance of the skin but can help improve gut health and all the various holistic systems involved for overall body wellness. If inflammatory disease is left unchecked, it could make the genetic condition much worse. The inflammatory response of the GI tract could manifest on the skin with advanced rosacea symptoms, eczema, psoriasis and acne.
Rosacea Treatments and Precautions
Rosacea needs to be dealt with as you would sensitive skin. The types of ingredients used in treatments must be non-irritating, as well as effective for the various problems manifesting on the skin. It is for this reason we created the Repêchage® Red-Out® Facial with Seaweed Extract and Silver.
This plastic surgeon-approved, clinically tested facial and at home collection harnesses the power of nature’s finest ingredients, including silver, laminaria digitata seaweed, ultra-hydrating hyaluronic acid, and powerful antioxidants like quercetin and rutin, and soothing mirabilis jalapa extract.
The Red-Out® Facial begins with a gentle cleanse, followed by our new Red-Out® Soothing Essence Mist to prep and awaken the skin. Next, the powerful Red-Out® Serum is applied and massaged in, hydrating and temporarily reducing the appearance of redness and dryness. An intensive calming mask visibly soothes, while Eye Rescue Pads are an eye contour treatment designed to reduce puffiness. Another spray of Red-Out® Soothing Essence Mist and a final application of our new Red-Out® Soothing Moisturizer complete this rejuvenating treatment, leaving skin refreshed and radiant.
One key ingredient that makes the Red-Out® Facial and collection so unique and different is pure, metallic silver. By a complex production process, a special surface structure of the silver particles is created that guarantees the release of silver ions over a longer time span. These silver ions are antibacterial, removing the bacteria that the demodex mites feed on.
During the course of this treatment when using the Red-Out® Serum, Moisturizer, Spray and Cleanser, the biggest immediate result Is that inflammation is reduced by a significant percentage, and over time the skin looks calm, hydrated and soothed.
In clinical tests by the manufacturer of this form of silver, it was found to have significant antibacterial and antimicrobial effects. It forms an invisible protection at the surface of the skin which quickly eliminates its unwanted microorganisms, reduces the redness, and thanks to its anti-inflammatory effect, it helps to reestablish the optimal physiological balance of the skin microflora. restoring the skin microbiome on the skin.
Microsilver releases silver ions over a longer time span than traditional silver powders to perpetuate the antimicrobial anti inflammatory and anti oxidant activity.
The formulations also include four different red, brown and green seaweeds, including Laminaria Digitata. These are most highly beneficial to restoring the skin’s microbiome, assisting with antioxidant protection, are soothing and calming, and are also a great source of amino acids, vitamins and trace elements.
Other important ingredients to look for include different forms of Hyaluronic Acid at different molecular weights to work together to increase the moisture content in the skin. Quercetin and Rutin are natural bioflavonoids which have high antioxidant properties to alleviate conditions associated with oxidative stress, and Mirabalis Jalapa, a flower extract, helps to alleviate skin discomfort, fades redness from skin sensitivity and hydrates the skin.
The Red-Out Facial and products have been approved by plastic surgeons. Dr. Samuel Shatkin, Jr., a board certified plastic surgeon, owner of the Aesthetic Associates Centre and instructor at the State University of New York at Buffalo, did a study using the products on ten patients, and the treatment was provided by an esthetician.
Results found that 99% of people saw a visible difference after one Red-Out® facial, 92% saw less irritation after using Hydra 4® Red-Out® Cleanser, and 89% saw great improvement after using Red-Out® Serum.
“We normally recommend the Red-Out® Facial for rosacea, but we also have recommended this for clients with inflammatory acne condition as well because it helps eliminate inflammation, and redness which then leads into better healing” says Sarfati. “While we have Hydra Medic® Facial and products, in the last five years, we have seen combining these two collections together deliver great results for the client.”
The box contains enough product in unidose packaging to fully perform five facials, but with every facial, you must start with consultation. Consultation is key to determine the clients’ challenges, concerns, what have they been doing, what have they not been doing, and what would be the correct course of action for helping them to attain clear skin.
As can be seen here in these before and after photos on a client who had advanced rosacea, a significant difference can be seen after a course of five facials. One of the key things here is to use the Silver Ball Massager both to apply the components of the facial and to administer a facial massage. This Silver Ball Massager is made of high quality 316-grade stainless steel. Employed in conjunction with the facial massage, it stays cool to the touch while providing consistently correct pressure and prevents further skin disruption by improper and inconsistent hand and finger manipulation, reducing the tactile vibration on the skin which could potentially cause skin irritation.
The Red-Out® Express Soothing Facial for Sensitive Skin is a great option for clients who are short for time. With this, they can alternate between full one hour facials and this 30 minute express option. Dr. Fazylova also uses this express facial in conjunction with dermaplaning and microneedling with very good results.
At-Home Recommendations:
Creating a full protocol for both in spa and at home is key to managing the manifestation of rosacea on the skin. It is important for estheticians to educate their clients on how to maintain proper diet and lifestyle habits to manage rosacea in between treatments as is using proper skin care.
Red-Out® Cleanser is a creamy, foaming cleanser for sensitive skin that visibly reduces redness while delivering a soothing yet powerful cleanse. It contains a powerful blend of sustainably harvested seaweed, antioxidant-rich quercetin, calming rutin, refreshing orange water, and ultra-soothing aloe. Plus, silver boosts the skin’s barrier, keeping it healthy and strong, helping to restore the microbiome.
Red-Out® Soothing Essence with seaweed extract and silver is a stay on essence that literally treats your skin through-out the day. Vitamin and amino acid–rich Laminaria Digitata extract balances and refreshes skin after every use, while Mirabilis Jalapa, Rosemary Leaf, Chamomile Flower and Silver help to soothe the appearance of sensitive skin, soften the look of redness and provide gentle comfort.
Red-Out® Soothing Moisturizer with seaweed extract and silver is a calming cream featuring seaweed and hyaluronic acid to quench and nourish skin. Silver adds an extra layer of support, reinforcing the skin barrier and helping to visibly reduce redness for a calm, refreshed complexion.
Red-Out® Serum is a blend of seaweed and hyaluronic acid that delivers lasting hydration, while antioxidant-rich quercetin and rutin provide essential skin protection. Silver offers extra support, leaving skin smooth, refreshed, and glowing.
Red-Out® Soothing Sheet Mask is a dermatologist tested mask specifically designed for the needs of sensitive skin that helps to reduce the appearance of irritation caused by the environment and stress. It utilizes a blend of vitamins, minerals, trace elements, amino acids, and antioxidants found in Seaweeds, combined with skin hydrators such as Aloe, Hyaluronic Acid, Allantoin, Azelaic Acid, and Mirabilis Jalapa extract to bathe skin in moisture while it helps to visibly reduce the appearance of redness.
Hydra 4® Starter Collection: This essential starter kit contains a full at-home program that combines ingredients such as four Seaweed extracts and Micro Silver and soothing botanicals such as Olive Leaf extract, Quercetin, Mirabilis Jalapa, St. John’s Wort, Chamomile and Green Tea to help nurture and soothe while helping reduce the appearance of redness and irritation. It contains five at-home care products in convenient starter sizes. In addition to the Red-Out® Serum, it also contains, the Hydra 4® Cleanser, Hydra 4® Soothing Toner, Hydra 4® Moisturizing Day Cream and Hydra 4® Soothing Clay Mask.
Going home with a starter kit collection is a great way to help them maintain their skin and while it also increases loyalty and commitment to their ongoing program.
Clients should be made aware of climate and environmental factors that can exacerbate their problems, such as extreme heat, sun and cold. Physical exertion, such as exercise, can be a consistent trigger for redness. Educate the client on washing their face immediately after exercise or the gym with Red-Out® Cleanser to restore the skin’s microbiome, then spraying face with a cooling Red-Out® Essence. This will allow the silver ions to stay on the face through-out the day.
Proper makeup use is also key for this skin group. Recommend a camouflaging green pigmented concealer such as the Hydra Medic® Corrective Concealer which contains silver to color correct redness while concealing rosacea, followed by a light-weight, non-comedogenic liquid foundation such as Repêchage Perfect Skin Liquid Foundation with zinc for environmental protection.
Be sure to write up all these recommendations for the client to bring home in order to help them continue to follow the protocols.
For more information, discussion and tips on helping your rosacea clients, watch the full Master Class , Soothe Sensitive Skin: Repêchage® Hydra 4® Red-Out® Facial.
Furthering your education on important topics such as chemical peels are key to your business, as well as your client’s safety. See all of the Master Classes to enhance your skills here.
