They say love the skin you’re in, but for millions of people with inflammatory skin conditions like rosacea, eczema, and psoriasis, that would require constantly dodging a minefield of triggers, or risk a flare-up—itchy bumps, flushed, flaky, dry, or cracked skin.
For many decades, prescription medications or pharmacy brands were the only tools available. In recent years, amid growing destigmatization, other-the-counter (OTC) brands have started injecting a sense of levity and enjoyment into what seemed like a sterile category. As education around these conditions continues to expand, a growing number of consumers are looking for solutions while not wanting to sacrifice aesthetics or luxurious formulas.
Prevalence, Triggers, and Unanswered Questions—a Dermatological Perspective
While research offers a number for how many individuals are affected, there are still uncertainties regarding the causes of rosacea, eczema, and psoriasis.
Rosacea, affecting 5% of the world’s population, has no known cause or cure. It is defined by skin flushing, visible blood vessels, and acne-like breakouts. It is most common in those ages 30 to 60, with fair skin, blond hair, and blue eyes, as well as menopausal women. Triggers range from sun exposure to stress and spicy foods. Certain microbiota, like Cutibacterium acnes, Demodex folliculorum, Bacillus oleronius, Staphylococcus epidermidis, and Helicobacter pylori in the GI tract have been found to contribute to rosacea.
The multifactorial nature of the condition makes it particularly challenging to research and diagnose. Other inflammatory conditions, like seborrheic dermatitis or lupus, can cause rosacea-like symptoms. Dermatologists must review a list of 30 to 40 different triggers like fluctuating temperatures, diet, product regimens, and prescription use during a consultation.
“There's a reason that there's a seasonality to it [rosacea],” said board-certified dermatologist Dr. Ranella Hirsch. “Seasonality supports the theory that there may be an infectious disease component, as well as reinforcing the nature of each person having unique triggers. That explains why some describe summertime flares with the greater UV exposure, while others report a worsening of symptoms during the cold and dry of winter. If you had a disease that was the uniform, how is it that everybody has completely different triggers?”
Dr. Hirsch sees rosacea as largely underdiagnosed for several reasons, key among them being that it is perceived predominantly as affectingthose of Fitzpatrick Skin Type I and II, despite the fact that all types are affected. The wide spectrum in which the condition shows up, ranging from light blood vessels to the rarer rhinophyma rosacea, which causes a thickening of the skin, also makes diagnosis a challenge.
Alpha agonists like brimonidine and oxymetazoline can help treat redness, although Dr. Hirsch notes a potential rebound effect with brimonidine once the patient goes off the medication. Ivermectin, minocycline, microencapsulated benzoyl peroxide, and azelaic acid are other useful topicals. Low doses of antihypertension drugs like clonidine and propranolol help those with redness, while antibiotics like doxycycline, minocycline, tetracycline, and erythromycin address the skin texture issues of rosacea. For nonmedical treatments, for appropriate candidates, Dr. Hirsch recommends a pulsed dye laser, and for patients with more melanated skin, one option is a neodymium YAG laser, which works on a deeper level (but also with more scarring risk). The lasers work by treating the vascular issues in the superficial layers of the epidermis and dermis, specifically targeting and destroying visible blood vessels.
“There are still quite a few unknowns around the condition. We're spending more time now talking about the role of mast cells [immune system cells that defend the body against threats but also play a role in allergic reactions] in the disorder, and that could open up a new avenue for therapy for mast cell degranulation [the release of inflammatory mediators like histamine and tryptase into the blood stream or surrounding tissues],” said Dr. Hilary Baldwin, a board-certified dermatologist and medical director of the Acne Treatment & Research Center in Brooklyn, New York. “People always ask me, what the gaps are in therapy. I don't honestly see us as needing all that much, as we have great drugs. Of course, our access is a problem. Medicare won't allow us to use the coupons that make those brand new drugs [like oral extended-release minocycline, released under the product name Emrosi in March 2025] affordable.”
Dr. Baldwin noted that subantimicrobial doses of doxycycline are not approved by insurance companies, forcing some practitioners to prescribe full doses, which can fuel antibiotic resistance and also kill off good bacteria. “Many doctors, when faced with having to do prior authorizations, or maybe it's not covered at all, give patients full-dose antibiotics. I'm very much opposed to that. There are some ways to get around it, but in general, being able to use the low-dose prescription is so much better for both the patient and the world.” Nonetheless, she remains optimistic. “Managing rosacea has never been as successfully done as it is now.”
Speaking on the efficacy of OTC treatments for rosacea, Dr. Baldwin stated, “I don't think it's very good. You need drugs for this condition. On the other hand, rosacea is certainly a barrier deficiency disorder, and we have data that shows that making the barrier better in and of itself might improve rosacea. So maybe with OTC products, you can get your barrier back into better shape and reduce at least some of the signs and symptoms of rosacea.”
Psoriasis—characterized by red, purple, or brown patches of skin, itching, and thick, raised skin—affects 2% of the population. The condition is caused by an abnormally rapid growth of skin cells (maturing in 3-4 days as opposed to 28-30 days), likely caused by an overreaction of T cells. There are five types of psoriasis (plaque, inverse, pustular, erythrodermic, and psoriatic arthritis), although plaque accounts for 80% of all cases. Lighter skin is twice as likely to be affected, although melanated skin is also being underdiagnosed due to a lack of research on these skin types.
Triggers include stress, overuse of corticosteroids, lifestyle factors like smoking and alcohol use, and cold air and UVB exposure. Research also shows a comorbidity with conditions such as heart disease, diabetes, and Crohn’s disease. Anti-inflammatory medications traditionally used in chemotherapy, such as methotrexate and photochemotherapy, have also shown efficacy in treating psoriasis. Previously, UVA light treatments multiple times a week were another option.
Eczema, also referred to as atopic dermatitis, affects 10%-20% of children and 2%-10% of adults worldwide. It can show up as pink or red rashes on lighter skin and brown/gray/purple rashes on more melanated skin. Black children were 1.7 to 2.1 times more likely to be diagnosed with the condition and twice as likely to have severe atopic dermatitis than white children. Eczema is sometimes misdiagnosed as psoriasis.
Common triggers include sweat, stress, food allergies, and contact with irritants. For example, when public fear around parabens caused many formulas to be made paraben-free, formulators replaced parabens with less-studied, often irritating preservatives “causing an epidemic of allergic contact dermatitis," stated Dr. Margo Reeder, a dermatologist and paraben researcher at the University of Wisconsin School of Medicine and Public Health, in conversation with the National Eczema Association.
Those with the condition also display a weakened or damaged skin barrier, due to less filaggrin and claudin-1 protein in the skin, which lets the skin’s water out and environmental allergens in. The condition is more common in industrialized and low-income areas, indicating an environmental response is just as much of a culprit as genetic predisposition.
Hydrocortisone cream is a common topical remedy for eczema, as are antihistamines, as well as oral medications like immunosuppressants and Janus kinase (JAK) inhibitors (which work on JAK, or enzymes that send inflammatory signals in the body).
All three conditions also have a genetic component. Further research is still needed to determine the role of the gastrointestinal tract and gut microbiome dysbiosis in these conditions.
The pharmaceutical industry is working on more solutions. In May 2025, Johnson & Johnson announced its psoriasis drug Icotrokinra, which the manufacturer expects to generate sales of $700M, demonstrated considerable reductions of the condition in those with scalp and genital psoriasis. Biotech MoonLake Immunotherapeutics’s sonelokimab, which would help treat psoriatic arthritis, as well as three other inflammatory conditions (hidradenitis suppurativa, palmoplantar pustulosis, and axial spondyloarthritis), is currently in Phase 2 and Phase 3 trials.
In terms of medical research into rosacea, Dr. Baldwin stated, “Rosacea and acne are both taking a real hit on the research pipeline. There are not enough people with the disorder who want to be treated, and sales were not very good, so the companies have stopped putting money into R&D for this condition. I don't think we're going to see much in the way of demonstrable change in the near future.”
Dr. Hirsch said, “We think of things like eczema and psoriasis in particular as more of a disease. Insurance in the US, at least, will likely cover treatment, which is not always the case. Rosacea symptoms can be incorrectly written off as a cosmetic concern.”
The impact of eczema, psoriasis, and rosacea isn’t just physical but also psychological. In an online survey of 401 participants, 51.6% stated that eczema negatively impacted their quality of life. In a survey by the National Rosacea Society across 1,675 patients, 82% stated the condition had a negative impact on their general outlook on life. Another study states that 98% of psoriasis patients see the condition as impacting their psychological and emotional well-being.
As for public discourse, Dr. Hirsch noted a rise in public education around rosacea with the marketing of rosacea medications like Mirvaso (brimonidine topical gel, FDA-approved in August 2013) and Soolantra (ivermectin cream, approved December 2014). “That was a tremendous part of teaching people the term; it did a lot of the heavy lifting. Awareness in the community became part and parcel of how First Aid Beauty and the others suddenly had a niche to slide into.”
Dr. Hirsch said dermatologists have not seen a massive uptick in cases, but rather growing awareness of these skin conditions through social media and celebrity representation has led patients to seek treatment or self-diagnose. She cited Kim Kardashian being vocal about her ongoing struggle with psoriasis (the YouTube clip of Kardashian discussing the condition on SheMD had 136K views at the time of publishing) as one example. On TikTok, #rosacea has 95.3K posts, #psoriasis has 181.5K videos, and #eczema has 287.1K videos.
OTC Solutions
Given the challenges of insurance coverage for dermatological treatments, many are strolling the aisles of their local pharmacies and drugstores for popular remedies that contain soothing colloidal oatmeal or centella. Experts also recommend seeking formulas free of common irritants like alcohol, fragrance, menthol, or certain essential oils like peppermint.
Spate insights showed 699.9k average monthly searches for rosacea, 2.7M searches for eczema, and 1.7M searches for psoriasis. The most common product formats searched were moisturizer, laser treatment, and oils (i.e., tea tree, coconut, rosehip) for rosacea; lotion, soap, and oils for eczema; and shampoo and oils (i.e., emu oil) for psoriasis.
For the brands entering this space, there is the potential for big business. The atopic dermatitis market is worth $17B, with approximately 40% of patients using OTC treatments. The rosacea treatment market is expected to reach $3.87B by 2032, while the global psoriasis treatment market is predicted to hit $ 68.24B by 2033, and the eczema market is estimated to reach $37.1B by 2034. The global medicated skincare market was valued at $48.38B in 2025, while the dermatological OTC drugs market is expected to register a CAGR of 4.3% until 2030.
Dermatological brands like Vanicream, Aquaphor, CeraVe, Aveeno, and dedicated lines from pharmacy brands like La Roche-Posay have been reliable treatment options on the shelf. With minimalist formulas and subdued white and beige packaging, some consumers missed the indulgence of more glamorous packaging or a luxurious product feel.
First Aid Beauty was an early entrant, bridging the gap. The brand, marketing itself for those with sensitive skin, was founded by Lilli Gordon in 2009. The brand’s products found their home at Sephora and QVC in its launch year, and later at Ulta Beauty in 2016. “Lilli saw this white space of a problem-solving skincare brand. If you had those skin issues, you had to go to the drugstore or buy stuff from your dermatologist. There was no prestige brand offering a product that people wanted to use with great texture, appealing packaging, but also meeting the needs of those with skin issues,” said Catherine D'Aragon, CEO at First Aid Beauty.
The brand’s debut and hero SKU, Ultra Repair Cream, is formulated with colloidal oatmeal, shea butter, and allantoin to calm and soothe the skin while repairing its barrier. It later received the National Eczema Association Seal of Acceptance, The National Psoriasis Foundation Seal of Recognition, plus the National Rosacea Society Seal of Acceptance. Today, it represents 25% of the brand’s total business. The brand has since expanded to other sensitive, skin-friendly formulas addressing concerns like keratosis pilaris and acne.
In 2018, First Aid Beauty was acquired by Procter & Gamble for an estimated $250M. As for distribution, 20% of the brand’s business is on Amazon. There is an even split between digital and brick-and-mortar channels, but D’Aragon noted more acceleration from the digital channel. D'Aragon said that First Aid Beauty’s shoppers on QVC are women over 50, but the brand’s audience is “cross-generation” with a core audience of 20- to 35-year-olds. First Aid Beauty is currently rebranding its message and aesthetic, looking to capture a wider audience, with a slight skew towards Gen X and teens but still including all ages, genders, and ethnicities. For the future, the brand’s partnerships will shift increasingly to dermatologists to give additional authority to its skincare solutions.
“The market has developed so much through social media, it's no longer a stigma [to have eczema]. Now we're going back to the root of real skin solutions and education. We want to become this skin support system. Skin issues are not an age; they're for everyone.”
A founder who has first-hand experience of dealing with these issues is Amy Liu, who created Tower 28 in 2019, following her own struggles with eczema. In early 2025, the brand earned the approval of The National Psoriasis Foundation and the National Rosacea Society, in addition to its previous National Eczema Association Seal (where she also acts as a board member). “People need and want validation and credibility. That’s why it's really valuable to have the three seals because they genuinely care about their cohort of community. The hope is that we're sending out a bat signal that whatever their skin health issue is, we'll be able to take care of them.”
While Liu formulated products in line with the National Eczema Association’s guidelines from day one, she didn’t mention her condition until further along in the brand journey, when press began asking her the reason behind the brand’s formulation ethos (which includes being free of common allergens like fragrances and formulated to the Credo Clean Standard).
“I didn’t think about putting myself in the story like that. I was worried that it would be too narrow; if I talked a lot about eczema, people would think that only if they have eczema is this for them. But what I've found is it's kind of actually been the opposite. Through my story, it's made it more relatable and humanizing.”
One of the brand’s hero products is SOS Rescue Spray, a three-ingredient anti-inflammatory and antibacterial blend of water, sodium chloride, and hypochlorous acid to reduce redness, soothe the skin, and minimize irritation. A Spate Ingredients Trend report found that there was a 291.6% increase in searches for hypochlorous acid year over year.
Liu notes that the company spent so much on testing while also accounting for eczema and rosacea sufferers within those tests, that it was a challenge to break even on opening orders. She estimates the brand spends nine times more on testing than the industry average. The brand combats this added expense by saving on packaging costs.
Liu noted a challenge in conveying the brand’s dermatological credentials to the consumer and reaching the customer who deals with these chronic skin conditions. “We’re a really colorful, fun brand, and the customer has almost been trained psychologically to think safe means clinical or safe means boring. How do we get credit for everything that we are doing, but also speak to two different types of people? We want to give a healthier, better, good-for-you option that still has high performance and looks the way you want it to on a vanity.”
The brand recently onboarded two medical advisory board experts (board-certified dermatologist Dr. Joyce Park and double board-certified plastic surgeon Dr. Kelly Killeen) to assist in these aspects of the brand’s storytelling and product development.
“We are making so much of an effort to create something that is a great solution. I've seen firsthand that it really works for people. The thing that I feel the most passionately about is wanting those people to be helped,” Liu added.
It’s not just skincare, but also water filter systems that present solutions for inflammatory skin conditions. Jolie produces showerheads that remove chlorine and heavy metals, which the company states contribute to rashes and irritation, from water through KDF-55 and calcium sulfite filters.
While hair loss and health were leading concerns addressed by the product, Ryan Babenzien, founder and CEO of Jolie, has anecdotally noticed customers seeing skin benefits. He received hundreds of messages from individuals who saw reduced eczema flare-ups, and even more who saw other improvements in their skin like reduced psoriasis or acne. “When a few thousand people start saying the same thing—unconnected, unprovoked—you realize we are helping these people with this issue.”
The company is currently conducting third-party tested clinical trials (a first for shower filter systems) for the product’s skin benefits in response to this feedback, the results of which will be unveiled shortly. Once the brand receives the clinical results of the trials, it will be able to market its product further to those with inflammatory skin issues.
Babenzien sees Jolie as preventative maintenance in solving the environmental issues, which can lead to or exacerbate skin issues, in addition to receiving medical assistance and prescriptions. “It's a two-step process; make the water as good as you can when you're showering because you're doing that every day and it may be triggering these issues. Solve it at the medical level, but doing that without the other probably means you're going to be in that situation where it's acting up more often than it needs to.”
Whether it’s shower filters, SOS sprays, or repair creams, there are more accessible treatment options for inflammatory skin conditions than ever before. As celebrities, consumers, and entrepreneurs bravely share their stories around rosacea, eczema, and psoriasis, it will encourage others to seek a diagnosis or stroll down a product aisle less traveled. Brand founders will increasingly seek medical partnerships and clinical trials to be able to market their products to those looking for a solution with confidence. In return, those finding an effective solution to these challenging conditions will return the favor with strengthened brand loyalty. If the saying “hope in a jar” previously connoted a product with more marketing than substance, this developing wave of brands is returning the phrase to its original meaning: creations that can impact someone’s skin (and life) for the better.
