BackgroundCertain cosmetic habits may trigger or aggravate rosacea, while there is little published epidemiologic evidence to support this point.PurposeTo examine if daily skin care habits have an effect on the development of rosacea in Chinese population.MethodsA multi-center retrospective case-control survey of 1,245 rosacea cases and 1,538 skin-healthy controls was conducted in China. Participants completed the questionnaire comprised of demographic characteristics, socioeconomic data and daily skin care habits. Data were collected retrospectively and analyzed using the chi-square test and t-test. Multivariate logistic regression analyses were used to predict rosacea.ResultsThe multivariate logistic regression analysis highlighted some results: Dry, oily or mixed skin (OR = 6.3–6.9, P< .001), the usage of foaming cleanser (OR = 1.45, 95%CI 1.115–1.886, P = .01), make up more than 6 times a week (OR = 2.839, 95%CI 1.962–4.108, P< .001), using facial mask more than 4 times a week (OR = 2.56–3.069, P< .001), facial treatments at beauty salon more than once a week (OR = 4.946, 95%CI 2.005–12.198, P = .0018) and using beauty salon products (OR = 2.334, 95%CI 1.435–3.976, P = .0018) are positively correlated with the development of rosacea. Using of moisturizing products (OR = 0.602, 95%CI 0.386–0.983, P = .035) and sunscreen cream (OR = 0.303–0.507, P< .001 or P = .0167 for different frequency) presented significantly negative correlations with rosacea. Frequency of cleansing showed a nonlinear association with rosacea: using facial cleansers 1~3 times per week (OR = 0.647, 95%CI 0.429–0.975, P = .038) showed beneficial effects while using facial cleanser excessively (twice or more daily) (OR = 2.131, 95%CI 1.394–3.256, P< .001) positively correlated to rosacea strongly.ConclusionsExcessive use of facial cleanser (twice or more a day) and facial mask (more than 4 times a week), frequent makeup (more than 6 times a week), regular skin care in beauty salon (more than once a week), and using beauty salon products were closely correlated to the development of rosacea in Chinese population.