Current treatment paradigms for rosacea focus on inflammatory lesions and other signs and symptoms of rosacea that appear on the skin surface. However, it is important to recognize the effects of the disease and its various treatments not only on the stratum corneum barrier but also on the biofilm. The effects of skin care products, cosmetics, and medications on the stratum corneum and biofilm must be carefully assessed, and nonirritating formulations should be used whenever possible.