Red face causes and treatments according to dermatologists

Having a red face is one of the most common complaints in dermatology. More than 1.2 million people look for a solution on google every month!

Although the red face's main reason is genetic, using a few simple lifestyle changes and the right over the counter products can help in many cases.

How to choose skincare for a red face?

Good hydration is essential for people with red and sensitive skin. People with red faces should look for a skincare routine that is mild and non-irritating. A gentle cleanser and moisturizer should include calming anti-inflammatory ingredients. Good non-irritating face washes for people with red, irritated skin are cleansers with ceramides or aloe vera. Good examples of redness relief moisturizers are fragrance-free daily creams that contain niacinamide.

Niacinamide is a great skin-calming ingredient that protects the natural skin barrier, hydrates the skin, and helps reduce skin redness and irritation.
People prone to a red face from any cause should avoid using harsh scrubs or exfoliants on their face and avoid products that contain highly irritating tretinoin, adapalene, and menthol.

What are the causes of the red face?

The face becomes red when blood vessels dilate. The dilated small capillaries make the skin red temporarily or permanently.

Sun exposure is the most obvious cause of a red face.

Temporary skin redness is frequently caused by excessive sun exposure. The skin sensitivity to sun exposure depends mostly on the skin type. Fair skin types are usually much more sensitive to the sun than darker skin types and will get redder much faster.

The solution for sun-induced redness is simple. Try to reduce sun exposure and always wear a good broad-spectrum sunscreen when outdoors. People with acne-prone skin or rosacea should look for a sunscreen that is oil-free, water-resistant (stays longer on the face), and preferably contain anti-oxidants and anti-inflammatory agents. SPF 30 is optimal. Check this link for a good example.

Seborrheic dermatitis as a cause for red face

Seborrheic dermatitis is a benign skin condition that will typically appear as redness and scaling on the nose folds and between the eyebrows. It will usually not cause redness on the cheeks. The red areas in seborrheic dermatitis, also called seborrheic eczema, usually look oilier and covered by a thick scale.

The two best treatment ingredients for seborrheic dermatitis are sulfur and salicylic acid. Sulfur is a potent natural antibacterial anti-fungal and anti-inflammatory ingredient. Salicylic originally derived from the bark of the willow tree and sebophillic, aka - dilutes in the skin oil (sebum) and penetrated the skin oil glands. Having penetrated the skin oil glands helps dissolve the keratins in the dead skin cells forming the scales and skin redness.
Using a dermatologist prescribed steroidal cream for seborrheic dermatitis is usually not a good idea. Application of steroidal creams on the face for more than one week can actually cause skin atrophy, aka thin skin, and more skin redness.

Rosacea: the most common cause of chronic facial redness

Rosacea is a common cause of temporary and chronic red sensitive skin. Some people with rosacea have discrete rosacea flare-ups, and some a permanent condition. The redness in rosacea-prone skin will usually start on the cheeks. In the beginning, the redness is temporary. With time, the skin gets red permanently, and acne-like pimples can develop. Prevention is key to success in reducing skin redness in people with rosacea-prone skin. Reducing alcohol, spicy food, saunas, and proper sun protection, can significantly reduce skin redness.

It seems that the best rosacea treatment is benzoyl peroxide, 2.5%. Other options are sulfur 3% and niacinamide 2-4%. People with red faces should avoid using retinoids in red skin areas.

Contact Dermatitis

Contact dermatitis on the face is also can cause a red face. The cause of allergic contact dermatitis on the face can be cosmetics products, wrong makeup, a shampoo that spills over the face of something in the air. Materials that we apply on the hand can also cause contact dermatitis on the face. Touch the face with poison ivy, latex gloves, fragrance coating hand creams can also cause allergy on the face and subsequently red areas. The only way to get rid of allergic dermatitis is to stop using the products that caused it. Seeing a dermatologist and doing allergy tests can be helpful in more severe cases of dermatitis.

Acne-Related Redness

Acne is actually not a cause for a red face. In acne, the redness and the inflammation develop around the opening of the clogged skin oil glands causes local discrete blemishes. Thus, except for rare cases of very severe cystic acne, most of the face will not be red.

That said, topical anti-acne medications can cause some skin redness and dryness. Having some redness acne treatment is normal. That said, using the right anti-acne topical medications, salicylic acid, and micronized benzoyl peroxide 2.5% while avoiding the highly irritating adapalene gel (Differin and Epiduo) can provide high treatment efficacy without excess redness.

Face Redness is Caused by Topical and Oral Medication

Quite a few medications can cause photosensitivity, aka excessive sensitivity to the sun. With these medications, a short outdoor trip can cause sunburn-like redness on the skin's exposed parts, including the face. Some of the most common medications that can cause photosensitivity are Antibiotics: doxycycline, tetracycline, ciprofloxacin, levofloxacin, ofloxacin, trimethoprim, and antidepressants: doxepin (Sinequan).

Atopic Dermatitis

Atopic dermatitis, also called atopic eczema, can be caused by itchy red rashes. The most common places for atopic dermatitis redness are the folds of the elbows and the knees, but it can also appear in severe cases on the face.

What are other rare causes of a red face?

Alcohol-related flushing

Flushing due to alcohol consumption is a rare genetic condition where you lack the enzyme to break down alcohol properly, causing an alcohol byproduct to accumulate and cause flushing. Taking an antihistamine before consuming alcohol may help reduce some of these flushing effects.

Systemic Lupus erythematosus

Systemic Lupus erythematosus (SLE) is an autoimmune disease that is more common in females. One of the typical lupus signs is redness over the cheekbones, and the nose bridge, also called a butterfly rash. This skin disease is diagnosed by doing special lab tests and should be treated by a dermatologist.

Sezary's syndrome

Sézary is a rare type of T-cell cutaneous lymphoma (CTCL) that can be manifested by skin redness in the body and face. The diagnosis of Sezary's syndrome is made by skin biopsy and lab tests. Treatment is usually by a dermatologist is in outpatient hospital clinics.

Atopic dermatitis: Diagnosis, treatment
Seborrheic dermatitis: Diagnosis and treatment
Contact dermatitis: Tips for managing
Cutaneous T-cell lymphoma
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