Facial redness: what are the possible causes and what treatments to relieve?

Why do we blush?

Facial redness is caused by dilation of blood vessels in the skin in the dermis layer, under the epidermis. This blushing is, basically, a normal reaction of the body, and can also follow a strong emotion (shyness, embarrassment, anger, excitement or stress), what we call “erythema pudise”. Redness can also be present after intense physical activity, to wick away sweat and thermoregulate the skin.

Facial redness: what are the aggravating factors?

Other factors can make facial redness worse:age (which causes skin aging and more redness), genetic heritage (this so-called “vaso-reactive” skin can be hereditary), hormonal factors (menopause and hot flashes), a certain hypersensitivity of the skin, ethnic group, UV exposure, temperature changes, occupational exposure to chronic heat and products toxic to the skin (chemicals, detergents, perfumes that cause eczema, etc.)”explains Dr Johanna Deniel, general practitioner.

The occurrence of sunburn (solar erythema) in childhood also seems to weaken the skin over time. It is also vulnerable to climatic conditions (heat, cold, wind, etc.). The increase in pollution is thus associated with facial skin hypersensitivity. Altered skin barrier, hyper-reactive sensory fibers, hypersensitive skin reacts more strongly than average to certain stimuli. “Hypersensitive skin is damaged more quickly and can take days or even months to repair itself.”adds the doctor.

Certain behaviors or situations can also cause facial redness, such as: excessive consumption of alcohol or spicy food, taking certain medications (such as vasodilators), voluntary exposure to high temperatures. (weather, sauna, jacuzzi, too hot bath…).

Facial redness can also be a sign of various skin diseases.

What are the symptoms that should concern you?

Facial redness can appear as diffuse redness, but also as red spots or patches. The skin becomes sensitive and irritable. In some cases, we can also observe other more annoying symptoms: swelling, itching, feeling of heat, small lesions, pain, peeling of the skin, etc.

What diseases can cause facial redness?

Several illnesses can cause redness during the day:

Rosacea (which may or may not be accompanied by rosacea)

Rosacea is the disease most frequently responsible for the phenomenon of redness and visible blood vessels on the face. “This chronic, genetic disease, very widespread, especially among women aged 30 and over, appears more particularly on light and thin skin, i.e. sensitive skin, and develops gradually. It most often affects the sides of the nose, the cheeks and sometimes also the chin and forehead.describes Dr. Johanna Deniel.

Rosacea progresses in several stages. Erythrosis is the first degree of rosacea: initially, the face reddens suddenly and too frequently, experiencing what are called “flushes” (fleeting outbreaks of redness, with the presence of burning and tightness). This redness may be accompanied by hot flashes. When these diffuse rednesses, which appear in the form of small patches, become permanent, we speak of facial erythrosis. The physiological causes of this chronic skin condition, which progresses in outbreaks, are still poorly understood, but certainly come from a disruption of the local immune system. However, we know that there are aggravating factors, such as exposure to the sun. “In all cases, rosacea is a disease that has a significant impact on the quality of life of those affected.notes the doctor.

Redness is very common in dermatology and the explanation is often rosacea. If it is not rosacea, then it is appropriate to look for another cause:

Acne

Acne appears on oily skin, typically during adolescence, during periods (ovulation peaks) or during pregnancy. It results from the obstruction of pores due to excessive secretion of sebum by the sebaceous glands and the colonization of certain bacteria. Acne lesions are red, due to the inflammatory nature of acne, and it is best to avoid touching them, otherwise it will cause lasting scarring. Furthermore, acne can give rise to post-inflammatory hyperpigmentation (PHI for short), which results in flat spots ranging from pink, red to brown, depending on skin tone.

The allergies

Redness can also be due to a reaction of the skin to an allergen (cream, food for example). For example, hives can appear as red patches on the face.

Eczema (atopic dermatitis)

This rash, which is accompanied by itching, can appear suddenly and make the skin dry (these red spots are recognizable because they look like scaly patches). Eczema generally affects the feet and hands, but also the skin of the face.

Eczema (contact dermatitis)

In this case, the lesions are triggered following contact with an allergen: it is an acquired inflammatory skin disease. Unlike atopic eczema, contact eczema is not due to an atopic condition. This is definitely an allergic reaction. After contact with the problem allergen, red patches, swelling, small pimples, fluid-filled blisters, thickening of the skin and peeling may appear. Most often, the allergens involved are: costume jewelry, clothing, certain medications applied locally, perfumes, cosmetics, hair products or chemicals, etc.

Seborrheic dermatosis

A chronic or recurrent skin disease, seborrheic dermatitis is manifested by redness and scales in the oily areas of the face (between the eyebrows, at the hairline, at the nasolabial fold, etc.). Its cause would rather be linked to immune dysfunction.

Exceptional illnesses

• Acute systemic lupus erythematosus : this chronic, multi-systemic, inflammatory disease, of autoimmune origin, occurs mainly in young women. It manifests itself as more or less significant erythema and edema of the face, with a characteristic so-called “wolf” shape (on the nose and cheekbones).
• La dermatomyosite : this autoimmune disease is characterized by inflammation of certain areas of the skin (dermis) and certain muscles. In this case, the redness is particular, more of a lilac hue.

This list is not exhaustive ! This is why it is advisable to consult a general practitioner or a dermatologist to establish a precise diagnosis and eliminate, in particular, rare causes.

Rosacea: how does it present?

Rosacea, as previously described, is the main condition to look for in facial redness. “It presents in the form of facial erythema or erythrosis, and can take several shades, ranging from more or less bright red to purple. Particularly visible in fair-skinned people, its presentation and duration may vary., notes Dr Johanna Deniel. It can affect a localized area (nose, cheeks, forehead, chin, neckline, etc.) or extend to the entire face (diffuse redness). Location is also important in the diagnosis.

Rosacea can develop in several phases: vascular rosacea, erythematous rosacea, papulo-pustular rosacea, granulomatous rosacea. The erythematous phase is the most common and within this phase, different types of redness occur. Some, like flushes (hot flashes) are temporary, others chronic (erythrosis, where you are permanently red; erythro-rosacea, where you are red with visible vessels). Chronic redness persists over time: for a few days, a few weeks, or even months. Please note: more severe forms (papulo-pustular rosacea) or rarer forms (granulomatous rosacea, Morbihan syndrome, rhinophyma, etc.) may also exist.

What happens in the specific case of this redness?

This redness reflects vasodilation of the vessels, which increase in diameter. This is a physiological reaction of the body, so that cells (white blood cells) arrive in this specific area which will fight the current disease: this “inflammatory cascade” is due to immune dysregulation. This vasodilation can be fleeting (flush) or permanent (erythrosis). When it lasts, the vessels permanently dilate and are visible: this is what we call “rosacea”.

What are the consequences of facial redness?

Aesthetic inconvenience, redness of the…