What Makes My Face Red?

Facial redness is complicated. On one hand, it can lead to a healthy appearance, while on the other hand, it can be a source of embarrassment. Let’s explore the details as to why facial redness could be a good or a bad thing. 

Why Facial Redness Can Be a Good Thing

In alternative medical traditions, the right amount of redness is thought to be a good feature. In Ayurvedic medicine, facial redness is a sign of the pitta dosha that in the balanced amount, gives the face a glow. In traditional Chinese medicine, the right amount of redness is a sign of Qi and Blood that are vital to a healthy appearance. Cosmetic products will sometimes intentionally include ingredients such as methyl nicotinate to subtly enhance facial redness.^[1] 

Several studies have looked at how facial redness may enhance appearance. One such study from the United Kingdom looked at how redness affects facial appearance.^[2] Participants in the study were asked to choose between two faces where one face had a slightly more reddish color to the face compared to the same face without the redness. The authors found that increasing the redness of facial photographs increased the perception of health and attractiveness.^[2] Another study showed that men rated photographs of women with more facial redness as more healthy and attractive.^[3] 

Why Facial Redness Can Be Embarrassing

The healthy appearance of facial redness has a limit. In the study where participants rated facial health and attractiveness based on redness, they did not choose the reddest face presented to them.^[2] This particular study was limited to Caucasian skin and future studies need to look at how these redness thresholds change across different ethnicities and cultures. 

Nevertheless, facial redness can become a source of embarrassment and this notion is supported by research. Quality of life was found to affect those with facial redness in rosacea^[4,5] and the perception of quality of life improves when the redness is treated.^[5,6] 

Causes For Facial Redness

There are many reasons for facial redness and the treatments can differ based on the cause. Here are a few common causes: 

1) Sun over-exposure and damage

Sunlight is rich in ultraviolet (UV) radiation. UV light-type A can cause collagen breakdown. As as a result, the skin gets thinner and blood vessels become more visible. Also, UV light-type B causes dilation of the blood vessels.^[7]

Solution: Sun protection is very important. Although this may not reverse any damage that has already been done, it will prevent any further damage to the skin. Sun protection involves avoidance of intense sunlight, the use of sun protective clothing, and the use of broad-spectrum sunscreens that block both UV type A and B.  

2) Rosacea

People with type 1 rosacea, known as erythematotelangiectatic rosacea, tend to have more visible blood vessels on the face.^[8] In type II rosacea, known as papulopustular rosacea, facial redness can be a result of having multiple red bumps and/or a background of redness due to inflammation.^[8] 

Solution: A qualified medical professional can help diagnose rosacea and discuss treatment options. Good sun protective habits are important, as UV light is one of the triggers for rosacea.[8] 

3) Irritation from skin care products

Skin care products can lead to redness and irritation, especially in people that develop sensitivity to chemicals within the product.^[9] One study asked participants for the most common causes for skin irritation and 36.6% of them thought their irritation was due to their skincare products.^[10]  The most common skin reaction was redness and represented 61% of all the reactions reported.^[10] 

Solution: Facial products can cause irritation even after years of use since some reactions can develop slowly. In some cases, the formulation of the cosmetic product may have changed without your knowledge. General non-prescription skin care products can be stopped to see if this is helpful in improving your skin condition. If a patient thinks that a prescription topical medication may be causing an allergy or a reaction they should let their medical provider know and discuss whether they should continue or stop the medication. 

4) Sun-induced lesions on the face

Sun over-exposure and sunburns can lead to the development of precancer lesions, known as actinic keratoses, and skin cancers. These lesions can have a reddish appearance and should be evaluated by a health professional. 

Solution: If there is a concern for a lesion that is not going away, is bleeding, is scaling, or is staying consistently red or pink, this needs to be evaluated by a medical professional. If diagnosed, precancerous and cancerous lesions should be treated as early as possible. 

5) Sensitivity to the sun

Some people can become overly sensitive to sunlight and this can be due to a variety of causes. Medically this is known as photosensitivity. Sometimes it can be due to a medication, herbal product, or supplement that is being taken. In other cases, it can be due to a condition that causes the body’s immune system to overreact to light; some examples include lupus and polymorphous light reaction. 

Solution: Assessment and treatment require the assistance of a qualified medical professional.