Redness on the face can be due to a number of internal factors such as red face rashes – shingles, seborrheic dermatitis, psoriasis, or acne, and external factors like sun damage, contact with an irritant, or an allergic reaction.
Skin redness can present in different ways. In some people, it can be dry red patches or splotchy areas on the skin, while for others, it may be red spots on the face.
Sometimes, the redness is localized to specific areas of the face, like reddened cheeks due to flushing or a red patch of seborrheic dermatitis next to the nose.
While usually, a red face is not serious, if your face redness is associated with other symptoms such as high fever, palpitations, or it gets worse, it’s best to see a doctor for proper diagnosis and treatment.
Causes
There are a number of factors and facial rashes that can lead to a red or blotchy face. Below, we will discuss 20 causes that can lead to red discoloration of the face.
1. Rosacea
Rosacea is a very common cause of a red complexion or red cheeks. It is a chronic skin condition that often starts with episodes of flushing and blushing.
Over time, in some people, it can lead to persistent redness, making the face appear red all the time. There are four different types of rosacea:
- Type 1 – Erythematotelangiectatic rosacea: Red areas on the face.
- Type 2 – Inflammatory/papulopustular rosacea: Facial redness, red bumps (papules), and pus-filled spots (pustules).
- Type 3 – Phymatous rosacea: Thick bumpy skin, especially on the nose.
- Type 4 – Ocular rosacea: Inflammation of the eyes and eyelids.
The exact cause of rosacea is unknown. However, there are several theories, such as altered immune response, genetics, hypersensitivity to mites – Demodex, etc.
Rosacea can be triggered by stress, sun exposure, and extreme temperatures.
Treatment and Prevention
Rosacea cannot be cured, but with the proper treatment plan, you can reduce facial redness and active flare episodes. The treatment consists of topical or oral antibiotics.
Some prescription topicals include azelaic acid, ivermectin, metronidazole, and brimonidine. You can get azelaic acid over the counter as well, but it is usually less than 15% (which is found only in prescription-strength formulas).
In addition, including soothing ingredients like niacinamide, oats, panthenol, green tea, and centella asiatica in your skincare routine can be helpful.
Some tips to prevent rosacea flares:
- Be gentle and don’t rub your face.
- Use fragrance and essential oil-free skincare.
- Avoid spicy food and alcohol.
- Avoid hot drinks.
- Avoid extremes of temperature.
- Work out in a cool area.
2. Seborrheic dermatitis
Red itchy patches on the face covered with greasy yellow scales may be due to seborrheic dermatitis.
Seborrheic dermatitis is a very common skin condition that can affect all ages. In adults, it is more chronic and cannot be cured.
Overgrowth of yeast – Malassezia on the skin, oily skin, and skin barrier dysfunction are some factors believed to trigger this condition. It predominantly involves oily areas of the face and body like the chest, back, and scalp.
Treatment and Prevention
For mild cases, the use of over-the-counter dandruff shampoos can provide some relief. These shampoos contain ingredients that can decrease Malassezia or reduce the buildup of dead skin cells.
Some ingredients to look for are zinc pyrithione, selenium sulfide, piroctone olamine, salicylic acid, and coal tar. It is important to use a good moisturizer as well to counteract the drying effects of dandruff shampoo.
For more severe cases, it is advisable to see a doctor for prescription topicals, which may include antifungals, steroids, or immunomodulators.
3. Psoriasis
Psoriasis is an immune-mediated skin condition in which the cells turn over at a very high rate – every 3-4 days compared to a normal cycle of 30 days. Instead of shedding, these dead skin cells can pile up on the skin.
This can result in red raised skin lesions called plaques, which are covered with silvery scales. These plaques can be associated with burning, itching, and cracking.
Red patches or plaques of psoriasis can appear anywhere on the skin; however, elbows, knees, and the scalp are commonly involved.
Psoriasis can be triggered by stress, cold weather, infection, skin injury, smoking, and heavy alcohol intake.
Treatment and Prevention
Psoriasis cannot be cured, but there are several effective treatments. Over the counter, you can find coal tar and salicylic acid in the form of dandruff shampoos.
Prescription topicals include steroids, vitamin A derivatives, vitamin D derivatives, or anthralin. In some cases, phototherapy is used.
Preventative measures:
- Avoid exposure to cold weather.
- Moisturize your skin.
- Manage stress.
- Maintain a healthy lifestyle.
4. Hives
Hives, also known as urticaria, are red, itchy bumps or welts that usually appear suddenly on the skin. They can be round, oval, or irregular in shape and can vary in size. Hives can appear anywhere on the body, including the face.
Hives are often a reaction to allergens, infections, or environmental factors. While they can be uncomfortable, hives are usually harmless and often resolve on their own within a day. Chronic hives, however, may persist for a longer period.
Treatment
- Cool compresses: Applying a cool cloth to the affected area can soothe the skin.
- Antihistamines: Over-the-counter or prescription antihistamines can help reduce itching and swelling.
- Corticosteroids: In severe cases, your doctor may recommend oral corticosteroids.
- Avoid triggers: If a specific trigger is identified, avoiding it can prevent future outbreaks.
- In rare cases, hives can be part of a severe allergic reaction called anaphylaxis. One should go to the hospital if hives are accompanied by shortness of breath, swelling of the face and throat, or low blood pressure.
5. Contact dermatitis
If your face suddenly becomes red, itchy, or starts burning, it may be due to something it came in contact with.
When our skin comes in contact with an allergen or an irritant, it can result in skin inflammation and a rash called contact dermatitis.
Common allergens are nickel in jewelry, poison ivy, fragrance, or dyes in skin care. Once our body is exposed to these, it can result in an allergic response with a skin rash. The skin can become red, itchy, dry, and may crack.
On the other hand, when our skin comes in contact with an irritant, it can damage our skin barrier and skin cells, resulting in irritant contact dermatitis. Common irritants include detergents, fragrances, essential oils, and cleaning supplies.
Treatment and Prevention
To reduce face redness and prevent its worsening, one needs to get rid of the irritant or allergen. If symptoms are more severe, over-the-counter antiallergic medications or mild topical steroids can be used (only for a few days and under a doctor’s supervision).
For future prevention:
- Avoid contact with known irritants and allergens.
- Use nickel-free jewelry.
- Use protective clothing or gloves when using harsh cleansing supplies or chemicals.
6. Perioral dermatitis
Rough red areas around the mouth, on the chin, near the nose, or eyes can be due to a rash called perioral dermatitis.
Perioral dermatitis is a skin condition often seen in young adult females (20 to 45 years of age). It results in a red scaly rash with red spots on the face. Sometimes these red spots are filled with pus. These can be associated with itching and burning sensations as well.
The exact cause behind it is not clear, however, it is associated with multiple factors like topical steroid use, fluorinated toothpaste, chewing gum, and dental products.
Treatment and Prevention
Treatment includes topical antibiotics such as metronidazole, clindamycin, erythromycin, and azelaic acid. In some cases, oral antibiotics may be prescribed.
Preventative measures:
- Use skincare meant for sensitive skin, free of fragrance or essential oils.
- Be gentle and don’t rub your skin.
- Avoid steroid creams.
- Frequently wash bed linens.
7. Shingles
Shingles is a viral infection caused by the Varicella Zoster virus (the same virus that causes chickenpox). If you ever had chickenpox, then this virus can stay dormant in the nerves and reactivate if there is a decrease in immunity.
Shingles can lead to a painful red rash with blisters anywhere on the skin, including the face. This rash usually appears on one side of the face or body. Blisters near the eyes can cause permanent damage. You may also experience fever, headache, and a burning sensation.
Treatment and Prevention
It’s very important to contact a doctor and get a proper diagnosis and treatment (antiviral medication). This will prevent long-term complications like nerve pain and damage to the eyes.
Shingles can be prevented by getting the vaccine.
8. Cutaneous lupus
Lupus is an autoimmune disease in which our own immune cells start attacking the body, affecting various organs. We don’t know the exact cause, but genes, hormones, and environmental factors are associated with it.
Cutaneous lupus can be divided into three types – acute, subacute, and chronic. The acute cutaneous lupus presents with a butterfly rash with redness on the cheeks and nose. This rash can become worse with sun exposure.
Treatment
You will need to see a doctor for proper diagnosis and treatment of lupus. Timely management can reduce complications. It is important to protect the skin from the sun.
9. Atopic dermatitis
Atopic dermatitis is the most common type of eczema. It results in skin rashes that can appear anywhere on the body. The affected skin is red, dry, itchy, and can ooze. The skin can become thickened over time.
The exact cause is not known. However, genetics and environmental factors play some role.
Treatment and Prevention
Treatment involves the use of steroids and barrier-restoring ointments or creams. In severe cases, other topicals can be prescribed as well.
The following tips can be useful in managing atopic dermatitis:
- Avoid irritants.
- Practice gentle skin care and regularly moisturize the skin.
- Manage stress.
- Get good sleep.
- Eat healthily.
10. Acne
Inflammatory acne is one of the common causes of red spots and blemishes on the face. These inflammatory acne lesions can be papules, pustules, nodules, or cysts.
In addition, when acne heals, it can leave behind red marks on the face, referred to as post-inflammatory erythema (PIE).
Treatment and Prevention
As you are treating your acne, make sure to nourish your skin with a good moisturizer as well.
To reduce facial redness, look for ingredients like niacinamide, salicylic acid, azelaic acid, green tea, and Centella Asiatica. In addition, do not pick at your skin.
11. Heat rash
Heat rash (also known as prickly heat) can appear anywhere on the skin, including the face. Extremely hot and humid weather can lead to blockage of sweat ducts and trapping of sweat under the skin.
Heat rash appears as small itchy red spots on the skin.
Treatment and Prevention
- Cooling the skin and staying away from heat can help it clear.
- Oatmeal baths can help with itching.
- Avoid using heavy creams or sunscreens to prevent it.
12. Telangiectasia
Redness on the cheeks is not always due to rosacea but several other causes which can also lead to broken capillaries or telangiectasia. These can give a blotchy appearance to the skin.
Sometimes, the broken capillaries can appear as red spots, especially on the cheeks or the nose.
In addition to rosacea, broken capillaries can form on the face due to a number of reasons:
- Sun exposure
- Physical trauma like using scrubs
- Fragrance in skincare
- Harsh skincare products
Treatment and Prevention
There is nothing you can apply topically to get rid of redness on the skin due to broken capillaries permanently. You will need to see a specialist and get laser treatment to zap them. However, to prevent more from coming to the surface:
- Be gentle with your skin.
- Do not use scrubs.
- Identify your rosacea triggers.
- Use sunscreen every day.
- Use fragrance and essential oil-free skincare.
13. Fifth disease (Erythema infectiosum)
Fifth disease is a viral illness more common in children than adults. It is caused by parvovirus B19. With this, one can get a red rash on the face, often referred to as a slapped cheek rash.
The rash can extend to the rest of the body as well. Other associated symptoms are fever, runny nose, and headache.
It can spread through respiratory secretions, such as saliva and sputum.
Treatment and Prevention
There is no vaccine to prevent it. However, you can reduce the chances of getting this or spreading it to others by:
- Washing your hands.
- Cover your mouth and nose when you cough or sneeze.
- Not touching your eyes, nose, or mouth.
- Avoiding close contact with sick people.
- Staying home if you are sick.
14. Reaction to a medication
Skin redness can be a result of a reaction to a medication or its side effects.
Some medications can cause reactions when you spend too much time outdoors in the sun. Prolonged use of steroids such as hydrocortisone can also lead to red discoloration of the face.
Treatment and Prevention
If you are using any medication, make sure to check for specific precautions. If you have been using hydrocortisone for too long without a doctor’s guidance, it’s best to stop and see if the redness subsides.
If the facial redness persists or becomes worse, consult a doctor.
15. Retinoid use
While retinoids like retinol or prescription-strength tretinoin are wonderful for the skin, they can lead to side effects like dryness, cracking, peeling, and redness on the skin. This is often referred to as retinol uglies or retinol burn.
Treatment and Prevention
To counteract these side effects, introduce retinoids slowly, use a thick nourishing moisturizer, and apply sunscreen every day.
16. Over-exfoliation
There are tons of exfoliating products on the market. These consist of alpha and beta hydroxy acids like glycolic acid, lactic acid, and salicylic acid.
Using these acids too frequently or using very high-strength chemical peels can harm your skin, leaving it red, dry, and irritated.
Treatment and Prevention
Step back from these acids and pamper your skin using barrier repair moisturizers with ceramides, shea butter, and niacinamide. If you want to include these acids back in your routine, use them sparingly and avoid higher strengths at home.
17. Hormones
Hormonal imbalances can also lead to facial flushing and red face, as seen in menopause and thyroid disorders. Some medications that influence hormone levels might indirectly cause facial redness.
Treatment
The treatment of a red face due to hormonal abnormalities typically involves addressing the underlying hormonal issue. Treatment might include hormone replacement therapy, medication to balance hormone levels, and lifestyle changes.
18. Foods and alcohol
Eating certain foods like spicy food, alcohol, certain cheeses, cinnamon, and tomatoes can cause vasodilation. This means the blood vessels in the skin can dilate, leading to a red face. This redness can be worse in someone with rosacea.
Prevention
Maintaining a food diary of your triggers and avoiding these foods or eating them sparingly can help manage this condition.
19. Alcohol flushing response
Some individuals, particularly seen in Asians, lack an enzyme called aldehyde dehydrogenase, which metabolizes alcohol. This can result in the accumulation of a toxic alcohol metabolite, acetaldehyde, leading to vasodilation and facial redness.
Other symptoms include nausea and rapid heart rate (tachycardia).
Prevention
- Avoid alcohol consumption.
- Oral antihistamines may be helpful for some people.
20. Sunburn
Prolonged exposure to the sun can cause sunburn, leading to red or pink skin, swelling, and eventually skin peeling.
Treatment and Prevention
- Be gentle with your skin, use a cool compress, and moisturize.
- Avoid picking at the peeling skin.
- Use sunscreen regularly, reapply as needed, and wear sun-protective clothing.
- Seek shade when possible.
21. Insect bites
Bites from insects like bees, fleas, and bed bugs can result in redness, swelling, and itching.
Treatment and Prevention
- Cool compresses and over-the-counter antihistamines may be helpful.
- If the cause of the redness is unknown or there’s a severe reaction to a bite, consult a doctor.
22. Blood disorders
Rarely, a red face or flushing with an itching sensation can be due to blood disorders or abnormalities such as polycythemia (it can be divided into different types – primary and secondary).
One may also have additional symptoms such as headaches, vision problems, confusion, etc. These disorders are diagnosed based on full blood counts and additional blood tests.
23. Rare Tumor/Cancer
- Skin cancers, such as squamous cell carcinoma and basal cell carcinoma, can present as red patches on the skin, especially on areas exposed to the sun, such as the face.
- Cutaneous T-cell lymphoma, including Mycosis fungoides and Sézary syndrome, can cause rashes and red patches.
- Rarely, neuroendocrine tumors may overproduce hormones like serotonin, causing facial flushing and other symptoms such as rapid heartbeat and diarrhea.
Any persistent or worsening redness, or if skin redness is accompanied by other systemic symptoms, should be evaluated by a medical professional.
Home remedies
To get rid of the redness on the face, it is important to identify the underlying cause and treat it accordingly. However, there are some home remedies that can help in reducing facial redness.
- Cold compress or bath: Skin redness can be reduced by the application of a cool compress with a cold washcloth or an ice pack. Taking a bath with cool water can also decrease redness.
- Apply aloe vera gel: Aloe vera gel is known for its ability to help with burns. It can provide some relief from mild facial redness as well.
- Be gentle: Be gentle with your skin if you have an underlying skin condition or when your skin is recovering from a rash. Do not rub or pull on your skin and use soft towels to pat your skin dry.
- Choose your skincare carefully: Harsh skincare products can irritate facial skin and lead to inflammation and redness. Instead, use products that are meant for sensitive skin and are free of fragrance, essential oils, and dyes. Also, use a cleanser with a pH of around 5.5 to protect the skin barrier.
- Add soothing ingredients: There are several ingredients that can reduce redness on the face and boost the skin barrier over time. Ingredients to look for are:
- Niacinamide
- Licorice extract
- Centella Asiatica
- Green tea
- Ceramides
- Azelaic acid and salicylic acid can be beneficial if you are dealing with acne and redness.
- Limit the number of products with actives: Less is more in skincare, especially when it comes to sensitive skin. Rotate ingredients like retinol and glycolic acid or other acids in your routine instead of using all of them together. Also, consider talking to your dermatologist to make sure you are using the right products.
- Protect your skin from the sun: Sun rays can lead to flares of several skin diseases, including face rashes. So, make sure to use sunscreen every day and reapply every 2 hours if you are sweating or doing any activities in the water.
- Wear breathable clothes: Wearing loose clothes will keep you cool and reduce the chance of flushing and a red face.
- Stay cool and hydrated: Make sure to work out in a cooler environment or drink cold water after intense exercise.
- Good sleep: Sleep deprivation can trigger a number of skin problems. So, take a good night’s sleep to help your body repair and boost its immune system.
- Avoid the use of alcohol or trigger foods: Avoid foods that are triggers for you and cause facial flushing and redness. The common ones are – hot drinks, spicy food, tomatoes, alcohol, and some cheeses.
- Manage stress: Stress is a trigger for many skin conditions. Relax by going on a walk, listening to music, doing meditation, or just talking to someone.
- Stick to your treatment: If you have already been diagnosed with a skin or medical condition, make sure to follow all the guidelines provided by your treating physician.
- Prescription: In severe cases, it is important to see a doctor who can help you identify why you have a red face. Your doctor may prescribe medication (topical or oral) to control the symptoms and also to prevent the possibility of any complications. Depending on what is causing the skin redness, these medications can differ widely.
Quick fix
Have a big event – a wedding, graduation, or a big party, and you wake up with a red face? Here are a few things you can do for a quick fix:
- Apply a cool compress: Take a clean soft towel or washcloth, wet it, and put it in the freezer for a few minutes. Apply compresses on your face with this. This can reduce the swelling and redness on your face.
- Apply an aloe vera mask: Take aloe vera gel and put it in the freezer for a few minutes. Apply a layer of this cool gel like a mask on your face.
- Use skincare or makeup products with a green tint: Yes, opposite colors can cancel each other out. So, to tone down redness on the face, a green-tinted product can be a perfect solution. The green tint is usually due to chromium oxide green in skincare products, such as moisturizers, sunscreens, or concealers.
- Makeup and concealer: The tint of the foundation and concealer can further help you cover any redness on the face. Make sure to choose your makeup products according to your skin tone.
When to see a doctor
If your facial redness is getting worse or associated with other symptoms like extreme pain, irritation around the eyes, fever, nausea, dizziness, and rapid heart rate, you should get medical attention immediately.
Key points
Redness on the face can be due to a number of reasons. While in some cases, it’s as simple as removing the irritant and pampering the skin, in others, it can indicate a more serious underlying health condition.
If the skin redness is an entirely new symptom for you, persists for over 2 weeks, and you have other unpleasant symptoms, it is best to see a doctor to get to the root cause.
Timely diagnosis and treatment can decrease the chances of complications.
References
- What is Lupus? (Lupus Foundation of America).
- Atopic Dermatitis. (National Eczema Association).
- Kapur S, Watson W, Carr S. Atopic dermatitis. Allergy Asthma Clin Immunol. 2018 Sep 12;14(Suppl 2):52. doi: 10.1186/s13223-018-0281-6. PMID: 30275844; PMCID: PMC6157251.
- InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Rosacea: Overview. [Updated 2020 Sep 10].
- Brooks PJ, Enoch MA, Goldman D, Li TK, Yokoyama A. The alcohol flushing response: an unrecognized risk factor for esophageal cancer from alcohol consumption. PLoS Med. 2009 Mar 24;6(3):e50. doi: 10.1371/journal.pmed.1000050. PMID: 19320537; PMCID: PMC2659709.
- Fifth Disease. (CDC).
- About Psoriasis. (National Psoriasis Foundation).
- Shingles. (CDC).
- Tolaymat L, Hall MR. Perioral Dermatitis. [Updated 2022 May 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
- Mycosis Fungoides. (National Organization for Rare Disorders).
Disclaimer: This blog post is for information purposes only and does not replace medical advice.