Causes of my red cheeks - when it's not Rosacea / Killaratosis Pillaris?

[18 Year Old Male]

5ft 10, 172lbs, 8% BF - Just to let you know im not overweight, very active, bodybuild and do not have any other obvious healthproblems.

Hi,

To keep the story short I currently have quite frequent episodes of redness in the cheeks only - this has been occuring since about November 2008 ( I started sixth form in September) and has kind of gotten worse in the sense the redness in the cheeks was at first very vague but has now gotten more prominent. The redness in the cheeks coincided with my first spot(s) which where whiteheads e.t.c commonly associated with puberty i.e 16-18 years old.

Basically the redness is only in my cheeks, not anywhere else on my body and can vary to the extent of how much of the cheek it takes up. There are no bumps on my face or anywhere else and there are also no visible blood vessels or dots of sporadic redness, its more or less a complete area only vaguely fading near the mouth area and near the side burns.

I originally believed this was to do with my regular spicy chicken I used to have at every night-time meal , however I have since stopped that habbit a good year ago as well as completely eradicating salt and dairy from my diet plus more water - to no avail. I then thought it may have something to do with the harsh soap I was using as a cleanser however since changing that I havent really noticed much difference - However... in the summer of this year (2010) I honestly cant remember a flare up or occassion I noticed any redness, I guess my tan covered it up perhaps? I only seem to take note of my redness when I feel flushes or hot which occured alot areound December to March of 2009/2010/2011 - similarily when in a hot room/ class room I used to get very hot (High body temperature?) and would notice my face getting pinker/redder.

I originally though I had Rosacea as it was one of the first results from searching redness/flushing in google however pictures such as this one:
flickrDOTcom/photos/djelpern/15445932/

Seem more common to my experince except my redness is not as bad / dosent extend to the eye brows side of head and dosent have visible capilaries or spots. Further more I workout 2x a day which has increased in intensity and duration from 2008 onwards - although I still worked-out prior to 2008 as well, I also used to tan alot however from 2008 my tanning decreased due to college and overall less personal time.

I would really appreciate some feedback from all you experinced members.

P.s When im cold my redness completely subsides - perhaps I have an allergy, other disease/ eczema? I have not had a formal medical diagnosis as of yet, however I have been to the doctors whereby the asked me to do a uring test which I eventually did not return as my redness kind of subsided at that time (April 2010).

I eat lots of tuna, porridge, rice milk, chicken, eggs and fruit, in addition to omega 3, zinc, multivitamic and water.

ALSO in alot of recent pictures it seems my mouth area - chin to lower cheeks is alot lighter/ whiter than my cheeks / forehead so it strikes a large, noticable contrast in my skin tone. I also do not sweat on my face / have not done since my redness began, leading me to think that my redness is a sign of my face unable to cool itself down.

Here are a few pictures doctor:

img513.imageshack.us/i/2008z.jpg/ ---------- (No Redness) 2008, September
img412.imageshack.us/f/2008veryflushed.jpg/ ---------- (First Redness) 2008, November
img255.imageshack.us/f/2008flushed.jpg/ ---------- (More Redness) 2008, Decemeber
img163.imageshack.us/f/2009v.jpg/ ---------- (Redness) 2009, Summer
img813.imageshack.us/f/2011he.jpg/ ---------- (Redness) 2011, Winter


Thanks in advanced,

J.

[J1992]

Updated Links:

http://img513.imageshack.us/img513/16/2008z.jpg                        
http://img412.imageshack.us/img412/2485/2008veryflushed.jpg
http://img255.imageshack.us/img255/47/2008flushed.jpg
http://img163.imageshack.us/img163/1857/2009v.jpg
http://img813.imageshack.us/img813/2703/2011he.jpg

1st Pic ---------- (No Redness) 2008, September
2nd Pic ---------- (First Redness) 2008, November
3rd Pic ---------- (More Redness) 2008, Decemeber
4th Pic ---------- (Redness) 2009, Summer
5th Pic ---------- (Redness) 2011, Winter

Regards,
J

[DrAttili]

Dear Joe,

I have had a look at your pics. However I have to say I cannot see anything pathological in the pics and subtle redness is extremely difficult to capture on photos. Regardless if you are otherwise well, the redness you describe is within physiological limits for someone with fair skin. I think you are worrying yourself too much about this. You should probably seek help from a local dermatologist, for reassurance.

Regards

Dr.Sasi Attili

[J1992]

Thanks for the response, I know the pictures dont show the severity of the problem - the reason I am concerned is that it appears as if my face is burning up, none of my parents have this problem and it seems when ever there is heat aka classroom, radiator e.t.c my cheeks go red and my face gets overly hot.

One other concern is that I never sweat in my face, could this be why my face goes red? I.e because it isnt sweating and cooling itself down, a tell-tale sigh is that it goes bright red because the heat is not being dissipated?

Thanks,

Joe

[Bhupinder Kaur, MD]

Hello,
It does not look like rosacea but can be due to blushing of skin. Blushing is a sudden and involuntary reddening of the face, neck and ears. You can overcome it by psychological counseling with a psychologist/psychiatrist and boosting up your confidence levels. The treatment of severe blushing includes anti anxiety medicines and beta blockers. Severe cases may need endoscopic thoracic sympathectomy (ETS).

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[J1992]

Thankyou for your advice and concern.

Its funny because Ive been having a decent spell this past week or so, then suddenly today when Id just come out of the bath and was laying on my bed with my head slightly raised I began to feel my face redden. I looked in the mirror and it was indeed very red in the cheek area.

Very confused and unhappy as its not Rosacea, or Killaratosis Pillaris as non of the symptoms match my condition other than the red cheeks. Every single picture of me pre September 2008 show me with a normal complexion, now suddenly I have really red cheeks, almost like 'slapped cheeks syndrome' children get.


I will book an appointment to my GP as its really starting to inhibit my life.

Thanks
Joe

[J1992]

Due to the fact I dont sweat at all on my face anymore - do you think this could be related to Anhidrosis?

I react very badly to heat / hot enviroments since september 2008, I remember when I used to sweat on my face i.e taste the saltly sweat on upper lip when I was young but now I dont sweat a drop on my face. Is it possible I may be chronically dehydrated?

In addition I stated getting spots, not too bad, but more than I had ever had before once I stopped sweating which I have heard is related to toxin build up which apparantly sweating helps to remove.

Joe

[J1992]

Im begining to link my redness to a possible allergic reaction - I seem to get very severe reactions after washing my face. Im going to examine the ingrendients in my cleanser and see if my previous soap also used to contain the same ingredients, (the product I was using when my face first started getting red).

Joe

[J1992]

Ok basically it has nothing to do with anything Ive been applying to my face. Ive since started moisturising and it has helped, but I still have slight redness, however not covering my cheek fully.

In addition ive started noticing that my skin has been becoming itchy when I get hot i.e would normally sweat, this subsides after about 1-2 mins i.e the itching, but I have an incling it has a connection with the fact I don't sweat and have a a dark redness of the cheeks.

Joe

[Dafne74]

Dear j.
I have been surfing the net for months now trying to find what the red patches on my face are that have developed in the last year.  I'm so glad I ran into your message as I have the exact same symptoms as you! not only the redness but also lack of perspiration from my face especially cheeks, nose and upper lip.  On top of everything I keep getting black spots or patches on my face for no apparent reason.  It looks like melasma but usually that is an effect of too much sun , a burn maybe or chemical peel which I didnt have- also I usually wear spf 20-50 all year round.  I was diagnosed twice with rosacea but the rosacea treatments do not work on me-when I look up close at my cheeks I really cannot see my pores anymore and they seem blocked by something.  That's when I thought I had a mild keratosis pilaris and that would bring about redness and probably lack of sweat? (I have the same on my arms).  One thing I noticed is that the sun helps actually- I moved to a place with really low sunlight hours/intensity and that's when my problems started.  Now I try to be in the sun more and cut back on the sunscreen a bit.  I also noticed that creams with Zinc or titanium oxides (natural sunscreens) help with the redness.  another thing I noticed is that even though I am not that white - I'm of mediterranean decent and always tanned nicely, now I don't.  I just get red.   Very odd- maybe my skin does not produce so much melanin anymore or it's confused ? from all the years of 50+ sunscreen? keep me posted...

Dafne

[J1992]

Well Id like to quickly update my situation, hopefully some professionals can give me some advice too.

Basically I went to my GP, who is a skin specialist two weeks ago. He examined my skin and said he couldnt see any broken capillaries or any other sign / symptons of rosacea, however due to the redness he said he would start off with prescibing me metrogel to try.

However, when I got home I tried it - nothing happened. The next day I was red all day, as most things I used to put on my face irritated it.

I did this for a week, making a log book of everything I did, I eat e.t.c

I basically found out my flare ups where occuring during bath or washing, however, now here is the very very strange part. As I am an avid fruit eater, I ran out of apples and oranges for a few days as a result of not going to the supermarket, from the day I stopped eating apples and oranges, my flushing completely, and I mean completely stopped. My face feels completely different i.e it is actually cold to touch for the first time in 3 years, working out dosent even cause a flare up, just the usual redness most people get. Bathing / washing my face dont even trigger it, extremes in temperatures dont even affect my face.

I have no idea why this works, but its been two weeks, off metogel and no apples or oranges, its boiling hot in England today and my skin still feels cold to touch.

My only concern is, that as the flushing has stopped, my skins redness has definately decreased but it is still there somewhat. I was wondering, as a result of the constant flushing over the years whether my skin will recover, as I dont have any damage to describe, and whether there is anything I can use to revert my skin back to normal.

Just a quick note, for the last 5 years my apple consumption has increased from 1 a day, to 3/5 a day, 365 days a year, always red apples.

Id like to stress, I dont flush anymore, and I mean never. I know what a flush feels like, the horrible burning tight sensation on your cheeks, well that has completely, 100% stopped. I get hot when doing normal things, but it dosent feel like the same heat. Also Ive started to sweat more on my upper lip, and below the eyes near the top of the nose.

Ive started using the metrogel and it dosent even irritate my skin anymore, im hoping maybe that will reduce the redness further.

The metrogel did make my skin peel initially, and the skin on my cheeks does feel very smooth, but it did nothing for the flushing previously two weeks ago. Ill see what happens now.

[J1992]

I know it sounds unbelievable, but I didnt change my cleansing, bathing routine at all, I eat a very confined diet so I know for a fact the only things I havent eaten are apples and oranges (its not carbs because I eat a ton of porrige, like 500grams a day).

Also I stopped the metrogel after a week, every day being flushed e.t.c, it only stopped as soon as I stopped eating apples and oranges ( Im almost 99% sure its the apples, but I dont dare eat oranges know).

Ive even eaten grapes since, and they didnt affect me either.

[J1992]

CAN I ALSO ADD -

When I stretch the skin on my cheeks, i.e move my mouth to the very left of my face so the skin on cheeks is stetched,  the redness on the cheeks completely fades, however when I stop stretching my cheeks it returns. The skin is very smooth, hydrated and not in anyway itching, tight, burning e.t.c

Thanks.

[razia12]

I am just curious to know how are you doing now? I am having the same problem as you described. Metrogel did not work.Please advice.