Facial Redness

Hello, I am a 22 year old with fair skin. I smoke cigarettes( pack a day). The upper portion of my face is always a pinkish red color. Even when I'm relaxed. I also had a reddish color, but it has become more noticeable the last few years. I flush and blushed a lot in the past, and I'm not sure if it turned into permanent redness. My cheeks dont' get red but below my eyes, the sides of my eyes and forehead are always red like I have constant heavy blood flow that shows. It's not my skin tone because I am fair everywhere else. People always think I have a windburn or sunburn. I also have cold hands and feet which makes me think it could be circulation. My hands are also usually cold and red and about the same color. While my face is warm and red. I have normal blood pressure. I have been dealing with this for a few years and have tried numerous things, as it is a HUGE concern in my everyday life. I went to a dermatologist who told me I don't have rosacea, and I just have pink skin. But it seemed he barely looked at me and was more concerned with a pair of gloves he bought since he also has cold hands. I have tried anti- redness cream and concealers, less harse cleansers, and I wear sunscreen and hats. It seems to be getting worse, I can see a few tiny capallaries under my eyes and my skin sometimes feels dry and tight. I use gentle moisturisers.
My question is could this be an allergy, bad circulation, from smoking, or being dehydrated? Do you have any idea what could be causing this? And what are some options I have to treat this ? Is IPL treatment a viable option?

[Jasmina Jankicevic, MD, MSc, CCRP]

Welcome to the Dermatology Expert Forum! Thank you for your question.

In people with fair skin, redness can be constitutional (thin, sensitive skin with weak capillary walls, etc.) and certain environment (sun exposure, smoking, alcohol consumption, dehydration, use of inadequate topical products, exposure to extreme temperatures or wind, etc.) usually contribute to progression of the disorder. Intermittent blushing and flushing plus appearance of telangiectasia (small dilated and/or broken capillaries) are signs of couperose (circulatory disorder of small vessels).

Cold hands and feet may or may not be related to forehead redness. For starters, it would be great to exclude existence of possible associated diseases (such as scleroderma, lupus, or cardiovascular disorders, Raynaud’s syndrome, thyroid dysfunction, etc.); if you use any oral drugs review their side effects; and work on smoking cessation.

In regards to treatment, until you know if these lesions are primary (constitution related) or secondary (due to defined internal disease), we can talk only about symptomatic therapy, and you already seem to be very well informed and proactive in that aspect. For face, hypoallergenic, fragrance free, hydrating/moisturizing, broad-spectrum sunscreen is the most relevant product.  You asked about IPL – it could be effective with telangiectasia and intense redness (so could certain lasers).


Wishing You Optimal Health,
Dr. Jasmina Jankicevic