red pigmentation face, 20 years

ok so 20 years ago (which would make me about 8yo at the time) my left cheek got a quarter sized red spot.over the years it has grown, so now it looks like the shape of texas on my cheek and about a quarter size circle on my right cheek too. it does not feel any different than the rest of my skin it's just a different color. it does not brighten or fade, itch or burn. doctors say it's not rosacea but don't know what it is. I've been wearing makeup over it for all these years but if anyone sees me without makeup on they say "wow your face is really red, are you sick?" what the heck is this? I would love to have a name to put to it and maybe even be able to fix it. by the way it's not just red, it's almost purple and looks like a blotch not an even color.

[Bhupinder Kaur, MD]

Hello,
It can be due to rosacea or lupus. The exact cause of rosacea is not known. The basic process seems to involve dilation of the small blood vessels of the face. It can be due to genetic causes, hormonal problems, the bacteria Helicobacter pylori.

Please get investigated for these two conditions from a dermatologist. You can get skin biopsy and your ANA levels checked.

I hope it helps. Take care and regards.