Why Is Your Face Flushed?

Does this sound familiar? "I'm just flushed from one too many glasses of wine," or "I've always blushed easily."

If these are common refrains, you may be seeing (and ignoring) symptoms of rosacea. If you've noticed any of these - facial redness and flushing, prominent facial blood vessels, thickening and redness in the nose, or enlarged oil glands (which appear as yellowish bumps) - don't put off seeing a dermatologist. Prescription treatments can alleviate symptoms and prevent rosacea from progressing further.

If you are Asian and experience facial redness after drinking alcohol, however, you probably don't have rosacea. You may actually be missing an enzyme that breaks down alcohol - as a result, you flush.

So unless you have other symptoms of rosacea (like broken blood vessels on the face or flushing after you eat spicy food), don't worry. Simply avoid alcohol and your problem is solved.

What causes rosacea?
Rosacea begins with frequent flushing, or dilation of the facial blood vessels; eventually those blood vessels lose their ability to contract to their original size and become permanently visible. It is most common in light-skinned people.

Interestingly, some evidence suggests that the same bacteria that cause ulcers, H. pylori, contribute to rosacea. I recommend that patients who have been diagnosed with rosacea be tested for H. pylori, which can be treated with antibiotics.

Experts are also increasingly interested in sun exposure as a cause of rosacea. One thing's certain: It doesn't help! Sun exposure breaks down your skin's collagen, weakening the supportive structures around your blood vessels and exacerbating the redness and prominent blood vessels associated with rosacea. Sunscreen is a daily must. (Another collagen attacker? Smoking.)

So, what can I do about it?
If you think you might have rosacea, the single best thing you can do is see a dermatologist. It's important to stop the progression of symptoms in its tracks, and a wide variety of treatment options can help you do just that.

While you're in your doctor's office, ask about skin care ingredients that help prevent and soothe rosacea symptoms, including:

  • Metronidazole (a prescription antibiotic)
  • Sulfacetamide (an anti-inflammatory ingredient used in several prescription cleansers)
  • Pimecrolimus (marketed as Elidel cream, a prescription product that calms the immune system and prevents the release of inflammatory factors)
  • Sulfur (an effective anti-inflammatory, although it can smell unpleasant)
  • Azelaic acid (Both an antibiotic and an antioxidant, azelaic acid may help lighten dark patches but can cause stinging in some sensitive types.)

Professional treatments like Intense Pulsed Light (IPL) and vascular laser treatments are effective options for minimizing broken blood vessels.

They're pricey (usually $400-500 per treatment), but the good news is that once a blood vessel is gone, it is usually gone forever. Annual follow-up treatments can target new blood vessels as they appear.

Of course, when you have rosacea, avoiding irritating ingredients and treatments can be as important as finding soothing ones. I caution my patients against "anti-redness" creams that contain hydrocortisone or other steroids, as they create a vicious cycle of redness. Steroids only temporarily shrink dilated blood vessels, which eventually rebound and may even become larger.

Finally, avoid spa skin treatments like facials, microdermabrasion, hot wax, or sauna and steam rooms, as they can irritate your sensitive skin. If you do opt for such treatments, make sure your aesthetician is aware of your rosacea and uses suitable anti-inflammatory ingredients.

Wishing you great skin!

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Dr. Baumann is author of the best-selling book, " The Skin Type Solution." To learn more about her revolutionary skin typing system, visit her Web site, SkinTypeSolutions.com.

All of Dr. Baumann's recommended skin care products are available online, and a portion of proceeds goes to The Dermatology Foundation.

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