"I need to determine the cause of your redness before I can prescribe the most effective treatment. If I look closely at your skin and see lots of tiny threadlike blood vessels just below the surface, for example, you're probably dealing with sun damage. Over time, UV exposure encourages the formation of these vessels. A laser treatment is the most effective solution; it can literally explode the little vessels—and that unwanted redness along with them. To treat dense clusters of blood vessels, around the nose, for example, I generally choose a KTP laser. I usually get the job done in one or two intense treatments; you'll look bruised for several days. (If I use lower-energy settings, you need more treatments but experience less bruising.) For diffuse redness, intense pulsed light (IPL) treatments are a better option; most patients require about four sessions, but there is minimal downtime.
"If your skin stings when exposed to sun or cold, or if it gets rosier when you eat spicy foods, you might have rosacea, a chronic inflammatory condition that manifests itself as a butterfly pattern of redness across the nose and cheeks, sometimes accompanied by small pimples. A topical antibiotic, like MetroGel or Sulfacet, is the simplest way to clear up the symptoms—usually in about two months. If you want faster results, a KTP laser or IPL treatment will reduce redness within days; you can then keep your skin clear with a topical antibiotic.
"Redness accompanied by flaking could be seborrheic dermatitis or eczema, for which I often prescribe a two-week course of a topical immunomodulator like Elidel, which blocks inflammation. If you're also experiencing some itching, you could have contact dermatitis, a reaction to a particular allergen. Common culprits are chemical sunscreens, certain cosmetic preservatives, hair dyes, and fragrances. I can do a patch test to determine if you have a skin allergy, and then give you a list of products to avoid (once you do, the redness should clear up quickly). If your redness has developed suddenly and it's not contact dermatitis, I might suggest getting a blood test to rule out an autoimmune disease like lupus.
"Whatever the source of your redness, you must be diligent about sunscreen—the sun exacerbates every root problem. Formulas containing physical blockers, like zinc oxide and titanium dioxide, tend to be the least irritating and are sometimes even soothing. Over-the-counter anti-inflammatory lotions can also temporarily reduce redness; look for ones with feverfew or licorice."
- A.M.: Physical sunscreen (like NIA 24 Sun Damage Prevention 100% Mineral Sunscreen SPF 30, $45)
- A.M. or P.M.: Products with feverfew (like Aveeno Ultra-Calming Moisturizing Cream Cleanser, $7) or licorice (Eucerin Redness Relief Soothing Night Crème, $15)
- One to six monthly KTP laser treatments, $300 to $500 each, or IPL treatments, $250 to $450 each
- For rosacea: Topical antibiotic, $30+
- For eczema: Topical immunomodulator, $90+