Why is my skin red?
There are many reasons that your skin may be red, but ultimately what it comes down to is that something is causing there to be more red blood cells near the surface of your skin than normal. This happens because the nervous system dilates blood vessels in the face, which diverts blood to the skin of the face. There are many reasons this might be happening, and one of the trickiest things with facial redness is figuring out what’s actually causing it. Of course, a certain amount of facial redness is normal (after exercise or when hot, or when sunburnt), but if your face is persistently red, there are likely to be other reasons for this.
One reason blood gets diverted to the surface of the face is to cool down the body and lose heat. This is something that happens during and immediately after exercise, and during the ‘hot flashes’ that come with menopause—the fluctuations in hormone levels send the body’s temperature regulation system a bit haywire. For this reason, some endocrine disorders also result in a red face because of the body overheating.
A second reason your skin might flush is due to inflammation. This is because the body increases blood flow to the damaged area to try and flood it with healing substances which can help to repair it. Such damage can be done by ultraviolet light; this is what happens in sunburn. The damage could also be irritation of the skin from over-exfoliation, overuse of retinoids or application of other harsh topicals. You also get this response in allergic reactions, such as contact dermatitis, and when the body is trying to heal acne. Post-inflammatory hyperpigmentation can also leave your skin red—this is the type of pigmentation left behind by inflamed acne, even after the spots themselves have disappeared.
A third reason is that when you enter fight-or-flight mode because of acute stress or embarrassment, ‘vasodilation’—a widening of the blood vessels—occurs in the face thanks to the rush of adrenaline and noradrenaline released by the adrenal gland. This is what we all know as blushing. Some people can worry a lot about blushing, which makes them (a) more likely to start blushing in the first place, and (b) blush far more than people who don’t worry about it. This is because the anxiety about it is already pushing the body towards a fight-or-flight response, so that blushing happens much more readily.
To a certain extent, our faces do go red, and then recover, and this is normal. But if a flushed colour persists, or you get ruddy patches flaring up occasionally, or flare-ups accompanied by a rash of spots, you might have rosacea. Have a look at our page on rosacea for more information about the condition, and how to manage and treat it.
There are additional conditions which could cause facial redness. These range from seborrheic dermatitis through to thyroid problems or lupus. It’s worth discussing your facial redness with your GP, who can refer you to a specialist dermatologist or other doctor, if the redness is getting worse, causing significant distress or appearing alongside other symptoms.