The pretty ﬂush you get post-workout is healthy. What’s damaging is a redness or crimson cast that looks ruddy and never seems to go away, derms say. Here’s what may be fanning the ﬂames.
PHOTO CLAIRE BENOIST
STYLING RACHEL STICKLEY/BERNSTEIN & ANDRIULLI
Red has never signified calm and tranquility. So when it’s the shade your skin has taken on, whether all over or in smaller patches, you need to do something about it. “Redness is an indication that there’s inﬂammation in the skin and blood is rushing in to try to heal it,” says Dr Joshua Zeichner, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City (NYC). The redness may be minor at ﬁrst and easily covered with foundation, but like a smouldering ﬁre, if you ignore it, things will escalate.
For one thing, chronic redness – and the ensuing inﬂammation – makes skin age much faster, says Dr Julie Russak, a New York City dermatologist. “Inﬂammation not only destroys your stores of skin-plumping collagen but also hampers the production of new collagen, so it’s a twofold insult,” she adds. It can also cause permanent dilation of blood vessels over time, which gives skin that ruddy look.
Figuring out exactly what’s got you red in the face can be tricky, though. Redness is skin’s default reaction to any number of conditions, and the three most common ones are rosacea, sensitivity, and allergies.
These guidelines will help you single out the source and restore your beautiful complexion.
What to watch for In its early stages, skin ﬂushes intensely and persistently when you eat spicy or hot foods, drink alcohol or hot liquids, exercise, are in extreme hot or cold temperatures or the sun, or feel stressed or nervous.
Of course we all get a little ﬂushed after a workout, but with rosacea, it comes on fast and furious and may bring a burning or stinging sensation. “Triggers that shouldn’t upset skin do, and they cause a reaction beyond what you’d normally expect,” Dr Zeichner says.
As rosacea persists, frequent and intense increases in blood ﬂow may weaken blood vessels – like a rubber band gone lax from being stretched too much – and other changes may cause the condition to progress. Skin could then look more crimson overall. It may also become inﬂamed, and you might see small, pimple-like bumps. These symptoms tend to worsen with age.
What causes it The condition is mostly driven by genetics, says Dr Ranella Hirsch, a dermatologist in Cambridge, Massachusetts. It’s most prevalent in the fair-skinned, but people with darker skin tones can develop it too.
In fact, because natural skin pigment can mask some of the early pinkness, those with darker skin tones may not realise they have it until it’s gotten worse and the redness is very noticeable.
Multiple factors likely play a role in causing rosacea. “We know that the nerves over-ﬁre, which overstimulates blood vessels to dilate,” Dr Zeichner says. People with rosacea also seem to have higher levels of pro-inﬂammatory peptides called cathelicidins in their skin, which may overreact to certain stimuli and unleash a major, unwarranted inﬂammatory response.
What to do If you suddenly start ﬂushing, see a dermatologist or your doctor to make sure you don’t have an underlying blood pressure issue, Dr Hirsch says.
Try keeping a diary of ﬂushing episodes to pinpoint your personal triggers so you can avoid them. And be especially gentle with your skin, Dr Zeichner says. Stop using scrubs, peels, and other drying, exfoliating, or fragranced products. All can make skin like yours even redder.
Instead, consider asking your dermatologist about Mirvaso. This topical gel addresses the persistent redness seen in patients with rosacea, says Dr Cheong Wai Kwong, a consultant dermatologist at the Specialist Skin Clinic. However, while Mirvaso provides an immediate and temporary reduction of the redness, it does not prevent rosacea ﬂare-ups.
Lasers, on the other hand, are still said to be the most effective and long-lasting treatment for ﬂushing (three or four sessions can eliminate layers of visible, overactive blood vessels).
SENSITIVE SKIN & ALLERGIES
What to watch for Skin feels tight or raw after you apply products (even mild ones) or in response to environmental factors like extreme weather and wind. Fair skin will look red and irritated, while darker skin tones may develop dark spots and pigmentation over time. Both skin types may become ﬂaky and dry, and may have redness, Dr Russak says, with all symptoms potentially worsening midway through your menstrual cycle, when progesterone surges.
What causes it While aspects of your skincare routine may be to blame (a hypersensitivity to a speciﬁc ingredient, for example), some people have a weaker skin barrier and their skin is naturally more reactive, Dr Russak says.
The term skin barrier refers to skin cells and a fatty substance between them that acts as a mortar to cells’ bricks. It’s the gatekeeper that holds water in and keeps irritants out. When it’s weak, water escapes and molecules in the environment or in products can penetrate more deeply. Your body senses an attack and launches an immune response, which triggers irritation, inﬂammation, and the increased blood ﬂow you see as redness.
What to do Abandon your products – especially those with a fragrance (one of the most common skin allergens) – and switch to cleansers and moisturisers with ingredients known to shore up the skin barrier, such as ceramides, and soothing, cooling aloe vera gel.
Also try to keep stress in check. A review in the journal Inﬂammation & Allergy – Drug Targets found that stress can affect barrier function, making skin drier and potentially more sensitive.
GET THE RED OUT
Here’s a simple three- step routine for calm, healthy skin – whether you have rosacea, sensitivity or allergies.
1. MICELLAR CLEANSER
These formulas suspend tiny cleansing drops in water that grab dirt and makeup. They’re the gentlest way to cleanse and won’t disrupt skin’s moisture content or the protective barrier between cells, Dr Zeichner says.
2. BARRIER-REPAIRING MOISTURISER
Slather on lotions or creams with ceramides – lipid molecules that are also found naturally in skin, and make up part of the protection substance essential for a strong barrier – and niacinamide, a form of vitamin B3 that helps your body produce its own natural ceramides. “These ingredients can help make up for what’s lacking in skin,” Dr Hirsch says. Bonus: niacinamide has anti-inﬂammatory properties.
People with sensitive skin and rosacea may be especially susceptible to UV damage. A survey from the National Rosacea Society found that 81 per cent of respondents in the US said the sun triggered a rosacea ﬂare-up. Chemical sunscreen ingredients are effective. But if they make your skin sting, look for those with titanium or zinc oxide.