Ask the Expert: How Can I Fix Skin Redness and Rosacea?

Updated 02/03/19

Red is a bold colour. Wearing a red dress has historically been viewed as loud or sexual. In China, red is auspicious and the colour for luck and ceremony. In L.A., bright red cars are magnets for speeding tickets. An investment banker once told me that when his girlfriends wore red, it made him think of markets in decline. It’s safe to say, red can be triggering in a lot of ways—but especially when it’s on your skin.

Fortunately, skin redness nowadays can almost always be cauterized or minimized with the help of careful skincare and in-office treatments like lasers. Unfortunately, the laser arena is vast, and requires a deep dive of investigation and reconnaissance work. Questions about brands, downtime, IPL vs. pulsed dye, and whether or not your face will look like it’s covered in Sriracha afterwards are common concerns. We turned to Dr. Jonathan Cabin of Beverly Hills’ Center for Advanced Facial Plastic Surgery (and a regular at Kardashian-Jenner events) to set the record straight about what makes our skin red and how to get rid of it.

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What causes redness in the skin?

Cabin: "For any patient with new skin redness, the first thing I’d want to do is make sure it’s not a symptom of a more serious medical condition, like an infection, immune disorder, or medication reaction. This involves a thorough medical history and exam. 

For redness that may be related to the immune system or environmental factors (like eczema or psoriasis), the first line treatments are topical and oral medications, as well as trigger avoidance."

What causes rosacea and what are the best treatments?

Cabin: "This is a tricky question. Rosacea is a complex skin condition that—depending on the sub-type—includes varying levels of fluctuating redness and/or visible blood vessels. Optimal treatment for this redness includes careful sun protection and skincare. Patients may also have redness “triggers” that, once learned, can be avoided. 

For persistent redness, there are some medications that can help. The VBeam laser (along with some other redness-targeting light therapies) is one of the most effective therapies to reduce persistent redness. But it will depend on how the rosacea presents itself and will typically be used only if conservative measures are not fully effective."

Click here to read about the rosacea diet and five natural remedies for rosacea

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What about post-inflammatory scarring or redness?

Cabin: "For an isolated episode of redness related to a time-limited event, like a scar, the wisest approach may be the simplest: the passing of time."

How do I avoid redness caused by broken capillaries?

Cabin: "Broken capillaries are really just dilated blood vessels very close to the surface of the skin. Certain people are pre-disposed to these lesions, especially those with fair skin. But in those predisposed (and even those that aren’t), external factors can cause these lesions and make them worse. Avoidance of trauma (such as facials or pimple popping), extreme temperatures, or extensive UV exposure can prevent these lesions from forming, and stop them from progressing.

Regarding in-office treatments, energy treatments like IPL and VBeam are really the only way to eliminate these lesions once they’ve formed. Complete elimination may require multiple treatments, and there is no guarantee that these areas of redness will be totally removed. So, an ounce of prevention is worth a pound of cure."

What about cherry angiomas, those pesky little red dots?

Cabin: "No one really knows what causes cherry angiomas (or reddish moles), but the characteristic overgrowth of small blood vessels within this lesion is what gives them their red hue. VBeam, an intense pulsed dye laser, is best for cauterizing these in usually one go."

 

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Q: What sort of downtime is there with a pulsed dye laser treatment like VBeam?

Cabin: "Typically, patients have six to eight hours of redness, swelling, mild pain (like a sunburn). In a minority of patients, these symptoms can last up to three days. A small number of patients will notice light darkening or bruising that typically persists for three to 10 days. 

The nice thing about VBeam is that makeup and lotions can be used immediately after treatment to reduce or eliminate any visible signs of treatment and to soothe the skin."

Q: Can people with dark or olive skin tones use lasers to treat redness and rosacea?

Cabin: "Contrary to popular belief, and although less common, individuals with darker skin can also suffer from rosacea. All laser and light treatments, whether for redness or other conditions, should be approached with extreme caution in darker skinned people. Individuals with darker skin tone are at risk for permanent hyper-pigmentation (skin darkening) or hypo-pigmentation (skin lightening) as a result of these treatments.

All laser and light-based redness therapies are an option for darker skinned individuals with rosacea, but it is wise to start with much lower settings, and to begin with a test area in a non-visible portion of the body (for example, under the chin) before proceeding with full treatment. IPL is a bit riskier because it emits light across many different wavelengths is harder to control the patient response. Therefore, laser treatments are slightly safer than IPL in darker skin tones, but all should be approached with caution."

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