Noticing persistent redness around your nose or cheeks? You’re definitely not alone and it’s more common than you might think. This kind of facial redness is one of the top skin concerns that dermatologists see every single day. While many people brush it off as a minor issue, such as general sensitivity, a flushed complexion, or irritation from skincare products, it can sometimes be a sign of an underlying condition that requires medical attention.
Mild redness may come and go, especially after exercise, hot weather, or exposure to spicy foods or alcohol. But when that redness becomes more frequent, more intense, or begins to linger for days or even weeks it’s time to take a closer look. That’s because facial redness can be caused by a variety of things, some of which go beyond the surface. It could be a chronic inflammatory skin condition like rosacea, a flare-up of dermatitis, or even something less obvious like lupus or an allergic reaction.
What makes it tricky is that many of these conditions can look quite similar at first glance. Without the right knowledge, it’s easy to misdiagnose yourself or waste time and money on products that don’t work or worse, make things more irritated. That’s why understanding the potential causes is so important.
In this article, we’ll guide you through some of the most common (and a few lesser-known) causes of facial redness, especially around the nose and cheeks. We’ll cover how to identify key symptoms, what signs to watch out for, and most importantly, when it’s best to stop guessing and see a dermatologist. Whether you’re dealing with a one-time flare-up or something that’s been bothering you for months, we’re here to help you figure out what might be going on beneath the surface and what steps you can take to calm and care for your skin.
Rosacea: Chronic Redness with Flare-ups
Rosacea is a long-term skin condition that primarily affects the central areas of the face, including the nose, cheeks, forehead, and chin. It often begins subtly, with symptoms like occasional flushing or a sensation of warmth in the skin especially after consuming spicy food, drinking alcohol, or exposure to sun and heat. Over time, this redness can become more persistent and visible, giving the skin a chronically flushed or inflamed appearance.
Common signs of rosacea include:
- Flushing and blushing easily: Episodes of sudden redness that may come and go, often triggered by external or internal factors like heat, stress, or diet.
- Visible blood vessels (telangiectasia): Small, broken blood vessels become more apparent on the surface of the skin, contributing to a red and blotchy appearance.
- Pimples or bumps that resemble acne: Although they may look similar to acne, these bumps are not caused by clogged pores and typically occur without blackheads.
Rosacea is not contagious or caused by poor hygiene, but it can significantly impact a person’s self-esteem and quality of life. Triggers can vary from person to person and may include spicy foods, hot drinks, alcohol (particularly red wine), sun exposure, cold weather, emotional stress, and even certain skincare products.
Treatment for rosacea depends on the severity and subtype. For mild cases, dermatologists may recommend topical treatments such as metronidazole, azelaic acid, or ivermectin creams to reduce inflammation and redness. More advanced cases might require oral antibiotics like doxycycline or laser therapy to reduce visible blood vessels and persistent redness. A gentle skincare routine and strict sun protection are also essential for managing symptoms and preventing flare-ups.
Although there is no permanent cure for rosacea, with the right treatment plan and avoidance of known triggers, many people are able to control their symptoms effectively and improve the appearance of their skin over time.
Seborrhoeic Dermatitis: Redness Plus Flaking
Seborrhoeic dermatitis is a chronic, inflammatory skin condition that typically affects areas of the body with a high density of oil (sebaceous) glands. It’s especially common on the face particularly around the sides of the nose, between the eyebrows, and along the hairline as well as on the scalp, ears, chest, and upper back. The hallmark signs are redness, greasy scales, and persistent flaking that can resemble dandruff or eczema.
This condition is thought to result from a combination of factors: an overproduction of sebum (skin oil), and an overgrowth of Malassezia, a yeast that naturally lives on the skin. While most people carry this yeast without issue, in some individuals, it can trigger an inflammatory response that leads to the characteristic symptoms of seborrhoeic dermatitis.
Signs and symptoms to watch for:
- Greasy, yellowish flakes: The skin may appear oily with scaly patches that have a white or yellow tint, often clinging to the skin or hair.
- Itching or irritation: Affected areas can feel itchy, sore, or sensitive, especially during flare-ups.
- Seasonal flare-ups: Many people find that symptoms worsen in the winter months due to cold, dry air and reduced sunlight exposure, and improve during warmer, sunnier seasons.
Seborrhoeic dermatitis is not caused by poor hygiene or allergies, and it’s not contagious. However, it can become a recurring issue without proper management. People with certain medical conditions such as Parkinson’s disease, HIV/AIDS, or depression may be more prone to developing severe or persistent forms.
Treatment and management:
Treatment typically involves a combination of over-the-counter and prescription products, depending on the severity. Medicated shampoos containing ingredients like ketoconazole, selenium sulphide, coal tar, or zinc pyrithione are often effective, especially when the scalp is involved. For facial areas, antifungal creams or corticosteroids may be used short-term to reduce inflammation. Barrier-repair moisturisers can help soothe dry, irritated skin and restore its protective function.
Long-term control often requires ongoing maintenance, especially during flare-ups. Gentle skincare, stress management, and avoiding harsh soaps or alcohol-based products can also reduce irritation and prevent recurrence.
Lupus: When Redness Is More Than Skin Deep
Lupus, or systemic lupus erythematosus (SLE), is a complex autoimmune disease in which the body’s immune system mistakenly attacks its own tissues and organs. One of the most recognisable signs of lupus is a distinctive skin rash across the face commonly known as the “butterfly rash” due to its shape. This rash spans the bridge of the nose and extends to both cheeks, often appearing as a flat or slightly raised area of redness.
Unlike rosacea or allergic skin reactions, the butterfly rash caused by lupus usually does not itch or sting. It tends to be persistent rather than intermittent and is often triggered or worsened by sun exposure, a phenomenon known as photosensitivity.
Key signs and symptoms to look out for:
- Persistent red rash in a butterfly pattern: This is a classic skin manifestation of lupus and may be the first visible clue to a deeper, systemic issue.
- Joint pain, fatigue, and sensitivity to sunlight: Many people with lupus experience achy joints, extreme tiredness that doesn’t improve with rest, and flare-ups after spending time in the sun.
- Possible involvement of other organs: Lupus doesn’t just affect the skin. It can impact the kidneys, lungs, heart, brain, and blood cells, leading to a wide range of symptoms such as chest pain, shortness of breath, hair loss, anaemia, or memory issues.
Because lupus affects multiple systems in the body, diagnosis can be challenging and often requires a combination of blood tests, physical examination, and a detailed symptom history. A dermatologist might suspect lupus based on a facial rash, but a rheumatologist usually confirms the diagnosis and leads ongoing care.
Why professional diagnosis is crucial:
It’s essential not to attempt to self-diagnose or treat lupus-related skin symptoms. Topical treatments like steroid creams may temporarily ease redness but won’t address the underlying immune dysfunction. Lupus requires systemic treatment often involving immunosuppressants, antimalarials like hydroxychloroquine, and strict sun protection.
Early diagnosis and medical intervention can prevent serious complications and improve long-term quality of life. If you or someone you know has unexplained facial redness along with other systemic symptoms, it’s important to seek medical advice promptly.
Contact Dermatitis: Irritation from Products
Contact dermatitis is a common skin reaction that occurs when your skin comes into direct contact with a substance that causes irritation or an allergic response. It’s often seen on the face particularly around sensitive areas like the nose, cheeks, and eyes where the skin is thinner and more reactive. This condition can develop suddenly after using a new skincare product, or it may build up gradually with repeated exposure to an irritating ingredient.
There are two main types of contact dermatitis:
- Irritant contact dermatitis, which results from direct damage to the skin’s outer barrier typically caused by harsh chemicals, soaps, or exfoliants.
- Allergic contact dermatitis, which involves an immune response to a specific allergen, such as fragrance, preservatives, or certain botanicals in skincare.
Common signs and symptoms include:
- Burning, itching, or stinging: These sensations often appear shortly after applying a product and may worsen with continued use.
- Redness after applying a product: Skin may appear flushed or inflamed, particularly in areas where the product was heavily applied.
- Flaking or peeling: As the skin’s barrier becomes compromised, dryness and scaling may occur, sometimes with small cracks or rough texture.
Unlike chronic skin conditions like rosacea or eczema, contact dermatitis is directly linked to external triggers making it especially important to identify what’s causing the reaction. Even products marketed as “natural” or “gentle” can trigger contact dermatitis in sensitive individuals if they contain essential oils, alcohol, or strong preservatives.
Managing and preventing flare-ups:
The first step is to discontinue use of any suspected irritants and allow the skin time to heal. Applying soothing, fragrance-free moisturisers and barrier repair creams can help restore the skin’s natural defences. If symptoms persist or worsen, it’s best to consult a dermatologist.
A patch test a type of allergy test done on the skin can help identify specific ingredients you may be allergic to. Dermatologists can also review your current skincare routine and suggest safer alternatives. Prevention is key, so always introduce new products gradually and perform a patch test on a small area before applying them to your entire face.
Broken Capillaries: The Result of Fragile Skin
Broken capillaries also known as telangiectasia are small, dilated blood vessels that appear close to the surface of the skin. They are most commonly found on the face, especially around the nose, cheeks, and chin. Although they’re harmless, they can create visible, persistent redness that’s difficult to conceal and often mistaken for conditions like rosacea.
These thread-like red, blue, or purple lines are caused when tiny blood vessels under the skin become enlarged or rupture. This can occur due to a variety of factors, many of which relate to the fragility of the skin and the blood vessels underneath.
You might notice:
- Thread-like red lines on the skin: These can appear in small clusters or as isolated streaks, often resembling fine spider webs or branches.
- Redness that doesn’t fade: Unlike temporary flushing, the redness from broken capillaries remains visible even when no triggers are present.
- A history of sun damage or sensitive skin: Chronic sun exposure weakens the skin’s collagen and elasticity, making blood vessels more prone to breaking. Similarly, people with fair or sensitive skin may develop capillaries more easily.
Common causes and contributing factors:
- Sun exposure: UV rays can damage the skin’s support structure, making blood vessels more susceptible to rupture.
- Ageing: As we age, our skin becomes thinner and blood vessels become more fragile.
- Genetics: A family history of broken capillaries may increase your risk.
- Trauma or skin stress: Aggressive exfoliation, harsh facials, or even frequent nose-blowing during colds can trigger their formation.
- Weather extremes: Rapid temperature changes, wind exposure, or freezing weather can also contribute.
Treatment and prevention:
While broken capillaries won’t disappear on their own, several dermatological treatments can reduce their visibility. Laser therapy such as pulsed dye lasers or intense pulsed light (IPL) is often considered the most effective option. These treatments target the blood vessels directly, causing them to shrink and fade over time.
To prevent new capillaries from forming, it’s important to:
- Protect your skin from the sun by wearing broad-spectrum sunscreen daily.
- Avoid hot water, harsh scrubs, and irritating skincare products.
- Treat your skin gently, especially if it’s prone to sensitivity or redness.
Although not dangerous, broken capillaries can be a cosmetic concern, and early intervention can help minimise their appearance and prevent further skin damage.
Frequently Asked Questions
1. Can facial redness be cured permanently?
It depends on the cause. Conditions like rosacea can’t be cured but can be managed with long-term treatment. Redness from contact dermatitis or broken capillaries may resolve completely with the right intervention.
2. How do I know if my redness is from rosacea or something else?
Rosacea often includes flushing, visible blood vessels, and acne-like bumps. If your redness is scaly, itchy, or appears in a butterfly pattern, it might be something else like seborrhoeic dermatitis or lupus. A dermatologist can provide an accurate diagnosis.
3. Will over-the-counter creams help reduce facial redness?
Some OTC products like gentle moisturisers or anti-redness creams may offer mild relief, but they won’t treat underlying causes like rosacea or lupus. It’s best to consult a dermatologist for a targeted treatment plan.
Final Thoughts: When to Seek Help for Facial Redness
If you’ve been dealing with persistent redness around your nose or cheeks, it’s not something you have to just live with. From inflammatory conditions like rosacea and dermatitis to autoimmune causes like lupus, there are many potential culprits but also many solutions.
Feel free to contact us to schedule a consultation with one of our expert dermatologists, who can accurately identify the cause of your redness and recommend a tailored treatment plan.
References:
- Van Zuuren, E.J., Fedorowicz, Z., Carter, B. & van der Linden, M.M., 2019. Interventions for rosacea based on the phenotype approach: an updated systematic review including GRADE assessments. The British Journal of Dermatology. Available at: https://www.ncbi.nlm.nih.gov/pubmed/29507460
- Naldi, L. & Borda, L.J., 2018. Treatment of Seborrheic Dermatitis: A Comprehensive Review. Journal of Dermatological Treatment, 30(2), pp.158–169. DOI: 10.1080/09546634.2018.1473554. (covers antifungals, inflammation, chronic management) Available at: https://www.tandfonline.com/doi/full/10.1080/09546634.2018.1473554
- Pierard-Franchimont, C. et al., 2023. Cutaneous lupus erythematosus: a review of etiopathogenic, clinical, diagnostic and therapeutic aspects. Journal of the European Academy of Dermatology and Venereology, 37(6), pp.1100–1112. Available at: https://pubmed.ncbi.nlm.nih.gov/36868923
- Errichetti, E., 2019. Dermoscopy in the differential diagnosis between malar rash of systemic lupus erythematosus and rosacea. Australasian Journal of Dermatology, 62(3), pp.364–369. Available at: https://pubmed.ncbi.nlm.nih.gov/31619142
- Al‑Dhalimi, M. et al., 2014. Comparative analysis of rosacea and cutaneous lupus erythematosus. Journal of the American Academy of Dermatology, 71(3), pp.441–447. Available at: https://pubmed.ncbi.nlm.nih.gov/24656728