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Despite its association with passion, love, and vibrancy the color red is not what most people want to see on their faces when they look in the mirror. Redness on your face develops from inflammation and from dilated tiny blood vessels right at the surface of your skin. Sometimes the redness can be sudden, whereas other times it can develop slowly over many years. Here are five things your should know about facial redness and what to do about it.

1. The most common cause of facial redness is Rosacea. Rosacea is a chronic inflammatory condition that leads to red, sensitive skin and sometime to pimples on the nose and cheeks similar to acne. People with Rosacea often have sensitive skin that stings when exposed to sun or cold and turns bright red when they eat hot or spicy foods. If you have Rosacea, then try products that contain anti-inflammatory and anti-redness ingredients such as feverfew or licorice.

2. Over-exfoliating or scrubbing your skin can lead to redness. This is common among young women with acne. Remember that acne is from bacteria trapped in clogged pores. Scrubbing with apricot scrubs or using alcohol based toners will not help erase your acne, but it certainly will worsen the inflammation. Often this makes a bad situation worse. Unless you have very oily, sebaceous skin, remember that scrubbing is best done in moderation and in the middle of winter when your skin is already is dry and sensitive, scrubs might not be needed at all.

3. Excess sun exposure over years can lead to redness. The ultraviolet radiation from the sun triggers blood vessels to grow like weeds across your face. If you look closely at some people’s skin, you can see that diffuse redness is actually millions of tiny threadlike vessels right at the surface. This condition can be treated by using a laser that targets blood vessels. The laser can literally explode the tiny vessels, destroying them along with their unwanted redness. The downside is that you will often have obvious bruising for a few days; however, when the bruising heals, the redness is often significantly reduced and sometimes is erased altogether.

4. Allergic contact dermatitis can also cause redness on your face. Common causes of allergy include chemical sunscreens, preservatives in cosmetics, hair dyes, and fragrances. Skin allergies occur when your immune system reacts to a particular allergen. It is the same reaction as poison ivy or poison oak and can lead to redness, scaling, and itching. If you have a rash around your eyes, a rash that is itchy, or a chronic redness and scaling on your face, then see your physician. He or she can do patch testing to determine if you have a skin allergy and can give you a list of products to avoid.

5. Rarely is redness on the face the result of an underlying medical condition. Women with lupus, an autoimmune disease that can affect many organs, sometimes develop a bright red rash on their cheeks and nose, often called a butterfly rash because from a distance it looks like a butterfly on their face. The rash is triggered by sun exposure but can occur any time of the year. If you have the sudden development of this type of facial redness, then you should see a physician. A few blood tests can diagnose the condition and sometimes treatment is needed to keep the immune system from flaring.

Labels: Lasers, Reddness

Facial scars are very common from injuries or surgical procedures. If you call your average physician and tell them that you have a recent scar, the chances are they will tell you that there is nothing that can be done for a year after the injury. Unfortunately, this is frequently misinformation.

There is evidence that by treating a scar early, the outcome of the result can be improved. Some studies have shown that when a scar is treated within 8 weeks of the injury or surgery that it can heal much better than waiting an extended time. I have adopted this method of treating traumatic and surgical scars of the head and neck and it has worked well. When a patient presents with a scar of the head or neck that is less than 8 weeks old, I will begin treatment with various modalities including steroid injection, silicone sheeting and pressure. When the scar reaches its point of primary healing then I will most commonly treat it with the CO2 laser. The laser performs several functions to improve the scar. Number one, it allows uneven tissue margins to be blended or smoothed down. Number two, it causes new collagen to be produced to fill in the irregularities and number three it helps blend the coloration with surrounding tissues. Lasering the scar is usually done under local anesthesia and takes only a few minutes. The area will be raw for the first 5-6 days and then be a smooth pink. This pinkness will fade over the ensuing weeks but may last several months in some cases. Sometimes I will use a V-Beam laser to bring the reddness and swelling down before I clean it up with C02 laser.

Sometimes the scar is lasered multiple times as it improves with each treatment. While simple lasering may work great for simple scars, more complex scars may need surgical intervention first. Many surgical procedures exist to make scars less noticeable by changing the direction of the scar, making it it more random (straight line scars stand out more) or making the margins even. Sometimes I will send the patient out to a surgeon before I use laser resurfacing to blend the scar.

Some depressed scars (those that are like craters) respond will to filler injection. By injecting fillers, many depressed scars can be simply “popped out” by filling the base of the depression with filler. This is useful in acne or pock scars. Subcision is another useful technique. Subcision is a process in which a special needle is used to break up scar tissue at the base of a depressed scar. A depressed scar has spider web like bands called adhesions that, in part, are what keep the depressed scar tethered down. By inserting this cutting needle under the scar and swiping it back and forth, these adhesions can be separated and allow the base of the depressed scar to rise up and fill in. Subcision can be performed multiple times to improve a depressed scar.

There are many myths surrounding the treatment of surgical and traumatic scars. Applying Vitamin E, commercial products like Mederma or Scar Guard or covering the scar with silicone sheeting are probably all useful, even if not scientifically proven. Keeping a new scar protected from the sun is also important.

I am always happy to discuss scar management.

Labels: C02, Fillers, IPL, Laser Resurfacing, Reddness, Scars

Rosacea can be divided in to three stages

• Stage I is the general redness and flushness on the cheeks, nose, and central face.

• Stage II is the addition of papules or pustules, and is referred to as acne rosacea.

• Stage III includes the changes associated with long standing rosacea, namely a larger bulbous nose or chin. In addition, rosacea patients can also suffer from blepharitis (inflammation of the eyelid margin) and the formation of styes.

For stage I rosacea, treatments include a topical medication such as metronidazole, sodium sulfacetamide, or azaleic acid twice a day. The effects of these topicals are varied. Laser is an excellent treatment for these cases, and sometimes the only acceptable cosmetic treatment. We use Prescribed Solutions (TM) products which have natural products that help in Calming the skin down.

For both stage I and stage II rosacea, the addition of doxycycline, minocycline, or tetracycline is usually added. Low-dose accutane can also be used in these cases.

For stage III changes, a small surgical procedure or laser can correct some of the changes seen with long standing rosacea.

The goal is to calm down the acne portion of your rosacea, then to perhaps do laser once that part of it is controlled.

Accutane is a reasonable option if you are a good candidate.

Labels: Reddness, Rosacea