What Causes Skin Redness?

Psoriasis, Eczema, Infections, Burns, and More

Skin redness on the face or the entire body can be caused by any of a number of dermatological issues. It may be as benign as temporary flushing that occurs after exercise or as serious as the fiery redness and blistering that arises from a severe burn. Between these extremes are common skin problems such as rosacea, dermatitis, and allergic reactions that cause hives.

Depending on the cause, redness often is accompanied by other symptoms— dryness, itching, and burning are common, for example. Once a diagnosis is made and treatment started, in most cases, red skin should return to a normal, healthy hue and other symptoms should abate.

When to See a Doctor

Most conditions or injuries that cause skin redness can be managed at home. However, it is advisable to see a doctor if redness:

  • Is accompanied by signs of infection—the affected skin feels hot or is leading fluids or pus
  • Is accompanied by a fever or vomiting 
  • Is painful or begins to blister
  • Appears suddenly and spreads rapidly
  • Covers large areas of your body
  • Affects your eyes or vision
  • Is accompanied by difficulty breathing
  • Is accompanied by loss of consciousness
  • Is the result of a large, severe burn

Dermatitis

Dermatitis includes a group of skin conditions caused by inflammation. In addition to redness, most types of dermatitis are characterized by dryness and itchy, although some types of dermatitis cause blisters and crusting.

Types

Of the many types of dermatitis, three are especially common:

  • Atopic Dermatitis: Also known as eczema, atopic dermatitis is the most common type of dermatitis, affecting approximately 15% to 20% of children (typically beginning before age 5) and 1% to 3% of adults. It presents as an itchy, red rash along with grey/brown/yellow areas of skin; itching; dryness; raised bumps that may leak fluid; cracked/thick/scaly skin; and areas of skin that are sensitive or even painful to the touch. Symptoms of atopic dermatitis may flare up during temperature extremes (very hot or very cold weather) and can be exacerbated by certain ingredients in skin products, food allergies, hormonal shifts, dust mites, and pet dander, and often is accompanied by asthma or hayfever. 
  • Contact Dermatitis: Sometimes called irritant contact dermatitis or allergic contact dermatitis, this skin condition arises when an allergen or substance touches and irritates skin. Symptoms are localized to the area of contact with the irritant and include redness, itching, cracked skin, bumps or blisters, swelling, burning sensation, or tenderness to touch. 
  • Seborrheic Dermatitis: This type of dermatitis most often affects the scalp as well as areas of the face and chest where there is a proliferation of sebaceous (oil-producing) glands. Symptoms include redness, greasy, scaly patches of skin, itching, and flaking.  

Seborrheic psoriasis on the scalps of babies is commonly called cradle cap.

Treatment

The treatment or management of contact dermatitis depends on the type. Topical cleansers and medications often are used, including corticosteroid creams or ointments. Dryness can be managed by keeping skin hydrated with an emollient. For dermatitis that arises in response to an allergen or irritant, avoiding triggers is key to preventing redness and other symptoms of a reaction. Other medications that may be used to treat dermatitis include antifungals, antihistamines to relieve itching, and antibiotics in the event a secondary infection arises.

Rosacea

As many as 15 million Americans have this condition in which skin flushes and reddens easily. As rosacea progresses, flare-ups can last for days, weeks, or even months.

Types

There are four primary tyes of rosacea:

  • Erythematotelangiectatic rosacea: Characterized by redness and flushing of the face and visible blood vessels, along with skin sensitivity, swelling, dryness, rough texture, and scaliness. 
  • Papulopustular rosacea: In addition to redness, symptoms include swelling and acne-like breakouts. Skin can become oily and sensitive as well.
  • Phymatous rosacea: A rare form of rosacea in which skin thickens and can develop a bumpy texture. Large pores and broken blood vessels are often visible. When the nose is affected (rhinophyma), it can become large and bulbous. It's most common in men between 50 and 70. 
  • Ocular rosacea: Causes eyes to become red and irritated, swollen eyelids, broken blood vessels on eyelids, and stye-like bumps. Ocular rosacea also can affect vision and increase sensitivity to light. 

Rosacea is thought to be caused by a combination of genetics and environmental factors. Triggers of flare-ups include eating spicy foods or cinnamaldehyde (found in cinnamon and chocolate), drinking hot beverages, exposure to a skin mite, a protein on the skin called cathelicidin, and infection with Helicobacter pylori (a gut bacteria). 

Treatment: Rosacea cannot be cured it can be managed. Strategies include avoiding flare triggers, lifestyle changes, topical medications, eye drops (for ocular rosacea), isotretinoin (a powerful oral acne medication that shrinks oil glands; it is known to cause birth defects), and antibiotics when infection or inflammation is involved. Broken blood vessels that become large and unsightly can be treated with intense pulsed light (IPL) laser therapy or ablative therapy, in which a laser is used to "shave" down thickened layers of skin.

Psoriasis

Psoriasis is a chronic autoimmune disease in which skin cells are produced more quickly than normal, resulting in thick, raised, scaly patches. These often unsightly lesions can arise on any area of the body but are most common on the knees, elbows, scalp, and lower back. There can be long periods of remission, months at a time, between flare-ups. More than 100 million people throughout the world live with psoriasis and, for many, co-morbidities such as arthritis, depression, and heart disease.

Types

The various types of psoriasis differ in appearance, areas of the body they tend to affect, and accompanying symptoms.

  • Plaque psoriasis: The most common type, characterized by red lesions, inflamed skin, crusty patches of skin, and silver/white scales
  • Inverse psoriasis: Smooth, shiny, red lesions without scaling in skin folds—typically under the armpits, in the groin area, and beneath the breasts
  • Guttate psoriasis: Small, red spots on the skin that often crop up after an infection such as tonsilitis. This type of psoriasis is most common during childhood and may resolve without treatment.
  • Erythrodermic psoriasis: A rare condition in which large, hot, inflamed patches of skin can be severe, causing swelling, fluid loss, protein loss, pneumonia, and even heart failure. 
  • Pustular psoriasis: White pustules surrounded by red skin, typically on the hands and feet, that most often affects adults.

Treatment: There is no cure for psoriasis. Management is based on type and symptoms but almost always involves avoiding triggers, maintaining a healthy lifestyle, and following a healthy skin care regimen. Some people require prescription-strength medicated topical treatments, such as steroid creams, oral medication, anti-inflammatory injections/infusions, or light therapy. 

Skin Infections 

Redness is a common symptom of any type of skin infection. As the largest organ of the body, the skin provides ample opportunity for infectious organisms bacteria, viruses, fungi, and parasites—to make their way in via cuts, scrapes, insect bites, and other openings.

Types

There are four types of organism that can infect the skin:

  • Bacteria: Typically develop when bacteria enter the skin through a hair follicle or a small cut in the skin. Symptoms include skin redness, red bumps, areas of skin that feel warm or hot to the touch, and abscesses. Mild infections are likely to clear up with topical antibiotics; more severe infections may require oral or intravenous antibiotics.
  • Viruses: Viral infections that affect the skin can be treated with topical creams, NSAIDs, and fluids. Vaccinations are available for certain viral infections that affect skin, including chickenpox (varicella), shingles, and measles.
  • Fungi: Fungi like damp areas of the body, such as the groin and between the toes. They can cause redness, itching, blisters, raised bumps, and scaly skin patches. They're rarely serious and be prevented by keeping skin clean and dry. Persistent fungal infections can be treated with OTC or prescription antifungal sprays, powders, or creams, or medication to help clear up the infection. 
  • Parasites: Parasites are tiny insects or worms that burrow into the skin where they either take up residence or lay eggs. Parasitic infections sometimes can spread to the blood or organs in the body, but typically are more uncomfortable than dangerous.

Treatment: There are medications designed to target most parasitic skin infections. Relief from redness, burning, and itching can be achieved with cold compresses.

Types of Skin Infections
Bacterial Viral Fungal Parasitic
 Cellulitis Chickenpox and shingles Fungal skin infections  Scabies
Impetigo Warts Ringworm (a red, ring-shaped rash) Lice
Folliculitis Measles Athlete’s foot Bedbugs
Methicillin-resistant Staphylococcus aureus (MRSA) Hand, foot, and mouth disease Oral thrush  
  Fifth disease (also called slapped cheek syndrome) Diaper rash  
       

Urticaria (hives)

Hives are red, swollen, raised bumps that sometimes itch or burn. They typically are caused by an allergic reaction to a specific trigger such as a food or bee sting but can arise for unknown reasons.

Types

Hives typically are categorized based on severity and whether they are acute or chronic.

  • Acute urticaria: Hives that last less than six weeks. Acute hives are most commonly caused by an allergic reaction to a food, medication, infection, or insect bites or stings. In the latter case, urticaria can be painful and involve swelling. For people who are highly allergic to certain triggers, there is a risk of anaphylaxis—a life-threatening reaction characterized by difficulty breathing, rapid heartbeat, confusion, dizziness, and loss of consciousness. Anaphylaxis is an emergency that requires immediate medical attention.
  • Chronic urticaria: Hives that last more than six weeks, often without a discernible cause. On rare occasions, they may be due to an underlying condition. 

Treatment: When triggers are known, hives can be prevented by avoiding them but when urticaria occurs, it often is advisable to steer clear of aspirin, alcohol, non-steroidal anti-inflammatory drugs (NSAIDs), and tight clothing as these can worsen symptoms. Antihistamines are most commonly prescribed to treat both acute and chronic urticaria. 

Lupus 

Lupus is a chronic autoimmune disease in which the body mistakes healthy tissue as foreign and unleashes a damaging immune response. When the skin is involved, lupus causes rashes, sores in the mouth and nose, scaly patches on the face, and areas that resemble sunburn.

Types of lupus that affect the skin include systemic lupus erythematosus (SLE), discoid lupus, drug-induced lupus, subacute cutaneous lupus erythematosus, and neonatal lupus.

Treatment: For lupus affecting the skin, treatment may include topical or oral steroids medication, antimalarial medication, steroid-sparing cream, or medications such as methotrexate or cyclosporine that calm the immune system. 

Drug Allergies

An allergic reaction to a medication can cause a rash, urticaria, swelling, itching, and for susceptible, highly sensitvie people, anaphylaxis.

Treatment: If you are found to be allergic to a medication, you will be advised to stop taking it. Antihistamines, corticosteroids, bronchodilators, or epinephrine (for anaphylaxis) can relieve symptoms.

Burns

Skin that has been burned will redden, hurt or itch, blister, peel, and weep fluid, depending on the degree of the burn. Types of burns include; sunburn, chemical burns, electrical burns, thermal burns, friction burns, and radiation burns. 

Treatment: Minor burns will heal in a week or two and can be managed by cooling the area, applying calming topical treatments, keeping blisters intact, and bandaging the burn when necessary. Ibuprofen or acetaminophen can relieve inflammation and discomfort.

Serious burns, including severe sunburn, require medical treatment. Medical treatment can range from topical treatments and dressings to surgery and skin grafts.

Seek medical attention for any type of burn that:

  • Is greater in size than the palm of your hand
  • Shows signs of infection such as weeping, severe swelling, or smells foul
  • Is located on the face, eyes, or genitals
  • Appears to be very deep with charring marks
  • Is caused by a chemical or electricity 
  • Worsens rather than heals over time
  • Causes severe pain and discomfort

Scarlet Fever

Scarlet fever is a contagious infection caused by group A Streptococcus bacteria that most often affects children. The hallmark symptom of scarlet fever is a distinctive red rash that first appears on the neck and chest and then spreads all over the body. The rash starts as small, flat blotches that eventually become tiny bumps that feel like sandpaper. It takes approximately seven days for the rash to fade in most cases. Other symptoms of scarlet fever include a high fever, sore throat, swollen glands, vomiting, and headaches. 

Treatment: Because scarlet fever is a bacterial infection, it is treated with oral antibiotics. Itching and discomfort can be relieved with NSAIDs and soaking in an oatmeal bath. To deter skin damage from scratching, it's advisable to closely trim the fingernails of children who have scarlet fever.

Spider Veins

Spider veins are small veins that burst and become visible on the surface of the skin, creating distinct areas of redness. They can result from pressure or sun damage and are neither serious nor painful but can be unsightly.

Treatment: People who are bothered by the appearance of spider veins can have them removed with either sclerotherapy (salt solution injections) and laser treatment (direct pulses from a laser light). 

Sézary syndrome

Sézary syndrome is a type of blood cancer in which white blood cells become cancerous and attack the skin. These cells, called Sézary cells, are found in the skin, blood, and lymph nodes. Also called cutaneous T-cell lymphoma, this rare disease manifests as a red, severely itchy rash over large portions of the body. Other symptoms include hair loss, enlarged lymph nodes, thickened skin on the palms of the hands and soles of the feet, abnormal nails, and an enlarged liver or spleen. 

Treatment: includes six different options; chemotherapy, radiation therapy, photodynamic therapy, biologic therapy, targeted therapy, and other drug therapy. The prognosis for people with Sézary syndrome is poor, and treatment is often palliative to relieve symptoms.

Red Skin Syndrome

Red skin syndrome—also known as topical steroid addiction or topical steroid withdrawal— is a side effect of long-term use of topical steroids in which skin becomes resistant to the effects of the medication and rather than responding to it skin becomes red and inflamed. Other symptoms of red skin syndrome include itching, burning, and stinging that can extend beyond the areas of skin where steroids have been applied. When the medication is discontinued, other symptoms can arise: swelling, the accumulation of fluid beneath the skin and that can weep out, blisters, flaky skin, nerve pain, increased sensitivity, swollen lymph nodes, hair loss, and dry, sore, irritated eyes. 

Treatment: The focus of treating red skin syndrome is on relieving symptoms with cold compresses, lotions, soothing baths, antihistamines, and pain relief. If symptoms are severe, an antibiotic such as doxycycline to prevent infection or an immunosuppressant may be prescribed.

Bone Infections

Osteomyelitis is a bone infection most often caused by Staphylococcus aureus, a bacterium that usually enters bone tissue via an open wound or, less often, a fungus. It often presents with redness and swelling of the skin that covers the affected bone. Skin redness is accompanied by intense pain, tenderness to movement or touch, fever, chills, sweating, irritability, lethargy, and fatigue. 

Treatment: Depending on the cause of the infection, osteomyelitis is treated with either antibiotics or antifungal medication that can be delivered orally or intravenously over the span of several weeks. In severe cases, surgery may be necessary to remove the diseased bone and tissues. 

Thrombophlebitis

Thrombophlebitis is the result of a blood clot forming in a vein that interrupts blood flow and causes inflammation. It most often occurs in the legs, sometimes as the result of long periods of inactivity, but can happen in other parts of the body. In addition to redness, thrombophlebitis symptoms affecting skin include pain, swelling, warmth, and tenderness. Risk factors include having a pacemaker or IV line; cancer, a history or stroke, or an inherited clotting disorder; pregnancy; obesity; and hormone therapy. People who smoke also are susceptible to thrombophlebitis. 

Treatment: Symptoms of thrombophlebitis can be relieved by elevating the affected leg, wearing compression stockings, applying heat, and taking an NSAID. If these measures aren't effective, less conservative measures may be necessary, such as blood-thinning medication, clot-dissolving medication, a vena cava filter, or varicose vein stripping. 

Other Rashes

Many types of skin rashes can cause skin redness. A few other common rashes that have not already been mentioned include; pityriasis rosea, lichen planus, lichen simplex chronicus, cercarial dermatitis, and kawasaki disease.

A Word From Verywell 

There are myriad reasons skin may become red, inflamed, and uncomfortable. Very few are a cause for alarm, but this symptom should never be ignored. If you or someone you care for develops redness for a reason you cannot determine, a dermatologist's care is advisable, especially if it is accompanied by other worrisome symptoms. In most cases, a doctor can diagnose the reason for skin redness and accompanying pain, discomfort, fever, and so forth, and treat the problem accordingly. Even conditions that cause chronic redness can be managed.

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Article Sources
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