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The Truth Behind Skin Redness

By: Cynthia Price, MD
Posted: June 27, 2014, from the July 2014 issue of Skin Inc. magazine.

The technical explanation for the redness seen in the skin of many clients is simply a heightened intolerance to topical products or external factors. This can be driven by a number of conditions—primarily rosacea, impaired barrier function, atopic dermatitis and poor lifestyle choices. Although there are still mysteries behind the causes of some of these challenges, there are also solid treatment guidelines available to alleviate them. The many myths and misconceptions that exist around skin sensitivity and redness make successful treatment difficult. Each condition will be reviewed in this article, as well as the gold standard for its treatment, and the myths that can cause confusion and improper treatment of redness will be dispelled.

What causes skin redness?

Erythema is characterized by redness of the skin or mucous membranes, caused by hyperemia of the superficial capillaries. Erythema is typically a result of the aforementioned skin conditions, skin injury, infection or inflammation. Sensitive skin conditions often present with some degree of visible redness and inflammation, which can cause clients some discomfort. Integrating topical anti-inflammatory ingredients to help combat redness will often also improve microcapillary function by suppressing the proinflammatory mediators, vascular endothelial growth factor (VEGF) and prostaglandin E2 (PGE2), and inhibit the production of inflammatory cytokines. Persistent erythema is usually a result of one or several of the following:

  • VEGF, which encourages microcapillary hyperpermeability (leakiness);
  • PGE2, which induces microcapillary dilation (capillary enlargement); and
  • Proinflammatory cytokines, the immune-activated cells involved in the amplification of inflammatory reactions.

Ingredients with higher levels of omega-3 and omega-6 essential fatty acids act as potent anti-inflammatory agents. Specific support ingredients assist in calming and soothing the skin. These anti-inflammatory and calming ingredients include:

  • Bisabolol, which is the active component in chamomile that provides anti-inflammatory benefits;
  • Evening primrose oil as a source of omega-3 gamma-linolenic acid (GLA), which provides both redness-reducing and anti-inflammatory benefits;
  • Menthyl lactate to soothe and cool irritated skin; and
  • Willow bark extract, a natural analgesic related to aspirin that also acts as a soothing and calming agent.

Because barrier function can be greatly reduced in those suffering with a sensitive skin condition, maintaining adequate epidermal moisture is imperative. To effectively hydrate the skin, a moisturizing product must contain humectant and occlusive ingredients.

Common skin conditions exhibiting redness

The most common sensitive skin conditions that are characterized by redness are rosacea, impaired barrier function, atopic dermatitis and unhealthy skin due to smoking. Although each of these conditions has a different etiology behind the appearance of redness, the treatments can often be quite similar. (See Treatment How-to: Redness-Prone Sensitive Skin Facial for a universal redness service.)

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