Why is my face still red after rosacea treatment?
The most common reason is that the treatment has worked on the inflammation but not on the blood vessels. Rosacea creams and tablets reduce spots and inflammation. Persistent redness and visible thread veins are caused by an increased number of dilated blood vessels near the skin surface, and no cream or tablet can remove them.
Inflammation and blood vessels are different problems
Rosacea is a combination of features. Papules and pustules are inflammatory - caused by an increased number of white blood cells clustering around the hair follicles - and they respond to ivermectin, metronidazole, azelaic acid or tetracycline tablets. Background redness and thread veins are a problem of the blood vessels themselves. This is why so many people find their spots have cleared but their face is still red.
Other reasons for persistent redness
- Flushing: episodes of redness triggered by heat, alcohol, stress or exercise, which may need different treatment such as beta-blockers.
- Irritation: a skincare routine containing irritant ingredients can keep the skin red.
- Another diagnosis: seborrhoeic dermatitis, steroid-induced rosacea and contact dermatitis can all cause redness.
What clears the redness
Vascular laser is the treatment of choice. Laser targets the blood within the vessels so that they are eliminated by the body's immune system. Most people need 3 to 6 sessions, 6 weeks apart, with occasional top-ups. Brimonidine or oxymetazoline creams reduce redness for some hours and can be useful for special occasions, but they do not remove the vessels and carry a risk of rebound flares.
Still red after treatment?
I can confirm what is causing your redness and whether vascular laser is likely to help. Consultations can be in person or remote.
Related Articles
- IPL vs VBeam (PDL) for redness and veins
- How many laser sessions do I need?
- Can laser make rosacea worse?
- Brimonidine vs oxymetazoline for redness
