Chapter 23 Facial Redness
Facial redness can be due to a variety of dermatologic causes including rosacea, physiologic flushing, telangiectasias, eczema, seborrheic dermatitis, psoriasis, irritant contact dermatitis, etc. All of these conditions have in common activation of the inflammatory cascade, which results in vasodilation and the recruitment of white blood cells. Facial redness is minimized by cosmeceuticals functioning as anti-inflammatories and barrier enhancers. Table 23.1 lists those cosmeceuticals that are currently used in moisturizers designed to improve facial redness. At present, there are no good cosmeceutical vasoconstrictors to deal with the vasoactive component of facial redness.
Table 23.1 Cosmeceuticals to minimize facial redness
| Cosmeceutical | Effects on skin physiology | Patient selection comments |
| Prickly pear | Mucilage rich in mucopolysaccharides forms protective film | Extract used in moisturizers, usually does not provide mucilage properties |
| Aloe vera | Mucilage containing 99.5% water and a mixture of mucopolysaccharides and choline salicylate | Salicylate component functions as topical anti-inflammatory, since mucilage properties lost in most moisturizer formulations |
| Bisabolol | Chamomile extract prepared by distillation | Potent anti-inflammatory in moisturizers |
| Allantoin | Comfrey root or synthetic manufacture from uric acid | Used commonly in sensitive skin formulations |
| Panthenol | Barrier enhancing humectant | Used to hydrate the skin and prevent barrier damage |
| Tea tree oil | Polyphenols | May cause allergic contact dermatitis |
| Evening primrose oil | Polyphenols | Purported to be of benefit in atopic dermatitis |
| Ginkgo biloba | Polyphenol fraction | Ginkgolides, bilobalides are active anti-inflammatories |
| Green tea | Polyphenols | Epigallocatechin, epigallocatechin-3-gallate are active anti-inflammatories |
| Saw palmetto |
