What is permanent diffused redness?


What is this condition?

Diffuse redness refers to a condition caused by dilated capillaries, most commonly affecting the nose, forehead, and cheeks. These enlarged blood vessels do not often present themselves as defined capillaries, but rather as a general facial redness, (for example, an often used description is “rosy cheeks”).

The skin obtains its pink, fleshy appearance from the red pigment called haemoglobin in the blood flowing through the vascular network of tiny veins, arteries and capillaries known as the microcirculation. This large network of capillaries function to control the cutaneous blood flow in response to the bodies thermo-regulatory (control of temperature) needs.

If the outside ambient temperature exceeds that of the body, blood flow is increased. On the other hand if the ambient temperature is markedly lower than that of the body, the blood flow is reduced. When these small capillaries loose their elasticity to accommodate changes in pressure and flow, they remain dilated, with maximum flow occurring and colour remaining.

The network of capillaries in the neck and facial area of the skin is much denser than on the body. As a result it is one of the first areas of the body to show a colour change due to a change in blood flow or pressure.

Were you born with a predisposition to have permanent diffused redness, commonly known as a sensitive skin, although not necessarily reactive?

Which areas does it affect and what are the characteristics?

Sensitive skins are characterised by patches of blotchy redness caused by the dilation of the walls of the peripheral blood vessels.

This vaso-dilation can be either temporary or permanent. Localised areas commonly affected are the nose tip, nose wings, cheeks, pre-auricular region (front of ears) upper chin and the sides of the neck or throat.

A rapid increase of colour intensity from the surface capillaries and the dermal vascular network due to temperature change or friction is considered to be solid evidence of thin and sensitive skin.

The thickness of the epidermal and dermal layers of sensitive skin can be visually judged by observing colour change. In many cases, diffused redness and couperose are combined together however, diffused redness alone can be seen without any visible blood capillaries. Skin displaying these characteristics should be treated as “hypersensitive”.

The skin type may have sensitivity due to allergic reactions to specific substances and primary allergens may include pollen, dust, medication, antibiotics, sunscreen chemicals, deodorants and steroids such as cortisone.

This skin condition is an indication of thin skin density and loss of structural integrity – we must remember that the loss of collagen, due to ageing causes the “collapse of the superficial blood circulatory system. The feature mostly observed with this skin is the colour, as it will be characterised by permanent patches of blotchy diffused redness caused by the dilation of the walls of the peripheral blood vessels.

Sensitivity due to allergic reactions to specific substances is generally caused by antibodies in the blood formed after exposure to the offending substance. Primary allergen include pollen, dust, medication, antibiotics, sunscreen, deodorants and steroids such as cortisone. (for more sensitising ingredients read article on adverse reactions to cosmetic ingredients and Allergy “action or reaction”)

Vascular disorders of the skin can take many forms, and are either congenital (intrinsic) or developed (extrinsic). The commonly manifest themselves as highly visible red coloured abnormalities and are caused by a localised over growth or permanent dilation of peripheral blood vessels.

Developed vascular skin disorders are caused by a variety of reasons. Physical, neuro-physiological, (emotional stress) chemicals drug related, digestive disorders, hormonal and diet can alone or combined lead to vascular skin disorders.

The older terminology used by the beauty therapist of hyper sensitive, couprose, or telangiectasias have been replaced with the use of rosacea grades 1 to 5.

Grade 1 Diffused redness

Grade 2 Couprose

Grade 3 Telangiectasia

Grade 4 A compounded condition of Telangiectasia

Grade 5 Would encompass the old acne rosacea and of course rhinophyma type of skin conditions

Rosacea is not an uncommon disorder affecting the face, and is characterised by easy blushability, facial telangiectasias, spider naevus, or centro-facial papules (with the absence of comedones) (acne rosacea). It can appear in a localised form on the nose, cheeks and forehead, and in severe cases appears aggressed and flaky. (EFAD)

Early symptoms are a persistent redness of the nose and cheeks, the redness gradually becoming more constant. It is frequently found in fair skinned people of Celtic origin but any nationality can develop rosacea. Rosacea can develop at any age, in either sex, but is more often found in women between 30 and 50 years of age, the skin showing extreme sensitivity to cosmetics. Aggravating factors in work/play lifestyle will affect rosacea, alcohol, spicy foods, medication, cigarettes, UVR, menopause, pregnancy, and extremes of temperature just to name a few.

Client consultation will often show that hay fever, allergies, eczema, asthma or arthritis have been part of the medical history, and that an assortment of medication has been used over the years. Most medication for these types of conditions is vaso-dilative, all having an effect on the micro-circulatory system with prolonged use.

To understand and diagnose the “rosacea skin” its important to have a comprehensive knowledge of the skin, its immune systems and the role they play in protection.

Your best key to diagnose a sensitive skin: WHEN IN DOUBT – GO SENSITIVE

The following conditions are commonly found on PERMANENT DIFFUSED RED skin types. And will be discussed under the relevant headings

1). Secretion
• Impaired acid mantle
• EFA deficiency

2). Complexion colour
• Pigmentation
• Couperose
• Telangiectasia
• Rosacea
• Diffused redness

3). Texture
• Excess keratinization
• Loss of structural integrity – prematurely

Professional treatment protocol

1st priority objective: Repair impaired acid mantle – soothing and occlusive products
Improve pigmentation
The aim is to soothe the skin and maintain the acid mantle
Avoid extremes of cold & hot & over dilation of the capillaries
Avoid hot spicy foods or harsh abrasive exfoliators
Avoid alcohol and coffee and artificial atmospheres
Massage with EFA and no long steaming

2nd priority objective: Excess keratinization
Loss of structural integrity
Reduce vascularity

Home Care advice
Use cleansers and toners with no fragrance or colour
Should use EFA supplements
No soap should be used
No alcohol in the toners
Soothing day creams
Sunscreen should be used every day to protect the skin
No AHA’s should be used at home

Inclined to premature ageing
Protect the skin
Maintain the acid mantle and build the skin with products that help collagen formation
Vit C – for formation of collagen – Fibroblasts


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