Acne redness treatment

Why acne turns red

Redness is inflammation. NIAMS explains that oil and dead skin cells plug a hair follicle, bacteria that normally live on the skin grow in the plug, and the body reacts with swelling, redness, heat and pain. Blackheads and whiteheads are plugs without much of that reaction. Papules, pustules, nodules and cysts are the inflamed kinds, which is why they look red and feel sore.

Acne redness treatment for a red, swollen pimple

1. Hands off. Squeezing often pushes the contents of a pimple deeper into the skin, which increases inflammation and makes the spot more noticeable, the American Academy of Dermatology warns.
2. Ice for pain and swelling. The AAD notes that ice reduces the inflammation of painful acne such as nodules and cysts.
3. One acne-fighting ingredient. For a red pimple, the AAD names adapalene, azelaic acid, benzoyl peroxide and salicylic acid. Benzoyl peroxide reduces acne bacteria, and azelaic acid both calms inflammation and treats the dark spots that can follow.
4. For one large, painful lump: a dermatologist can inject a corticosteroid, which flattens most acne nodules and cysts within 48 to 72 hours.

Topical antibiotics also calm inflammation, but dermatologists combine them with benzoyl peroxide so the bacteria don't become resistant. For how these line up by severity, see our sister guide on treatment for inflammatory acne.

Acne redness treatment for red marks left behind

Once a pimple heals, a flat red or pink spot often stays on lighter skin, while medium and darker skin more often keeps a brown or bluish gray spot. The AAD calls this post-inflammatory hyperpigmentation and says these flat spots are usually not scars; they tend to fade, though it can take time. DermNet lists redness (erythema) next to darker and lighter patches among the color changes acne can leave.

The AAD's plan for fading spots after acne starts with sunscreen: broad-spectrum, SPF 30 or higher, water-resistant and non-comedogenic, put on before you go outside. After that, a product with azelaic acid, glycolic acid, a retinoid such as adapalene, or vitamin C can help fade existing marks. Keep treating the acne too; the AAD notes that clearing the acne removes what is causing the spots.

A pit or a raised bump that stays after the color has gone is a scar, and scars need a dermatologist rather than a cream.

A gentle routine for red, irritated skin

Inflamed skin is easily irritated, so keep the rest of the routine plain. Wash up to twice a day and after sweating with a mild cleanser, using your fingertips rather than a scrub. Choose moisturizer, sunscreen and makeup labeled non-comedogenic. Some acne ingredients make skin more sensitive to the sun, another reason the AAD pairs acne treatment with sunscreen.

How long redness takes to settle

Treatment takes time. The AAD says that if you don't see results in 4 to 6 weeks, a dermatologist can help, and it advises giving an over-the-counter product 6 to 8 weeks before judging it. A mark left by a pimple fades more slowly than the pimple itself, so give acne redness treatment for marks months rather than weeks, with sunscreen the whole time.

When the redness is not acne

Rosacea is the most common lookalike. The NHS describes redness across the nose, cheeks, forehead and chin that comes and goes, with a burning or stinging feeling when you use water or skin care products. The AAD adds that acne-like bumps from rosacea appear where the face is red. Rosacea needs its own treatment, so if this sounds like you, ask a doctor before you treat it as acne. Azelaic acid is one of the few ingredients used for both, according to DermNet.

When to see a dermatologist

See a dermatologist when acne causes deep cysts or nodules, which can leave scars, or when it hasn't cleared with treatment you can buy without a prescription. Prescription options for red, inflamed acne include stronger retinoids, combination creams, an oral antibiotic for a limited time and, for women, hormonal treatment.

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