How do I get rid of my red blemishes? (Photos)

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. Persistent red blemishes that don’t fully respond to tretinoin could potentially be related to a condition like rosacea—especially if they’re accompanied by flushing, visible capillaries, or sensitivity—but they could also be post-inflammatory erythema from past acne, which is common at your age. Since tretinoin is already helping slightly by improving skin turnover, you’re on the right track, but if the redness is vascular in nature, topical treatments alone usually aren’t enough. In terms of procedures, both CO2 laser and Pico laser can be helpful, but for redness specifically, the choice depends on the underlying cause. CO2 laser is more aggressive and better for resurfacing texture issues, scars, or fine lines—it can help with residual acne scarring and overall skin rejuvenation, but it won’t directly target redness. Pico laser can help reduce red marks, pigmentation, and even stimulate collagen without significant downtime. I hope this helps and best of luck!

Hi! Dr. Peterson here —
From your description, this does look like it could be rosacea, but it’s important to know that redness and persistent blemishes can have several causes. Without a full in-person exam and history, it’s not possible to give a definitive diagnosis, which is why a consultation with a board-certified dermatologist is so important.
If it is rosacea, there are several treatment approaches: • Topical options like metronidazole, azelaic acid, or ivermectin creams can calm redness and bumps. • Oral medications such as low-dose doxycycline can help with inflammation and breakouts. • Light and laser treatments like VBeam (pulsed dye laser) or BBL (broadband light) are excellent for targeting redness and broken vessels and can significantly even out skin tone.
Tretinoin is great for many concerns, but it can sometimes make rosacea worse, so it’s worth reviewing your current regimen with your dermatologist.
Bottom line: the good news is there are effective ways to improve persistent redness and bumps, but the exact plan should be customized after a thorough evaluation.

Hello! I’m Lauren, the aesthetic provider here at Colorado Plastic Surgery Center. Since Tretinoin has only helped slightly, you might consider Intense Pulsed Light (IPL) therapy. IPL is a popular treatment for reducing redness, visible blood vessels, and blemishes caused by rosacea or sun damage. It works by using light energy to target and break down the red pigments in the skin, helping to improve tone and texture over time. Multiple sessions are usually needed for best results.

Vbeam laser is an excellent modality for patients who have rosacea, blushing of the skin, facial and body telangiectasia, spider veins, redness, post surgical redness, and skin flushing. It is a safe procedure that can be used at varying depths to help treat micro blood vessels in the skin. We also use it in our office for facial skin inflammation, keloids, and hypertrophic scarring. It is an important part of scar therapy. Vbeam can be combined with chemical peels and other lasers, but experience with the treatment is essential. The Vbeam laser does not affect deeper tissue. Schedule a consultation with an expert in Vbeam and you will find it to be an excellent modality for many skin types.

Best,
Dr. Karamanoukian
Realself100 Surgeon