What's Wrong If You Have Red, Shiny Nose?

Illustration: Jim Cooke, Gizmodo

All this talk about whether or not Rudolph the Red Nosed Reindeer is problematic has obscured a very important question — i.e., what was actually wrong with Rudolph’s nose? Like, medically? Did no one ever think of taking him to a doctor, to see if there everything was OK with his nose, before being mean to him about it?

In case you yourself develop a glowing-red nose, after many years of regular-nosehood — we have, for this week’s Giz Asks, corralled a top-notch bunch of rhinologists to tell us what, if anything, a red nose indicates, when you’re a human (as opposed to a stop-motion reindeer).

Dr. Sanjeet Rangarajan

Assistant Professor of Otolaryngology-Head and Neck Surgery & Rhinology and Endoscopic Skull Base Surgery at the University of Tennessee, with a focus on medical and surgical management of disorders of the nose and sinuses, as well as minimally invasive approaches to the skull base and orbit

There’re a couple of things, at least in humans, that could cause a red nose. The first is something that’s pretty common, called acne rosacea, which is an inflammatory condition of the skin.

When you think about the old-fashioned pictures of Santa Claus, or of the drunk down the street, they always have a red nose. So people always used to think: is it from the alcohol? Is it the drinking that makes your nose red? And what we think now is that it’s actually caused by rosacea: the skin becomes inflamed, and if it progresses, it can become permanently red and inflamed, and can even become bulbous or change shape, and that’s a disorder called rhinophyma. So that’s kind of the end-stage of that disorder.

It could also be from allergies or sinus problems. We get a lot of kids who come into the hospital this time of year whose parents have been wiping their nose with Kleenex, and that can lead to a chronically irritated red nose that’s in need of some kind of salve or healing.

With rosacea, it’s not gonna be shining through the night, but it can get pretty red. Not quite like Rudolph, but a nice healthy pink, several shades redder than the average caucasian skin tone.

Martin J. Citardi

Professor and Chair of the Department of Otorhinolaryngology-Head and Neck Surgery at McGovern Medical School at The University of Texas Health Science Center at Houston

Redness (“Rubor” in Latin) is one of the cardinal signs of acute inflammation. (The other signs are warmth/heat, swelling, pain and loss of function). Thus, infection of the skin of the external nose is among the most likely causes of a red nose that develops over the course of a few hours (or days). As the skin swells in this acute infection, it can appear shiny or glossy, too.

Facial cellulitis is a bacterial infection of the skin of the face. Most commonly caused by bacteria, facial cellulitis can spread rapidly. Risk factors include diabetes and a weak immune system. Skin trauma, including insect bites and “pimple popping,” can spread bacteria into the skin a trigger facial cellulitis. Mild cases of facial cellulitis can be treated with oral antibiotics. But if the infection is severe, or oral antibiotics are not effective, intravenous antibiotics will be necessary.

Vijay Ramakrishnan

Associate Professor of Rhinology, Director of Rhinology Research, University of Colorado Anschutz Medical Campus

This type of problem could be attributed to disorders of the skin. Redness is a classic sign of inflammation, and it can either result from skin irritation or from underlying medical disorders. Most frequently physical irritation, such as frequent nose blowing during a cold, can result in physical irritation of the skin. Sensitive skin and allergic reactions can similarly result in redness. In addition, skin disorders such as rosacea and rhinophyma can cause severe skin inflammation over the nose and cheeks.

A shiny appearance of the face may be attributed to oily secretions from sebaceous glands in the skin. Inflammation of these glands is the main source of acne. I am not suggesting that Rudolph had a skin disorder, of course! However these would be problems that could explain a “red, shiny nose” in humans.

Jayant Pinto

Associate Professor, Department of Surgery, University of Chicago, who studies studies sinonasal and other airway disorders

A red nose can be a sign of many things. Typically, increased blood flow to the skin on the nose causes the red colour. This elevated blood flow can be from changes in emotion, like being embarrassed or drinking alcohol. It can come from inflammatory problems with the skin, such as rosacea. In extreme cases, a condition called rhinophyma causes the nose to be red and bulbous. Lupus can manifest as a red rash across the face and nose in the shape of a butterfly. Probably most common is redness around the nose from irritation from wiping your nose when you have allergies or a cold. This is common since the average American gets 4-6 colds a year and millions have allergic rhinitis. Keeping your nose healthy is important. Breathing is key for life and your nose plays a critical role!

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