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Expert Q&A:
Why do my 20-month-old's cheeks get bright red and hot?

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Answered by Anthony Mancini M.D.
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Dr. Mancini received his undergraduate and medical educations at the University of Arizona, and trained in pediatrics, pediatric dermatology, and dermatology at Stanford University. He is currently Associate Professor of Pediatrics and Dermatology at Northwestern University's Feinberg School of Medicine and Head of the Division of Dermatology at Children's Memorial Hospital in Chicago, Illinois.



Dr. Mancini has served as a member of the AAP Executive Committee, Section of Dermatology since 2001. He is a member of the AAP Super CME Planning Group and the AAP Pedia Link Pediatric Dermatology Project Team, and is Secretary-Treasurer of the Society for Pediatric Dermatology. His teaching accomplishments include the Faculty Excellence in Education Award from the Department of Pediatrics at Northwestern, which he has received for the last eight years. Dr. Mancini is a peer reviewer and/or sits on the editorial board for several academic journals, and has published over 75 peer-reviewed articles, abstracts, and book chapters. He is co-author of Hurwitz Clinical Pediatric Dermatology, 3rd edition, and is an associate editor for the comprehensive dermatology textbook Dermatology. His special interests include infectious skin diseases and exanthems of childhood, vascular malformations and hemangiomas, and neonatal skin maturation and skin disorders.



Dr. Mancini is a Fellow of the American Academy of Pediatrics and the American Academy of Dermatology. He and his wife, Nicola, a neonatal intensive care nurse, have three children (Mallory, Christopher, and Mackenzie) and reside in Evanston, Illinois.
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Question


Why do my 20-month-old's cheeks get bright red and hot?

Answer


Some babies are more prone than others to develop what you describe. Red cheeks seem to be related to differences in vascular reactivity, the opening and closing of small blood vessels in the skin. When these vessels open up, or "dilate," blood flow is increased and the skin may appear red and feel warm to the touch. This dilation may be caused by fever, illness, weather changes, medications, or, in most cases, normal variation. Some skin disorders, such as eczema and keratosis pilaris, may be associated with red cheeks, but these conditions do not go away within hours as you describe. Although "rosy cheeks" may occur now and then, the changes will likely become less prominent as your son gets older.
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