Facial plethora involves facial swelling and redness. It’s a symptom of another condition, rather than a condition itself.

It occurs when blood flow to your face increases. It can also happen when the amount of blood in your body increases.

The underlying causes of facial plethora vary greatly, and treatment depends on the specific cause.

Several possible conditions can cause facial plethora. They include:

Cushing syndrome

Facial plethora is a main symptom of Cushing syndrome, a rare condition that’s caused by high levels of cortisol, known as the stress hormone.

The hormone cortisol is produced by your adrenal gland. It’s involved in bodily functions like the stress response, metabolism, and inflammation.

Too much cortisol can happen if you have a tumor in the pituitary or adrenal gland. The tumor causes your body to overproduce cortisol, leading to high levels. It can also happen after taking corticosteroid drugs, like prednisone.

High levels of cortisol can increase blood pressure. This increases blood flow in the skin on your face, resulting in facial plethora.

Superior vena cava syndrome

The superior vena cava (SVC) is a major vein in your body. It brings blood to your heart from your chest, head, neck, and arms.

Some types of cancer, like lung cancer, can partially or completely block the SCV. A blood clot can also block the SCV. If this happens, a group of symptoms called superior vena cava syndrome (SCVS) may develop.

In SCVS, the blockage of blood flow causes upper body swelling. This can lead to symptoms like facial plethora.

Carcinoid syndrome

Neuroendocrine cells are involved in basic bodily functions. They work by sending information via hormones.

If neuroendocrine cells develop into a tumor, it’s called a carcinoid tumor. Carcinoid syndrome happens when the tumor spreads to your liver and makes too much serotonin.

The tumor releases chemicals into the bloodstream, causing a range of symptoms. Some chemicals widen the blood vessels and increase blood flow, resulting in facial swelling.

Polycythemia vera

Polycythemia vera is a rare blood disorder that causes excess production of red blood cells. This increases red blood cell mass, causing thickened blood and swelling.

The swelling can lead to plethora of the face and palms.


Rosacea is a chronic inflammatory skin disorder. The inflammation can cause facial flushing and swelling.

In people with lighter skin tones, the flushing appears red. In those with darker skin tones, it may look like brown discoloration.

Other symptoms of rosacea include:

  • acne-like breakouts
  • thickening skin
  • burning
  • warm skin


A sunburn happens when ultraviolet rays from the sun damage skin cells. This causes your body to release inflammatory substances, resulting in dilated blood vessels and increased blood flow.

The increased blood flow leads to swelling and redness, or facial plethora.

In some cases, facial plethora may indicate a syndrome.

According to a 2015 study, facial plethora is one of the first identified symptoms of Cushing syndrome. It’s also one of the first symptoms to get better as Cushing syndrome is treated.

Facial plethora may also be caused by SVCS or carcinoid syndrome.

Facial plethora involves a group of features, rather than a single characteristic. It generally involves facial symptoms like:

  • swelling and increased roundness
  • increased puffiness in your cheeks
  • redness (on lighter skin tones)
  • brown discoloration (on darker skin tones)

The symptoms of facial plethora may be uncomfortable. But there’s no research stating that facial plethora itself is linked to complications.

However, if the underlying condition goes untreated, it may lead to complications. The condition may get worse or cause other side effects.

That’s why it’s important to contact a healthcare professional if you think you have facial plethora.

Treatment for a plethoric face depends on the condition causing it. Treatment may include:


A healthcare professional may suggest using medication for the following conditions:

  • Cushing syndrome. A doctor can prescribe medications that lower your cortisol levels.
  • SVCS. If this condition is caused by a blood clot, a therapy called thrombolysis can be used to break down the clot. This procedure allows medication to get to the site of a blood clot and dissolve the blockage.
  • Carcinoid syndrome. Some medications can block the chemicals produced by a carcinoid tumor.
  • Polycythemia vera. If you have polycythemia vera, you might need medication to reduce red blood cell production.
  • Rosacea. A dermatologist can prescribe topical medication to manage rosacea symptoms.

Chemotherapy or radiation

Chemotherapy or radiation treatment may be used for tumors that cause:

  • Cushing syndrome
  • SVCS
  • carcinoid syndrome


In certain cases, you might need surgery. This option may be used for tumors that cause:

  • Cushing syndrome
  • SVCS
  • carcinoid syndrome

If SCVS is caused by a blood clot, surgery may be used to insert a stent or remove the blood clot.

Facial plethora is characterized by facial swelling and puffiness. It can cause redness in lighter complexions and brown discoloration in darker skin tones.

It’s a main symptom of Cushing syndrome, but it may also be a symptom of SVCS and carcinoid syndrome. Other causes include polycythemia vera, rosacea, and sunburn.

Treatment depends on the specific cause. If you experience facial swelling and discoloration, reach out to a healthcare professional for a diagnosis.