Facial erythema is a common skin symptom, with heterogeneous clinical presentation, including various dermatological and systemic diseases and conditions that cause flushing. Facial erythema represents a major diagnostic challenge for clinicians and may cause a psychologic burden for the patient. Differential diagnosis of facial erythema is broad. Several cutaneous diseases like rosacea, demodicosis, perioral dermatitis, contact allergic and irritant dermatitis, phototoxic and photoallergic dermatitis, atopic dermatitis, seborrheic dermatitis, fungi infection, periorbital dermatitis, dermatomyositis, cutaneous lupus erythematosus, systemic lupus erythematosus, and some less common diseases are included in the differential diagnosis of facial erythema. An experienced clinician can set diagnosis, for most of the listed diseases, based almost exclusively on patient’s history and physical examination. A clinician should take into concern details of anamnesis about the type and time of the appearance of the lesion, the accompanying symptoms, the use of systemic therapy or topical drugs, the presence of disease-precipitating factors and the appearance of similar skin disease in the patient’s family history. In unclear cases, there is a need for additional diagnostic tests. Due to its anatomical and physiological characteristics, the facial area is a highly sensitive region, therefore certain local drugs such as local corticosteroids should be applied with caution.