Flushing Treatments

  • Best Results2-6 months
  • Treatment Recovery0- 2 days
  • Procedure Time5 to 10 minutes
  • Skin SpecialistDermatologist (medical)
  • Duration of ResultsVariable
  • AnaestheticNA
  • Back to Work0-1 day
  • Cost$-$$

Flushing Treatments

Flushing & facial redness is a common skin concern. Some cases are secondary to conditions such as rosacea & menopause. Another common cause is exaggerated physiological flushing. This usually has a psychological element. In many cases there are multiple factors contributing to flushing & facial redness. A medical dermatologist can guide you through the treatment algorithms.

FactsFacts on flushing, blushing & redness

  • Symptoms of flushing include a sensation of warmth coupled with sweating
  • Signs of chronic flushing include facial redness & broken capillaries
  • Medications such as propranolol & blood vessel modulators are helpful
  • Bioequalevant hormones are indicated if hormone levels are low
  • Cognitive behaviour therapy can be helpful for anxiety associated flushing
  • Anti-inflammatory skin care is helpful if flushing is secondary to rosacea
  • Lasers are useful if there are broken blood vessels or background redness
  • A medical dermatologist can investigate & initiate effective treatments

What causes flushing?

Flushing may be defined as a sensation of warmth accompanied by visible reddening of the skin. Normally, it is part of a coordinated physiological response to heat that is modulated by emotions & other stimuli.

Abnormal flushing occurs when this response is exaggerated or prolonged. The causes of flushing are the treatment algorithm can be very complex. Hopefully this page can help you better understand the causes & guide you accordingly.

Disclaimer: Though I can systematically work through diagnosis & treatment options for flushing, my skill set nowadays is entirely procedural, namely I laser persistent cases of redness. You will get the most benefit from a medical dermatologist or general physician.

What is the difference between normal flushing & abnormal flushing?

In a nutshell if you are reading this sentence, you have abnormal flushing. Abnormal flushing is when flushing & blushing has an impact on your life. Examples include signs such as persistent redness & broken capillaries or symptoms such as burning, stinging, social phobia or embarrassment.

How do you know if rosacea contributes to redness & flushing?

Rosacea is the most common cause of flushing that presents to dermatologists. It is a clinical diagnosis that can be complex as there are many types of rosacea including flushing, papular pustular, ETR (capillaries), phymatous rosacea & ocular rosacea.

Rosacea & flushing commonly occur together. Lasers can reduce redness.

Chronic flushing & blushing can lead to fixed redness due to increased superficial capillaries. In some cases, there may be an overlap between rosacea, menopausal flushing & emotional causes. A dermatologist can assist in the diagnosis & prescribe suitable medications. For a non-pharmacological approach, see the relevant sections in this website. My job is purely laser & procedural based. If required I will refer you to suitable specialists for further management.

What is emotional or physiological flushing?

This group of flushing/blushing is common. It is triggered by emotion, (as there is an overlap with anxiety related flushing) as well as temperature changes, foods & situational triggers. It is more common in young adults. This type of flushing can be more resistant to treatment.

CBT or cognitive behaviour therapy can be prescribed by psychologist to address emotive flushing & sweating.

A medical dermatologist & a psychologist should be your first point of contact. A trial of propranolol & psychotherapy should be considered. Lasers are not indicated as first line treatment.

Davin’s Viewpoint on flushing treatments

This is one of the harder conditions to manage, especially non-pharmacologically. Lasers are good for treating static redness, namely broken capillaries & telangiectasia or spider veins. They have a role to play in treating inflammatory skin conditions including rosacea. They are less useful for carpet bombing normal skin. If you have normal looking skin, & flush intermittently, the best person to see is a medical dermatologist. Procedures are not indicated as first line management. In some cases my team & I will induce flushing & blushing. This will give us a target to hit with laser treatments.

I have trouble remembering what I ate for breakfast. It’ normal. A diary can give more accurate findings especially with correlations to flare ups.

The top four conditions that cause flushing, & blushing are physiological (with emotive input), rosacea, hormonal & a combination of these. The treatment algorithms are very complex, ranging from pharmacological, through to psychological therapy. A medical dermatologist (not me) can help exclude super-rare conditions like carcinoid syndrome, & neoplastic causes & co-ordinate a treatment program using drugs such as beta blockers & clonidine. Treatments such as ETS or endoscopic thoracic sympathectomy can be extremely effective, albeit side effects such as compensatory hyperhidrosis (sweating).

Rosacea responds to laser therapy. Static redness responds very well to lasers.

I play a very narrow role in the management of flushing, namely using lasers & neurotoxin to treat vasculature. I am not addressing the cause but treating the end result of chronic flushing. Lasers can decrease background redness & broken capillaries. Lasers are much less useful in treating normal skin with a tendency to intermittently flush.

Novel treatments include Botox. This can be delivered via Tixel or microneedles using Aquagold. These delivery systems are much safer than traditional intradermal injections as less diffusion occurs.

aqua gold-davin-lim
Aquagold can improve redness, pore size, wrinkles, oil production & sweating.
It is a form of mesotherapy that adds Botox to the deeper layers of skin.

If you have benign cutaneous flushing, meaning flushing not related to rosacea, menopause, or rare secondary causes, a psychological assessment is of great value. This especially applies to young adults who may suffer from anxiety & social phobias. Lasers have very little to offer in comparison to cognitive behaviour therapy with psychologists.

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