Blushing: Increased blood flow with facial redness
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Blushing (rubeosis, flush, flushing) indicates involuntary, transient and episodic redness of the skin. This is due to dilated blood vessels which increase blood flow. Flushing is also associated with a feeling of warmth or burning on the face, but the whole body may be temporarily red and warm. Various environmental and emotional factors such as alcohol, anger and fear are linked to flushing, but a patient also blushes more when suffering from certain conditions such as a tumor in the pancreas. The doctor will tailor his treatment to the underlying cause. Finally, by avoiding risk factors it is often possible to control blushing attacks.
Causes: Increased blood flow due to dilation of blood vessels
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The temporary redness of the skin
Symptoms: Redness and warmth in the face
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Blushing most often occurs on the face and neck, but the upper trunk and abdomen may also be affected. The flushing occurs on one side of the face or on the entire face and sometimes other areas of the body are also involved. Furthermore, the skin is usually red, but sometimes also red-brown to red-blue. Patients who flush often report a feeling of warmth and burning of the skin during an attack. Repeated flushing for an extended period of time may lead to telangiectasia (skin condition with dilated blood vessels) with permanent redness, broken capillaries and occasionally the patient develops classic facial rosacea. Depending on the cause, a patient will sweat more, experience a faster heartbeat (tachycardia), breathe more slowly (tachypnea) and / or have low blood pressure (hypotension)
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Diagnosis and investigations
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Physical and Diagnostic Exam
Treatment of flushing
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Treatment for flushing is usually focused on treating the underlying disease or avoiding triggering factors. For patients who blush because of anger or shyness, explanation and reassurance is sufficient. Green-toned foundation camouflages blush. Women who flush due to menopause benefit from hormone replacement therapy, clonidine, selective serotonin reuptake inhibitors (SSRIs), or gabapentin. Non-selective beta blockers, clonidine, or anti-anxiety medications are effective in idiopathic (no known cause) emotional flushing. Topical (applied to the skin) brimonidine gel (selective α2-adrenergic receptor agonist), vascular laser therapy, or intense pulsed light are useful in patients with rosacea-related flushing. An endoscopic examination may occur in severely flushing patients
Prognosis of patient blushing
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Flushing itself does not lead to serious medical problems. However, the underlying cause of flushing is sometimes serious. It is important to contact a person with additional symptoms.
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