Flushing & Persistent Facial Redness
Flushing & blushing occurs as an involuntary response to chemical and neural changes which may begin in the brain or hormonal system and end at the skin and blood vessels. Flushing can often be accompanied by sweating and often only lasts for a few minutes.
Facial flushing and persistent redness occurs when the blood vessels under the skin dilate and expand, allowing more blood flow to the skin.
Whilst most cases of facial flushing are benign and due to stress, embarrassment or anxiety, there are a few medical problems which can lead to facial flushing which require medical investigation.
Persistent redness of the face can occur due to a variety of conditions including rosacea and keratosis pilaris rubra faceii.
Conditions that induce skin flushing and redness
There are many causes of facial flushing. We mention a few types below.
Rosacea is a chronic disorder which can cause flushing and may or may not be associated with red bumps and broken capillaries. The flushing component of rosacea is often triggered by hot drinks, spicy foods and alcohol.
Various forms of anxiety can lead to flushing in many people. Patients often experience increased heat in the face and become aware that they are flushing. This often makes flushing worse as patients become even more embarrassed at their appearance. Flushing due to anxiety or embarrassment is often felt to be normal, however, when the flushing occurs regularly with minimal stress, and a constant fear of recurrence, intervention by health professionals should be sought.
Hormonal changes during menopause cause changes to the way your blood vessels behave. Hot flushes are very common during menopause leading to a feeling of intense warmth and a red appearance of the face.
Keratosis Pilaris Rubra Faceii
Typical keratosis pilaris is commonly seen as small bumps and redness of the skin of the outer upper arms. Some people refer to this as ‘chicken skin’. Keratosis pilaris rubra faceii is a variant of keratosis pilaris. It is the cause of the facial redness and flushing that effects Prince Harry. There is often fixed redness of the face with a slight bumpy texture, mostly affecting the cheeks.
Other Medical Conditions
There are a few medical conditions that can also cause flushing. This includes hyperthyroidism and carcinoid syndrome. These conditions need to be considered in anyone who has a problem with facial flushing and be investigated by appropriate specialists.
Treatment of facial flushing and persistent redness
The first step in identifying an effective management plan for facial flushing is to establish the cause and have a firm diagnosis of the problem.
Avoiding common triggers and known aggravators is the first step. In cases where flushing is caused due to anxiety, it is important that underlying psychological factors are addressed by GP’s, psychologists or psychiatrists. Sometimes medications such as beta-blockers can be used to treat some forms of facial flushing. Whilst surgery can be performed to cut specific nerves to stop flushing, there are significant and irreversible complications that may occur with such an operation.
Hormonal treatments may be of benefit for menopausal flushing. If flushing is caused by an underlying medical problem such as hyperthyroidism or carcinoid syndrome, specialist medical care is essential.
In most cases where medical treatment is started, vascular laser therapy may be of some additional benefit to any form of facial flushing. Lasers can be used to seal-off the small blood vessels of the face and decrease the amount of blood that can travel through them. The less blood in the vessels means less visible redness. This is often a good treatment for rosacea, menopausal flushing as well as the flushing associated with anxiety disorders. Often, the cycle of anxiety or embarrassment is broken when the patient knows that they are no longer visibly red, even if they feel anxious and hot in particular situations. This feedback to the brain allows one to relax and not think about their appearance.
Another treatment option for facial flushing and redness is muscle relaxant or anti-wrinkle injections. When such injections are placed in the very top layer of the skin and in small quantities, they can stop the messages from the nerves to the blood vessels from being relayed. This procedure should only be done by experienced practitioners.