Rosacea Flushing

Types, Patterns & Systems

Rosacea is a progressive skin disorder unless treated. The blood vessels continue to grow with age and the more blood vessels one has near the surface of the skin, the more one is likely to flush and stay flushed. Rosacea sufferers have on average more facial blood vessels than the general population, or they have blood vessels which are more prominent or severely damaged. Treatment of rosacea needs to begin with an understanding of what causes or influences your rosacea flushing. Effective skin care for rosacea must address the flushing issues. Consequently, anything that stimulates facial dilation cannot be handled easily or properly. We will attempt to help you understand vascular constriction and dilation. Dilation, or enlarging of the blood vessels, produces the flushing which rosacea sufferers experience. Understanding what causes the vessels to dilate will help you in controlling the factors that aggravate a rosacea flush.

One of the earliest symptoms of rosacea is flushing or diffuse redness. The flushing factor tends to be cause of comment and embarrassment for the rosacea sufferer. Facial redness or erythema is best defined as a lengthy flush of embarrassment or emotion in a social situation that may last for a few minutes to many hours. While for many others it is the more constant redness or blotchy flushed appearance that becomes the cause of embarrassment. The redness is generally located on the cheek area but can spread down to the chin, neck or even upper chest. In some cases the forehead may also be involved. This redness can be associated with many things such as food, dust, environmental or chemical allergies, stress, over-exertion, exercise, alcohol, and extreme heat or cold. If the redness becomes more permanent or constant, one may suspect the skin condition known as rosacea.

Many rosacea patients definition of rosacea is a hot burning sensation 'of sensory feelings' like a sunburn. Other patients definition is the 'appearance' that they personally view themselves and how others socially view their red sunburn appearance. In the early stages of rosacea this redness may come and go. In the later stages of rosacea, the effect becomes more permanent. The facial redness or flushing may last anywhere from hours to days at a time.

These are some of the primary types of flushing, and there are other types of rosacea flushing such as sun exposure flushing, drug medication flushing, medication induced sun sensitivity flushing, laughter flushing, allergy/histamine flushing, etc. The goal is to decrease vascular dilation through vascular constriction which will minimize flushing of any type.

Each of the following items is part of a complex interaction of several systems.

Clock rosacea or systemic flushing - The body does operate on a clock! Universally, hospital physicians have known for years that the lowest body temperature of the 24 hour day is usually around 3:00 to 4:00 A.M. while the highest temperature of the day is generally 7:00 to 8:00 P.M. The average rosacea sufferer does not have hospital waking and sleeping hours, therefore their temperature lows and highs may vary 3 to 5 hours each way. A high temperature for some may be as early as 3:00 P.M.

Flushing usually occurs when the body becomes fatigued and/or stressed which stimulates the sympathetic nervous system. The key to this is the autonomic nervous system (more specifically, the sympathetic postganglionic efferent nerves). Any activation of these nerves causes vasoconstriction of "body blood vessels" -- except in the "facial blush/flush areas" where it induces potent vasodilatation or flushing with the resulting "rosacea flush."

A typical rosacea sufferer would flush in the fifth grade even if the answer was known when the teacher asked a question, and obviously the flushing would be noticed by the other kids. Again, the sympathetic nervous system reacting to stress.

Increase in internal body temperature stimulates the sympathetic nervous system, whereas obviously a decrease in body temperature decreases the sympathetic system due to the parasympathetic system calming the system.

The sympathetic nervous system is especially important to rosacea patients who tend to have one or more of the following:

Stress
Lack of sleep (a minimum of 8 to 9 hours are needed nightly)
Genetically weak blood vessels
Damaged blood vessels from years of sun
Damaged support system for blood vessels (collagen-elastic of skin)
Increased number of blood vessels

Alcohol flushing - The best way to avoid this type of flushing or vascular dilation is to not drink any alcohol! All alcohol is fermented, but because beer and wines (red wine being the worst) are not further distilled, they can cause allergy redness for many rosacea sufferers. Alcohol is a diuretic which pushes water out of the body cells. In this state of "dehydration", the body is prone to flushing. Alcohol is a concentrated source of calories and is metabolized very quickly. This causes the blood vessels to dilate causing redness.

If you feel you need to drink alcohol at social functions or to relax, here are some recommendations to minimize the flushing effect:

Wine is heavy in carbohydrates and even higher in preservatives and sulfides causing more flushing, with the red wines usually being the worst for most of us. If you prefer wine, a white wine would be best.
Avoid beer as it is higher in carbohydrates; however, if you like beer, drink domestic beer from your own country as it is usually sold within six weeks of production. Foreign beers imported into your country usually have preservatives which make for more facial redness. Domestic 'light beer' usually does not have as many carbohydrates and less alcohol content making it the beer of choice.
It is better to drink small amounts of gin, vodka, or whiskey, diluted with water instead of sugared soft drinks or mixes which also can stimulate the cardiovascular system. A good choice would be a Long Island Iced Tea substituting the mix with water and diluting it. Small amounts of gin are frequently less stimulating than vodka or whiskey. You should "chase" any alcoholic drink with water.

Although these recommendations can help to minimize flushing, still the best thought is "not to drink any type of alcohol." Even though alcohol sedates, it can prevent a good night sleep as the alcohol stimulates the brain.

Heavy meal flushing and sugar/carbohydrate flushing - This flushing or vascular dilation is caused by more stress on the digestive system resulting in a higher blood flow to the digestive system with the residual blood being heavier to the face. Three small meals with breakfast being the most important and grazing or snacks in between is better for limiting this kind of flushing. This will maintain the proper blood sugar content for energy to prevent fatigue or exhaustion. The type of food that you eat is also very important as various foods stimulate blood flow differently.

Simple carbohydrates such as donuts, sugars, alcohol, etc. enter the blood stream quickly causing hyperglycemia (high glucose spikes). This rapid influx of sugar into the blood stream is a potent vasodilator.

Fiber intake decreases the amount of food that the stomach has at one time and prolongs digestion; therefore, it prevents the sudden influx into the blood stream with the resultant flushing.

Carbohydrates are needed for energy and as a part of every meal; however, let's try to enjoy the baked potatoes, beans, corn, apples (fruit but still a carbohydrate), etc. instead of simple carbohydrates.

Proteins, fruits, and vegetables provide the body with so many nutrients that are needed to repair the body tissue while carbohydrates are needed for energy and is most often stored as fat.

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This page was last updated on February 5, 2012 .