Flushing or blushing, being a physiological phenomenon most of the time and only a transient cause of social embarrassment, does not require any active treatment. However, severe flushing interfering with the individual’s social interactions and associated with other disabling symptoms like palmoplantar hyperhidrosis or with systemic diseases calls for therapeutic interventions.
Most often flushing disappears after treatment of the primary cause, as in thyrotoxicosis, mastocytosis or carcinoid syndrome.
How to Treat Flushing
- Avoidance of the triggering event. Finding the cause of flushing and eliminating it is, of course, the first step in the management of flushing. (Learn more about the causes of flushing before proceeding to the next section).
- Treatment of Physiological Flushing. If the physiological flushing is severe and socially disabling, temporary relief may be obtained with the beta-blocker propranalol and minor tranquilizers. Very severe cases accompanied by palmar hyperhidrosis (excessive sweaty palms) may opt for trans-thoracic endoscopic sympathectomy.
- Treatment of Menopausal Flushing. The following medications are effective in controlling troublesome menopausal flushing: oral or transdermal estrogen replacement therapy, combined oral contraceptive pills, progesterone, clonidine and selective serotonin reuptake inhibitors.
- Treatment of Drug Induced Flushing. Stopping or reducing the dosage is the only solution here. Flushing caused by fumaric acid esters used in psoriasis has been found to reduce by the addition of pentoxiphyllin.
- Treatment of Alcohol Induced Flushing. Severe flush caused by alcohol can be controlled with aspirin and antihistamines belonging to the H1 and H2 classes.
- Treatment of Food Induced Flushing. Avoiding hot spicy food by sensitive individuals is the only option in controlling the food induced flushing. Aspirin and antihistamines may help in severe cases.
- Treatment of Scombroid Fish Poisoning. As this poisoning is caused by histamine intoxication from spoiled fish, a combination of H1 and H2 antihistamines should be given immediately. If the signs and symptoms are severe, adrenaline (epinephrine) and corticosteroids may be required.
- Treatment of Carcinoid Syndrome. Alcohol and following food items should be avoided in carcinoid syndrome to control the flushing associated with this disease complex: aubergine, avocado, bananas, chocolate, hickory nuts, kiwi fruit, pecan nuts, pineapple, plum, red wine, spicy foods, tomatoes, walnuts.
Flushing control in carcinoid syndrome can be achieved by the use of clonidine, antihistamines (H1 and H2 combined), phentolamine etc. Octreotide and lanreotide given as depot injections relieve both flushing and diarrhea and also causes regression of the tumors in carcinoid syndrome. Other treatments for carcinoid syndrome include surgical excision and chemotherapy.
Treatment of flushing thus involves general measures against the chemical mediators as well as specific treatment of the primary disease responsible for the flushing.
Further Reading
Reference
Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
