Flushing

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Introduction

What is flushing?

Flushing is an involuntary, temporary reddening of the skin, usually of the face. Facial flushing may be accompanied by flushing of the neck or chest. In general, flushing results from dilation of the blood vessels beneath the skin surface. Although flushing is similar to blushing, flushing typically refers to a more pronounced redness of the face than blushing.

In most cases, flushing occurs as a normal body response to physical circumstances, including exercise, hot temperatures, or consumption of alcohol or spicy foods. A variety of emotional states, such as anger, sexual arousal, or embarrassment, can also cause flushing. Flushing can also occur as a result of hormonal changes in the menopausal transition, often accompanied by hot flashes, and in pregnancy.

Flushing is also seen in conditions in which the body is overheated, such as fever, heat exhaustion, or heat stroke. Flushing can accompany allergic reactions and inflammatory conditions. Rarely, it may be a symptom of carcinoid syndrome, a condition in which a tumor produces hormones leading to vascular changes and a characteristic flushing that is a hallmark of the disease.

Certain medications, such as niacin and drugs used to treat erectile dysfunction, may be associated with flushing.

Flushing alone is rarely a sign of a serious condition and is most often a normal body response to physical or emotional stress. If flushing is accompanied by symptoms such as difficulty breathing or chest pain, seek immediate medical care (call 911).

Seek prompt medical care if you have flushing along with fever. If flushing is persistent or causes you concern, contact a medical professional.

Symptoms

What other symptoms might occur with flushing?

Flushing may be accompanied by other symptoms, depending on the underlying disease, disorder or condition that causes it. Symptoms that frequently affect the skin, such as flushing, may also involve other body systems.

Facial symptoms that may occur along with flushing

Flushing of the face may accompany other symptoms affecting the facial skin, such as the development of pimples or nodules in rosacea. These symptoms include:

  • Blotchiness or irregularity of skin appearance

  • Feelings of warmth

  • Itchy skin

  • Skin pimples or blisters

  • Sweating

Other symptoms that may occur along with flushing

Flushing may accompany symptoms related to other body systems including:

Serious symptoms that might indicate a life-threatening condition

In some cases, flushing may occur with other symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:

Causes

What causes flushing?

Flushing, also called ‘plethora’ occurs when the blood vessels beneath the skin surface become dilated for any reason. This process can occur as a normal response to intense emotions, such as embarrassment, anger, guilt, anxiety or stress. Flushing is also a normal response to physical stimuli or events, such as sexual arousal, high environmental temperatures, exercise, or consumption of certain foods and alcohol.

Everyday causes of flushing

Flushing is the body’s way of responding to many everyday conditions or normal body states including:

  • Alcohol consumption

  • Exercise

  • High environmental temperatures

  • Medication side effects

  • Menopause

  • Pregnancy

  • Rapid changes in temperature

  • Sexual arousal

  • Spicy foods

  • Strong emotions

Other causes of flushing

Flushing can also be caused by medical conditions that are localized to the skin or may affect the entire body including:

  • Carcinoid syndrome (group of symptoms caused by a tumor that secretes hormones and other biologically active substances)

  • Polycythemia (increased amount of circulating red blood cells)

  • Fever

  • Heat stroke or heat exhaustion

  • Hyperthyroidism (overactive thyroid)

  • Mastocytosis (accumulation of a type of inflammatory cells, called mast cells, in body tissues)

Allergic causes of flushing

Flushing may accompany allergic reactions including:

  • Drug allergy, such as to penicillin or codeine

  • Food allergy

  • Hay fever or allergic reaction to animal dander, dust, cosmetics or pollen

  • Insect allergy, such as to a bee sting

Serious or life-threatening causes of flushing

In some cases, flushing may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These conditions include:

Questions for diagnosing the cause of flushing

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your flushing including:

  • How long has your flushing been present?

  • Are you experiencing any other symptoms?

  • How often do you experience flushing?

  • Is the flushing worse after you consume alcohol or specific foods?

  • Is your flushing becoming worse or more frequent?

What are the potential complications of flushing?

Flushing is seldom a symptom of a serious medical condition. Occasionally, flushing is seen in diseases that may have serious or long-term complications. For example, carcinoid syndrome, a rare cause of flushing, can lead to complications including:

Flushing may also be a symptom of other serious or life-threatening medical conditions, such as anaphylactic shock or heart attack. Left untreated, these conditions can lead to complications including:

  • Coma

  • Heart failure

  • Shock

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 26
  1. Skin blushing/flushing. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003241.htm
  2. Rosacea. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000879.htm
  3. Izikson L, English JC 3rd, Zirwas MJ. The flushing patient: differential diagnosis, workup, and treatment. J Am Acad Dermatol 2006; 55:193.
  4. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
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