Facial Flushing

[tedstriker]

Hello....

I posted a few months back about flushing after taking accutane; I am still suffering but seem to recognise the causes but the docs don't want to know as soon as I mention accutane.

Can anyone shed some light on this or things that can help.

I took accutane 10mg for 4 months; I started flushing within the first week and the longer I took the accutane the more I flushed to triggers which I had never done before.

My main trigger which started on the accutane was being outside for a prolonged period (ex: golfing, flishing, day trips); my cheeks would feel cold even in hot weather and I would look normal, but as soon as I get home and sit down my face would go beet red and take a couple of hours to calm down; this started in the second month and has remained the same 7months after finishing the course.

If I eat spicy food my face will turn pink but feel cold to touch, sometimes the same happens with beer but the more I drink the less sensitive I become to these triggers.
I know this may be anxiety related because the accutane has caused me to be very anxious over the flushing.
Throughout the day my face will look pink then normal then pink etc etc.

I have noticed that the blood vessels in my face seem to be sensitive, if I splash water on my face it quickly turns red but then turns pale just as quick.
If I have a hot bath my skin will look very pale after I get out.

Since finishing the accutane the back of my neck would feel constantly hot and my left cheek would constantly burn.
The doc put me on propranolol and an antidepressant (Luvox) which quickly reduced the heat sensation in my neck and cheek although the antidepressant hasn't seemed to help with the actual flushing side; the propranolol helps with the anxiety side of the flushing but nothing seems to help with the temperature side of the flushing.

I have seen a couple of derms and a skin doctor in the GP clinic who say its not rosacea but that confuses me more than ever as the flushing is a symptom of rosacea.

Is there anything I can do to reduce the flushing????
This has been new to me as I have never turned red apart from extreme embarrassement.

Thanks
Ted

[Bhupinder Kaur, MD]

Hello,
Facial flushing is a known side effect of using Accutane especially when you do not avoid the sun. Using tacrolimus often resolves the itch, redness, and tenderness but it should be taken after a dermatologist’s guidance. Avoiding caffeine, spicy foods, and alcohol, also may help clear the skin. But if the symptoms persist then IPL treatment and alternate IPL with Nd:YAG 1064 laser may also be required.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[maatson]

Do use photoprotection since retinoids are  known to induce photosensitivity, albeit rarely.