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Flushing and rosacea....picture included

Any advice will do???
Suffered high levels of stress for 2yrs due to a nerve problem.
Went to a derm 14months ago and he put me on low dose accutane to combat the oilyness which appeared due to the stress.
I suffered facial flushing after the 1st month on accutane, I  have been off it for exactly a year and the flushing seems to be getting worse.
I have seen a reputable derm and he's told me its accutane induce rosacea.
My flushing triggers all come from stress and excessive exercise and prolonged periods outdoors (does not matter what the weather is I will always flush when I come indoors), the slightist bit of anxiety will cause me to flush but I sweat with that one as well.
The outdoor flush and the exercise flush cause a dry flush (no sweating involved), both occur about an hour after I come indoors or finish exercising.
I seem to flush most evenings as well but I dont feel it but my face will be red; my nose also swells when I am flushed.
I have attached a picture of me flushing after playing golf for 6 hours; this flush started around 2 hours after getting home.
Whilst I am exercising or golfing (outdoor activities) my face will be pale whether its 1degree or 30degrees.
same goes for work I'll be pale all day but flush when I'm at home.

I dont have allergies or food intolerences, mite problems etc which go along with alot of rosacea sufferers.
It all seems to be stress related, but I dont know how I can reduce my stress levels.

I am on slow release propranolol, Elavil SSRI, Pregabalin.

My left cheek is always worse than my right cheek (as shown in the picture) and I can see some blood vessels on the surface as well as some permanent redness.

I did get broken blood vessels on my right cheek before the flushing, these came up when all the stress started.

Is there anything I can do to treat this or reduce the flushing?

My triggers are -


I don't have any other triggers.

1 Responses
563773 tn?1374250139
Treatment options for rosacea vary from antibiotic creams, antihistaminics, sun screens to laser treatment. You should wear long sleeved cotton clothes and apply sun screen with a minimum spf of 30 atleast half an hour before going out in the sun.

Also, treatment of flushing and blushing has been attempted by means of the centrally acting α-2 agonist clonidine, but it is better if you avoid the triggers which may cause such blushing. Otherwise you can go in for vascular laser (single wavelength) or intense pulsed light (broad spectrum).

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.

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