General: Symptoms of facial flushing may be treated with a cool compress or by drinking cool fluids. However, the only way to prevent facial flushing from returning is to treat the underlying cause. Once the cause is treated, symptoms may resolve. If flushing occurs after a patient feels embarrassed or angry or after exercise or sex, symptoms will resolve without any treatment.
Avoiding triggers: If alcohol, certain foods, beverages, or food additives are causing the reaction, symptoms will resolve on their own, unless it is a symptom of a severe allergic reaction called anaphylaxis; this condition is a medical emergency that requires immediate treatment with epinephrine. Avoiding or minimizing exposure to these products helps prevent symptoms from recurring. If a drug is causing the reaction, a healthcare provider may recommend an alternative medication or dose.
Allergy medications: Allergy medications like diphenhydramine (Benadryl®) may be used if facial flushing is a symptom of an allergic reaction. However, unless the patient avoids exposure to substances that trigger the allergic reaction, symptoms will return once the medication wears off.
Epinephrine: A medication called epinephrine is used to treat a severe allergic reaction called anaphylaxis. Epinephrine is injected into the skin at a hospital. Patients with a history of anaphylaxis should carry an auto-injectable epinephrine (EpiPen®) with them at all times. If symptoms of anaphylaxis appear after exposure to an allergen, the patient uses the device to inject the epinephrine into his/her thigh. Epinephrine acts as a bronchodilator because it opens the patient's airway. It also constricts the blood vessels, which increases blood pressure. Patients who experience anaphylaxis may also be admitted to the hospital to have their blood pressure monitored and possibly to receive breathing support.
Topical antibiotics: Patients who experience facial flushing as a symptom of rosacea typically receive antibiotics that are applied to the skin. These medications are used for their anti-inflammatory effects rather than their antimicrobial (ability to kill bacteria) effects. Antibiotics like metronidazole (Metrocream®, Metrogel®, or Noritate®) or azelaic acid (Azelex® or Finacea®) have been used to reduce redness and inflammation associated with the skin disorder.
Cool compress: Patients can soak a clean cloth under cool water and apply it to the face. This helps relieve symptoms of facial flushing. This treatment is especially beneficial if exercise, spicy foods, hot beverages, extreme temperatures, or sex/orgasm triggers symptoms.
Cool fluids: Drinking cool fluids or eating ice chips may help alleviate symptoms of flushing. This treatment is especially beneficial if exercise, spicy foods, hot beverages, extreme temperatures, or sex/orgasm triggers symptoms.
Estrogen: Patients experiencing menopause may benefit from hormone therapy with estrogen to help alleviate symptoms, including facial flushing. However, according to research, patients who receive estrogen have an increased risk of stroke. Patients should consult their healthcare providers to determine the potential health benefits and risks associated with hormone therapy.
Traditional or theoretical uses lacking scientific evidence
Oregano: Traditionally, oregano has been used to treat symptoms of rosacea. However, there are currently no available human studies that evaluate the safety and efficacy of this treatment.
Research suggests that oregano is well tolerated in recommended doses. Avoid if allergic or hypersensitive to oregano. Use cautiously if allergic or hypersensitive to other herbs from the Lamiaceae family, including hyssop, basil marjoram, mint, sage, and lavender. Use caution with diabetes and bleeding disorders.Pregnant or breastfeeding women should not consume oregano at doses higher than those normally found in food.
Perilla: Although perilla, an herb in the mint family, has been traditionally used to treat rosacea, scientific evidence is lacking in this area. Until scientific research is conducted, it remains unknown whether perilla is an effective treatment for rosacea.
Avoid if allergic/hypersensitive to perilla or members of the Lamiaciae/Labiatae family. Use cautiously with cancer, low HDL-cholesterol, and immune disorders. Use cautiously if taking nonsteroidal anti-inflammatory drugs (NSAIDS) or barbiturates. Avoid if pregnant or breastfeeding.
Relaxation therapy: Relaxation therapy has been suggested as a possible treatment for rosacea. However, there are currently no available scientific studies on the safety and efficacy of this treatment.
Avoid with psychiatric disorders like schizophrenia/psychosis. Jacobson relaxation (flexing specific muscles, holding that position, then relaxing the muscles) should be used cautiously with illnesses like heart disease, high blood pressure, or musculoskeletal injury. Relaxation therapy is not recommended as the sole treatment approach for potentially serious medical conditions and should not delay the time to diagnosis or treatment with more proven techniques.
Fair negative scientific evidence
Evening primrose oil: Scientific studies suggest that evening primrose oil is not an effective treatment for facial flushing caused by menopause.
Avoid evening primrose oil if allergic to plants in the Onagraceae family (willow's herb, enchanter's nightshade) or gamma-linolenic acid. Avoid with seizure disorders. Use cautiously with mental illness medications. Stop use two weeks before surgery with anesthesia. Avoid if pregnant or breastfeeding.
Avoid exposure to known allergens.
Avoid or minimize exposure to hot or cold temperatures if they are known to trigger symptoms.
Do not consume alcohol with drugs that are known to cause facial flushing.
If alcohol has caused facial flushing, patients can avoid or limit their alcohol intake to prevent symptoms from occurring.
If menopausal, speak to a healthcare provider about therapeutic options to reduce facial flushing and hot flashes.
Individuals with a history of anaphylaxis should carry an autoinjectable epinephrine device (known as an EpiPen®) with them at all times. A trained family member or friend may help the patient administer the epinephrine, if necessary.
Try to avoid hot drinks, spicy foods, or food additives if they are known to trigger symptoms.