General: Facial flushing is usually a symptom of an underlying medical condition or reaction to certain substance. Below are some of the most common causes of facial flushing.
Alcohol: Facial flushing may occur after alcohol consumption. This is because alcohol causes the blood vessels to expand. As a result, more blood flows to the face. For unknown reasons, people of Asian decent are more likely to experience alcohol-induced facial flushing. Certain drugs, including disulfiram (Antabuse®), chlorpropamide (Diabinese®), metronidazole (Flagyl®), and cephalosporin antibiotics (like Keflex® or Pulvules®), may cause facial flushing when taken with alcohol.
Allergy: An allergic reaction may cause many symptoms, including facial flushing. An allergic reaction occurs when the body's immune system overreacts to a substance that is normally harmless. The immune system mistakenly identifies a substance (like pollen or dust mites) as a foreign invader, such as bacteria. When the immune system starts to fight off the foreign substance, allergy symptoms, which may include facial flushing, develop.
Facial flushing may be a symptom of a severe and potentially life-threatening allergic reaction called anaphylaxis. The most serious symptoms of anaphylaxis include low blood pressure, breathing difficulties, shock ,and loss of consciousness, all of which can be fatal. Patients should seek immediate medical treatment if these symptoms develop.
Drugs: Facial flushing is a side effect of many drugs, including vasodilators, calcium channel blockers, nicotinic acid, morphine, amyl nitrite and butyl nitrite, cholinergic drugs, bromocriptine, thyroid releasing hormone, tamoxifen, cyproterone acetate, systemic steroids, and ciclosporin.
Facial flushing may also be a sign of a severe allergic reaction to the medication. If flushing occurs in other areas of the body and is accompanied by other symptoms, such as difficulty breathing, chest pain, hives, or nausea, patients should seek immediate medical treatment.
Emotions: Certain emotions, including embarrassment (blushing), anxiety, anger, stress, and guilt, may cause facial flushing. When patients experience such emotions, the body releases a large amount of hormones, such as adrenaline, under pressure. The blood vessels in the face respond by releasing chemicals that cause them to dilate (expand). This may lead to a reddening in color in the face (facial flushing), sometimes called adrenaline flushing.
Exercise: Some patients may develop facial flushing after exercising. This is because exercise increases blood flow throughout the body, including the face. This causes the face to become red.
Food additives: Food additives are substances or chemicals that are added to food to make it last longer, taste better, or look more appealing. Patients can read the labels of food to determine the food additives that may be present in the product. Consuming large amounts of certain food additives, including MSG (monosodium glutamate), sodium nitrate, and sulphites (such as potassium metabisulfite), may cause facial flushing. MSG is used to enhance the flavor of some foods. Sulfites occur naturally in some foods and they are sometimes added to food to prevent mold growth or enhance crispness. They also form when wine ferments. Sulphites are present in beer, cider, wine, desserts, fried and frozen vegetables, fruit juices, frozen prawns, and shrimp and milk products.
Foods and beverages: Spicy foods and hot beverages may cause facial flushing.
Menopause: Facial flushing is a common symptom of menopause (when a woman stops menstruating). In fact, an estimated 80% of menopausal women experience facial flushing. The decreased levels of hormones, such as estrogen and progesterone, may lead to facial flushing, as well as hot flashes (sudden feeling of warmth that causes sweating) and facial tingling.
Sex: Facial flushing may also occur after sex and/or orgasm. This is because there is an increase in blood flow throughout the body, including the face. This causes the face to become red.
Skin disorders: Certain skin disorders, including rosacea, may cause facial flushing.
Weather: Exposure to hot or cold temperatures may cause facial flushing.
Patients who have facial flushing experience a sudden reddening of the face. In some patients, the face may also feel hot. Sometimes the neck and upper chest may also become red.
Depending on the underlying cause, additional symptoms may also be present. For instance, if facial flushing is triggered by an allergic reaction, symptoms, such as sneezing, runny nose, or hives, may also be present. If menopause is causing facial flushing, symptoms such as hot flashes, difficulty sleeping, night sweats, and irritability may also occur.
A healthcare provider can diagnose flushing after a physical examination and medical history. Since facial flushing may be a symptom of an underlying medical condition or allergy, additional tests may be necessary to determine the cause of symptoms.
In order to determine the tests that are necessary, a healthcare provider will ask the patient several questions about his/her symptoms. For instance, the healthcare provider may ask whether symptoms affect the whole body or if the face feels hot. It is important to determine how often flushing occurs and whether symptoms are becoming more frequent or severe. A physician will also ask whether symptoms worsen after alcohol consumption and if the patient is going through menopause. It is important to know whether other symptoms, such as wheezing, hives, diarrhea, or difficulty breathing, are also present because this usually indicates an allergy.