Flushed Face: Medications That Can Cause Red Skin

Key Takeaways

The most common medical conditions that cause flushing of the face include fever, rosacea, menopause symptoms, lupus, certain endocrine disorders, cluster headaches, and migraines.
Some of the medications that can cause facial flushing include vasodilators, such as amyl nitrite for chest pain, calcium channel blockers used to treat high blood pressure, nicotinic acid (niacin or vitamin B3), corticosteroids, certain antibiotics, opioid pain medications such as morphine, certain cholinergic drugs, tamoxifen used to treat certain types of breast cancer, and sildenafil (Viagra) for erectile dysfunction.
Facial flushing can be managed by reducing your alcohol intake and consuming fewer hot drinks like tea and coffee, avoiding spicy food, keeping your room cool, avoiding bright sunlight, spraying your face with cool water, and sipping on cold drinks if you feel hot. If your flushed skin is due to rosacea, oral beta blockers can be used if conventional therapy does not yield an adequate response.
While facial flushing can happen at the same time as high blood pressure in response to cold weather, exercise, and emotional stress, elevated blood pressure does not directly cause facial flushing.

What is facial flushing?

Skin flushing is the result of increased blood flow, also known as “blushing.” Facial flushing happens when there is an increased blood flow to the cheeks. When this happens, blood vessels dilate to accommodate this increased flood flow, and this is the reason for facial flushing or “blush.”

Due to the increased blood flow, you may feel a warm sensation in the face, neck, upper chest, or upper trunk.

Facial blushing is a normal response to extreme emotions such as anger, embarrassment, or excitement. In addition, flushing typically occurs after exercising in hot conditions, exposure to extreme temperatures, drinking alcohol or hot beverages, and eating spicy foods or food additives like monosodium glutamate (MSG).

But sometimes, flushed skin can be a sign of a medical condition or a medication side effect. Please continue reading to learn more about some of the medications that can cause flushing.

What medical condition causes flushing?

Many medical conditions can cause facial flushing. Some of the most common causes include fever, rosacea, menopause symptoms, cluster headaches (this headache disorder is not the same as migraines), Parkinson’s disease, dumping syndrome after gastric surgery triggered by hot drinks or strong glucose, autonomic hyperreflexia (a dangerous and acute increase in blood pressure), spinal cord injuries, brain tumors, and endocrine conditions (disorders of hormone production) such as thyroid gland disorders, Cushing’s syndrome, or carcinoid syndrome.

Anaphylactic allergic reactions can be life-threatening if left untreated. Anaphylactic symptoms can be caused by a condition called mast cell activation syndrome (MCAS). During an anaphylactic reaction, the following symptoms can occur: hives, itching, trouble breathing, facial flushing, swelling, and low blood pressure.

According to the American Heart Association, facial flushing occurs during emotional stress, cold weather, sun exposure, spicy foods, hot beverages, and certain skincare products. These are all the factors that can raise blood pressure. At the same time, these triggers also cause dilation of facial blood vessels, causing facial flushing. With that said, high blood pressure and facial flushing can happen at the same time as a result of these environmental factors and triggers. Keep in mind that facial flushing can also occur in people with normal or low blood pressure.

You should make an appointment with your healthcare professional if your flushed skin occurs due to no obvious cause, the symptoms begin getting worse or happening more frequently, or if the facial flushing is accompanied by other symptoms, such as abdominal discomfort, stomach pain, hot or cold sensation, burning sensation, runny nose, excessive salivation, high blood pressure, low blood pressure, hot flashes, racing heart, frequent urination, or diarrhea.

Get immediate medical attention if, along with skin flushing, you develop a skin rash, hives, itching, blistering, peeling (signs of an allergic reaction), swelling of the face, throat, hands, or feet, chest pain, or difficulty breathing or swallowing.

Your medical professional will obtain a medical history, perform a physical exam, and order laboratory and other tests to find out if there is an underlying condition that may be causing facial flushing.

Why does alcohol cause skin flushing in some people?

People of Asian descent are at a higher risk of flushing after alcohol intake due to altered alcohol metabolism (defects in an enzyme called aldehyde dehydrogenase, which leads to a buildup of acetaldehyde).

Additionally, certain fermented alcoholic beverages, such as wine, beer, and sherry, which contain histamine or tyramine, are more likely to cause skin flushing.

Some people who are exposed to industrial solvents can develop skin flushing after drinking beer.

People with carcinoid tumors who consume mushrooms and drink alcohol can develop flushing.

Susceptible individuals can develop flushed skin if they drink alcohol while on certain drugs, for example:

Medications used as deterrents in people with chronic alcoholism (disulfiram, calcium carbimide)
Diabetes medications, such as chlorpropamide
Medications such as phentolamine, which are used to treat pheochromocytoma (a rare condition of the adrenal gland) and hypertensive emergencies
Oral antibiotics such as metronidazole and cephalosporins

Which medications are most likely to cause flushed skin?

Sometimes, the underlying cause of flushed skin is a medication side effect. Certain medications act on the blood vessels and produce dry flushing, while others act on blood vessels and nerves and produce flushed skin along with sweating. Some of the medications that can cause facial flushing include:

Vasodilators and calcium channel blockers used to treat high blood pressure, chest pain, and heart failure
Nicotinic acid (niacin or vitamin B3)
Corticosteroids
Certain antibiotics like vancomycin. Vancomycin flushing syndrome is characterized by red rash in the face, neck, and upper trunk; low blood pressure, dizziness, and headache may happen in some cases.
Opioid pain medications such as morphine
Medications used to treat angina (chest pain), such as amyl nitrite
Cholinergic drugs prescribed for glaucoma, Alzheimer's disease, urinary retention, paralytic ileus, and myasthenia gravis
Bromocriptine which is used to treat certain menstrual problems, stop milk production, and treat infertility due to high prolactin levels
Tamoxifen (used to treat certain types of breast cancer)
Sildenafil (Viagra)

What blood pressure medications cause facial flushing?

Blood pressure medicines and vasodilators can cause facial flushing. These include:

Calcium channel blockers such as diltiazem (Tiazac, Cardizem), nifedipine, amlodipine, and felodipine
Vasodilators such as minoxidil (Loniten), hydralazine (Apresoline), and nitroglycerin (Nitrostat)

What is the treatment for facial flushing?

Treatment options for flushed skin depend on the underlying cause. The following strategies can help you manage symptoms of flushed skin:

Cut down on alcohol and hot drinks like tea and coffee
Avoid spicy food
Keep your room cool
Stay out of bright sunlight
Spray your face with cool water
Sip on cold drinks if you feel hot

Talk to your healthcare provider about treatments for flushed skin. For example, oral beta blockers may help people with facial flushing due to rosacea who have not responded to conventional treatment.

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