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  • propranolol

    hi guys, i hope everyone is well.
    i wanted to ask a couple of questions about your experiences with propranolol and its effectiveness.
    i have been taking propranolol for about three months now, and it has DRAMATICALLY improved my flushing. which is kind of puzzling to me because my greatest flushing trigger was a change in cold (or even just a tad chilly) weather to a warmer climate. again, this didn't require going from the freezing cold to a heated room, but even a change in just comfortable light jacket weather to t-shirt weather would trigger a flush.
    i also experienced anxiety-flushing, although it was much more transient, more like blushing. the cold weather flushing, however, was the classic ten hour long burning pain flushing.
    so, when i began propranolol, i assumed only the anxiety flushing would be helped out. much to my surprise, i have not flushed at all since being on the propranolol. i can't say that i haven't turned red or anything, but the bright red, burning flush, the kind that everyone asks me if i'm okay and need to see a doctor, haven't had it at all. it was nothing short of shocking to me.
    i must add that i have had other mysterious health problems starting at the same time as the flushing began. i was diagnosed with an autonomic nervous system dysfunction, so the inderal also helps the rapid heart rate and arrythmias i experience.
    i have noticed that as soon as the beta blocker wears off, the flushing returns. so it is by no means "better," but masked with medication.

    my doctors still do not seem to take my flushing seriously. i went to a top-ranked dermatologist in my city, who was also recommended on a rosacea site, and he told me that i absolutely do not have rosacea because i have an autonomic nervous system dysfunction. i also do not have papules or pastules. i wanted to speak with him about possible laser treatment, but he wouldn't have it. all my other doctors, who treat the ANS dysfunction, agree that the flushing seems very much like rosacea.

    so, i am just wondering if anyone else has found total relief, or near total relief, of their flushing from the use of inderal? would one expect that inderal would treat all kinds of flushing triggers in rosacea, or just the anxiety/adrenaline related ones? is my response to inderal in regards to flushing more in line with an autonomic dysfunction, or is it typical for rosacea?

    i suppose i am trying to figure out how much i should pursue rosacea treatments. so that i do not have to be on medication four times a day for the rest of my life. i am only 25, and fear greatly the day that the propranolol is not effective. it also makes me very very tired and lethargic, which is fine as long as it helps my heart and flushing, but not sustainable for the rest of my life. but i already had the "rosacea" doc in my area decline working with me, so i'm wondering if i just accept my flushing is a result of an ANS dysfunction, or do i really try to find a derm who will help me with laser and such?

    thanks so much guys.

  • #2
    Hi Gracie,

    First of all it is great that the Propranolol has helped you so much!

    I understand your desire to "fix" what the problem is rather than masking it and I think that is a smart way to go. To find a doctor who can treat your ANS dysfunction. However, I definitely do not think that pursuing laser is the way to go since a top rosacea doctor refused and you do not have rosacea.

    I understand that it is not an ideal situation as the propranolol makes you lethargic and all. Are you on the lowest dose possible that still helps curb your flushing?

    Honestly, I would love to find a med that would help control my flushing and burning and I would have no problem taking it forever LOL as long as the side effects were tolerable. I would have a problem taking a drug that makes me feel sluggish as I love being active but if it helped stop my flushing I might take it when I was going to a social function etc and not when I was going to be outside biking for example.

    Sorry I am not any help here but I would urge you not to find a doctor who will do the laser treatment because believe me, if you look hard enough you can find a doctor who will do almost anything you want. I don't think this would be the best path for you to take. I don't know anything about your condition but I am confident you are under the care of doctors who are experts in that area and I would look to them for more tolerable long term solutions.

    Best of luck Gracie and let us know how you are doing.



    • #3
      hi, thank you so much melissa, it is great to hear from you. and as always, i appreciate your insight so much.
      i agree that i am pretty much willing to do anything to stop the flushing, and am so grateful that the inderal has helped me as well as it has. however, when i do say that the inderal causes lethargy and unpleasant side effects, i mean they are wicked side effects!!! i pretty much constantly walk around completely detached from the world. i find myself always just staring off into space, into some kind of la-la land, and i'll have no idea how much time has passed. i know some people take some hard drugs to experience these feelings, but for me, they are not good at all!!! i have also always been very active, and i am a student and work, so spending the day completely checked out of the world is not good.
      and yes, i am on the LOWEST dose. such a low dose that doctors insist the propranolol possibly can't help me. at first, my docs all told me i'm better and don't need it. so i stopped and sure enough, heart rate sky rocketed, all my symptoms came back, and everyone agreed i definitely need to be on it. i'm just super sensitive to its effects. so in most people, it might cause a little tiredness, but in me, i definitely feel drug-induced.
      now, when i have to choose between the symptoms that the inderal takes care of (like the flushing) and the constant detachedness, i choose the detachedness. i just fear the day that the effects "wear off" and i'm left with all the old symptoms.

      thanks for your advice about laser. i am definitely not gung-ho finding a doctor who'll do it, because like you, i totally recognize someone, somewhere will do it to make a buck. i just always feel so unsure because most of my doctors tell me the flushing must be rosacea, but the derm said no way. but i also felt like the derm was telling me it was not rosacea simply because i don't have pastules. i was not flushed when i saw him, and when i tried to tell him how scarlet red i become, which lasts for hours and hours, he told me that is not rosacea and he could tell, just by looking at my face, which does not have papules, that i do not have it. when i tried to address the fact that a subgroup of rosaceans just have flushing, he wouldn't have it. so i always wondered about that...
      and i also wondered if, after the two years of flushing i went through every single day, i did some serious blood vessel damage/growth that will forever cause my face to flush or become pinker than "normal." when i say the propranolol has dramatically reduced my flushing, it hasn't completely ceased it. i don't experience burning pain for hours, but do still get reddish. i am by no means complaining, because i am so thankful for the improvement i have seen, and i know so many on here continue to struggle as i had not long ago to find anything to help, but i just want to find a way to have me back. inside and out. so i can't help but shake the thought that laser treatment might help take care of the crazy damage all that flushing may have done. and perhaps curb it for if in the future i continue to experience it again (should the medicine stop working or i can no longer take it).

      thank you so much once again.


      • #4
        You are very welcome Gracie

        Thanks Gracie for the further detail.
        I guess a drug induced stupor is not a good way of life either so now I have to rethink what I said previously. Also, I thought it was definite that you did not have rosacea however it is troubling that the derm who said this did so because you do not have any papules. As we all know (at least all of us on the Rosacea forums LOL) you can have one without the other.

        Is there a teaching hospital near you where you can make an appt with a top derm and get another opinion?
        I feel in any case there might be a better drug that can help curb your flushing without the terrible side effects. I am the same as you in that I do not want to be in a drugged stupor. It is nice to have your emotions and feel what you feel.

        I have to go now as my husband has been very patient and it is getting late here but if I can think of anything else I will add it tomorrow. Hopefully there is a good solution where your flushing can be diminished without sacrificing your clarity.

        Best wishes,


        • #5
          Gracie Tiger,

          I have read your posts with interest, as your idea about the possibility of having undergone excessive blood vessel growth and damage is probable.
          I have been tested for carcinoid syndrome and mastocytosis, which both came out negative. For me these diseases would have been secondary to my rosacea, which is currently very bad. The doctor running these tests told me that if someone has carcinoid or mast cell disease and they flush severely they can develop rosacea within a year.
          This scenario seems to share similarities with your situation. ( It is not necessary to have P&P's by the way).
          From what I understand, you want to determine if you have indeed undergone excessive vascular growth and if so, will removing this excess help reduce some of your flushing?

          I am not certain, but doesn't Dr Crouch of the UK have some kind of technology called 'Angiomapping or such"?, which can determine what is going on underneath the skin?
          It might be worth your while contacting him, explaining your case and asking his opinion.
          I guess it is fair to say, your case will likely be unique to him, but nevertheless, hopefully with his skill, he will be able to provide you with an informed answer.
          Previous Numerous IPL.
          Supplements: High dose Niacinamide, Vit K2, low dose Vit A. Moderate Dose Vit C, Iodine, Taurine, Magnesium. Mod- dose B's. Low dose zinc. Testing Quercetin.

          Skin Care: No Cleanser, ZZ cream mixed with Niacinamide gel 4% and LMW HA 2%, ethyl ascorbate 2%.

          Treating for gut dysbiosis.(This is helping).
          Previous GAPS diet. Have now introduced lots of fibre.
          Fermented Foods. Intermittent fasting -16-18 hours.
          Oral Colostrum. Helps reduce food reactions.


          • #6
            I found propanolol to be very helpful. I found that the tiredness went away once my body had got used to it and have been taking it for years with no real problems. I take a time release capsule and so just take one per day. What is the actual dose you are on?


            • #7
              hi, thank you guys very much.
              thank you for the suggestion of contacting dr. crouch. it is always worth a shot! i have asked every single doctor i have seen in the last two years (which are in the dozens) about the flushing, and i get such a mixed response.
              melissa, i have a team of docs i see at a large, and very very good, teaching hospital, and i have not yet seen a dermatologist. i most certainly will though! that is a great idea. i just need an answer. i am so thankful that the inderal is not causing any more damage to be done to my skin, but i want to be sure that it is or isn't possible for me to fix the damage that has already been done. i by no means want to go through laser, but would if a doctor told me that i had significant damage. even without being diagnosed with rosacea, i did spend the last two years getting a ten hour terrible flush every single day.

              phlika, i am wondering how the inderal helped you??? did it reduce almost all of your flushing, especially in the worst of the triggers?

              i am especially curious why i am having such a profound reaction to it in regards to the flushing. so for example, just three to four months ago, pre-propranolol, being outside in somewhat chilly weather for just an hour, then going inside, not even into a heated envrionment, but let's say my car, would produce a crazy flush. just this last weekend, i spent all day outdoors in quite cold weather and was SURE that even though the propranolol has reduced my flushing drastically, this would undoubtedly bring on a motherload of a flush. i did experience a little pink hue, and my face felt a little warmer than usual, but NOTHING like before. nothing.
              is this typical of rosacea? to respond like this? especially to a medication that blocks adrenaline? i'm not really sure how the propranolol would affect a cold to warm weather flush. is it possible it constricts my blood vessels that much??? but if so, i wouldn't understand then why i wouldn't experience much colder hands and feet? why just in the face?

              i suppose, overall, i feel very frustrated about not having any answers. i know a lot of rosaceans have a hard time getting a dermatologist to understand their condition or even get an appropriate diagnosis, so totally hear me. but i also feel especially confused because i developed so many other sudden, out of the blue health problems along with the flushing, at the same exact time. it wasn't like i had been a blusher or flusher for a couple years beforehand, not even mildly, then something got a little out of whack and it turned into rosacea. i never blushed or turned red. then i lived in africa, came home, and wham! full on flushing and blushing. which got worse really really quickly, like in two months. is this a normal onset? i was on birth control at the time, and had been for like five months, so other than a living experience in africa, this could be the only other contributor. and i have heard of the pill making rosacea worse, but could it really cause a person to go from no redness ever to severe burning hours long redness in just a matter of months, so suddenly?
              and if this doesn't sound like rosacea, then i don't really understand how there could be NO explanation for such a drastic change in a 23 year old's body!!!! i mean, i don't know anyone else who just one day starts turning fire engine red with a lot of pain. it's not normal!!!!!


              • #8
                Propranol for flushing!

                GracieTiger: When I saw your post I felt compelled to register and comment because I've had so many of the same experiences/results with inderal/propranolol! I realize this comment is years after your post but I hope you'll see it and update us on how you're doing and what's working for you now!

                I started using propranolol 5 years ago (early 20s) and noticed immediately that it helped not only with my social anxiety but also my rosacea. I had the extreme flushing even as a teenager but like you was also told that it couldn't be rosacea due to my age and no papules. Nevertheless I was prescribed metrogel but it didn't seem to do much.

                I'm so glad that I stumbled on the inderal because honestly it's been a lifesaver for me, not only for situational anxiety and flushing but for other purposes as well (irritability, hypomania). I have 10 mg tablets but sometimes cut them into 5 mg and only need that much. I used to need a lot more. Some of the negative side effects for me have been: cognitive dulling, like you mentioned (it's such a pain to feel my brain slipping away as it kicks in!), decreased libido, and rarely my BP drops too low even on that low of a dose.

                Anyways, I'll stop this before it's super long but I hope you're well!


                • #9
                  Logged in to ask you a question CharmQuark. Are your symptoms the same as GracieTigers? I.e blushing out of the blue that turned into deep flushing from cold to warm enviroments. Like Gracietiger i too only need to be in a slightly cold temp and then put back into a warm/mild room and experience a flush. 100x worse when its actually cold out but a flush none the less.

                  Had basically give up on rosacea meds as clonidine did't work for me. The only other med that i thought was worth bothering with was propranolol but i've never tried it. I had no idea it could help with cold to warm flushing (my biggest trigger by far)!!!!!

                  Thanks for your time


                  • #10
                    Also do you notice that after a few drinks of alcohol your rosacea calms down? my perm swelling goes to pre rosacea stage when im drunk. The photos of me drunk and sober are like 2 different people!


                    • #11
                      Interesting that you get better when drunk! I haven't gotten drunk since I got this so can't tell you if i react the same.

                      I've taken propranolol for two weeks today. It may make me less sensitive to heat and cold, but it's hard to tell as I've avoided it as much as possible. I'm pretty sure it helps against my edema though as I haven't had this little swelling in a long long time! However, it seems like it worsens the ache. Anyone experienced this? Don't know if I should continue taking it or not. Sort of wanna try it for at least another two weeks but scared it's making it worse.


                      • #12
                        I definitely want to try it but i don't want to fork out another £250 for an app with Tony chu or try to convince my doctor i need a heart medication for "my sensitive skin" My edema is awful.

                        Thanks for your reply
                        Last edited by philmitchel; 30 March 2013, 03:01 PM.


                        • #13
                          I'm not sure that it would matter, but follow-up consultations with Chu are £125 instead of £200-something. You can also see him on the NHS if you get someone to write a referral.


                          • #14
                            What about printing out some medical research papers linking propranolol to reduced flushing?

                            I printed them out and took them to the GP and asked her to at least give me a trial period of a month, then see if my flushing and redness had reduced.
                            'Heart medication' sounds very heavy and serious, but this medication is used on a large scale and even with normal blood pressure, I found that it will only temporarily lower your bp, the body soon compensated to a degree (I have slightly lower bp now).

                            Worth a try and just emphasize how this burning (pain is important to mention) and flushing keeps you from living your life and how she/he would feel if they had a burned up face all day, like after a sun burn.... Good luck

                            My rosacea related blog:


                            • #15
                              You might also have some luck explaining that you need propranolol for 'physical symptoms of anxiety' if the flushing is anxiety-related. Propranolol seems to be a more recognised treatment for such symptoms.