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Thread: Constantly flushing nose - worried about rhinophyma

  1. #1
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    Default Constantly flushing nose - worried about rhinophyma

    Hi there,

    I'm 31 and I've had rosacea for 5 years. I have permanent redness on my cheeks but what bothers me the most is my flushing nose. It used to flush for 2-3 hours after my evening meal. Now its pretty much all day and night.

    I also have excessive sebum, especially on the nose and especially when flushing. My pores have enlarged to release the sebum so I now have the Orange peel look.

    I've had many IPLs, PDLs, YAG etc over the years. It's calmed my cheeks a bit but my nose continues to worsen.

    I've also tried beta blockers and Mirtazapine. Mirtazapine worked a bit on my cheeks but not the nose.

    I need to get my nose under control. I don't want it developing into rhinophyma.
    I was thinking of trying Mepacrine or low dose accutane. The accutane may also help my sebum problem.

    I'd love to hear your thoughts on where I can go from here

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    Mepacrine might be a good option. I would be very cautious with Roaccutane as a number of people on the board have found it has worsened their flushing significantly even if it did help with pustules or papules.

    Have you addressed diet and cleansing. E.g. trying Cetaphil or the Sher System (Foaming Face wash 1). Also the honey masks, and not putting hot water on your face. These may help to improve the quality of the skin a little, though of course may not help much with swelling. Nevertheless, even severe rosacea flushing is helped I think by good cleansing. I wouldn't have believed how much it could help before I tried it. I only wash my rosacea affected areas in mineral water and have baths and dont put the face in the water. Other people use filtered water. I've certainly noticed a decrease in pore size. The Sher System also do an SOS solution which acts as both a camouflage and is the best thing I've found for controlling sebum. Huge pustules will dry up overnight that might have otherwise taken weeks to heal. SOS really does work well. I would only try the two products I've mentioned from them though. The others aren't terribly helpful, at least for my rosacea. I take Mepacrine, Mirtazapine and Moxonodine also.

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    do u have any photos?

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    Hi flemmo

    Some will suggest it but for you i would not advise Accutane. Though it is great for sebum reduction, it is not so recommended if one is battleing flushing issues. I know Dr chu has mentioned this to a few severe flusher members of this forum, and my hospital Derm also agrees it is not advisable to go down this road unless you have tried everything else first and therefore there is nothing to loose.

    I had oily skin for years until my newish hospital Derm put me on Stieprox liquid (this year). It is an anti-dandruff shampoo (maybe called Loprox overseas??) but it is not overly drying and irritating like other can be for sensitive skin persons (Selsun blue, Sebizole, Heads n shoulders etc). In-fact, it actually has anti-inflammatory properties so that is why it works for me (having both Rosacea and SD). I would recommend you give this a try if you can find it at one of the local Pharmacies - you may need to ask for it over the counter (in NZ they keep it behind the counter). this is all I use now, no cleanser, and my skin has normalised and is the best it has been in years in terms of controlled oil production. So if your flushing is related at all to the oil glands going crazy, or Seborrheic Dermatitis, this stuff might be worth a shot. this, in conjunction with on-going pulsed dye laser may have positive impact on your flushing. all I do is make a bubbly lather and leave it on the face for 3-5mins a time and rinse with lukewarm water.

    Another option is trying Pindolol. It is a Beta-Blocker and recommended by my Derm as I have the Neurogenic type Rosacea. Your GP might let you try it, or maybe low-dose Clonidine.

    Keep us updated, I hope this helps somewhat.

    Best, shantelle
    Last edited by shantelle; 15th September 2011 at 04:13 AM.
    Shantelle

    31 Year old female from NZ

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    [QUOTE=flemmo;261330]Hi there,
    I'm 31 and I've had rosacea for 5 years. I have permanent redness on my cheeks but what bothers me the most is my flushing nose. It used to flush for 2-3 hours after my evening meal. Now its pretty much all day and night.
    I

    Hi flemmo,

    I also had bad nose flushes till I started clonidine. The nose flushes became quite bad last winter, and more especially in the evening when sitting on the sofa and when laying down. I started to sleep up right in an attempt to control the flushing but it wouldn't help. I could not eat or drink hot or even warm as my nose would right away flush and going out for a walk would ensure me a bright red nose once back home. Then, last spring, at work, my nose started to flush awful, without fail, after lunch. By that time, I was experiencing an ongoing pressure in the nose.

    I decided to stop drinking tea in the morning to see if it would help with the afternoon flush. It actually did, which means that this flush was induced by caffeine withdrawal (dilation after constriction).
    I stopped putting tee tree oil (4% dilution) on my nose (I am sure it was partly caused by TTO) and started clonidine. Within 3 weeks my nose flushes had totally stopped.

    So, if you drink tea or coffee, just stop that and see what happens and try clonidine.

    I hope you can stop that. Nose flushes are really the worst.

    Best. Marie

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    Hi all. Thank you so much for taking the time to post.
    I've been away on training all week for work. Heading to bed now but I'll be back tomorrow night to answer your questions and give more info.

    Thanks again.
    Night

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    Hi folks.
    Sorry for the late reply, but I've been a little under the weather this weekend. But I'm feeling a little better

    Quote Originally Posted by antwantsclear View Post
    Mepacrine might be a good option. I would be very cautious with Roaccutane as a number of people on the board have found it has worsened their flushing significantly even if it did help with pustules or papules.
    Hi antwantsclear. Is this the case for really low dosage, say 5mg every 3 days?


    Quote Originally Posted by antwantsclear View Post
    Have you addressed diet and cleansing.
    Yes I'm pretty strict about these things. I only eat fresh veg, white meat and fish. No sugar, dairy, wheat, gluten, alcohol or fun LOL. I also have seb derm so that compounds the issue.
    I spent hundreds finding the right cleanser for me. I've settled on Toleriane dermo cleanser. Its gycerin based so doesn't try my skin and its the only thing I've found that doesn't make me redder. Having said that it doesn't do anything for the massive sebum problem I have.



    Quote Originally Posted by tests View Post
    do u have any photos?
    Hi tests. This is the first photo I've dared share... but I need advice so here goes!


    The photo was taken when the flushing is at its worst, in the evening. You can clearly see the enlarged pores from all the sebum. Thats why I was thinking Accutance, as to my knowledge its the only thing that will realistically help in that area.



    Quote Originally Posted by shantelle View Post
    I had oily skin for years until my newish hospital Derm put me on Stieprox liquid (this year). It is an anti-dandruff shampoo (maybe called Loprox overseas??) but it is not overly drying and irritating like other can be for sensitive skin persons (Selsun blue, Sebizole, Heads n shoulders etc). In-fact, it actually has anti-inflammatory properties so that is why it works for me (having both Rosacea and SD). I would recommend you give this a try if you can find it at one of the local Pharmacies
    Hi shantelle. I've tried many anti-dandruff shampoos on my nose over the years (I also have SD) but its always led to a massive increase in flushing. But I'm willing to try anything, so I'll give it a go

    Quote Originally Posted by shantelle View Post
    Another option is trying Pindolol. It is a Beta-Blocker and recommended by my Derm as I have the Neurogenic type Rosacea. Your GP might let you try it, or maybe low-dose Clonidine.
    I've tried Clonidine in the past for 'fight or flight' flushing that I also struggle with, but never daily for flushing. What does dosage of Pindolol do you take? Is it the slow release kind?


    Quote Originally Posted by Souris24 View Post
    ]I also had bad nose flushes till I started clonidine. The nose flushes became quite bad last winter, and more especially in the evening when sitting on the sofa and when laying down. I started to sleep up right in an attempt to control the flushing but it wouldn't help. I could not eat or drink hot or even warm as my nose would right away flush and going out for a walk would ensure me a bright red nose once back home. Then, last spring, at work, my nose started to flush awful, without fail, after lunch. By that time, I was experiencing an ongoing pressure in the nose.

    I started clonidine. Within 3 weeks my nose flushes had totally stopped.
    Hi Souris24. Oh I can relate to everything you're saying there! Sounds exactly like me! Though I've never drunk tea or coffee.
    I Clonidine effective for others with servere nose flushing? I've heard some people having success with facial flushing but never the nose. Sounds promising though! Could you tell me what dosage of Clonidine you take daily?

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    Oh I forgot to mention I also have Raynauds, so I'm a bit uneasy of Clonidine after reading things like this:
    http://www.rosaceagroup.org/The_Rosa...p/t-10477.html

    Why do you guys think?

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    wats raynauds?

  10. #10
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    Default Raynauds

    Quote Originally Posted by tests View Post
    wats raynauds?
    .........Raynauds is a circulatory condition : )

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