Page 3 of 3 FirstFirst 123
Results 21 to 29 of 29

Thread: Flushing in the evening medication

  1. #21
    Senior Member
    Join Date
    Feb 2017
    Location
    Indiana, USA
    Posts
    201
    Country: United States

    Default

    Quote Originally Posted by laser_cat View Post
    In the US - my experience is that most derms will not be able to offer much more than PCP. I began by asking PCP to trial medications mentioned here or in literature (clonidine, beta blockers). Eventually I landed on 2 derms who have an interest in neurovascular rosacea, but even they realize a large part comes down to trial and error per patient. My therapist had an "in" at my local teaching hospital and asked around for doctors who would specialize in flushing (how I found one of my derms). I found my other derm by looking up authors of rosacea publications. What I am able to get from these 2 derms I am not able to get from PCP or myself - how long to trial a given medication before I give up, why I wouldn't be a candidate for laser, how to titrate medications, medications that aren't typically "thought of" (calcium channel blockers, Xolair, birth control, IVIG, baclofen, ..), pathophysiology behind my symptoms and similar patients. There are derms who are very interested in neurovascular stuff and who realize that flushing conditions can be anywhere from mild to disabling, but these derms are far and few between I think, most derms will try to rx soolantra, antibiotics etc.
    That's quite discouraging. I don't have such a big issue with flushing in general, but it seems to creep up at certain times of the month, if you know what I mean, and also sometimes when I lie down for long periods of time. (Like when I sleep) vBeam has improved it quite a lot, but I would rather it just not happen EVER, and give my vessels a rest, if possible.

    I have anxiety that sometimes can induce a flush. Would that be a good enough reason to get my GP to prescribe it, do you think?

  2. #22
    Senior Member
    Join Date
    Mar 2012
    Posts
    408

    Default

    In retrospect I wish I had skipped trying different drugs to stop flushing and instead just gotten Vbeam and used tranexamic acid for flushing. I know topical tranexamic acid is still somewhat of an unorthodox therapy, but it can be perfect for nighttime flushing.

  3. #23
    Senior Member nat007's Avatar
    Join Date
    Jun 2005
    Posts
    1,906

    Default

    Quote Originally Posted by Geoff1 View Post
    I started at 15mg and I'm pretty sure it's had a big effect on both the nose flushing at bedtime, and after my evening meal.

    I've just moved up to 30mg but, like you say, I'm not sure whether this will be better or worse. It feels like 15mg was good, so I'm hoping that 30mg will be twice as good, but am well aware that this might not be how it works.
    Mirtazapine can help a lot for some her with flushing and burning. But it has a strange dual functioning. At lower doses, (7.5 - 15 mg) it has the strongest antihistamine effect, which causes the drowsiness side effects and hunger feeling also. For flushing, this can be an axcellent dose, as we benefit from these antihistaminic actions (histamine = a blood vessel dilator). I use 22,5 mg since 2006 and it really helped with my severe flushing problem. Still suffer from it but I'd say mirtazapine + clonidine + propranolol low dose has helped at least 60% for me personally. But... at 30 mg mirtazapine gets less strongly antihistaminic and instead has stronger noradrenaline activation (which is also a sympathetic nervous system stimulant), which is not always as effective against flushing, so strangely enough a lower dose of mirtazapine often helps more against flushing than a higher dose.

    It's trial and error, and this drug isn't helpful for everyone, but if you notice that at 30 mg you have more flushing problems again, you may have to screw your dose back to 15 mg or maybe a little bit higher?
    Last edited by nat007; 30th April 2019 at 10:08 PM.

  4. #24
    Senior Member
    Join Date
    Aug 2010
    Posts
    867

    Default

    Quote Originally Posted by jrlhamcat2 View Post
    In retrospect I wish I had skipped trying different drugs to stop flushing and instead just gotten Vbeam and used tranexamic acid for flushing. I know topical tranexamic acid is still somewhat of an unorthodox therapy, but it can be perfect for nighttime flushing.
    What oral medications did you try before you used topical tranexamic acid, and what percentage improvement has it given you? I'm not sure if anyone else apart from you has really talked in detail about trying t acid yet on the Forum.

  5. #25
    Senior Member
    Join Date
    Mar 2012
    Posts
    408

    Default

    Quote Originally Posted by antwantsclear View Post
    What oral medications did you try before you used topical tranexamic acid, and what percentage improvement has it given you? I'm not sure if anyone else apart from you has really talked in detail about trying t acid yet on the Forum.
    Propranolol, clonidine, mirtazapine, and mepacrine. Propranolol helped, but not that much and made me unable to exercise. Clonidine gave me Reynaud's in winter and years later one of my toes looks damaged because of it. Mirtazapine and mepacrine made me feel insane, and I couldn't sleep.

    I'd say the TXA solution probably gave me about a 50% improvement, but you have to keep up with it, because it reduces the vascular tone but it's not clear whether it eventually gets rid of the veins. I do want to encourage people to work with a doctor and be very cautious about this, because the studies are small, and there is a known coagulation risk when taken orally. I don't know if anyone knows if there is a similar risk to topical treatments, and it might depend on how it's mixed.

    What helped me the most (I am currently not using TXA) was a series of Vbeam treatments of slowly increasing intensity over around a year. Most of the time you can't really tell I have rosacea anymore, and I had pretty intense flushing throughout the day before. At its worst, I was turning purple.

  6. #26
    Senior Member
    Join Date
    Aug 2010
    Posts
    867

    Default

    Quote Originally Posted by jrlhamcat2 View Post
    Propranolol, clonidine, mirtazapine, and mepacrine. Propranolol helped, but not that much and made me unable to exercise. Clonidine gave me Reynaud's in winter and years later one of my toes looks damaged because of it. Mirtazapine and mepacrine made me feel insane, and I couldn't sleep.

    I'd say the TXA solution probably gave me about a 50% improvement, but you have to keep up with it, because it reduces the vascular tone but it's not clear whether it eventually gets rid of the veins. I do want to encourage people to work with a doctor and be very cautious about this, because the studies are small, and there is a known coagulation risk when taken orally. I don't know if anyone knows if there is a similar risk to topical treatments, and it might depend on how it's mixed.

    What helped me the most (I am currently not using TXA) was a series of Vbeam treatments of slowly increasing intensity over around a year. Most of the time you can't really tell I have rosacea anymore, and I had pretty intense flushing throughout the day before. At its worst, I was turning purple.
    How many treatments did you do with the TXA before you started to get results?

  7. #27
    Senior Member
    Join Date
    Mar 2012
    Posts
    408

    Default

    Quote Originally Posted by antwantsclear View Post
    How many treatments did you do with the TXA before you started to get results?
    I saw an improvement from the first soak. You probably need to keep it up to keep the veins under control.

    Sent from my Pixel 2 using Tapatalk

  8. #28
    Senior Member
    Join Date
    Dec 2016
    Posts
    101
    Country: Canada

    Default T Acid topical

    Quote Originally Posted by jrlhamcat2 View Post
    I saw an improvement from the first soak. You probably need to keep it up to keep the veins under control.

    Sent from my Pixel 2 using Tapatalk
    Hi,
    Exactly how do you use the T acid topically ?
    Are you using the tablets or injection solution to make the mixture for the dressings?
    Do yo need a script for this?

    Many thx,
    Bluedog

  9. #29
    Senior Member
    Join Date
    Mar 2012
    Posts
    408

    Default

    I've only used powder. It might be prescription-only depending on where you live. The pills are OTC in some countries, but might be difficult to use for soaking because of the fillers. The solution (normally used for injection in emergency medicine; it would be really dangerous to inject this stuff for rosacea) are prescription-only.

    There is an example of the soaking technique in this thread:

    https://www.reddit.com/r/Rosacea/com...t_for/enal8fo/

    This is definitely self-experimentation. I would suggest being cautious and working with a dermatologist on this.

Similar Threads

  1. Evening flushing
    By Loz in forum Newbie questions / Introduction
    Replies: 5
    Last Post: 18th December 2018, 05:24 PM
  2. Flushing/Bushing and pain in the evening
    By timo in forum Erythematotelangiectatic Rosacea
    Replies: 6
    Last Post: 8th August 2018, 12:35 AM
  3. General afternoon/evening flushing
    By Martindon in forum General rosacea questions
    Replies: 3
    Last Post: 19th February 2017, 09:08 PM
  4. Evening and morning flushing - anyone else?
    By pennya in forum General rosacea questions
    Replies: 3
    Last Post: 24th October 2008, 04:31 AM
  5. Evening flushing
    By pack82 in forum General rosacea questions
    Replies: 17
    Last Post: 14th January 2008, 07:48 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •