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Thread: Worst flare up of flushing

  1. #1
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    Default Worst flare up of flushing

    I seem to be in the midst of the worst flare ever. I had this all under control over Summer but since the weather had got colder it's returned along with the horrible night flushing.

    I can't lie down or sleep, the flushing in my cheeks and ears are so bad. Now I have hot, red patches of skin which aren't calming down. I really hope they do.

    I'm on clonidine 50mcg 3 x a day and 15mg mirtazapine at night. The mitazapine really helped me when I first started having all the symptoms earlier this year however it seems to have no effect now.

    Should I up my dose of both clonidine and mirtzapine? Is there anything else anyone can recommend? Would plaquenil perhaps help? Perhaps duloxetine? I need something to stop the night flushing before it does anymore damage.

    I have a pack of carvedilol which I have never taken. Worth trying that now? Has that helped anyone with flushing?

    Any help or ideas would be greatly appreciated.

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    i'm not sure this helps you but for me when I feel hot I wash my face with lukewarm water put some tinted sunscreen (shea butter) on and then go outside for a walk. if its windy cover your face with a scarf and a hat. that might not fix your problems but should ease the flush

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    Thanks! Exercise normally tends to help me too and I've been pacing up and down my room for the last few hours trying to calm it down. It's calming a bit but still very red. But then when I sit down it starts up again, something about the blood just getting trapped in extremities. So depressing, I hate this.

    I noticed on another thread LDN helping a lot of people. I actually have a prescription for this which I have been too fearful to take as my skin was doing okay up until recently and I didn't want to rock the boat on it. Do you think it would help with the night flushing? My ears and cheeks are the worst. Starts in my ears first then radiates to my cheeks.

    This all started this January after a long term course of low dose accutane.

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    Quote Originally Posted by owldog View Post
    Thanks! Exercise normally tends to help me too and I've been pacing up and down my room for the last few hours trying to calm it down. It's calming a bit but still very red. But then when I sit down it starts up again, something about the blood just getting trapped in extremities. So depressing, I hate this.

    I noticed on another thread LDN helping a lot of people. I actually have a prescription for this which I have been too fearful to take as my skin was doing okay up until recently and I didn't want to rock the boat on it. Do you think it would help with the night flushing? My ears and cheeks are the worst. Starts in my ears first then radiates to my cheeks.

    This all started this January after a long term course of low dose accutane.

    Sorry to hear your skin started acting up again after you had it under control. Is the colder weather the only factor you think could have caused it?
    My skin's main trigger is heat, so it's usually pretty happy in the winter but last year my skin did get pretty dry when colder weather came and caused some pretty bad flaring. Sleeping with a humidifier and using a thick moisturizer made an incredibly big difference in flushing- I was surprised at the difference. Just wanted to throw that possibility out there that if your skin is dry your skin's barrier could be compromised and more susceptible to triggers.

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    I've found moxonodine works a lot better than clonidine - they both play a similar function, but moxonodine does not give rebound flushing just before you need the next dose and its effect does not wear off the longer you take it. Hydroxychloroquine (plaquenil) has also been very helpful for me.

    The other thing that can help is Zhongzhou cream because it controls the demodex mites, which nearly everyone has and has been shown to play a part in the rosacea process (both flushing and pustules).

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    Quote Originally Posted by owldog View Post
    Thanks! Exercise normally tends to help me too and I've been pacing up and down my room for the last few hours trying to calm it down. It's calming a bit but still very red. But then when I sit down it starts up again, something about the blood just getting trapped in extremities. So depressing, I hate this.

    I noticed on another thread LDN helping a lot of people. I actually have a prescription for this which I have been too fearful to take as my skin was doing okay up until recently and I didn't want to rock the boat on it. Do you think it would help with the night flushing? My ears and cheeks are the worst. Starts in my ears first then radiates to my cheeks.

    This all started this January after a long term course of low dose accutane.
    Yikes, I was contemplating low dose accutane (eg 10 mg / wk for flushing/burning) and although I knew it would be a wild card, I haven't heard of anyone getting symptoms after low dose before. I'm sorry that happened to you.

    Btw I searched google scholar for the mechanism behind (permanent or temporary) accutane-induced flushing/burning and can't really find anything except for sun sensitivity/dry skin (I don't believe that explains it fully). Does anyone know more?

    SNRI's are good for the "blood pooling while sitting" for me but not a cure. I dab amitriptyline topical 2% on my ears, behind my ears, sideburns and upper neck (not my face) and it helps quite a bit (with the ears). Mirtazapine 22.5 mg helps me lie down at night / sleep through flare, if needed. I tried LDN and it made evening symptoms worse for me actually (but I returned to baseline no prob after stopping).
    I learned that the peripheral constrictors propranolol and clonidine were making my evening flares worse .. like I was always ready to rebound and so always chasing my tail.
    There's a lot to try even though it's not one-size-fits-all so don't get discouraged

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    Quote Originally Posted by laser_cat View Post
    Yikes, I was contemplating low dose accutane (eg 10 mg / wk for flushing/burning) and although I knew it would be a wild card, I haven't heard of anyone getting symptoms after low dose before. I'm sorry that happened to you.

    Btw I searched google scholar for the mechanism behind (permanent or temporary) accutane-induced flushing/burning and can't really find anything except for sun sensitivity/dry skin (I don't believe that explains it fully). Does anyone know more?

    SNRI's are good for the "blood pooling while sitting" for me but not a cure. I dab amitriptyline topical 2% on my ears, behind my ears, sideburns and upper neck (not my face) and it helps quite a bit (with the ears). Mirtazapine 22.5 mg helps me lie down at night / sleep through flare, if needed. I tried LDN and it made evening symptoms worse for me actually (but I returned to baseline no prob after stopping).
    I learned that the peripheral constrictors propranolol and clonidine were making my evening flares worse .. like I was always ready to rebound and so always chasing my tail.
    There's a lot to try even though it's not one-size-fits-all so don't get discouraged
    I'm not sure if anyone else has reported rosacea flushing purely from low dose accutane (e.g. 5mg per day). However, there are many reports from normal dose accutane (e.g. anything above 10mg per day) if you search accutane/rosaccutane/isotretinoin in this forum. The mechanism of drying out the skin is stronger than simply dry skin with accutane. For instance, side effects recorded included psoriasis and cheilitis of the lips - I knew someone who had this condition so badly from taking accutane that he could not eat properly for some time; the lips kind of dissolved. Rosacea type 1 is associated with hypersensitivity of the skin, and this is enhanced when you the skin barrier is damaged by normal dose accutane.

    Hyroxychloroquine (plaquenil) has been found by several forum members to help with accutane-induced flushing.
    Last edited by antwantsclear; 2nd November 2019 at 10:48 AM.

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    Quote Originally Posted by antwantsclear View Post
    I'm not sure if anyone else has reported rosacea flushing purely from low dose accutane (e.g. 5mg per day). However, there are many reports from normal dose accutane (e.g. anything above 10mg per day) if you search accutane/rosaccutane/isotretinoin in this forum. The mechanism of drying out the skin is stronger than simply dry skin with accutane. For instance, side effects recorded included psoriasis and cheilitis of the lips - I knew someone who had this condition so badly from taking accutane that he could not eat properly for some time; the lips kind of dissolved. Rosacea type 1 is associated with hypersensitivity of the skin, and this is enhanced when you the skin barrier is damaged by normal dose accutane.

    Hyroxychloroquine (plaquenil) has been found by several forum members to help with accutane-induced flushing.
    Thanks, and thanks for the dosage references (will see my derm soon). It's interesting that plaquenil (anti-inflammatory - but don't know precise MOA) can correct this ... at least partially.

    I've never taken accutane but for ~10 yrs prior to flushing/burning onset, my lips would peel off / fall off each day. A recent lip biopsy showed some inflammation but nothing alarming. Clonidine I believe dried out my nose (a couple nose bleeds / wk) and seemed to accelerate nose flushing/burning symptoms. Got better after I went off, but never back to baseline on its own. I would understand I guess how severe drying out could set a cycle of hyper-reactivity in motion.

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    Quote Originally Posted by antwantsclear View Post
    I've found moxonodine works a lot better than clonidine - they both play a similar function, but moxonodine does not give rebound flushing just before you need the next dose and its effect does not wear off the longer you take it. Hydroxychloroquine (plaquenil) has also been very helpful for me.

    The other thing that can help is Zhongzhou cream because it controls the demodex mites, which nearly everyone has and has been shown to play a part in the rosacea process (both flushing and pustules).
    may I ask what you experience is with Soolantra and Propranolol?

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