Management of flushing

The mainstay of management of flushing is to identify the cause and treat any associated conditions; see Factors and conditions associated with flushing for factors and conditions associated with flushing. Minimise or eliminate triggers. Stop suspected drugs if clinically possible.

For patients with flushing from menopause, consider the need for short-term hormone replacement therapy. See Summary of menopause management for information on systemic menopausal hormone therapy (MHT), and nonhormonal and nondrug strategies for vasomotor symptoms of menopause.

Oral therapies for flushing are often poorly tolerated and ineffective. However, if a patient desires treatment, consider a trial of:

If the patient does not respond to propranolol, and still desires treatment, consider a trial of:

Other treatments (eg carvedilol) are used by dermatologists.

Flushing is episodic, so it usually takes 4 to 6 weeks to assess response to oral therapy.

If flushing is severe or prolonged, and is not associated with systemic symptoms, refer to a dermatologist. If flushing is associated with other systemic symptoms (eg diarrhoea, sweating), refer to an endocrinologist or general physician for investigation of phaeochromocytoma.