Aspirin for Flushing says Dr. Bikowski


Alluding to a link between rosacea and migraines, Dr. Joseph Bikowski says that aspirin should be the first line of defense against rosacea flushing.

A recent article in Dermatology Times highlights the potential benefits (and risks) of taking low doses of aspirin, long term for rosacea swelling and flushing.

From: Miracle-worker aspirin represses rosacea flushing

An informal study with his rosacea patients who took a daily aspirin (81mg) reported less flushing and shorter episodes of erythema.

Dr. Bikowski argues, “Aspirin therapy is safe. It’s great for the heart. It’s great for the colon. Why not the skin?” He further notes that there are few contraindications for aspirin use, it’s inexpensive and it can be taken in combination with most drugs.

The NRS also recommends aspirin: Tripwires – Foods and Beverages

Taking an antihistamine about two hours before a meal may counter the effects of histamine, while aspirin may reduce the effects of niacin-containing foods in sufferers affected by these substances.

And finally, Asprin forms part of Dr. Linda Sy’s rosacea swelling relief regimen.

At bedtime: Take 1 baby aspirin; 1 chlor-trimeton(4 mg) and 1 tab of Tums (Calcium Carbonate , an antacid to offset the gastric irritating effect of the aspirin.

In the AM: Take a B Complex vitamin that contains 50 mg. of B-6. Avoid
one w/ Niacin (Niacinamide is fine) and 1 Tagamet (200 mg). During bouts of flushing, apply a cool (not cold) compress on face. Do deep breathing 10 times slowly.

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How about you ? have you take aspirin specifically for rosacea swelling or flushing ? did it help any ?

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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70 Reader Comments

  1. gail smith says:

    I take aspirin for my rosacea and I do find that it helps. I don’t take it daily, I only take it when I’m in a flare. It helps with the burning and the flushing. I was affaid to take it every day because I have read it’s not good for the stomach……………………….gail

  2. MaryRN says:


    I read the article on Dr. Bikowski’s recommendations, and I had a few questions. It seems that the flushing he is referring to relates the the onset of migraines in patients. Patients experiencing the migraines, see visible signs of flushing prior to, or during the pain.

    Wouldnt this type of flushing then fall under the category of alcohol or the intake of cold drinks? It seem that this is really an antihistamine issue?

    Any further clarification would be great!

  3. suzi says:

    Is taking aspirin low dose every day and useing metrogel ok?

  4. Hi Suzi, I’m not aware of any complications taking aspirin and metrogel topically. Please do check with your doctor and let us know what you find out.

  5. As an additional caution, the RSRP Page on Aspirin says “As a warning, Aspirin causes thinning of the blood, so those with bruising or bleeding problems or those on blood thinners should discuss taking Aspirin with their doctors. Also, many rosaceans have reported that Aspirin, NSAIDs and natural salicylates cause additional flushing”. see

  6. donna h says:

    I have good results with aloe vera juice. 100%. It will stop flushing quickly and if I drink a small amount before I eat a trigger, the red and flushing never happen. Even with chili powder or alcohol. I read it on a rosecea board once, and it works for me. Have you heard anything else on this?

  7. Ian Lees says:

    I couldn’t disagree more! I have found that Aspirin and Paracetamol are major triggers of papules and pustules and should be avoided.

  8. Donna Butler says:

    I was put on aspirin and niacin because my cholesterol was a little high. (221). I have noticed more bruising lately. Is this the cause? Thank you.

  9. Hi Donna,

    According to Allergic reactions to aspirin and other pain killers, “Common side effects of aspirin include bruising and stomach upset”, so it is indeed possible. It is good to heed warnings about all drugs we take because it is possible to get unwanted side effects.


  10. Holly says:

    My doctor put me on Sirius, which is a generic for something (can’t remember the name), and it’s only $10/month with my insurance, and works fantastic. The non-generic stuff seriously upset my stomach. I tried the metrogel first, and it made it worse, then the aspin, and no help there either.

  11. jasper says:

    metrogel is a totall no-no for me. i believe it addresses the bacteria in the demodex’ gut, without dealing with the demodex themselves, and so if only metrogel is used, there is the possibility that the bacteria will then motivate the demodex to go to war. just a theory.

    as regards aspirin, once a day every three days works great for me, however i do know some people are allergic to salycilic acid (which is what aspirin is). for those with such an allergy, aspirin cannot be used – hopefully, other substances will help you.

    personally i absolutely cannot drink aspirin on an empty stomach, and will only have it as a drink with a main meal. tastes quite palatable.

    btw – people under twenty years of age should always be checked for any major reaction to aspirin .. not sure why, but is pretty necessary so i have been told.

  12. D.Dennis says:

    People under 20 years of age can be affected after taking
    aspirin by developing Reye’s syndrome which is a serious syndrome-I believe the cause is unknown. There seems to be a connection between three factors: age-teenagers, aspirin, and flu-like symptoms.

  13. Sue Ibrahim says:

    We normally advise patients to avoid the over use of Aspirin and Iburofen at our clinic. (elan medical clinic).

  14. Jasper says:

    difficult to discern amongst the various scams and good advices. usually it is best just to give advice and not promote your company at the same time; especially if you are giving very basic advice – otherwise you come across as a cynical poster, seeking money.

  15. Just to get back to this comment above ; “i believe it addresses the bacteria in the demodex’ gut, without dealing with the demodex themselves, and so if only metrogel is used, there is the possibility that the bacteria will then motivate the demodex to go to war. just a theory.”

    I have not seen any evidence that metrogel has any effect on demodex mites. There is also a very weak link between one bacteria sometimes found in demodex and an immune response i.e. possible cause a papule or pustule.

    Theories are fine, but I just don’t want people to read all of this as statements of fact when I don’t see it that way.


  16. Jasper says:

    of course, perhaps i did not explain myself properly.
    and if, in my explanation, i postulate more theory as fact, please forgive, and also please kindly show me the error of my expression, thanks. 🙂

    i do not believe metrogel has any ‘direct’ influence or therapeutic benefit whatsoever as regards demodex mites. therefore, i do not use it ..

    the one time i did use it, got a massive shooting pain in the area of skin between the upper right cheek and smoother skin below the eye. it was unbearable. a deep red dot appeared on one side of the margin. then, the pain again, and on the other side of the margin, another deep red dot appeared. quite small no larger than half a millimeter.

    the demodex could not care less about the metrogel antibiotic, however the bacteria in their stomach *appears* to abhor the substance. therefore i avoid the use of metrogel (topically) as i see it as stirring up trouble without much or any benefit at all.

    as regards taking the substance internal, it is a type of ‘flagyl’ antibiotic (spelling) and i just prefer to utilise a range of over-priced supplements rather than risk that family of antibiotic.

    once i had to go to hospital in 1996. the nurses thought i had a staph infection, isolated me, and gave me some pretty intense antibiotics, understandably enough. the next day, i looked in the mirror, nearly shouted for joy. my golden tan skin had returned. it went away again after i started eating. anyway, i have a range of theories, and metrogel is not included in any regime, because i see other ways as being more effective long-term.

    i believe there is, amongst other things, a staph infection associated with rosacea, in a “diffuse” form, difficult to detect.



  17. Denise says:

    What are the supplements that have helped you?

  18. LaDonna says:

    Jasper. i also have rosacea mine is mild its on my nose onto my dry/very sensitive in those areas but i do break out. Im on metro cream havent seen much improvement,But there again dr gives me samples of a cleanser that has sodium Laurl sulfate and has alcohols well i looked that up and go figure they r skin irritants to very sensitive pple. shows what they know huh lol. I totally agree with u have to get to the root of the problem. Go to and look what they have to offer to..But what supplements do u take to keep from flushing.I even went all day without eating only drinking water and i still flushed towards evening.I didnt even get in the wind or sun i stay in all day and i was calm no emotional problems. what gives. anyway take care

  19. maureen says:

    Don’t agree with using aspirin. Can thin the blood cause ulcers. Even using tums with the aspirin isn’t good either. To many tums weakens the splinter in the stomach, which then leads to acid reflux, now another whole problem.
    I use a nettie pot in place of any nasal sprays. My husband and I swear by this. The non iodized salt that is used with this is very healing, helps with allergies or just feeling stuffed up or when you have a cold.

  20. Doug says:

    What time of day should you take the aspirin?

  21. Doug says:

    I take 2 Aleve’s (30 min apart) and an antihistamine before I go out drinking, etc and my face is white all night no matter what I drink or eat. It seems the extra Aleve helps me as I tried 1 Aleve and an antihistamine with mixed results.

  22. Hazell says:

    Hi I am new to this site but I take antihistimine at night only and have now been put on Dixarite tablets for high blood pressure to see if it will help the redness. I would like to hear from anyone else who has used tabs for blood pressure in hope that it will help the redness.

  23. Donna says:

    Has anybody tried Virgin Coconut oil? if not what do you do for the horrible dryness that comes with the rosacea? Do you guys have stomach issues too? They say that is linked.

  24. shelly says:

    I have noticed that no matter what I eat during the day I almost always flush in the evening. Also I have been having bad indigestion lately and have read that Rocesea and indigestion are linked. Is anyone else a vegetarian. I was wondering if that might have something to do with it.

  25. jp says:

    i have rosacea and dermatitis on my neck and rosacea on my chest and dermatagraphyia over my whole body can anyone recommend any tye of cleanser,toner,moisturizer i have recently been put on clonidine for blood pressure and it is suppose to help constrict the blood vessels have difficulty trying to get home from work i wear neutrogena sunscreen spf 100 and wear hat find it difficult to take showers any help would be appreciated

  26. ArtisiaLong says:

    I have been suffering with the occasional redness on my face for a couple of years. My face would look like it was sunburned. I had to cover up with lots of heavy makeup and it felt awful. Finally made the appointment to see my doctor when I couldn’t stand it anymore.

    The doctor gave me 2 different perscriptions for gels and ointments. They seemed to work but it took weeks to see any results and my face still had to be covered with makeup to hide the redness. I bought the Shielo Complexion Moisturizer after reading some of the reviews and decided this would be cheaper than another $25.00 doctor visit plus the cost of more of the same expensive creams. I gave it a shot.

    Boy, was I surprised. The burning stopped with the very first application and the redness was greatly reduced overnight. I no longer have the dryness that the other ointments caused.
    After just 2 or 3 days, my face was back to normal and even my husband was amazed at the quick improvement. Going to be keeping the Shielo Moisturizer on hand for flare ups.

  27. Hazell says:

    I have been trying dixerit to help stop flushing as heat is a great trigger also cold weather, after a sleep at night I waken up red. Been drinking only water for a few days so far not made the slightest difference but its early days.
    Also been on antibiotics for another 3 month which helps the pustules and paps but I think can cause aother problems so cutting them down then trying rosex cream which is scary as I tried the metro gel and it dried my skin out so badly but didnt stop the redness or spots. Please has anyone had any success with using the cream feeling desperate.
    Just been reading about diet and I am wondering could this be because of my love of chocolate as I dont drink alcohol eat currys but since this happened have put on quite a bit of weight. anyway just a thought.


  28. Glenys says:


    I always find my face feels warmer and will often flush with no triggers/activity in the late afternoon/evening. Drs and Dermotologists I’ve mentioned this to are unaware of the following, but I have found several links explaining “clock rosacea” as to why the evening seems to be a trigger time (an avoidable trigger: just being alive in at a particular time of day!). Here’s one explanation I came across recently:

    “Flushing or facial skin redness is more likely to occur when the body temperature is elevated. The body does operate on a clock! Hospital physicians have known for years that the lowest body temperature of the 24 hour day is usually around 3:00 to 4:00 A.M. while the highest temperature of the day is generally 7:00 to 8:00 P.M. The average rosacea sufferer does not have hospital waking and sleeping hours, therefore their temperature lows and highs may vary 3 to 5 hours each way. A high temperature for some may be as early as 3:00 P.M. ”

    Overall I find the “just avoid your triggers” advice frustrating and inadequate as certains triggers only have an effect sometimes, not always. And personally, the recommended “triggers to avoid” are all the things I find make life worth living: spicy foods, steaming bowls of hot soup, a nice hot tea or coffee, red wine/alcohol in general, lovely hot baths, a good work out, getting rugged up and skiing or walking outside in winter and then coming inside to a crackling fire.

    Seriously, life is for living and meant to be enjoyed! So I continue for other options. Best wishes,

  29. Hazell says:

    Hi Glenys also JD

    I have been using cetaphil gentle cleanser and cetaphil moistuizer as it contains no fragrance or lanolin which can trigger my skin to get very red as I am allergic to these ingredients which is quite common for lots of others I have been told.
    The clonindine (dixerit)is what I have been using for a bit now but I still get red at least once a day if I am not careful. I drink cold water,let my food get cool or cold,dont eat currys,chillies,spices.Hot baths or showers everthing I loved.
    I dont drink alcohol, I do have the 1 or 2 coffees in the day havent cut that out yet.
    In the last year I have quite a bit of redness now trying rozex cream now 2 weeks only on pustules spot testing only but seem to be getting lots of them and redness?

    If I get very red I calm my skin down 3 ways drink cold water drink put on some pro biotic drink on my face which is cold from fridge or use cetaphil moisturizer stored in fridge so its cold or open a window to cool of if its colder outdoors.

    I still cant find any cover up makeup that is completely fragrance free and lanolin free as wearing makeup with those ingredients make my skin really really sore and red. When this first happened I ate for comfort I now am back in control of what I eat at least eating healthy food again which I cook myself for 6 weeks now so hopeing it will eventually help my skin.

  30. Toni says:

    Hi All
    I’ve been using bio-oil on my face for the last three weeks and it has made quite a significant difference, the redness seems to have calmed down and the dry scaly skin is almost all cleared up. I’ve been taking, and am at the moment, Tetracyline on and off for about three or four years which does keep my spots under some control but doesn’t help with the redness at all. I have been suffering with Rosacea for about 5 years, I’m 46.

  31. Toni says:

    I should have said I use it every night before I go to bed

  32. gehan says:

    What is the solution to bouts of irritability and redness in the face Is this useful medication allergies

  33. Hazell says:

    Hi all

    Finding the cetaphil gentle wash and the cetaphil cream has got rid of the dryness on my face and the erthromicin antibiotics helps with paps and pustules but not completely. I am on clonidine for the flushing which I still get but not as severe, my eyes are permantly red now even using gel for dry eyes have asked the doctor for other tabs as Clonidine side effects can cause dry eyes think it is the reason for my sore eyes however asked for something else and doctor said there is nothing!!!
    I live in the UK but have read somewhere on your website I think that other tabs can be used for vascular so wonder why he said that.
    I have stopped going out and mixing with people as I find it so stressful having to explain why I cant sit in the sunshine or go out walking in cold windy weather this has changed my life making me feel quite sad at times
    Have read about a clinic that does vein removal has anyone any information on this treatment for rosacea and seborreic derm.

  34. Sandy says:

    Hi all
    I’ve suffered from rosacea for years now and have not found a lot that helps. I had some laser treatment but that didnt do anything either.
    I’ve just been reading all the comments on rosacea. Like everyone else hoping for a miracle cure of which there does’nt seem to be one. I have used a high blood pressure tablet called Catapres 100. It does’nt help with the redness but it helped to alleviate some of the burning. I also use Clinique continuous coverage as it has the best coverage as the name suggests. Applied with a wet sponge is the best way to get an even coverage. I do’nt go out without it on.
    I’ve also started wearing glasses the last 12 months and find that the glasses sitting on my nose irritates the skin on my nose.

  35. Miss P says:

    I am 49 yrs old and I have had rosacea for years now and it has really changed my life. I don’t go out and there are many many unexplained avoidances for me with friends and family. Ballgames, beach trips, dinners, dates, etc. Most of the fun things I used to do are not on my calendar anymore because my face always looks horrible. Sometimes I hide out all weekend in the house. I was not diagnosed properly for a long time so I’ve tried so many different remedies for many different conditions, with not much luck either. I also took accutane for what Dr’s thought was adult acne…my face got much worse and I took that two different times over a 2 yr period. Finally my dermatologist told me he didn’t know what was wrong with me. My regular doctor finally told me it was Rosacea. I currently suffer w very severe paps and pustules. Not so much red cheeks just the broken out face 24/7. There is never a day that I don’t have 3-15 serious bumps on my face with lots of inflamed skin around them and it spreads to. From years of this undiagnosed condition, my scars are really bad and very hard to hide. Makeup really irritates my skin especially by days end, but I will not walk out of my house without makeup on. My condition is that unsightly. Clinique’s continuous coverage foundation is good but will irritate over time, it is a heavy makeup that I could not use. I have spent a ton of money on makeups and cleansing products with no luck on finding one that won’t break me out. I also have white scars all over my face that most makeup will not cover. The constant breaking out is so embarassing, I don’t want to go to work most days days but I no choice in that matter. I notice a lot of people don’t give complete brand names when referring products. Please do so in the future if something works for you. I am on doxycycline now and about to double my dose to two tablets a day because it seems my breakouts are getting much worse to an infection stage. It seemed to clear me about 80% for about 8 months but now I must be getting resistant so I am going to try the heavier dose of two tablets a day. I did call my doc today and she is calling me in something topical to go along with the two tablet of doxycycline. It’s been a really hot summer down here in the south so far and I am very sad that I have this horrible condition to find a way to somehow manage for many many years to come. It’s really hard ! I pray for a cure.

  36. SammiS says:

    I don’t have servere rosacea , but i used to have alot of redness on my face. I was happy with Made from Earth’s Rosehip + Hibiscus Face Serum (its for rosacea) and after 1 month of using it, it reduce a lot of my redness and even got rid of some breakouts. It doesnt dry up your skin. . . cause you need that moisture to maintain a balance.

    Just do not use alot of the product. Only a little is needed to calm down your skin.

  37. Sandy says:

    Hi SammiS I live in Australia and was wondering where about’s you live as I would like to try this product.

  38. Julie says:

    Miss P –

    My heart goes out to you and the other on this board who have been so negatively affected by this condition. I too am affected but I have only the severe flushing to date. I have tried many products and found almost all dry out my skin or irritate terribly. The good news is with age (50) I kinda don’t care as much and just enjoy life. I agree all the triggers to avoid lists are crazy! I too love spicy foods, the occasional glass of wine, etc.
    That being said I wash my face with pure JOJOBA OIL only. It is really inexpensive, just make sure it is pure with no fragrances, etc. It is a wonderful moisturizer and for me at least it does not cause breakouts. Hormonal breakouts are under control with a small dab of clean and clear cream cleanser with the jojoba oil and then wash again with just the oil.
    I hope this helps anyone out there…

  39. Ron says:

    What has been extremely is cosmetic laser therapy. It is not that expensive and it really gets rid of the noticable veins and the ones less noticable. It works and really leaves your face looking normal. You still may have flareups but that leave your face red but you do not have the bulbous nose and the showing veins.

  40. lindi says:

    Hi All

    I am 34 and trying to get rid of blushing since age 11! I usually do not eat at work unless it is something very grean and healthy (miserable, ha ha) drink so much water as i would be running million of miles. I try to exercise, also tried to use baby aspirin which helped me, but not my stomach (unfortunately). I cover my face green + mineral make up and try to look cool- but it is visible and I am not very happy about it.
    Well, I went to IPL clinic and they told me that from blushing I have a mild rosacea- i will try next week a laser IPL treatment but I am so tired of that -especially when I start to ‘burn’ it seeems to last for hours before I cool down. (people avoid me and that is so painful..)
    If I just would be able to find a natural cure I would help everyone for freee, as it really distroys my life and I still do not understand how I met my husband, I work full time and study…and weekends I feel like I have no energy for nothing.

    Good luck everyone and sorry to be a bit down about it:)

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