Rosacea Flushing and Propranolol

Written by on December 3, 2005 in flushing with 1 Comment

Symptomatic treatment of idiopathic and rosacea-associated cutaneous flushing with propranolol, Journal of the American Academy of Dermatology, Volume 53, Issue 5 , November 2005, Pages 881-884.

Some interesting extracts from this paper;

(propranolol, also known as inderal is a non-selective beta-blocker)

On the other hand, flushing associated with rosacea commonly fails to respond to standard therapies for rosacea. Idiopathic flushing rends to occur in women and the symptoms persist for a long duration. Treatment of flushing is difficult primarily because it has been assoicated with multiple etiologies. Improvement in transient flushing is also difficult ot quantitate, although attempts to provoke flushing and to measure the responses to medications have been performed. Even so, only small series and case reports are found in the literature.

Beta-blocker therapy should be monitored for side effects. Fatigue, somnolence, and dizziness and reported by approximately 10% of patients.

Symptomatic idiopathic flushing and flushing associated with rosacea deserve separate treatment, since the flushing does not respond to conventionial rosacea treatment. Although the perceived improvement of flushing and its sumptoms in 8 of our 9 patients treated with propranolol is encouraging, prospective randomized studies with control subjects and standardized quality of life date are necessary to better determine the efficacy of propranolol therapy.

Flushing has been associated with medications, rosacea, menopause, carcinoid syndrome, pheochromocytoma, polycythemia, and mastocytosis, although it can occur without known cause. There are no known specific treatments available, but beta-blockers have suppressed flushing reactions in some patients, particularly when associated with anxiety. The medical histories and clinical characteristics of 9 patients with either idiopathic flushing or flushing associated with rosacea were reviewed. Eight patients experienced subjective improvement with propranolol therapy.

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

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