Re: Flushing: Types, Patterns & Systems

[Guest guest]

What a lot of useful information! As I was reading through it all, it could

have been my biography.

I will follow the advice (especially about the beer!).

And, thank you for sharing this information as it must have taken you a good

bit of time to put it all together and get it typed.

Thanks again and good luck.

.

>

>Reply-To: " Bass & Boney, Inc. " bass.and.boney.inc@...>

>To: rosacea-support >

>Subject: Flushing: Types, Patterns & Systems

>Date: Fri, 8 Feb 2002 09:12:47 -0500

>

>cea Flushing: Types, Patterns & Systems

>

>Each of the following items is part of a complex interaction of several

>systems.

>

>Clock rosacea or systemic flushing- The body does operate on a clock!

>Universally, hospital physicians have known for years that the lowest body

>temperature of the 24 hour day is at usually around 3:00 A.M. while the

>highest temperature of the day is around 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. Flushing usually occurs

>when the body becomes fatigued and/or stressed which stimulates the

>sympathetic nervous system. The key to this is the autonomic nervous system

>(more specifically,the sympathetic postganglionic efferent nerves). Any

>activation of these nerves causes vasoconstriction of " body blood vessels "

>-- except in the " facial blush/flush areas " where it induces potent

>vasodilatation or flushing with the resulting " rosacea flush " . A typical

>rosacea sufferer would flush in the fifth grade even when the answer was

>known when the teacher asked a question, and obviously the flushing would

>be noticed by the other kids. Once again the sympathetic nervous system.

>

>a.. Stress stimulates the sympathetic nervous system

>b.. Lack of sleep stimulates the sympathetic nervous system

>c.. Anxiety (fight or flight) stimulates the sympathetic nervous system

>d.. Increase in internal body temperature stimulates sympathetic nervous

>system, whereas obviously a decrease in body temperature decreases the

>sympathetic system due to the parasympathetic system calming the system.

>The sympathetic nervous system is especially important to rosacea patients

>who tend to have either:

>

>e.. Genetically weak blood vessels

>f.. Damaged blood vessels from years of sun

>g.. Damaged support system for blood vessels (collagen-elastic of skin)

>h.. Increased number of blood vessels.

>cea sufferers have more facial vessels or the vessels that we have are

>severely damaged. The result being that anything that stimulates facial

>dilation " cannot " be handled easily or properly.

>

>Heavy meal flushing and sugar/carbohydrate flushing- This flushing is

>caused by more stress on the digestive system with a resulting larger blood

>flow to the digestive system and with the residual blood being heavier to

>the face. Therefore, three small meals with breakfast being the most

>important and grazing in between meals is better for limiting this kind of

>flushing, however it is important to keep the daily calorie intake within

>one's calorie budget to maintain your ideal weight. The type of food that

>you eat is also very important as various foods stimulate blood flow

>differently. Simple carbohydrates such as donuts, sugars, alcohol, etc.

>enter the blood stream quickly causing hyperglycemia (high glucose spikes).

>This rapid influx of sugar into the blood stream is a potent vasodilator.

>Fiber intake decreases the amount of food that the stomach has at one time

>and prolongs digestion, therefore there is not the sudden influx into the

>blood stream with the resultant flushing. Carbohydrates are needed for

>energy and as a part of every meal, however, let's try to enjoy the baked

>potatoes, beans, corn, apples (fruit but still a carbohydrate), etc.

>instead of simple carbohydrates.

>

>Steroid flushing - When a rosacea patient is erroneously treated for a

>prolonged time with topical steroids the disorder may at first respond, but

>inevitably the signs of steroid atrophy emerge with thinning of the skin

>and marked increase in telangiectases. The complexion becomes dark red with

>a copper-like hue. Soon the surface becomes studded with round, follicular,

>deep papulopustules, firm nodules, and even secondary comedones. The

>appearance is shocking with a flaming red, scaling, papule-covered face.

>Steroid rosacea is an avoidable condition which in addition to

>disfigurement is accompanied by severe discomfort and pain. Withdrawal of

>the steroid is inevitably accompanied by exacerbation of the disease, a

>trying experience for a patient and physician. (Drs. Gerd Plewig and Albert

>Kligman).

>

>For information on steroid use, please see First World Congress of the

>International Academy of Cosmetic Dermatology.

>

>Adrenalin flush rosacea - This kind of flushing is caused by an adrenaline

>rush or a large supply of adrenaline under pressure with immediate or

>instant flushing. It is the same as sympathetic nerves, but it is hormone

>released. Stress is the body's reaction to a perceived threat. Adrenaline

>and hormones are released, and the nervous system is activated, sharpening

>our senses, but simultaneously our pulse rises, our muscles tense and our

>immune system begins to shut down. Those that can not relieve stress as

>needed may experience fatigue, upset stomach, and frequent headaches, and a

>flushing face. Long-term stress can contribute to family breakdown, job

>fatigue, with resulting long-term health problems such as depression, heart

>disease, high blood pressure, and rosacea. Also, adult acne is adrenal

>related in both " men and women " as a reaction to mental stress or body

>stress. In women testosterone is produced by the ovaries with the other

>half of testosterone in women being produced by the adrenal glands.

>Obviously, estrogen smoothes out the testosterone produced by the ovaries,

>but when the estrogen level drops several days before the menstrual

>periods, sometimes resulting acne occurs especially when the adrenal glands

>over produce due to stress or fatigue. Likewise, the adrenal glands can be

>stressed continually in both men and women resulting in too much

>testosterone with the resulting over stimulation of the sebaceous glands.

>The adrenal glands produce testosterone directly or via peripheral

>conversion of DHEAS (dihydropiandrosterone sulfate), DHEA

>(dihydroepiandrosterone), and androstenedione which are the three major

>adrenal androgens. Similarly, in the male an over abundance of testicular

>testosterone especially with overly stimulated adrenal glands causes the

>overly stimulated sebaceous glands. Quite often more stress is placed on

>the adult after puberty, with the current stressful period of having

>gameful employment, progressing in employment and marriage, child raising

>and the resulting continuing financial problems which causes stress of

>great magnitude. While we can not produce more estrogen to level out the

>testosterone, we can drink much more water which will help relieve stress

>and assist both acne and rosacea. Also getting enough sleep and finding

>ways to relax will help relieve stress and reducing the adrenaline reaction

>that follows. You will read considerably more about stress under Lifestyle

>changes later. Also,there within, you will find many ideas on limiting your

>stress.

>

>Exercise flushing is caused by the cardiovascular system pumping harder and

>faster due to exercise. While keeping the body in good shape by burning

>calories and toning muscles, exercise should be done moderately in a cool

>area with the body well hydrated with water to minimize the redness. The

>body, hydrated well with water, will result in less redness. The body

>should adapt slowly over time to the exercise so that the body is aerobic

>(with oxygen) instead of anaerobic (without oxygen causing redness-you

>remember when you tried holding your breath for a minute with the result of

>your facial skin immediately turning pink or red). Therefore, the body can

>handle more vigorous exercise as your exercise training increases. Better

>cardiovascular shape and exercise means more oxygen in the blood and more

>oxygen in blood constricts vessels. Also, there is a myriad of benefits of

>water for exercise and metabolic waste build up. Also, water is absolutely

>necessary for strong, flexible plasma membranes of all cells. See more

>details in the Lifestyle Changes.

>

>Cigarette flushing - Smoking, which depletes the skin of vitamin C,

>essential for the formation of collagen, accelerates the crosslinkage of

>collagen and the hardening of elastin and furthermore creates a trillion

>free radicals, which destroy the capillary structure. Smoking, which

>additionally robs the skin of oxygen, is a potent initiator of

>telangiectasis. Also, the smoker may have a variety of medical problems

>such as high blood pressure, and mineral deficiencies, which can cause the

>appearance of telangiectasis. Remember what cigarette smoking does to the

>lungs. The lung tissue is less pliable, receiving less oxygen. Well, a

>similar thing happens overall to the skin with the epidermis being less

>pliable and receiving less oxygen with the result being that the " Marlboro

>Man " has more wrinkles. Most importantly is that the blood vessels are not

>as pliable and receive less oxygen therefore compounding the problem.

>Usually, noticeable smoking symptoms are not visible to the lungs nor the

>face as blushing is minimal for weeks, months, or years, however, there is

>continual damage to the lungs and the skin that is very hard to regain.

>

>Hot shower/bath flush rosacea- Obviously the skin is redder by the

>stimulation of hot showers/baths or hot weather. Overall, it is better to

>shower in tepid water below body temperature of 98.6 or in the range of 85

>to 95 to cool the body. You may choose to shower with warmer water to open

>the pores up to clear them or for relaxing, however, remember to begin to

>lower the temperature to a much lower degree for cooling off and to prevent

>the skin from turning red or to reduce the redness from the prior higher

>temperature.

>

>Alcohol flushing- The best way to avoid this type of flushing is not to

>drink any alcohol! All alcohol is fermented, but because beer and wines

>(red wine being the worst) are not further distilled, they can cause

>allergy redness for many rosacea sufferers. Alcohol is a diuretic which

>pushes water out of the body cells. In this state of " dehydration " , the

>body is prone to flushing. Alcohol is a concentrated source of calories and

>is metabolized very quickly. This causes the blood vessels to dilate and

>cause redness. If you feel you need to drink alcohol at social functions or

>to relax, here are some recommendations to minimize the flushing effect.

>Avoid beer as it is higher in carbohydrates, however, if you like beer,

>drink your domestic beer from your own country as it is usually sold within

>six weeks of production. Foreign beers imported into your country usually

>have preservatives which makes for more redness. And obviously, domestic

>'light beer' usually does not have as much carbohydrates and often less

>alcohol content making it the beer of choice. And likewise wine is heavy in

>carbohydrates and even higher in preservatives/sulfides and alcohol causing

>even more flushing with the red wines usually being the worst for most of

>us. Instead, drink " very, very small, weak portions " of gin, vodka or

>whiskey, ideally with water instead of sugared soft drinks or mixes which

>also can stimulate the cardiovascular system. An ideal mixed drink would be

>a Long Island Ice Tea and even better yet would be the Long Island Ice Tea

>without the mix and replacing it with water and diluting it. Or simply use

>another glass, and mix the drink to " cut " it in half with twice as much

>water. Small amounts of gin are less stimulating than vodka or whiskey to

>many drinkers. You should " chase " any alcoholic drink with water, and water

>again in between drinks. Although these recommendations can help to

>minimize flushing, still the best thought is " not to drink any type of

>alcohol " .

>

>

>This 3-year old daughter of a rosacean flushes from enjoying the snow for

>only an hour. She also flushes with laughter, anger, and playing hard

>during the summer. Obviously, she does not use alcohol, tobacco, coffee or

>harsh soaps, etc. However, she does have the genetic propensity for

>rosacea and may develop rosacea if her skin is abused by all of these

>elements during the next several decades.

>

>Chilly or cold weather flushing - These flushing flare ups result from

>coming in from the chilly cold into a room where the normal room

>temperature ranges from 70 to 75 degrees. While the rosacea sufferer is

>outside in the cold weather the cardiovascular system is pumping hard as it

>normally does, however the extremities such as the feet, hands, ears, nose

>get less blood supply than the rest of the body and are directly exposed to

>the cold along with the facial skin. Its partially due to direct contact,

>but it is more a cause of conservation of heat by internal thermostat --

>causing constriction of vessels by decrease sympathetic activity to vessels

>which also happens when you take a 'cool' shower. When the rosacea

>sufferers come into the warm office or home with normal temperatures, the

>warmer temperatures quickly warm the facial skin areas and extremities

>while the cardiovascular system is still in a moderately high exercise

>mode. The rosacea sufferer should try not to enter the cold if possible or

>minimize the extreme cold exposure by warming up the car prior to use,

>wearing a facial mask/hat/scarf depending on length of exposure and

>severity of cold temperatures, or whatever else can be done to minimize

>cold exposure. After being exposed to the cold for a long period, prior to

>arrival in the warm office or home, try to slow down the exercise, walking,

>etc. so the cardiovascular system will not be as stimulated. Also, you

>might choose to remove the overcoat or some outer wear if possible just

>prior to arriving at the office, home or building with normal temperatures.

>If possible enter slowly at a foyer or vestibule, or corridor, take a break

>in that area by reading a newspaper, etc. for five minutes, or reviewing

>plans for the next few hours, etc., then proceed slowly into the warmer

>office/home with the normal temperature to minimize flushing.

>

>These are some of the primary types of flushing, and there are other types

>of rosacea flushing such as sun exposure flushing, drug medication flushing

>or drug/sun sensitivity flushing (see list later under Lifestyle changes),

>laughter flushing, allergy/histamine flushing, and the list goes on and on.

>

>cea is a progressive skin disorder unless treated. The blood vessels

>continue to grow with age and are stimulated and damaged by stress,

>food/drinks, dehydration, weather, sun exposure, abrasive soaps/exfoliating

>medications, hot bath, exercise, etc. The more blood vessels one has near

>the surface of the skin, the more one is likely to flush and stay flushed.

>

>

>In a message dated 2/7/02 7:45:07 PM Eastern Standard Time,

>mlramsey@... writes:

>

>My derm told me many patients tell her they flush the same time each day.

> My flushing is definitely related to my " down time " each day - the time

>of

> day when my body is most tired. I seem to perk up after that time.

>

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