From the Guidelines
Facial flushing associated with prednisone therapy is primarily caused by the dilation of blood vessels near the skin's surface, leading to increased blood flow to these areas, as evidenced by the common side effects of corticosteroid treatment 1. This flushing typically appears as redness on the face, neck, and upper chest areas and is generally harmless though sometimes uncomfortable or embarrassing. The side effects of prednisone, including facial flushing, are dose-dependent, meaning higher doses are more likely to cause these effects, and they typically subside as the body adjusts to the medication or when the dose is reduced 1. Some key points to consider regarding prednisone-induced facial flushing include:
- The medication causes blood vessels near the skin's surface to dilate, increasing blood flow to these areas 1
- This side effect is dose-dependent, with higher doses more likely to cause flushing 1
- It typically subsides as the body adjusts to the medication or when the dose is reduced 1
- To manage prednisone-induced facial flushing, patients can take the medication with food to reduce irritation, avoid triggers like spicy foods, alcohol, and hot beverages, and apply cool compresses to affected areas for temporary relief 1
- If the flushing is severe or accompanied by other concerning symptoms like difficulty breathing or swelling, patients should contact their healthcare provider immediately as this could indicate an allergic reaction rather than a typical side effect 1
- Patients should never stop taking prednisone abruptly without medical guidance, as this can lead to withdrawal symptoms 1
From the Research
Causes of Facial Flushing
- Facial flushing can be caused by various factors, including changes in cutaneous blood flow triggered by multiple conditions 2
- The pathophysiology of flushing involves changes in cutaneous blood flow triggered by multiple intrinsic factors that are either related to physiology or disease 3
- Flushing can be divided into episodic or persistent causes, with episodic flushing mediated by the release of endogenous vasoactive mediators or medications, and persistent flushing resulting in a fixed facial erythema with telangiectasia and cyanosis due to slow-flowing deoxygenated blood in large cutaneous blood vessels 3
Relation to Prednisone Therapy
- There is no direct evidence in the provided studies that links prednisone therapy to facial flushing
- However, it is known that corticosteroids like prednisone can cause changes in cutaneous blood flow, which may lead to flushing 2, 3
Treatment and Management
- Botulinum toxin A can be used to decrease persistent facial flushing temporarily 4, 5
- A precise systematic approach is needed to exclude potentially serious underlying causes of flushing, and if symptoms are not progressive, the patient should be advised about its apparently benign nature to avoid unnecessary studies or initiating treatments of minimal benefit 6