Flushing of the face — reddened, warm skin — can sometimes occur as one of the symptoms of multiple sclerosis (MS), as a side effect of MS treatment, or for other reasons. Flushing can feel warm and uncomfortable. Many MyMSTeam members empathize with this “annoying” symptom of multiple sclerosis.
Although a flushed face can be embarrassing and frustrating to deal with, there are ways you can help manage it, through a discussion with your doctor or with approaches you can take at home. This article discusses possible causes of face flushing with MS, as well as how to manage the flushing.
Dealing with a flushed face can be difficult, especially combined with other MS symptoms. As one MyMSTeam member shared, “I have a flushed face daily. When my face is flushed, my face and scalp sweat. It’s embarrassing when I am in public.”
Many members report feeling generally overheated or feverish when their face becomes flushed. “I got up this morning with a fever and a flushed face,” wrote one. Some find that certain conditions exacerbate this symptom — as one member described, they sat in “a strong breeze and sunshine all day — face is stinging and flushed!” Another shared that they “get so hot I have to go into the bedroom [and] lie down with the overhead fan on and my stand fan on.”
Facial flushing is a paroxysmal symptom of MS. Paroxysmal symptoms refer to symptoms that appear suddenly and disappear after a short period, usually just seconds or minutes. Paroxysmal symptoms — which also include spasticity, vision problems, and dysphagia (difficulty swallowing) — are caused by issues with the central nervous system in which nerve fibers send out the wrong signals at the wrong times.
The exact relationship between flushing and multiple sclerosis, in particular, is still somewhat of a mystery. It is unknown whether flushing is a direct symptom of MS, but there is evidence that it is driven by treatments for the disease. Research has indicated that flushing often occurs due to medications for multiple sclerosis.
There are many other reasons why people with MS experience a flushed face. Some foods can cause the face to flush, as can menopause and certain skin conditions like rosacea.
Speaking to your neurologist or a dermatologist about your specific case of flushed face is recommended, as they can diagnose the underlying cause and help manage this symptom.
Many MyMSTeam members have shared that their MS treatments are responsible for facial flushing. Tecfidera (dimethyl fumarate), in particular, is a common culprit. Prescribing information lists facial flushing as a common side effect, and up to 40 percent of people who take the medication experience flushing. As one member wrote: “I am taking Tecfidera for my MS. I get a reaction to it: burning, itchy, flushed skin on my face, neck, and chest. I only get the reactions with my morning dose and every second day.” Another member shared that they have the exact same symptoms with Tecfidera: “Itching, rash, and burning. It is sporadic, and I never know when it will hit. It seems to be worse if I’m already hot when it occurs.”
Another member shared that Tysabri (natalizumab) causes them to become flushed and warm: “My flushed face usually occurs during the afternoon or evening. I’m on Tysabri infusion every four weeks. The flushing is usually accompanied by skin itching and hot flashes.” Flushing may be a sign of an infusion reaction to Tysabri, so be sure to mention any facial redness and warmth to your doctor.
Another potential factor that can bring about a flushed face or make flushing worse is stress. As one member wrote, “I have found that if I get stressed, [my flushed face] flares up.” Stress can be a common reason, as flushing can be stress-related whether or not you have MS.
Other dermatological conditions may also cause a person’s face to become red or flushed. One such condition is rosacea — an inflammatory skin disorder that leads to reddened skin and visible blood vessels on the face.
Interestingly, according to the American Academy of Dermatology, women who develop rosacea also have an increased risk of autoimmune diseases that affect the immune system, including multiple sclerosis.
Rosacea tends to cause facial redness that is persistent (chronic). It also tends to worsen over time if left untreated. When treated, it can go into remission and only resurface during flare-ups or when exposed to triggers. Rosacea triggers include:
Other conditions that can cause redness or flushing of the face include Cushing’s syndrome (often caused by long-term steroid use), hyperthyroidism (in which the thyroid gland is overactive and produces excess hormones), and menopause. Alcohol intake can also precipitate facial flushing, especially in those who have trouble metabolizing it.
Treatment options for a flushed face can vary from changing medications to using makeup or adjusting your diet. If you find that your facial flushing lasts for long periods, remains for longer than usual, or appears more and more frequently, it’s time to go to the doctor. Check in with your neurologist or visit a dermatologist to get to the bottom of this symptom.
Very often, flushing is a product of our environment, and it goes away just as quickly as it arrived. Take note of when your flushed face appears and what may be responsible. Did you drink a hot beverage or eat spicy foods? Have you been dealing with high levels of stress? Noticing what spurs episodes of facial flushing can help you avoid those triggers, potentially alleviating the symptom.
If your facial flushing appears to be related to your MS medications, talk to your doctor about the possibility of adjusting your dose or changing medications entirely. They will work with you to find the best way of managing your MS while avoiding unwanted side effects such as a flushed face.
One MyMSTeam member offered the following tip: “I have found that eating a spoon of peanut butter after you take your Tecfidera helps with the flushing. Also, if peanut butter isn’t for you, an egg will help, as well.” Experts also recommend taking Tecfidera with food to help reduce flushing. Taking an aspirin shortly before your dose may help as well.
Makeup, like foundation and concealers, can help mask a flush. If you choose to conceal flushing with makeup, you may want to do so in situations where you don’t want to appear flushed, such as during a job interview or a presentation.
When dealing with flushing, it may help to remove a layer of clothing or turn on the air conditioning or a fan. Keeping cool can also help you avoid triggering other MS symptoms that are sensitive to heat.
MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 169,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.
Have you dealt with MS-related facial flushing? What’s worked to improve it? Share your experience and tips in the comments below or by posting on MyMSTeam.