Skin blushing/flushing

The heat in spicy foods like chilis and curries is caused by a chemical called capsaicin found in chili peppers and paprika.

Causes of Facial Flushing

There are many possible causes for red, hot cheeks in adults, commonly known as facial flushing. Physiologically, it occurs when blood vessels just below the surface of the skin, called capillaries, widen and fill with blood.

The trigger for facial flushing can range from common conditions like fever, menopause, and changes in body temperatures to uncommon ones like carcinoid syndrome (caused by a rare, slow-growing cancer). Emotions can also cause facial flushing, referred to as blushing.

This article looks at seven possible causes of facial flushing, both benign (harmless) and malignant (cancerous).

mheim3011 / iStock / Getty Images

Benign Causes of Facial Flushing

Facial flushing can occur spontaneously for any number of reasons, most of which are relatively mild.

Extreme Emotions

When you are embarrassed, angry, or experience any strong emotion, your body may release a hormone called epinephrine (adrenaline) which causes blood vessels to dilate (widen). Epinephrine is one of the hormones associated with the “fight-or-flight” instinct that helps our body respond to threats.

When epinephrine is spontaneously released, dilated blood vessels cause the overlying skin to turn red and hot.

Changes in Body Temperature

When the body becomes overheated, it responds by dilating blood vessels. The dilation allows heat to be dispersed into the environment while triggering sweating to cool the body down.

A high fever is a common cause of facial flashing. Other causes include exercising strenuously or being overheated in hot climates or places like a sauna or steam room.

Taking an antipyretic drug like aspirin or Tylenol (acetaminophen) can help ease fever. Placing a moist, cool cloth on the face can help ease facial flushing.

Do not use aspirin in children or teens with fever as it is linked to a potentially life-threatening reaction known as Reye’s syndrome.

Menopause

Menopause is characterized by hot flashes. Hot flashes are caused when sudden changes in hormones spontaneously change the body temperature.

Estrogen, the hormone that helps regulates menstrual periods, also influences a part of the brain called the hypothalamus which acts as the body’s thermostat. Fluctuating estrogen levels during menopause can make it difficult for the hypothalamus to regulate temperature, leading the hot flashes and facial flushing.

Estrogen-replacement therapy (ERT) may help ease hot flashes during menopause.

Spicy Foods

The heat in spicy foods like chilis and curries is caused by a chemical called capsaicin found in chili peppers and paprika.

When you eat capsaicin, it stimulates a receptor in the digestive tract called capsaicin receptor TRPV1. The stimulation of these receptors makes your body feel warmer so that you can sweat and cool it back down. Facial flushing occurs with the sudden rush of heat.

The degree of flushing can vary from person to person but tends to correspond to the heat of a chili pepper as measured by Scovill heat units.

Rosacea

Rosacea is a chronic skin condition characterized by redness and skin bumps. It is more common among adults over 30, especially those with lighter skin tones.

Rosacea often begins with episodes of flushing, followed in time by symptoms such as burning and stinging sensations, papules (skin bumps), pustules (pimples), and permanent redness.

The cause of rosacea is unknown but may be due to genetics, environment, an overactive immune system, or a combination of these. Rosacea is not contagious or caused by poor hygiene. Antibiotics or acne medications may help reduce symptoms of rosacea and prevent disease progression.

Alcohol Use

Alcohol flush reaction is a condition common among many Asians who experience facial flushing after drinking alcohol. Also referred to as Asian flush syndrome, Asian flush, or Asian glow, it affects up to 36% of East Asians, including people of Japanese, Chinese, and Korean descent. Nausea, headache, and rapid heart rate can also occur.

Alcohol flush syndrome is caused by the lack of an enzyme that helps break down alcohol. Without this enzyme, alcohol is only partially broken down into a substance called acetaldehyde . As acetaldehyde accumulates, the immune system will respond with inflammation, causing blood vessels to dilate in the face.

Medications

Some medications used to treat high blood pressure, thyroid disease, and other conditions can also trigger an inflammatory reaction that leads to facial flushing.

ACE inhibitors
Calcium channel blockers
Cholinergic drugs
Corticosteroids (oral, injected, or intravenous)
Cyclosporine
Morphine
Niacin
Nitroglycerin
Tamoxifen
Thyroid releasing hormone
Vasodilators

Malignant Causes of Facial Flushing

Carcinoid syndrome is a rare condition typically affecting people with advanced carcinoid tumors. These rare, slow-growing tumors affect hormone-releasing neuroendocrine cells. The tumors can develop in different parts of the body, including the digestive tract, lungs, and ovaries.

Summary

Facial flushing can occur for many relatively harmless reasons, including strong emotions, menopause, and eating spicy foods. It can also develop with a fever. when drinking alcohol, or as part of a chronic skin condition called rosacea. A rare, cancerous cause is carcinoid syndrome, most often caused by a carcinoid tumor in the digestive tract.

A Word From Verywell

This article covers most of the common causes of flushing, but some rarer causes should also be considered. Pheochromocytomas, which release vasoactive mediators like catecholamines that cause hypertension, are also associated with flushing. Some patients with medullary thyroid cancers, pancreatic neuroendocrine tumors, and endogenous Cushing syndrome can also develop flushing.

12 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Nikolic M, Majdandzic M, Colonnesi C, de Vente W, Moller E, Bogels S. The unique contribution of blushing to the development of social anxiety disorder symptoms: Results from a longitudinal study. J Child Psychol Psychiatry. 2020 Dec;61(12):1339–48. doi:10.1111/jcpp.13221
Walter EJ, Hanna-Jumma S, Carraretto M, Forni L. The pathophysiological basis and consequences of fever. Crit Care. 2016;20:200. doi:10.1186/s13054-016-1375-5
National Organization for Rare Disorders. Reye syndrome.
Freedman RR. Menopausal hot flashes: Mechanisms, endocrinology, treatment. J Steroid Biochem Mol Biol. 2014;142:115–20. doi:10.1016/j.jsbmb.2013.08.010
Fattori V, Hohmann MSN, Rossaneis AC Pinho-Ribeiro FA, Verri WA. Capsaicin: Current understanding of its mechanisms and therapy of pain and other pre-clinical and clinical uses. Molecules. 2016 Jul;21(7):844. doi:10.3390/molecules21070844
Ahn CS, Huang WW. Rosacea pathogenesis. Dermatol Clin. 2018;36(2):81-6. doi:10.1016/j.det.2017.11.001
Cho Y, Kwak S, Lewis SJ, et al. Exploring the utility of alcohol flushing as an instrumental variable for alcohol intake in Koreans. Sci Rep. 2018;8(1):458. doi:10.1038/s41598-017-18856-z
New Zealand Trust/DermNet. Flushing.
National Organization of Rare Disorders. Carcinoid syndrome.
American Cancer Society. Tests for gastrointestinal carcinoid tumors.
Ravikumar R, Avasthi S, Avasthi D. Flushing: A diagnostic dilemma. Cureus. 2021 Jun 8;13(6):e15515. doi:10.7759/cureus.15515
Hannah-Shmouni F, Stratakis CA, Koch CA. Flushing in (neuro)endocrinology. Rev Endocr Metab Disord. 2016;17(3):373–380. doi:10.1007/s11154-016-9394-8

By Heather L. Brannon, MD
Heather L. Brannon, MD, is a family practice physician in Mauldin, South Carolina. She has been in practice for over 20 years.

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Skin blushing/flushing

Skin blushing or flushing is a sudden reddening of the face, neck, or upper chest due to increased blood flow.

Causes

Blushing is a normal body response that may occur when you are embarrassed, angry, excited, or experiencing another strong emotion.

Flushing of the face may be associated with certain medical conditions, such as:

High fever
Menopause
Rosacea (a chronic skin problem)
Carcinoid syndrome (group of symptoms associated with carcinoid tumors, which are tumors of the small intestine, colon, appendix, and bronchial tubes in the lungs)

Other causes include:

Alcohol use
Certain medicines used to treat diabetes and high cholesterol
Exercise
Extreme emotions
Hot or spicy foods
Rapid changes in temperature or heat exposure

Home Care

Try to avoid the things that cause your blushing. For example, you may need to avoid hot drinks, spicy foods, extreme temperatures, or bright sunlight.

When to Contact a Medical Professional

Contact your health care provider if you have persistent flushing, particularly if you have other symptoms (such as diarrhea).

What to Expect at Your Office Visit

The provider will perform a physical exam and may ask about your medical history and symptoms, including:

Does the flushing affect the whole body or just the face?
Do you have hot flashes?
How often do you have flushing or blushing?
Are episodes getting worse or more frequent?
Is it worse after you drink alcohol?
What other symptoms do you have? For example, do you have diarrhea, wheezing, hives, or difficulty breathing?
Does it happen when you eat certain foods or exercise?

Treatment depends on the cause of your blushing or flushing. Your provider may recommend that you avoid things that trigger the condition.

Alternative Names

Blushing; Flushing; Red face

References

Dinulos JGH. Acne, rosacea, and related disorders. In: Dinulos JGH, ed. Habif’s Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 7.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Erythema and urticaria. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews’ Diseases of the Skin. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 7.

Review Date 6/7/2023

Updated by: Elika Hoss, MD, Assistant Professor of Dermatology, Mayo Clinic, Scottsdale, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Face Flushing After Eating

Skin blushing/flushing

Causes of Facial Flushing