Flushing
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| ICD-10 | R23.2 |
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| ICD-9 | 782.62 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
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Overview
For a person to flush is to become markedly red in the face and often other areas of the skin, from various physiological conditions. Flushing is generally distinguished, despite a close physiological relation between them, from blushing, which is milder, generally restricted to the face or cheeks, and generally assumed to reflect embarrassment. Flushing is also a cardinal symptom of carcinoid syndrome – the syndrome that results from hormones (often serotonin or histamine) being secreted into systemic circulation.
Differential Diagnosis
- Alcohol
- Anaphylaxis
- Anxiety
- Basophil chronic granulocytic leukemia
- Carcinoid syndrome
- Dehydration
- Drugs: Physiological response to vasodilators — for instance, a recent high dose of niacin, nitroglycerine, calcium channel blockers, or any drug that causes release of adrenal hormones that raise blood pressure such as stimulants
- Emotions: anger, embarrassment
- Erythromelagia
- Exercise: An abrupt cessation of physical exertion (resulting in heart output in excess of current muscular need for blood flow)
- Extremes of emotion
- Heat
- High fever
- Hot beverages
- Hypertonic crisis
- Limerence
- Mastocytosis
- Medullary carcinoma of the thyroid
- Menopausal flushing
- Neuroendocrine tumors: carcinoid syndrome, pheochromocytoma, VIPoma, thyroid medullary carcinoma
- Pheochromocytoma
- Post-menopausal decrease in estrogen production
- Psychedelics or other drugs, such as 3-Quiniclidinyl Benzilate(BZ)
- Quincke's Edema
- Rapid changes in temperature
- Renal cell carcinoma
- Retinoids
- Rosacea
- Sexual arousal (see section to follow)
- Spicy foods
- Thyrontoxicosis
- Trigeminal Neuralgia
- Vegetative dystonia
- VIPoma (Vasoactive Intestinal Peptide-producing tumor)
- WDHA (Watery Diarrhea, Hypokalemia, Achlorhydria)
Sex flush
Commonly referred to as the sex flush, vasocongestion (increased blood flow) of the skin can occur during all four phases of the human sexual response cycle. Studies show that the sex flush occurs in approximately 50-75% of females and 25% of males, yet not consistently. The sex flush tends to occur more often under warmer conditions and may not appear at all under cooler temperatures. It has also been commonly observed that the marked degree of the sex flush can predict the intensity of orgasm to follow.
During the female sex flush, pinkish spots develop under the breasts, then spread to the breasts, torso, face, hands, soles of the feet, and possibly over the entire body. Vasocongestion is also responsible for the darkening of the clitoris and the walls of the vagina during sexual arousal. During the male sex flush, the coloration of the skin develops less consistently than in the female, but typically starts with the epigastrium (upper abdomen), spreads across the chest, then continues to the neck, face, forehead, back, and sometimes, shoulders and forearms.
The sex flush typically disappears soon after orgasm occurs, but this may take up to two hours or so, and sometimes, intense sweating will occur simultaneously. The flush usually diminishes in reverse of which it appeared.
References
Acknowledgements
The content on this page was first contributed by Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3] Phone:617-525-6884
List of contributors:
Suggested Reading and Key General References
Suggested Links and Web Resources
For Patients
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
