For some patients the most debilitating and distressing symptom of rosacea is severe and uncomfortable facial flushing. This can be triggered by stress or by social situations and can have a major impact on confidence and personal and professional life.
Flushing may be unresponsive to topical therapies or vascular laser treatments and medications like beta blockers can be an effective treatment option.
Beta blockers—such are medications developed to treat high blood pressure and heart issues. They function by blocking the effects of adrenaline (epinephrine) and noradrenaline on the body's beta-adrenergic receptors, effectively slowing the heart rate and reducing the force of heart muscle contraction.
Beta blockers can be effective at halting the sudden widening of blood vessels that occurs in flushing associated with rosacea flushing that is triggered by factors such as emotional stress, acute anxiety, public speaking, embarrassing situations, or intense physical exertion.
In my experience carvedilol - which also has some effect in blocking alpha receptors - is more effective than other beta blockers in flushing. Another good option is propranolol which can be useful in reducing the symptoms of anxiety as well as flushing.
Potential side effects include low blood pressure, fatigue, cold hands and feet, and occasionally dizziness upon standing. Beta blockers should not be used by patients with asthma, as blocking beta receptors in the lungs can trigger severe bronchospasms.