I started taking Metformin about a year ago (1000mg 2x day). I've had great success with it--lost about 40lbs since starting the drug.
About 4 months after starting the drug, I noticed I started having these 'facial flushing' episodes--my cheeks would get REALLY hot and REALLY red. No correlation to foods. Some correlation to warm/hot environments. I do have some very mild acne/bumps, but hey--I have PCOS. So no surprise there.
Anyways, the facial flushing/burning continued to the point where my face started becoming permanently red--esp over the cheek area, but the redness also now shows up over my eyebrows and the bridge of my nose.
My Dr. thinks it's rosacea and I've been taking an oral AB plus a topical one to try and treat the condition. No change.
Then I found out today that metformin can cause 'flushing'.
My questions:
--are we talking about ALL OVER flushing, GENERALIZED flushing, FACE/CHEEKS flushing...? Where exactly can metformin cause you to flush?
--do you think the DR is right--is it rosacea? Or could the metformin be the cause?
--If the metformin is the cause, does anyone know of any ways to combat the flush? Are there alternative drugs for us PCOS girls that are similar to metformin?
I have had such good luck with metformin in the weight department and blood sugar department--no more blackout episodes, no crazy weight gains--that I am a little scared to go off of it. However, the flushing is getting really persistent and painful, so I want to explore all possible causes/solutions.
Any feedback or suggestions would be highly appreciated!!
I haven't had the facial flushing you described but I have gotten a few "hot flashes (the all-over-the-body kind) since taking Met. My episodes are uncomfortable but not unplesant and painful like yours seem to be. I get mine every once in a while and usually at night.
I'm no doctor but it could be that the flushing is caused by the hormonal changes that's occuring in your body by the blood sugar leveling off on Met. The redness sounds like rosacea to me; maybe you've had a genetic tendency for rosacea all along that was exacerbated by the Met flushing episodes.
As for your last question, I'm pretty new to Met (and PCOS in general) so I have no idea of any alternative drugs that are similar to Met other than Avandia, which is another diabetic drug used to control IR. You may want to ask your doctor about it.
Anyway, I'm sorry to read that you might have to go off Met, as it seems to working very well for you (other than the pesky flushing).
Hm. That hadn't occured to me, about the blood sugar possibly being related to the flushing. I know many rosaceans swear by low glycemic/low carb type diets as a way to control the flushing; I wonder if there is a relationship here. It is DEFINITELY something I will pursue.
I would definitely rather change other things and be able to keep the met if at all possible--everything else has been so wonderful. And in fact if the end answer is "met makes your face red", I may still decide to stay with it anyways. The good generally outweighs the bad.
I have switched back to spironolactone completely in the last week, and additional redness has started to go down--haven't had a flare in the last week. I was originally on spiro, but had to stop because of bleeding and low blood pressure. I took propecia (.5mg) for about the last year instead. Definitely less body hair, less head hair shedding, no other changes (bad or good). Due to cost I looked into switching back to the spiro...my dr seemed very convinced that my hormones would be different being 40lbs lighter. And in fact so far, taking 100mg (I only took 25-50mg when I was having problems with spiro before) now I have had no bad side effects other than being thirsty. ANd it does seem to be helping some with the redness.
All leading me to believe that you may be right, siamlovex2!
Metformin might indirectly be the cause just by changing blood sugar, or something like that...hormones are all related, and not all completely understood.
For what it's worth - I have Rosacea (lucky me a fair/pink faced redhead) and it started before I started Met. I haven't seen any relationship with Met and flushing - and let me tell you, I flush at the drop of a hat. If you aren't ttcing right now, there are some creams (metrocream) that you can use on the rosacea which your doctor can give you or go to the drugstore and try some anti-redness creams. I found that the anti redness creams worked well, but I had to stop them because I'm ttcing. You never know if those products are safe or not. I know Metrocream is not safe. I use a green tea bag (well cooled!!) on my face at night and it helps with the redness. There have been studies done about topically applying green tea to the affected areas and it's reduction of rosacea symptoms. I'm waiting for a green tea cream to come out on the market!!
__________________ Nat
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Dx PCOS June '06
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Currently pregnant with #2 after taking Met (1500 mg/day) only. Stick, baby stick!
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Mut, I get the exact same thing you are talking about daily, I would think I had a fever, because I felt so warm. I know it relates to the met because about an hour after taking the pill that is when it happens.... I have learned to deal with it. My doctor didn't seem to concerned. I also wondered about my blood pressure, because I was nervous of that, I have a blood pressure machine, which my DH uses and it always comes out normal..... I dont know.... It's just one of the great S/E of Met!!!
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There are green tea facial creams out on the market now. I don't know if they'll help your rosacea, but they might be worth checking out. They don't seem to be too expensive. Here's a few links to several varieties out there:
I have the exact same thing and i was diagnosed with Rosacea. I take metformin too and did see the effect after use. People are always like "so you have rosy cheeks so what?" but they really burn. It's like the heat is radiating off of me and like I have a bad sunburn on my cheeks all the time. It is also way worse on one side of my face than the other. I am so sorry you are going through this too. Have you found anything out?
My DR was really insistent that the two were not related. No real answer to my question "then why is facial flushing listed as a side effect?"
So frustrating.
I tried a low carb/low sugar diet (still about 1500-1700 cal/day) for about 3 weeks. no change in facial redness, no weight loss either.
Due to other side effects, I had to switch back from spiro to propecia. Again, no SIGNIFICANT reduction in redness/sensitivity.
*however* I also switched from Yasmin to Zovia in Feb, and the redness cleared up significantly. I still looked 'rosy', but I didn't have any 'flushing' episodes. I have heard that some cases of Rosacea may be due to BCP or other hormonal imbalances. So i wonder if this is the issue. But since I never changed my bcp (had been on Yasmin for like 5-6yrs) I wonder why the problem cropped up now. Maybe just my body changing?
But then the zovia started causing some significant weight gain, so in the last week i've switched back to Yasmin. And yes, the flushing episodes returned.
I have found that finacea applied to my cheek area really helps reduce the sensitivity/severity of flushing episodes. I use metrogel on my forehead/nose/chin--for whatever reason finacea causes acne when I use it there but not on my cheeks.
I have no explanation for that one....but the derm doesn't seem to think it's too terribly unusual, so I guess it's OK.
Merc:
I wish I could correlate my flushes like that! I only tend to get them when I'm borderline warm/hot, like that moment right before you start sweating. It seems like if I get to that point my skin goes ape. I haven't noticed any correlation to blood pressure--mine is chronically low (in fact that's partly why I had to stop the spiro--it was just TOO low).
Still, I think I would rather have skin problems than be so overweight...regardless of what met may be doing to my skin, it has definitely helped me loose weight. And I am over the moon about that. So i guess I shouldn't complain TOO loudly, huh?
__________________
Metformin 2000mg per day since Oct 07
Yasmin 1xday2001-March 2009
Spiro 50mg 1xday Oct 07-Jan 08; stopped due to bleeding and low BP side effects at higher dosages. Started again at 50mg March 09-present.
Propecia .5mg 1xday Jan 08-Dec08. Started again March 09-present
Diagnosed in 2001. Found a Dr that would treat me for PCOS in 2007.
Feel free to contact me with specific questions--I am always glad to help a fellow cyster To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
Dear Mutant,
I do not take any kind of BCP. The doc told me it would cause me to gain more weight. NO thanks. I am 25 (with rosacea, which is uncommon, which really pisses me off I take finacea too. Does it make your face burn at all right after contact? Like a tingly crawling burn? It does that to mine, but I take it anyway, it seems to help a little. What kind of soap do you use to wash your face? (sorry this is sounds like the spanish inquisition, but I need to know that someone else out there feels like me) I am also on doxycycline. The doctor prescribes spiro for me too. I have not taken it yet. My blood pressure is always super low too and I am worried it will just be too low. It's weird. I think because i am overweight, people expect mine to be high and then it is so low and faint they sometimes have trouble hearing it... I am so glad the metformin has helped you lose weight. Does it make you sick at all? What if you do not take it with enough food?
Sorry for all the questions. I am so glad I have this board.
No worries about the questions I will answer as best I can:
--I am also 25.
--the finacea burns/itches like crazy. I've been taking it for a few months and have never seen that sensation go away/diminish. It feels like ants all over my skin; lotion does not seem to make it stop itching. But it does reduce redness...
--I took -cyclines for many years. Was on Vibramycin for 2 years, but developed stomach issues so my Dr recommended switching to Minocycline, as its supposed to be easier on the stomach. I had a massive allergic reaction (by myself, in an airport no less). Had to use my epipen=highly unpleasant. Needless to say, I can't ever take anythign in that family again. I did amoxicillin for about 8 months after that, which worked ok on acne but not so much on the dermatitis or rosacea. Now I take erythromycin 500mg 2x day. It's working pretty well so far--i feel like the inflammation is really reduced (I was starting to develop what looked like 'bags' around my eyes which turned out to be swelling from rosacea). And it's surprisingly easier on my stomach than anything else.
--I use aquanil, recommended by my derm. It is similar to cetaphil but I find it to be less drying. I cycled through a few different lotions, but I found the best one by FAR to be the Good Skin creme (for red/irritated skin) found at kohls. It moisturizes well enough (I tend to have oily skin, so i was a little weirded out that a 'cream' didn't overdo it) and I've never noticed a break out from it.
--I agree about the bcp and weight. I've been having so many issues with it lately...I'm thinking I might just stop it completely. I'm not supposed to because of some of the other meds I'm on (I absolutely CANNOT conceive) but...still....
--Always had low blood pressure, whether I was 105 or 175. My mom has the same thing (and she is heavy)--so maybe it's just genetic? Spiro made it low to the point I started getting chest pain, fainting spells, etc. Be careful about that. Though my mom takes it (also for PCOS) and has no blood pressure issues at all. I always used to get the weird looks and double checks from the nurses when i was 175lbs and my bp would be like 89/68 or somethign retarded like that. Like clearly a fat person can't have low bp...lol
--The first few weeks I did get some sickness with the Met. I find it's not necessarily the AMOUT of food I eat with it but that I HAVE to have some kind of carb with it (a small piece of bread, a little bit of potato, whatever)--low carb diet + metformin = disaster for me. But hang in there, it WILL pass. Radically decreased my low blood sugar episodes, not hungry all the time, etc. I feel like it kind of levels the playing field, so now going to the gym actually pays off. I would not say it is a miracle weightloss drug on it's own. I increased the dosage very slowly as well:
500mg 1x day (after dinner) for 2 wks
500mg 2x day (after breakfast, after dinner) for 2 weeks
1000mg 1x day (after dinner) + 500mg (after breakfast) for 2 weeks
1000mg 2x day (after dinner and after breakfast) for almost a year now.
Do also be careful to time it out. For example, if you sleep in and take it with breakfast at 10am, dont' take it with an early dinner at 5pm. Wait a little longer inbetween doses. Or be prepared to stay near a bathroom . Also, I do not take the time release (XR) stuff. That DID make me sick regardless of what I did (like vomiting kind of sick).
Hope this helps I am really glad for this board too. It's a little easier to discuss some of this stuff w/o being face to face, IMO.
__________________
Metformin 2000mg per day since Oct 07
Yasmin 1xday2001-March 2009
Spiro 50mg 1xday Oct 07-Jan 08; stopped due to bleeding and low BP side effects at higher dosages. Started again at 50mg March 09-present.
Propecia .5mg 1xday Jan 08-Dec08. Started again March 09-present
Diagnosed in 2001. Found a Dr that would treat me for PCOS in 2007.
Feel free to contact me with specific questions--I am always glad to help a fellow cyster To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
Thank you so much for all of your help. I will definetly go out and buy that face stuff asap. I must be really fat because I think 175 is like my ideal weight I take the Metformin XR because the regular made me have like explosive diarrhea...haha gross but so true. Doxycycline does make my stomach hurt and I cannot take Amoxicillian because I am allergic to Penicillian...sometimes life is just great...haha. I definetly cannot concieve with my other meds either, unless I want my kid to have side effects like a crack baby haha. I am glad you found stuff that is working for you. Thanks so much again. You have been a blessing.
Take Care,
Boudica
Thanks for posting this. I think I might have rosacea, but maybe it's the Met. I did have issues with my face getting flushed and hot before the Met, but infrequently. Since reading your posts, I think it's the met. Because I have normally been taking 500mg in AM and 1000mg after lunch-I hardly have diarrhea since I changed from taking it 3 times daily. I normally get this flushing/hot face right after lunch time. I never thought about it being the Met.
when i first started taking metformin i too suffered HOT HOT cheeks. My friends joked they could fry an egg on me!! What the Dr eventuelly put it down to was me putting pressure on myself for losing weight. TTc etc and that I had caused a huge rise in blood pressure! Once i had sorted myself out and taken the pressure off, my blood pressure went down and the red hot cheeks disappeared too!
Metformin and facial flushing/burning? 
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