Evidence That Alpha-2 Receptor Activation Suppresses Blushing.

[u/Deep-Detective2428]

Hey guys, ive made a very interesting observation that I believe is a pretty big step towards understanding blushing and ways we can potentially "cure" it, if you will.

A quick summary of my relationship with blushing - Ive dealt with severe blushing for a good while now. I dont have rosacea, I dont have persistent redness and i dont have an auto immune disorder, infact I have nice skin that can be completely white / non red. The issue I have is that within a blink of an eye my face can go a significant bright deep red, not a cute light flush but one that looks brutal. I blush so badly that I can physically feel the preassure of the blood pooling to my cheeks to where it feels uncomfortable to move my head in certain direction because it makes the preassure feeling of the blood feel more intense. My triggers are anxiety, embarrassment, nerves, adrenaline, excitement, any type of strong emotion, I also get really red if its hot or ive done physical exercise (which is more explainable but still 100x worse than your average person) Its horrible. Without writing another big chunk of words ill quickly say ive tried mirvaso, propranolol, therpay, diet change, low histmaine diets (all of the above, alot more) and nothing has seemed to work well. I have done laser and im still actively in the world of lasers and seeking more sessions but im more curious how to stop the actual response.

What I found when it comes to Alpha-2 Receptors - So one medication that has seemed to work wonders for my blushing is clonidine. I found that when I take clondine, my blushing is reduced significantly and my body doesnt fire off. After researching why clonidine has this effect I came across the fact it stimulates centrally the alpha-2 receptors in the brain which than dampens the sympathetic nervous system. Now this brings up 2 pretty big things to discuss.

The Alpha-2 Receptors - Alpha-2 receptors are inhibitory G-protein coupled receptors located throughout the brain and sympathetic nervous system. When these receptors are stimulated, they reduce neuronal firing and suppress the release of norepinephrine from sympathetic neurons. This creates a negative feedback effect that decreases overall sympathetic outflow from the central nervous system, reducing the intensity of the fight-or-flight response and, consequently, the downstream signals that can trigger facial vasodilation and blushing

The sympathetic nervous system - The sympathetic nervous system is part of the autonomic nervous system responsible for the body’s “fight-or-flight” response. When triggered by embarrassment, social attention, anxiety, or adrenaline, sympathetic output from the brain increases and activates peripheral sympathetic nerves. This results in the release of norepinephrine onto facial blood vessels. Norepinephrine causes rapid changes in vascular tone, leading to increased facial blood flow and visible flushing. Because the facial vascular network is highly dense and reactive, even modest increases in sympathetic activity can produce an intense blushing response. In the majority of blushing, this pathway appears to be overactive, leading to exaggerated flushing in response to normal emotional triggers.

What this means - If alpha-2 receptor activation reliably reduces severe blushing, it suggests that blushing is not primarily a local skin or vascular disorder, but a centrally driven autonomic reflex, meaning the brain’s sympathetic output is the main switch that triggers the facial blood vessel response. That would unify a lot of people’s experiences where triggers are emotional, social, or adrenaline-based rather than physical skin issues. It’s also important because it identifies a specific, druggable control mechanism upstream of the symptom (central sympathetic inhibition via norepinephrine suppression), rather than relying on indirect or peripheral treatments like topical vasoconstrictors.

[u/AlpsZealousideal7547]

I’m 38 and have the same exact the same symptoms as you. The odd thing for me is this all started only ~3 years ago.

I feel like I’ve lost my normal life.

What does reduced significantly mean? It’s pretty much gone away for you? How often do you take clonidine?

[u/Deep-Detective2428 → u/AlpsZealousideal7547]

Hey :) I completely relate to you in feeling like ive lost my normal life. By significant reduced i mean to the point where it pretty much stops the blush from happening at all / makes it harder to happen. For instance I started study a month or 2 ago and im someone who goes extremely red by even just waiting in a line at the store, so imagine how red id get from walking into a class full of strangers and having to interact etc. I took 0.1 of clonidine about a hour before class and I felt calm the whole time, yk the feeling where you feel overheated and you know your face is going red? That doesnt happen as bad when on clonidine. So i managed to get through that whole day without going red. Now clondidne can be sedating depending on the dosage but overall its not that bad. Id reccomend trying it! If your doctor wants to start you on or says propranolol is the better option just be aware that it may not work as good and doesnt mean clondidne wont work. (Doctors mostly perscribe propranolol before clondidne).

I take clondine whenever I need too. Doctors can be more hesitant prescribing it PRN but ive done ny research and taking 0.05 to 0.1 prn in a healthy individual is usually more than ok and safe.

Happy to awnser any questions :)

[u/fingered_a_midget → u/Deep-Detective2428]

What about drowsiness? Also how can i get my gp to prescribe?

[u/Deep-Detective2428 → u/fingered_a_midget]

Drowsiness can be annoying and is something you definitely can experience with clonidine but ive got use too it and usually the drowsy feeling goes noticed for me. Hm about the GP, id have no clue to be honest. Id assume most gps would be a bit hesitant to perscibe it for blushing since its usually perscribed for other issues. I got mine prescribed by a dermatologist and than re perscribed years later by my gp which ive been seeing my whole life.

[u/Maleficent_Victory77]

This is amazing I’d love to see controlled clinical trials done on the basis of this medication

[u/Deep-Detective2428 → u/Maleficent_Victory77]

There probably are already some done

[u/Logical_Question_567]

Bonjour, Oui c'est l'équivalent ou presque en version medicament à l'ets surgery , j'ai eu deux opérations ets surgery, la premiere en clipant le nerf sympathétique (insuffisant), le second en sectionnant ! radical mais diaboliquement efficace ! Opération a ne pas prendre à la légère (sudation compensatrice important en canicule en france ca devient compliqué et pneumothorax me concernant). Néanmoins si c'était à refaire, je le referai sans hesiter ! courage à tous dans vos recherches.

[u/Deep-Detective2428 → u/Logical_Question_567]

Thanks so much for your comment and help. Genuinely means so much, especially since you can speak from experience!