Differential diagnosis and treatment of flushing in rosacea: current data and clinical practice

There is a limited amount of data on this subgroup of patients and the potential variation of patient management. This article analyzes and systematizes current knowledge on the pathophysiology and differential diagnosis of flushing in rosacea and hot flashes as a menopause symptom. A clinical case is presented, highlighting the successful use of topical therapy combined with an advanced modality of intense pulsed light (IPL) therapy (broadband light, BBL) in a female patient exhibiting flushing associated with overlapping erythematotelangiectatic and papulopustular subtypes of rosacea. This case serves as a vivid demonstration that novel treatment approaches targeting key factors implicated in the rosacea pathogenesis are currently being developed, implemented, and refined. To optimize patient adherence, it is essential to discuss treatment duration, expected time to clinical improvement, and the likelihood of achieving clear skin during consultations; additional factors such as adherence to general skin care routines, avoidance of trigger factors, masking techniques, photoprotection, the need for maintenance therapy, and possible side effects should also be addressed. KEYWORDS: rosacea, flushing, neurovascular dysregulation, erythema, proangiogenic molecules, overlapping rosacea subtypes, phototherapy. FOR CITATION: Ostretsova M.N., Kasikhina E.I., Kostetskaya A.V., Monakhova A.A., Zhukova O.V. Differential diagnosis and treatment of flushing in rosacea: current data and clinical practice. Russian Medical Inquiry. 2025;9(6):346–352 (in Russ.). DOI: 10.32364/2587-6821- 2025-9-6-8