Polycythemia vera (PV) is a rare type of blood condition in which the body’s bone marrow produces too many blood cells. The increase in blood cells in PV is usually the highest with red blood cells (erythrocytosis), although most people diagnosed with PV also have more white blood cells and platelets than normal. One of the less common symptoms of polycythemia vera is a red, flushed face.

Not everyone with PV will experience facial redness or flushing. If you or someone you love has been diagnosed with PV and has this symptom, talk to your health care provider or an oncology (cancer) specialist. They can work with you to find the best way of managing facial redness and flushing.

How Do People Experience Facial Redness With Polycythemia Vera?

When people experience facial redness and flushing with polycythemia vera, they usually have other symptoms. These other symptoms of PV can include:

• Nausea
• Fatigue
• Headaches
• Dizziness
• Shortness of breath
• Vision issues, especially when lying down
• Night sweats
• Itchy skin (pruritus)
• High blood pressure (hypertension)
• Blood clots

These symptoms may be nondescript and vague for years before a person is diagnosed with PV. Because PV is so rare, most physicians begin by treating the symptoms individually. It is hard to recognize that they are all occurring together as signs of a larger issue.

Watch Dr. Andrew Kuykendall talk about flushing and itching in PV.

What Causes Facial Flushing in Polycythemia Vera?

The high number of red blood cells in the veins and arteries means that the blood becomes thick. This makes it harder for the blood to circulate through the body and can cause a variety of symptoms, including dizziness, itchiness, headaches, nausea, and blood clots. Over time, the body may lose its ability to produce red blood cells due to scar tissue formation in the bone marrow, leading to other problems as well.

Facial flushing can occur in polycythemia vera because of the number of red blood cells in the body and the slow speed at which they are moving through the veins and arteries. These concentrated, slow-moving red blood cells can accumulate in the veins, arteries, and capillaries under the surface of the skin, causing the face to appear red or flushed.

A histamine reaction can also cause the skin to look red. This occurs because high levels of blood cells can trigger the immune system to produce a chemical (histamine) that is released during allergic reactions in response to certain stimuli, like hot water. This can make the skin itch, causing the redness you see. Scratching can make the itch worse.

Finally, PV can also cause bruising, even in locations where there has been no injury or only a minor one. In the beginning, bruises can look red. If these areas occur on your face, it might look red for a while before the bruise changes color or fades.

Other Potential Causes of Facial Redness and Flushing

Most people diagnosed with PV receive their diagnosis after a blood test. When the test shows a high red blood cell count, your health care professional will then need to eliminate other causes before they can diagnose PV. Some people will also need a bone marrow biopsy to confirm their diagnosis.

If your health care provider is unsure of the cause of your flushing, they may perform physical exams or order diagnostic tests for other conditions that can cause this symptom, including:

• Rosacea
• Hyperthyroidism
• Menopause

Rosacea

Rosacea is a skin condition that features small, red bumps on the face, as well as easily triggered flushing of the facial skin.

Hyperthyroidism

Flushed skin is one potential symptom of hyperthyroidism, or an overactive thyroid gland.

Menopause

Menopause — the time when menstruation ends — frequently causes individuals to experience hot flashes and facial flushing.

Managing Facial Redness and Flushing With Polycythemia Vera

There are many ways to treat the facial redness and flushing that can come with PV. Be sure to ask your health care provider or oncologist for medical advice to find the best treatment option for you. Let them know if a treatment isn’t working — if your facial redness persists, it’s time to try new treatments until you figure out what works for you.

Treat Your Polycythemia Vera

Because a red, flushed face is a consequence of PV, finding an effective treatment for the PV itself should help manage this symptom. You have many options when it comes to treating PV.

Phlebotomy

Venesection (also known as phlebotomy) involves regularly removing blood from your body (in the same way that you would donate blood). It helps keep your blood volume and blood cell counts in the normal range. This will help your blood flow normally again and should relieve many PV symptoms. The goal is to create a deficiency of iron in the body, which will limit the increase in red blood cells.

Medication

PV is most commonly caused by a genetic mutation in the JAK2 gene. If you test positive for it, you may be able to take medication targeted toward undoing the effects of that mutation. Other drugs — including chemotherapy drugs (like interferon or hydroxyurea), antihistamines, low-dose aspirin, and more — can be used to combat and manage the effects of PV.

Managing Facial Flushing

There are several ways of relieving a red, flushed face at home. Your doctor can help you determine the most effective ways of managing this symptom alongside your PV treatments.

Cool Your Face

If the redness in your face causes you to feel hot (or if heat brings out the redness), cool your face or body using damp compresses. Hold the compress to your face until you begin to feel better. Avoid taking hot baths and showers, as they can cause the skin to become red, inflamed, and itchy in those with PV.

Limit Sun Exposure

Avoid prolonged sun exposure and tanning beds to help reduce facial redness. Covering the skin with loose-fitting light clothing, wearing a wide-brimmed hat, and using SPF 30 or higher sunscreen will help keep your skin safe.

Drink More Water

Drinking more water can help thin your blood and keep it moving. Although it cannot change your number of blood cells, staying hydrated helps your body function as well as it possibly can. Experts recommend drinking six to eight glasses of water each day. You can sip water throughout the day or drink each glass in one sitting. Avoid dehydrating beverages with caffeine, alcohol, and sugar for maximum effectiveness.

Reduce or Avoid Tobacco

Tobacco products contain nicotine, which causes the blood vessels to narrow. This can make it even harder for your body to push thickened blood where it needs to go. It also puts you at an increased risk of suffering a stroke or a heart attack. Smoking can also increase your red blood cell count.

If you smoke, talk to your doctor about making a plan to stop. This could make you feel better relatively quickly and have monumental benefits for your overall health.

Find Your Team Today

Join myMPNteam today, the online social network for people diagnosed with myeloproliferative neoplasms, including PV. When you join, you’ll find a community of people from all over the world who can answer your questions and offer support. Reach out today to find answers to your questions, join in ongoing conversations, and get to know other people with PV.

Have you experienced facial redness or flushing with PV? Share your experience or tips for managing the symptom in the comments below or by posting on myMPNteam.