Flushing: Neuroendocrine Mechanisms and a Structured Diagnostic Approach
Manuel Ramón García-Sáenz1, Ernesto Sosa-Eroza1, Aldo Ferreira-Hermosillo2
1Servicio de Endocrinología, Hospital de Especialidades "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Clinical Endocrinology
|May 12, 2026
Summary
Flushing, a common symptom of heat and redness, signals underlying neuroendocrine and vascular issues. Understanding these mechanisms aids in diagnosing serious conditions by distinguishing between wet and dry flushing.
Area of Science:
- Neuroendocrinology
- Vascular Biology
- Dermatology
Background:
- Flushing is a common symptom of vasodilation and erythema, often with heat sensation.
- It can indicate various endocrine, neuroendocrine, autonomic, inflammatory, pharmacologic, or neoplastic disorders.
Purpose of the Study:
- To review neuroendocrine and vascular mechanisms of flushing.
- To propose a structured diagnostic approach based on symptom patterns and pathophysiology.
Main Methods:
- Narrative literature review on thermoregulation, neuroendocrine signaling, and vascular control.
- Synthesis of evidence to develop a mechanistic framework and diagnostic algorithm.
Main Results:
- Flushing involves disrupted thermoregulation, involving hypothalamic nuclei and peripheral pathways.
- Vasoactive mediators like serotonin, histamine, and prostaglandins play key roles.
- Neurotransmitters, endothelial function, and autonomic tone modulate vascular response.
Conclusions:
- Flushing reflects integrated neuroendocrine and vascular dysregulation, not just a skin issue.
- Distinguishing wet vs. dry flushing and using a mechanism-based approach improves diagnosis.
- This facilitates earlier identification of significant underlying disorders.
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