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Symptoms of MCAS include flushing, itchy skin, low blood pressure, constipation and/or diarrhea, abdominal pain, shortness of breath, and nasal congestion.[ref] The symptoms of MCAS are driven by excess histamine and overlap with histamine intolerance

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Topical prescription agents such as hydroquinone, retinoids, azelaic acid, or tranexamic acid are applied directly to affected areas and are used under medical supervision to influence pigment production and skin renewal processes

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doi: 10.1016/j.clinthera.2019.04.028 5