Blushing

What is blushing?

Blushing is a sudden reddening of the face, neck and occasionally, upper chest. Blushing is the result of neurological flushing. It occurs most often after a high level of anxiety, for example it may occur in a person during a presentation, meeting or social situation where they are anxious of being judged, criticised and evaluated by other people. However, blushing also occurs without stress or anxiety. Some individuals are born to blush excessively without any apparent emotional stimuli. Blushing can cause severe embarrassment and frustration to anyone who experiences it regularly and it can often lead to social phobia or other anxiety disorders. Erythrophobia is the name given to the compulsive state related to the fear of blushing.

What causes blushing?

As part of the “fight or flight” response when we are exposed to environmental or emotional stimuli, the body responds via the sympathetic nervous system. This causes the widening of small blood vessels (capillaries) just beneath the surface of the skin, hence blushing occurs.

What treatment is available?

In most people facial blushing takes a minute or two for the blush to disappear, hence causing slight embarrassment. However, in some people severe and frequent blushing can become a real hindrance and affect both personal and professional life. Several treatments are available for severe facial blushing.

Psychological treatments

Cognitive behaviour therapy – this is a form of psychotherapy that helps you to weaken the connections between troublesome situations and how you react to them, e.g. blushing (behaviour therapy), and teaches you awareness of how certain thinking patterns cause you to blush (cognitive therapy). For more information on cognitive behaviour therapy see www.cognitivetherapy.com.

Drug treatments

Several medications are available to help treat facial blushing. See your doctor for suitability of medical treatments.

• Anxiety medications – used to help calm the person and reduce frequency and/or severity of blushing
• Clonidine – used to treat uncontrollable facial blushing by reducing the widening of blood vessels that results in blushing
• Beta-blockers – manage the symptoms of anxiety such as blushing and heart palpitations.

Surgical treatments

Often blushing occurs alongside hyperhidrosis (excessive sweating). Endoscopic thoracic sympathectomy (ETS) is a surgical treatment considered an effective way to treat severe facial blushing and hyperhidrosis. The operation is performed under general anaesthesia and involves clamping off parts of the overactive sympathetic nerves that causes these symptoms. Because of the risks associated with surgery under general anaesthesia, this procedure should only be performed if other more conventional therapies have failed. Side effects include hyperhidrosis (increased sweating).