Blushing

Introduction

Blushing is when your face, ears, neck and, occasionally, your upper chest, become red in colour. The redness is sometimes accompanied by a hot feeling in the area. Blushing is sometimes referred to as 'flushing' by health professionals.

Your skin contains a network of small blood vessels which have tiny muscles inside the walls. Usually, these muscles are partly squeezed (contracted). Extreme contraction causes the blood vessels to close down so that less blood passes through them.

If the blood cannot flow easily, the skin becomes pale and white. When the muscles are completely relaxed, the blood vessels widen (dilate). This allows more blood to pass through the skin, which makes it red.

Blushing affects both men and women, but is more common in teenagers due to anxiety, feeling nervous, or hormonal activity.

The autonomic nervous system

The small muscles in the blood vessels are controlled by the autonomic nervous system. This system is the network of nerves in the body that produce automatic reactions. You do not have any control over it.

The autonomic nervous system can be affected by factors such as heat, illness, and emotions. If you are the type of person that tends to blush easily or regularly, it may be because you feel embarrassed or angry. Other types of emotions can also cause you to blush – for example, feeling excited.

Sometimes, the reason for blushing is due to the autonomic nervous system working too hard.

Some people blush more easily than others. For example, after eating spicy food, the face of one person may become slightly flushed, whereas someone else eating the same food can become very red. Severe cases of blushing are known as idiopathic cranio-facial erytherma.

Related conditions

Rosacea

Rosacea is a common skin condition of the face that causes redness that looks like blushing. Rosacea occurs when the face becomes inflamed, and it is caused by the permanent widening of the blood vessels in the skin of the cheeks and nose. It can also affect the eyes.

Hyperhidrosis

Some people who get facial blushing may also have excessive sweating, particularly of the face or hands. This condition is known as hyperhidrosis.

Other medical conditions

Flushing of the face can be linked to medical conditions, such as the menopause. In the majority of cases, blushing is not usually linked to any serious medical conditions.

However, there is a rare disorder called carcinoid syndrome, which causes flushing of the face. The flushing lasts for about 20 minutes each time, and is usually accompanied by:

  • Stomach pains.
  • Palpitations (irregular heartbeats).
  • Diarrhoea.

You should seek medical advice if you have facial flushing and all of these symptoms.

Blood vessels


Blood vessels are the tubes in which blood travels to and from parts of the body. The three main types of blood vessels are veins, arteries and capillaries.

Blood


Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.

Anxiety


Anxiety is an unpleasant feeling when you feel worried, uneasy or distressed about something that may or may not be about to happen.

Stomach


The sac-like organ of the digestive system. It helps digest food by churning it and mixing it with acids to break it down into smaller pieces.

Pains

Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.

Palpitations


Palpitations refer to an irregular heartbeat, or the sensation of skipped or extra heartbeats.

Diarrhoea


Diarrhoea is the passing of frequent watery stools when you go to the toilet.
Last updated: 04 October 2011

Causes of blushing

Blushing is usually a natural response to emotions, such as anger, guilt and embarrassment.

Other common causes of blushing include:

  • drinking alcohol,
  • carcinoid syndrome, which is a collection of symptoms due to a tumour which produces large amounts of hormones,
  • eating hot, or spicy, foods,
  • drinking hot drinks,
  • menopause,
  • a high temperature or fever of 38C (100.4F) or above,
  • sudden hot or cold temperatures,
  • exercise, due to an increase in body temperature, and
  • monosodium glutamate, which is a chemical that is sometimes added to food to improve flavour.


Certain medications that are often used to treat a range of different conditions can also cause blushing. They include:

  • chlorpropramide (for diabetes),
  • tamoxifen (for breast cancer),
  • raloxifene (for osteoporosis),
  • calcium-channel blockers (for angina or high blood pressure),
  • calcitonin (for some bone disorders), and
  • glyceryl trinitrate and isosorbide dinitrate (for angina).


Certain medications that are sometimes used to treat prostate tumours in men can also cause blushing. These are:

  • buserelin,
  • triptorelin,
  • goserelin, and
  • leuprorelin.


Phobia

Some people have a fear, or phobia, about blushing. The medical name for this is erythrophobia and it is linked to social phobia.

Social phobias may occur as a result of an anxious, upsetting or intense experience in a social situation. Or, it may be that your social confidence did not have the chance to fully develop past the normal stage of shyness as a young child.

 

Glossary

Brain
The brain controls thought, memory and emotion. It sends messages to the body controlling movement, speech and senses.
Blood vessels
Blood vessels are the tubes in which blood travels to and from parts of the body. The three main types of blood vessels are veins, arteries and capillaries.
Blood
Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.
Hot flushes
A hot flush (also known as a hot flash) is a temporary feeling of heat in the face, neck and upper body, causing the skin to become flushed and sweaty.
Fever
A high temperature, also known as a fever, is when someone's body temperature goes above the normal 37°C (98.6°F).
Last updated: 04 October 2011

Treating blushing

The treatment for blushing will depend on what is causing the condition. If blushing is due to another condition, such as the menopause, or a skin disorder, such as rosacea, the condition needs to be diagnosed and treated appropriately.

Teenagers tend to grow out of blushing if it is caused by anxiety, feeling nervous, or hormonal activity.

If flushing is triggered by eating hot and spicy foods, or drinking alcohol, avoiding these triggers will help to control your symptoms.

Psychological treatments

If your blushing is caused by nervousness, or social phobia, there are a number of psychological treatment options available including:

  • Cognitive behavioural therapy (CBT) - a form of therapy that helps to identify and eliminate unwanted thoughts, and can help you to change your behaviour in response to those thoughts.
  • Breathing techniques - to help relieve anxiety and rapid breathing.
  • Changing thoughts - a technique to change and redirect your thoughts so blushing episodes are reduced.
  • Clinical hypnotherapy - a technique that may help you to reduce your fear of blushing.
  • Paradoxical intention - a technique to intentionally bring on symptoms of blushing to cancel out the anxiety.


Colour-corrective moisturiser

Blushing can be camouflaged using a green colour-corrective moisturiser. They are also useful for covering up broken veins.

Some colour-corrective moisturisers can be used under a foundation. Others that are suitable for using on their own can be particularly useful for men with blushing problems. Hypo-allergenic brands are suitable for sensitive skin, and can be bought over-the-counter (OTC) from your local pharmacist.

Endoscopic thoracic sympathectomy

Surgery may be considered in cases of severe facial blushing which are accompanied by excessive sweating (hyperhidrosis).

An endoscopic thoracic sympathectomy (ETS) can be performed, in which some of the nerves that cause your facial blood vessels to widen are cut. Surgery is performed under a general anaesthetic.

Glossary

Palpitation.
Palpitations refer to an irregular heartbeat, or the sensation of skipped or extra heartbeats.
Anxiety
Anxiety is an unpleasant feeling when you feel worried, uneasy or distressed about something that may or may not be about to happen.
Blood vessels
Blood vessels are the tubes in which blood travels to and from parts of the body. The three main types of blood vessels are veins, arteries and capillaries.
Heart
The heart is a muscular organ that pumps blood around the body.
Last updated: 04 October 2011

Complications of surgery for blushing

Haemothorax

Recent studies have shown that surgery is not always an effective treatment method for blushing because it can cause sudden and severe complications in some patients, such as haemothorax.

Haemothorax is when blood gathers in the space between your lungs and the walls of your chest (pleural cavity).

Horner's syndrome

Other patients have experienced adverse effects after having surgery for blushing, such as Horner's syndrome, which affects the nerves and muscles of the eye and eyelid.

Horner's syndrome causes your eyelid to droop and your eye to appear sunken into your face. The pupil of your eye gets smaller and there is also a reduction of sweating in the affected part of your face.

Compensatory excessive sweating

Another common side effect following surgery for severe blushing is compensatory excessive sweating. This is where you sweat in other areas of your body in contrast to your original problem areas .

Sweating is the natural way for your body to regulate your temperature. As surgery involves cutting some of the nerves in your face, which stops sweating in that area, your body may compensate causing sweating to occur in other areas.

Last updated: 04 October 2011