Can you remember being in a social situation or a work situation where everyone’s eyes were on you? You felt anxious about what you were doing and the result was that you started to blush, getting redder by the minute? Most people experience this from time to time and it’s particularly common in adolescence – excessive blushing at school can lead to a lot of amusement for others.

This article on excessive blushing is written by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

When excessive blushing becomes a problem...

Blushing is a normal physiological response – it happens in normal healthy people and it is thought to have evolved as part of sexual attraction and as a way to establish solid relationships. However, in the complex setting of modern society, excessive blushing can occur for no real reason. Because it is so obvious, it does tend to grab the attention of other people and many can’t help but comment on it. This draws further attention to your red face, which makes the blushing and the underlying embarrassment and anxiety worse, creating a cycle that can lead to the medical condition known as erythrophobia.

What is erythrophobia?

Erythrophobia is a fear of blushing. The knowledge that some situations are likely to make you blush, actually brings on excessive blushing. As your anxiety escalates, you blush even more, no matter how hard you try to stop. This becomes a serious problem for many people who find their fear of blushing hampers their social life and their work life. The idea of being the centre of attention in either a large or small group becomes intolerable and many sufferers respond by starting to avoid situations in which they might go red. This is why erythrophobia can lead to isolation, poor work prospects and fewer opportunities to have intimate and meaningful relationships. It can also lead to the development of Social Anxiety Disorder (SAD) or Generalised Anxiety Disorder (GAD), both of which may require medical and psychological treatment.

The link between erythrophobia and hyperhidrosis

Erythrophobia is often linked with another anxiety-related condition – hyperhidrosis, or excessive sweating. If you experience excessive blushing, it is also common for your face to sweat, particularly around the forehead and on the nose. During an attack of blushing you feel as though you face is on fire and sweat is pouring from you, causing even more embarrassment. Excessive sweating also extends to other parts of the body – the palms, armpits and feet.

Treating erythrophobia

Several treatments are available to help you cope with excessive blushing and erythrophobia:

  • Self-help and relaxation techniques can work in mild cases. Using deep breathing and muscle relaxation to calm down in social situations may work well to break the cycle of blushing and anxiety before it leads to more severe erythrophobia.
  • Facing your fears – some experts believe that the best way to cure yourself of excessive blushing and erythrophobia is to get used to doing the things that scare you most – like signing up for a course in public speaking. It is possible to be an extrovert and have erythrophobia – if this is you, this may be the best way forward.
  • Counselling and alternative therapies such as hypnosis can also have good results. Both of these aim to reduce your general level of anxiety, increase your self-confidence and self-esteem and to help you respond better to blushing when it happens.
  • Drugs used to treat erythrophobia help to control blushing by reducing anxiety. In severe cases, drug treatment with beta blockers or SSRI inhibitors may be recommended. Often, drug treatment is recommended in together with counselling as a way to break the cycle, so that you can control excessive blushing without the use of drugs after a time.
  • Surgical treatment may be considered in cases of erythrophobia that do not respond to any of the above treatments. Excessive blushing can cause such an impact that your quality of life that you may feel it is worth having surgery. A procedure that has been used with some success for excessive blushing as well as excessive sweating is an endoscopic thoracic sympathectomy (ETS). This involves clamping or destroying some of the sympathetic nerves in the upper chest, using a keyhole technique. The sympathetic nerves are responsible for physical responses to emotional signals; excessive blushing in response to social embarrassment being a perfect example of sympathetic nerve activity. By damaging key nerve fibres, it is possible to reduce the signals that travel to the face to set off blushing – you still may feel anxious and embarrassed, but your skin will not go red.

Life beyond erythrophobia

The fact that excessive blushing and the social embarrassment that goes with it are not life-threatening medical conditions can be little comfort to someone badly affected by erythrophobia. However, it is reassuring that many people have dealt with the problem using one or more of the available treatments. Once the association between social activities and blushing is broken, people usually find that they are more willing to try new things, move out of their comfort zone and increase their activities – all of which prevent a return to erythrophobia.

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