Treating blushing 

Blushing only needs to be treated if it's affecting your quality of life or if it's caused by an underlying condition.

The types of treatment recommended will depend on the cause.

Psychological conditions

Your GP may suggest that you try a psychological treatment if your blushing is caused by an irrational fear of blushing (erythrophobia), social phobia or generalised anxiety disorder (GAD).

Cognitive behavioural therapy (CBT) is a widely used treatment for these conditions. This is a type of therapy based on the idea that unhelpful and unrealistic thinking leads to negative behaviour.

CBT aims to break this cycle and find new ways of thinking that can help you behave in a more positive way.

For example, many people with a fear of blushing think others will make fun of them if they blush. As part of treatment, the therapist could suggest that this fear is based on an unrealistic thought. Most people are generally supportive and don't take pleasure in the embarrassment of others.

So a more realistic thought might be: "I may come across as a person who is shy, but other people will usually be happy to accept this and often will make extra effort to engage with me".

A course of CBT on the NHS usually consists of around six weekly sessions, with each session lasting an hour.

Medications, such as a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI), can also be used to reduce feelings of fear and anxiety.

Read more about treating phobias and treating generalised anxiety disorder.

Rosacea

If blushing is the result of rosacea, avoiding potential triggers such as stress, prolonged exposure to sunlight and spicy foods may help.

Blushing can also be camouflaged using a green colour-corrective moisturiser. This type of moisturiser is also useful for covering up broken veins. Some colour-corrective moisturisers can be used under a foundation. Others can be particularly useful for men with blushing problems. Hypo-allergenic brands for sensitive skin are also available.

Few medications have been shown to be effective in reducing blushing caused by rosacea, although laser and intense pulsed light (IPL) treatments can sometimes help by shrinking the blood vessels in your face.

Read more about treating rosacea.

Menopause

Many women experience hot flushes and blushing at the time of the menopause. In such cases, it can help to:

Hormone replacement therapy (HRT) or a medication called clonidine can also often help reduce hot flushes caused by the menopause. Certain antidepressants such as venlafaxine and fluoxetine  may be useful too, although these medications are unlicensed for this use.

"Unlicensed" means the medication hasn't undergone clinical trials to see whether it's a safe and effective treatment for your condition. However, doctors sometimes consider using an unlicensed medication if they think it's likely to be effective and the benefits outweigh any associated risks.

Read more about unlicensed medicines and treatments for the menopause.

Surgery

In the most severe cases of facial blushing, where other treatments haven't helped, a type of surgery called endoscopic thoracic sympathectomy (ETS) may be considered.

This is a surgical procedure where the nerves that cause the facial blood vessels to dilate (widen) are cut. The operation is carried out under a general anaesthetic, which means you'll be unconscious during the procedure and won't feel any pain while it's carried out.

At the start of the procedure, small incisions will be made beneath one armpit, and a thin, flexible tube with a camera on the end (endoscope) will be inserted through an incision.

The surgeon will be able to locate the nerve that controls the blood vessels in one side of your face. Special surgical instruments can then be inserted through another incision and used to cut the nerve.

When this is complete, the surgeon will repeat the process on the other side of your body.

Although most people are satisfied with the results of ETS, the procedure doesn't always work and some people experience short- or long-term complications afterwards.

Some of the main risks of ETS include:

  • excessive (compensatory) sweating – as the cut nerves also control sweating in some areas of the body, the procedure can cause other areas of your body to sweat more
  • Horner's syndrome  where nerve damage causes the upper eyelid on one side of the body to droop
  • pneumothorax  where air gets into the chest cavity and needs to be drained by inserting a temporary tube

Due to problems such as these, particularly excessive sweating, some people regret having ETS. If you're considering this type of surgery, make sure you discuss the possible risks and benefits with your doctor or surgeon beforehand.

The National Institute for Health and Care Excellence (NICE) has more information about endoscopic thoracic sympathectomy for primary facial blushing.




Page last reviewed: 10/03/2016

Next review due: 01/03/2019