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.

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.

In such cases, it can help to:

• avoid possible triggers, such as stress, spicy foods, caffeine, smoking and  alcohol
• exercise regularly  
• lose weight  if you're overweight or obese
• wear light clothing

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.

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 .