Facial blushing treatment

Excessive facial blushing is such a problematic anxiety symptom for some social phobia sufferers that they seek treatment. Sufferers of this condition find it highly embarassing that they flush so easily.

Cognitive Behavioural Blushing Treatment

People who fear blushing worry that:

  • “My face ( and neck and/or chest) will go red
  • “”People will notice if I blush””
  • “People will judge me negatively if they notice I’m going red””

Sufferers of excessive facial blushing may try to prevent themselves from going red by:

  • trying to stay cool ( e.g. turning on the air conditioning, under dressing, having cold drinks, avoiding hot drinks
  • avoiding eye contact
  • avoiding some topics of conversation which they fear may trigger redness

People who flush down their neck and/or chest may  resort to safety behaviours to prevent people from noticing they are flushing  such as

  •  wearing roll neck jumpers, button up shirts and turning up their collar
  • wearing heavy foundation on their skin,
  • covering their face with their hands,
  • wearing their hair long etc.
  • dimming lights or seeking out dark areas in a room

People with a blushing phobia may  volunteer a comment when they redden  about the room being hot or feeling sick,  in the hope that this will prevent observers from concluding that they are reddening due to anxiety and think badly of them for doing so. Excessive blushing sufferers may also avoid social situations where they fear they may go red, be the centre of attention etc.

CBT treatment starts by going over with the client one or more typical episodes of blushing. The psychologist obtains from the client a  description of a recent situation in which they blushed. Then the psychologist asks the client what thoughts they had in that scenario, what safety behaviours they used, what anxiety symptoms they experienced and whether they had an image in their head of how they might have appeared to observers ( e.g. turning as red as a mail box), whether they were aware of anxious feelings that they thought might be observable etc Cognitive behavioural treatment challenges the sufferer’s beliefs as to how

  1. other people view  blushing. For example, it’s possible an onlooker may think your facial blushing is cute rather than indicative of dishones
  2. how visible the redness is.

For instance, facial blushing often feels worse than it looks. Research by Professor Peter Drummond, professor of psychology at Murdoch University,  suggests that  the majority of people don’t redden as severely  as they believe they do. Professor Drummond found that there was very little correlation between  how severely people blushed and how much they believed they were reddening.  Catherine Madigan, clinical psychologist, offers video feedback in group treatment sessions to show sufferers how strongly they actually blush. Many people are pleasantly surprised, on watching their video, to find their  face/neck/chest is not as red as they believed. Treatment would also involve getting the sufferer to confront the situations where they fear going red. When confronting feared social and performance situations, the sufferer must abandon their safety behaviours. If the person’s anxiety and fear about facial blushing stops so will the redness

Catherine Madigan, Clinical psychologist in Hawthorn, Victoria offers cognitive behavioural therapy for social anxiety. Call now for an appointment (03) 9819 3671 or 0419 104 284 or email anxietyaustralia.com.au@gmail.com

You can read more about her work with facial blushing sufferers here in an article which appeared in the Sydney Morning Herald, “Good Weekend”


Medication Treatment

Beta blockers may be helpful for people with excessive blushing, however beta blockers have side effects such as tiredness and low blood pressure.

Surgical Blushing Treatment-Endoscopic Transthoracic Sympathectomy (ETS)

This medical procedure has complications that can occur during surgery such as excessive bleeding, a reaction to the anaesthetic, or pneumothorax, where the lung collapses. There can also be serious side effects of the procedure. For example, although the facial blushing  may be relieved, some people find they then sweat more in areas such as the chest, back and legs. This is called compensatory sweating. Some people end up with Horner’s Syndrome, eyelid droop due to nerve damage, following ETS. There are other negative serious side effects of surgery but only a few are listed here. ETS surgery is a last resort, all other treatment options should be explored first. Some people who have have undergone ETS surgery deeply regret their decision and say the side efffects are far worse than the reddening was and wish they had never undergone the procedure. I have met some social anxiety sufferers who have had the ETS operation, and although it stopped them from going red, some of them reported that they still had the sensation that they were going red. Some people who had had the operation were still presenting for treatment for social anxiety; having the operation had not solved all their anxiety issues.

This article published on Nov 10, 2012. View related Articles

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