BLUSHING & SWEATING

Blushing and/or sweating are problematic anxiety symptoms for some social phobia sufferers. When people get nervous they may find they have sweat dripping down their forehead, or large wet patches under their arm pits. Obviously, severe sweating is visible to others and facial sweating may be particularly distressing for women who like to wear makeup as sweating can make foundation run. Fear of sweating can lead to people (1) adopting hairstyles which obscure their face, (2) favouring clothes which they think are less likely to reveal sweat and (3) avoiding shaking or holding hands because their palms are sweaty.

Blushing can also lead to people adopting hairstyles which obscure their face. People who blush down their neck and/or chest may also resort to wearing roll neck jumpers, button up shirts. and turning up their collar

Why do I blush?

When people are exposed to embarrassment or stress, the fight or flight response stimulates the release of extra adrenaline into the bloodstream.. Adrenaline affects the sympathetic nervous system and widens blood vessels throughout the body by altering the muscle tone of blood vessels. When the muscle tone in the blood vessel walls relaxes the blood vessels just below the skin fill and there is an increased volume of blood going to the skin. Given that we have red blood cells, not surprisingly our face, neck, ears, chest go red. People usually blush when they have done something embarrassing such as spilling their food or drink, or tripping over their feet, but people can also blush without there having been an embarrassing event.

Socially anxious people fear that their blushing will be negatively interpreted by others as e.g. a sign of weakness, or dishonesty . However, it is also possible that people may think someone who is blushing is shy or nervous, ill or sensitive. Fearing blushing actually increases the probability someone will blush as it increases the activity of the sympathetic nervous system.

SOME TREATMENT OPTIONS FOR BLUSHING AND/OR SWEATING

ANTIPERSPIRANTS
People with excessive sweating may find some antiperspirants helpful. Antiperspirants with aluminum chloride and ethyl alcohol are recommended.

COGNITIVE BEHAVIOURAL THERAPY
Cognitive behavioural therapy (CBT) would challenge the sufferer's beliefs as to how other people view blushing and/or sweating, ie. it's possible an onlooker may think your blushing is cute rather than indicative of dishonesty.
CBT may challenge the sufferers beliefs about how visible the blushing and/or sweating is. ie your blushing/sweating often feels worse than it looks.
CBT would also involve getting the sufferer to confront the situations where they fear blushing and/or sweating. If the person's anxiety about blushing/sweating decreases so will the blushing/sweating.

MEDICATION
Beta blockers may be helpful for people with blushing and sweating, however beta blockers have side effects such as tiredness and low blood pressure. Amitryptilline, an antidepressant, alleviates sweating but has the side effects such as: dry mouth, weight gain and dizziness. Anticholinergic drugs may be helpful but their most commonly experienced side effect is a severely dry mouth. Other side effects include constipation, blurry vision, memory impairment and increased heart rate.

BOTOX
Botox can be injected into the hands, face and underarms, to paralyse the nerves that stimulate the sweat glands. However multiple injections are needed and it wears off after a number of months, therefore repeated injections may be necessary. These injections do involve some degree of pain and as most people do not wish to have multiple injections in their hands and face, Botox is usually only used to combat underarm sweating. Botox injections into the hand have been associated with temporary paralysis of hand muscles.

IACTOPHOESIS
This treatment for sweaty hands and feet involves a a low volt electrical current is applied to the hands and/or feet whilst they are submerged in water. This procedure can alleviate sweaty hands or even solve the problem for a short period.

SURGERY-ENDOSCOPIC TRANSTHORACIC SYMPATHECTOMY (ETS)
Another treatment option is to have a endoscopic transthoracic sympathectomy. The operation entails cutting part of the sympathetic nerve that runs down the backbone.. This medical procedure is an effective treatment for both blushing and facial and hand sweating. but there are complications that can occur during surgery such as: e.g. excessive bleeding, a reaction to the anaesthetic or pneumothorax, where the lung collapses. There can also be side effects of the procedure e.g. although the sweating in the face and hands may be relieved some people find they then sweat more in areas such as the chest, back and legs. Some people end up with Horner's Syndrome, eyelid droop due to nerve damage, following ETS.

REFERENCES
www.hyperhydrosis.org
www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Anxiety_disorders
www.endsweat.com
www.sweaty-palms.com

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