From the Guidelines
Facial flushing, also known as erythema, is primarily caused by the dilation of blood vessels beneath the skin in response to various triggers, including emotional stimuli, physical factors, and underlying medical conditions, as noted in a study published in the British Journal of Dermatology in 2017 1.
Causes of Facial Flushing
The causes of facial flushing can be categorized into several factors, including:
- Emotional triggers, such as embarrassment, anxiety, or stress, which activate the sympathetic nervous system, leading to the release of adrenaline and subsequent dilation of blood vessels in the face 1
- Physical factors, such as alcohol consumption, spicy foods, hot temperatures, and certain medications, which can affect blood vessel dilation and contribute to facial flushing 1
- Underlying medical conditions, such as rosacea, a chronic inflammatory disease of the skin that can cause erythema, telangiectasia, papules, pustules, and other symptoms 1
- Genetic factors, heightened sensitivity to social situations, or conditions like social anxiety disorder, which can increase the frequency and severity of blushing 1
Triggers of Facial Flushing
Common triggers of facial flushing include:
- Public speaking
- Receiving attention or compliments
- Being the center of attention
- Experiencing embarrassment
- Consuming alcohol or spicy foods
- Exposure to hot temperatures
- Certain medications, such as beta-blockers or vasodilators
Treatment of Facial Flushing
Treatment options for facial flushing depend on the underlying cause and severity of the condition. For those experiencing problematic blushing, treatments may include cognitive behavioral therapy to address underlying anxiety, beta-blockers to reduce physical symptoms, or in severe cases, endoscopic thoracic sympathectomy surgery, though this last option carries risks and is typically considered only after other approaches have failed 1. Additionally, topical therapies, such as microencapsulated benzoyl peroxide, may be effective in reducing erythema and other symptoms of rosacea 1.
From the Research
Causes of Facial Flushing
- Facial flushing, also known as erythema, can be caused by various factors, including rosacea, a chronic skin disorder characterized by persistent painful facial flushing and often accompanied by papules and pustules 2
- Emotionally triggered blushing can also contribute to facial flushing, which may be mediated by the sympathetic nerves 3
- Social phobia and anxiety can exacerbate facial blushing, having a strong negative impact on the quality of life 4, 5
- Other factors that can cause flushing include medications, menopause, carcinoid syndrome, pheochromocytoma, polycythemia, and mastocytosis, although it can occur without known cause 6
Triggers of Facial Flushing
- Receiving attention from other people can trigger uncontrollable and rapidly developing blushing 3
- Stressful situations can also contribute to facial blushing, as well as heart palpitations 4
- Childhood blushing has been reported more frequently in individuals with rosacea, suggesting a possible link between childhood experiences and later development of facial flushing 2
Treatment Options
- Cognitive-behavioral therapy may help to reduce social anxiety in people with severe rosacea and fear of blushing 2
- Thoracoscopic sympathectomy and endoscopic transthoracic sympathicotomy are surgical options that have shown effectiveness in treating facial blushing 3, 4
- Pharmacologic treatments, such as propranolol, have also been used to suppress flushing reactions, particularly when associated with anxiety 6