Scientists are still unsure what causes blushing, which is different from redness caused by physical conditions. Blushing is triggered by embarrassment or anxiety and occurs in the cheeks due to more capillary loops and larger blood vessels. Those with pale skin are more noticeable, and adolescents blush more often. Blushing can cause lifestyle issues and erythrophobia, a fear of blushing, which is linked to social anxiety disorder. Some people suffer from idiopathic craniofacial erythema, which can be treated with cognitive behavioral therapy or surgery.
Although Charles Darwin once dubbed blushing “the most peculiar and most human of all expressions,” scientists have yet to figure out what exactly makes some people blush.
While flushing is often confused with redness, the two problems have very distinct differences. The redness generally extends over more of the face, neck, and upper chest. It also typically has an identifiable physical cause, such as rosacea, menopause, carcinohyoid syndrome, or a bad reaction to certain types of prescribed medications. By comparison, the blushing is limited to the cheeks and triggered by embarrassment or anxiety.
From a physiological point of view, redness occurs in the face because, per square millimeter, the skin of the face has more capillary loops, as well as more vessels per unit volume than other parts of the body. Also, the blood vessels in the cheeks tend to have a larger diameter and are closer to the surface of the skin. Fluid in cheek tissue does not tend to obscure blood vessels as much as in other parts of the body. When the body is faced with stress, the “fight or flight” responses kick in and release the extra adrenaline that stimulates the sympathetic nervous system to cause the face to flush.
Many different types of people have problems with redness, but the condition is most noticeable on those with very pale skin. Although women tend to blush more often than men, they are also better at covering up their problem with skillful makeup application. Statistically, adolescents blush more often than adults, but scientists aren’t sure whether this is caused by hormonal changes at puberty or a lack of adequate coping mechanisms for stressful situations.
While many people blush at some point in their lives, the condition can cause serious lifestyle issues for some individuals. People who blush regularly may feel so self-conscious about their problem that they avoid potential triggers like meeting new people, speaking in front of large groups, or trying new activities. People who modify their daily activities based on a fear of blushing are said to suffer from erythrophobia, a term which literally means ‘fear of blushing’. People with erythrophobia will experience symptoms such as dry mouth, nausea, shortness of breath, dizziness, heart palpitations or excessive sweating when faced with a situation that caused them to blush profusely in the past. Because erythrophobia is linked to social anxiety disorder, the condition is usually treated in much the same way.
Some people also suffer from a disorder known as idiopathic craniofacial erythema, which causes them to blush with little or no provocation. This condition is usually treated with cognitive behavioral therapy, although more extreme cases can sometimes be helped by a surgical procedure called an endoscopic transthoracic sympathectomy, in which parts of the sympathetic nerve trunk are burned, removed, severed, or blocked off to prevent the blush reflex.
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