Facial blushing

"At the Clinica we have developed an alternative treatment consisting of the application of percutaneous radiofrequency, with radiological control, in charge of transmitting the nerve impulses that trigger sweat".

DR. AGUSTÍN ESPAÑA ALONSO
DIRECTOR. DERMATOLOGY DEPARTMENT

Facial blushing is a natural, everyday physiological reaction that anyone can experience in any situation in their life and that is triggered by situations that activate our warning system or occur in response to physical or psychological stimuli.

The problem arises when this blushing reaction is excessive in its intensity or frequency, or occurs without any external stimulus to cause it.

In this case we are talking about pathological facial blushing, a serious problem that can lead the affected person to a clear limitation in their social or working life, with the consequent psychological discomfort that this entails.

The fact that blushing can not be controlled voluntarily or can be set in motion without any reason, simply to a thought and at the least desired time, makes the person often develop a fear or phobia of redness, which is called a erythetophobia, in which the mere idea of redness causes the reaction of blushing.

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What are the symptoms of facial flushing?

In many occasions the phobia to redden, like the hyperhidrosis, is a symptom more of the denominated social phobia, that is an anxiety disorder characterized by a persistent fear to social situations or performances in public, in which the subject fears to act of humiliating or embarrassing form.

In addition to these symptoms (blushing and hyperhidrosis), patients usually present other physical symptoms in social relationship situations, such as palpitations or trembling, and it is frequent that they present deficits in social skills, with a tendency to avoid social relationship situations and to isolate themselves, as well as a deteriorated self-esteem.

In this psychopathological context, the problem usually lies in the importance that the patient gives to the symptom (blushing, hypersudation...), the excessive attention he pays to his internal sensations and the attributions or interpretations he makes of them.

The most common symptoms are:

  • Anxiety.
  • Facial redness.
  • Profuse sweating.

Do you have any of these symptoms?

You may have a problem with facial blushing

Triggering factors

The factors that trigger blushing are the same as those that cause hyperhidrosis (exaggerated sweating of a body area) in the hands or armpits.

In general, these are situations that cause stress in the person, normally related to social contexts (speaking in public, fear of being observed or of remaining in the company of other people...); it is very strange that the fear of blushing is present when one is alone.

How is facial blushing diagnosed?

The diagnosis of facial flushing begins with a dermatological and psychological evaluation.

It is the specialist in Dermatology who evaluates the patient. Since it is a pathology with such characteristic symptoms, it is not necessary to perform any additional tests.

How is facial blushing treated?

The approach is multidisciplinary, with the participation of specialists in dermatology, clinical psychology and thoracic surgery, who analyze the individual characteristics of the patient and the problem he presents before proposing the treatment to be followed.

From the psychological point of view, we work with the thoughts and the attributes or interpretations that the patient makes of his symptoms to refute his erroneous beliefs, because such beliefs have an impact on the intensity of the symptoms he presents. The patient is taught techniques for the management and control of anxiety and a program of gradual exposure to the feared situations is carried out. 

In the case that the dermatological and psychological treatments do not give the desired results, an approach of psychiatric type with a psychopharmacological treatment is raised and, in the most severe cases in which neither the psychiatric treatment offers the desired results, the possibility of a surgical treatment is raised.

Surgery will be considered as the last option within the therapeutic approach of these patients. The first thing will be to try to control the disease from the medical and psychological point of view. Those cases that do not respond well to such treatments could be candidates for surgical treatment.

The operation is performed under general anesthesia and consists of making an incision of approximately 2 cm on each side of the chest, through which an optic is introduced to locate the thoracic sympathetic chain. This is the nerve pathway through which the nerve impulses that generate facial flushing are transmitted.

Once it is located, it is sectioned at a certain level, at the level of the second thoracic sympathetic ganglion. In this way, the nerve impulses are no longer transmitted through this chain and consequently the facial blushing is stopped.

The procedure requires a 24-hour admission and the patient usually returns to normal life after a week.

The main unwanted effect is compensatory sweating. This occurs in those subjects who in addition to blushing present hypersudation of the face, hands or armpits. What occurs is an increase in sweating from areas that previously did not sweat such as the trunk or the groin. In most cases this is of a mild nature and is well tolerated.

Approximately 80% of patients report improvement in their quality of life after the intervention.

This means that they notice a decrease in the intensity of facial blushing or a complete remission of this, which allows them to improve their personal and social life.

It is convenient to evaluate the patient at one month, six months and one year after the intervention. This way, the psychological and social benefit that the intervention may have brought is adequately studied.

Where do we treat it?

IN NAVARRA AND MADRID

OUR MEDICAL TEAM

Specialists of the Department of Dermatology

The Department of Dermatology of the Clinica Universidad de Navarra has extensive experience in the diagnosis and treatment of dermatological diseases.

We have extensive experience in highly precise surgical treatments, such as Mohs surgery. This procedure requires highly specialized personnel. 

We have the latest technology for the dermo-aesthetic treatment of skin lesions, with the aim of achieving the best results for our patients.

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Why at the Clinica?

  • Experts in Mohs Surgery for the treatment of skin cancer.
  • We have the best technology for dermo-aesthetic treatments.
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