Facial Blushing, Redness of the Face, Ears and Neck
A Sign of Shyness or Social Phobia
Social Anxiety Shyness Info
The action mechanism of the medications used in Shyness and Social Phobia / Social Anxiety is controversial. There is some unity in the explanations of the hypothetical antidepressants action mechanisms. That being so, I will offer a few considerations on them.
Facial blushing, also known as redness of the face or red face, is an important sign of Shyness or Social Phobia. It may or may not be associated with blushing of the ears and neck, and its appearance is accompanied by a characteristic sensation of sudden heat, or flush, in the affected areas. The lighter the skin, the more noticeable it is.
Causes – There are two main causes of facial
blushing: psychological and physiological. The psychological ones are the
very causes of Shyness or Social Phobia. In general, blushing occurs when
one feels criticized or negatively evaluated by others, whether by
acquaintances or strangers, even if the unfavorable opinion is only
imagined. It can also occur when one is in the company of friends and family.
The physiological causes of redness in the face and/or ears and/or neck
are thought to be the sudden vasodilatation and intense flow of blood to
these areas without there being a natural demand for it. The reason that
blushing occurs in these particular areas is found in the fact that the
skin there has significantly more vascularization in relation to the skin
in the other parts of the organism. These areas, as well as the soles of
the feet, the palms of the hands and the lips, are the parts most
frequently exposed and, consequently, they are endowed with greater
The flow of blood to the skin or to any part of the body or to a special
area of it serves two purposes: to carry nourishment to the cells and
maintain body temperature. Any part of the body that is compressed for
several minutes will experience a greater flow of blood after
decompression (and, subsequently, turn red) because the organism sends
more blood to compensate for the loss of nourishment during compression.
This is what happens during a normal increase in blood flow. The increase
or decrease of blood to the skin will be greater or lesser, depending on
the body’s need to loss or retain hear.
However, in the case of subjacent anxiety, whether in Shyness or Social
Anxiety Disorder / Social Phobia, the afflux of blood results from a
complex interaction of the nervous system that is not yet clearly
understood. This increased afflux does not serve any physiological need.
Nevertheless, there is a vasodilatation of the blood vessels in the skin
of the above-referenced areas.
A Sign of Shyness or Social Phobia? – Blushing can be as much
a sign of Shyness as of Social Phobia; in other words, it is part of the
indication for both conditions. Alone, it is not sufficient to distinguish
one indication from the other. The diagnosis of Shyness and Social Phobia /
Social Anxiety Disorder is made through an analysis of the particularities
of the signs and symptoms of both indications. Blushing is a sign that is
added up; it is not a particularity. In summary, facial blushing appears
in the indication of mild shyness as well as in that of severe social
Fear of Blushing – Blushing attracts attention and, as
such, it is a source of embarrassment, seen as an indicator that the
person is not comfortable or at ease. As a result, the person is commonly
judged to be “nervous”. This serves to provoke a fear of “turning red”. It
can then be said that blushing in a shy person will cause him to become
even shyer or avoid altogether those situations that are known to
stimulate blushing of the face or ears or neck.
If the skin is darker or black, the afflux of blood is not noticed by
others and the person can usually deal with the heat, of flush, sensation.
As no one comments about the physical manifestation, the person doesn’t
develop the underlying fear of blushing and there is a greater possibility
that he won’t develop ancillary problems related to it.
Treatment – The treatment is the same as that applied to
other signs and symptoms of Shyness or Social Phobia. In other words,
depending on the orientation of the consulted professional, the
recommendation might include psychotherapy or medications or a combination
of the two.
Is there a specific treatment for blushing using medication? Technically,
the answer is yes. If blushing is the result of vasodilatation in the
area, then a form of medication that produces vasoconstriction could help.
And the medications used for this purpose are the beta-blockers, which are
also used to reduce the intensity of other signs and symptoms of Shyness
or Social Phobia.
In practice, beta-blockers (such as propranolol, 20 to 40 mg daily) can
be helpful when blushing occurs in very specific situations; for example,
when a person only turns red when speaking in public. In this case, he
would take medication occasionally, one or two hours before his
presentation. On the other hand, if blushing could occur at any given
moment, depending on certain events or occurrences over which the person
has no control (for instance, someone playing an unexpected prank on the
person in school), medication would have little possibility of yielding
results. In this case, the person would need permanent coverage of
medication, with dubious results as well as the possible side effects.
Surgical Treatment – In more dramatic situations, surgical
treatment of the blushing is indicated. In these cases, the redness is
also associated with excessive sweating in the affected areas. After
exhausting all conservative treatment alternatives, surgery, when
performed by an experienced surgeon, may bring the desired relief. In
essence, the surgery consists of interrupting the arrival of certain nerve
fibers involved with vasodilatation and excessive sweating to the skin of
the affected areas. These fibers come from a chain of ganglia (nodules
with nerve tissue) of the sympathetic nervous system, located in the
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