Facial Blushing, Redness of the Face, Ears and Neck

A Sign of Shyness or Social Phobia

Ruy Miranda
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 vascularization.

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 phobia.

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 thoracic cavity.

May, 2006

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