How to Deal With Blushing When You Have Social Anxiety Disorder

blushing woman covering face

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Blushing is a normal physiological response that results in the face, neck, and/or chest becoming red. It is also a common symptom of social anxiety disorder (SAD), which involves a fear of being in the spotlight or negatively evaluated or judged by others.

Blushing that is troublesome can be a source of emotional pain and misunderstanding, as others may assume that you are embarrassed or hiding something when it's just your anxiety acting up.

5 Facts About Blushing

Here are some facts about blushing that might surprise you.

It May Signal an Underlying Medical Condition

Blushing may result from strong emotions such as embarrassment, anger, or excitement. However, it may also be linked to medical problems. Some examples include:

  • Carcinoid syndrome
  • Endocrine disorders
  • Fever
  • Menopause
  • Rosacea

Certain medications, such as those used to treat diabetes and high cholesterol, can also cause flushed skin as a side effect.

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You Can't Stop It

When you blush, the blood vessels in your face widen, allowing more blood to pass through to the skin. The tiny muscles in your blood vessels usually keep the vessels slightly squeezed; however, during a blushing episode, nerves in your body send signals to relax these muscles.

Because this process is automatic, it is nearly impossible to stop once it has begun. In fact, the harder you try to stop blushing, the redder you will usually get.

It Can Be Treated

In fact, a number of treatments are available for problems with blushing. If your blushing goes along with other physical symptoms or appears along with a medical problem, a medical cause is likely and a medical doctor can offer the best course of treatment.

When blushing is a symptom of SAD, cognitive behavioral therapy (CBT) directed at the underlying anxiety that maintains blushing is a good treatment option. Through CBT, you will learn how to think, act, and feel differently, which in turn will have a positive impact on your problems with blushing. Another treatment option that can help at the same time is medication to treat SAD.

It Doesn't Affect Everyone With SAD

Not everyone with SAD blushes, and not every person who blushes has SAD. However, for those with SAD who have problems with blushing, reddening of the face usually happens frequently.

When a person with SAD blushes, it usually goes along with a host of negative automatic thoughts, such as "Everyone is noticing how red I am" or "Everyone thinks that I'm weird." Some people with SAD blush when they are put on the spot, made the center of attention, or caught off guard in a social situation.

It's Not Always a Bad Thing

In a 2016 study of 102 children aged 4.5 years who were asked to sing in front of an audience and then watch their performance in front of the audience, contrary to what might be expected, blushing was related to lower social anxiety (rated by the parents) for some children.

The results of this study showed that for children who showed "positive" shy behaviors (e.g., smiling while averting their gaze), more blushing did not mean more social anxiety. In contrast, for children without these positive shy behaviors, more blushing meant more social anxiety.

In addition, children with "negative" shy behaviors (e.g., negative facial expressions) were very socially anxious whether they blushed or not.

The authors of the study concluded that for children, those who blush and have negative or no facial expressions may be showing early signs of problems with social anxiety. On the other hand, children who blush but have positive facial expressions such as smiling are showing the ability to use adaptive social mechanisms.

Clearly, more research needs to be conducted on this topic to understand the meaning behind a blush. However, it seems clear that it is not something to be overly concerned about unless your child also appears distressed by the blushing.

How to Deal With Blushing Due to Social Anxiety

If blushing is a problem for you, knowing how to stop blushing and lessen its impact is critical. To prevent blushing before it starts, think ahead to situations in which you usually blush. If it's usually when you are made to be the center of attention, have a plan in place to cope when that happens.

This might involve relaxation strategies that you can employ in the moment, such as deep breathing or focusing on a positive mantra such as "I am calm and relaxed." Just as the children who were smiling while they blushed, you can also blush without spiraling into an anxiety attack. 

A Word From Verywell

If blushing is problematic for you to the point that it disrupts going about your daily life, interferes with schoolwork, or holds you back at your job, consider consulting a mental health professional, particularly if you have not already been diagnosed with an anxiety disorder.

This will allow you to determine if there is a cause beyond anxiety that is making you blush, or to receive treatment such as cognitive-behavioral therapy to help you manage negative thoughts that may make blushing worse.

5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Aan het rot M, Rot Ma, Moskowitz DS, De jong PJ. Intrapersonal and interpersonal concomitants of facial blushing during everyday social encounters. PLoS ONE. 2015;10(2):e0118243. doi:10.1371/journal.pone.0118243

  2. Hannah-Shmouni F, Stratakis CA, Koch CA. Flushing in (neuro)endocrinologyRev Endocr Metab Disord. 2016;17(3):373–380. doi:10.1007/s11154-016-9394-8

  3. Pelissolo A, Moukheiber A. Open-label treatment with escitalopram in patients with social anxiety disorder and fear of blushing. J Clin Psychopharmacol. 2013;33(5):695-8. doi:10.1097/JCP.0b013e31829a878b

  4. Voncken MJ, Bögels SM. Physiological blushing in social anxiety disorder patients with and without blushing complaints: Two subtypes?. Biol Psychol. 2009;81(2):86-94. doi:10.1016/j.biopsycho.2009.02.004

  5. Nikolić M, Colonnesi C, De vente W, Bögels SM. Blushing in early childhood: Feeling coy or socially anxious?. Emotion. 2016;16(4):475-487. doi:10.1037/emo0000131

Additional Reading

By Arlin Cuncic
Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety."