Erythrophobia (Fear of Blushing): Symptoms, Treatments, & How to Cope

What Is Erythrophobia?

Erythrophobia is a specific phobia involving a deep fear of blushing that can trigger embarrassment, social anxiety, and vulnerability. It can impact one’s ability to make friends, meet partners, and excel at work. Someone with erythrophobia may avoid situations that could induce blushing, including interviews, public speaking, or dating. While some aversion to blushing is typical, it becomes a problem if it prohibits you from engaging in certain activities, or constantly makes you feel socially awkward and uncomfortable.

Erythrophobia is related to anxiety disorders. It’s an abnormal and chronic fear of blushing that often appears to be irrational. The fear is related to being the center of attention. Those with social anxiety may also be more prone to the residual feelings of embarrassment or shyness. Many times, if someone with erythrophobia is in a situation where they’re blushing, they may attempt to reverse their blushing; however, this only triggers them to blush more, creating a vicious cycle.

How Does Blushing Work?

Blushing is an automatic response to a trigger within the sympathetic nervous system. When we feel vulnerable, embarrassed, or nervous, our sympathetic nervous system becomes activated, and our brains send adrenaline throughout the body, triggering the physiological response of blushing. Adrenaline can also mask pain and cause increased pulse and digestive issues.

Adrenaline rushing throughout the body makes certain veins in the face widen, which is why our cheeks redden. Blushing can also be a side effect of certain medications or substances, such as alcohol.¹

Blushing & Social Anxiety

Blushing can be a sign that you’re dealing with underlying social anxiety, which generally comes from others giving you undesired attention. It can leave you feeling nervous or vulnerable, which can trigger blushing and keep you feeling like the center of attention. Similar to stage fright, being in the spotlight can feel overwhelming and stir up negative feelings and thoughts.

Symptoms of Erythrophobia

Erythrophobia is itself a symptom of many types of anxiety disorders, including social anxiety. That said, there are other symptoms related to erythrophobia that may show up simultaneously, including sweating, shaking, or twitching.

Symptoms related to erythrophobia are:

• Blushing
• Feeling anxious
• Sweating
• Panicking
• Fast heart beat
• Shaking or muscle twitching
• Changes with breathing
• Trouble forming sentences
• Avoidant tendencies

What Causes Fear of Blushing?

While there are known causes of erythrophobia, such as social anxiety, it can also develop as an experiential phobia from a traumatic experience that happened to someone around blushing. For example, children who are severely bullied due to some of these basic physiological responses like blushing tend to have an aversion to it. They may also lead to a fear of being judged, which leaves them more vulnerable to blushing, making the whole experience that much worse.³

Impacts of Erythrophobia

If you’re afraid to blush or be seen while blushing, it can leave you feeling isolated. You may avoid large groups or social situations, even with friends. Family gatherings may be a particular challenge since relatives have a way of triggering embarrassment. The workplace or professional situations may also be difficult, leading you to not pursue certain tasks or projects. As a result, you may not reach certain goals. This can make it really hard to feel positive, leading to other issues like low self-esteem and depressed mood.²

How to Cope With Erythrophobia

Fortunately, there are many ways to treat erythrophobia. Regardless of where it stems from or why it was developed, interventions like deep breathing, acknowledgement, and distraction can reach a wide population of people.

Here are nine tips to overcome erythrophobia:

1. Notice and contemplate your anxiety-increasing beliefs about blushing: Delve into your anxiety-provoking beliefs to spot any patterns that worsen the way you feel. In turn, you’ll be able to put things into perspective and understand your patterns so you can ease your anxiety and work through your phobia.
2. Examine any blushing-related memories: Perhaps you were teased or even bullied for blushing. These experiences are understandably upsetting and may have led to your phobia, yet you may realize that they don’t need to dominate your life.
3. Deep breathing: This can help to relax the body, slow down your breath, and reduce your pulse, which helps limit blushing and redness in the cheeks.
4. Cool compress: Consider splashing cold water or placing a cool compress on your face to reduce the redness.
5. Try to make yourself laugh: If you can think of something funny that makes you laugh or smile, it can feel easier to deal with your fear.
6. Acknowledge it and let it pass: Remember, all feelings are fleeting (this includes fear and embarrassment).
7. Remove yourself when necessary: Avoidance is not an ideal solution, but if you need to remove yourself for a moment to gather yourself, that is OK.
8. Attend therapy: If you find yourself avoiding a lot of activities, consider trying therapy to determine if you’re dealing with an underlying mental health or physical health issue.
9. Accept that blushing may happen and enjoy your social life anyway: Accepting that blushing may inevitably occur can be tough and can take time to digest. But it can pave the way for you to start enjoying your social life more freely and with less worry.

Erythrophobia Treatments

Fortunately, there are many ways to treat the phobia of blushing. Therapy is a great way to address and cope with this phobia. To find the right therapist who is a good fit, start by searching an online therapist directory and learn more about different therapeutic modalities. For some, medication may also be helpful.

Cognitive Behavioral Therapy (CBT)

CBT can help you understand why you have this phobia in the first place. Learning where it comes from and why it developed can give you insight into what you may need to do to change your responses. CBT is designed to help rewire thoughts and behaviors so they’re more manageable.

Task Concentration Training (TCT)

TCT helps people understand how their hyperfixation on themselves and how others perceive them may impact their interactions. It helps them to focus more directly on their task at hand, whether that be interacting with another person or part of their environment rather than wondering what others think of them during that interaction. It takes time, but it is possible to use this technique to redirect your attention to actual tasks instead of reactions.

Exposure Therapy

Continued or intermittent exposure to the phobia in exposure therapy can help reduce the fear and anxiety around the actual act of blushing.

Virtual Reality Exposure Therapy

Using virtual reality exposure therapy, you can practice being in social situations, learn how to handle blushing with some separation, and apply other practices to manage it.

Mindfulness

Mindfulness meditation can help you focus on the present moment. It takes away the element of surprise and allows you to redirect your mind to whatever is happening right now vs. what others may be thinking or your own preoccupied thoughts.⁴

Medication

While there is no specific medication to treat this phobia, there are medications for anxiety to consider with your physician. If there are other physical reasons you may be blushing, a physician may prescribe a beta-blocker. It’s important to speak to a physician before starting and/or ending any medication.

Surgery for Erythrophobia

Endoscopic thoracic sympathectomy (ETS) is a procedure used to reduce facial blushing and erythrophobia. This treatment is generally recommended when other interventions like therapy and medication have been exhausted. Although ETS has mainly been used to treat excessive sweating, it can also be used to treat severe and persistent blushing.^5,6,7

Risks & Side Effects of Surgery

ETS for excessive blushing is performed under general anesthesia, and it involves cutting the sympathetic nerves that regulate flushing in the face. As with any surgical procedure, ETS can have risks and side effects.

Possible risks and side effects include:^5,6,7

• Treatment on the face may only work successfully on one side and some people may continue to blush on the other side of their face.
• Some people may experience a sensation that they’re blushing even though they’re not, which can worsen erythrophobia.
• ETS only targets blushing, thus the mental aspects or root cause may persist
• A small percentage of people may not see any results at all
• For some individuals the flushing may come back
• Nerve damage is a possible result of the surgery
• Allergic reaction to the anesthesia, hemorrhage, and/or infection are possible