Jump to:
- Why do we blush?
- How blushing works
- How to stop blushing
- Skin conditions that may resemble blushing
When you trip over your words in an important conversation and a familiar warmth rushes over your face, you don’t need a mirror to know that you’re blushing. The involuntary pink cheeks happen to us all, and, ironically, they only worsen the embarrassment.
Meet the Experts: Ava Shamban, M.D., a cosmetic dermatologist based in Los Angeles, Peter Lee, M.D., chief surgeon of WAVE Plastic Surgery, and Azza Halim, M.D., a board-certified, multi-specialist physician who practices aesthetic medicine.
Below, experts explain what’s happening internally when we blush and why it takes over at the most inconvenient times.
Why do we blush?
Similar to why you get goosebumps after seeing a jump-scare on-screen, blushing is an evolutionary response activated by an heightened nervous system, explains Ava Shamban, M.D., a cosmetic dermatologist based in Los Angeles. “It is attributed to our natural fight or flight reaction, or the way our body responds in an emergency,” she adds. Except, instead of fear, the fuel for reaction is embarrassment, nervousness, or anxiety—be that from a flubbed phone call or a first kiss.
How blushing works
When the nervous system is activated by whatever stimulus—a corny pick-up line or being caught in the act—the heart is prompted to deliver more blood and oxygen to the muscles and organs, including the skin cells, Dr. Shamban explains. To accommodate the excess nutrients, blood vessels and capillaries dilate. “The anatomy of the human cheek is such that there are many relatively wide blood vessels lying relatively close to the surface of the skin,” adds Peter Lee, M.D., chief surgeon of WAVE Plastic Surgery, which is why the blood flow is more visible there. In other words, your whole body fields the blood rush, but it’s most visible on your face.
How to stop blushing
Because blushing is natural, it can’t really be controlled, especially if it’s already been triggered, says Azza Halim, M.D., a board-certified, multi-specialist physician who practices aesthetic medicine. Individual response and intensity also varies.
Dr. Shamban adds that you may be able to prevent blushing by practicing meditation and breath work. “If the body relaxes, it slows the heartbeat, blood pressure, and stress hormones, therefore controlling stress, which can help control face flushing,” she says.
In extreme cases, Dr. Lee says that beta-blockers, a type of medication used to tamp performance anxiety, may control blushing and the emotions that prompt it. Also, laser treatments can destroy the blood vessels that enlarge in the blushing process, he adds.
Skin conditions that may resemble blushing
There are some skin conditions that may resemble blushing, but are not the same. These are the most common, according to our experts:
Contact dermatitis
Contact dermatitis is “a skin rash caused by a reaction to an irritant, most commonly, a cosmetic, a detergent, or some form of dye in fabric that comes in contact with the skin,” explains Dr. Lee. It usually comes with itching, swelling, and sometimes blistering, he adds, and can be treated with anti-itch medications and topical creams.
Eczema
Eczema, also known as atopic dermatitis, can produce a dramatic red rash on the cheeks, says Dr. Lee. This is commonly treated with a combination of steroids, antihistamines, and prescription drugs, he adds.
Rosacea
Similar to blushing, rosacea causes the small blood vessels in the face to swell, but is caused by an immune reaction, rather than a nervous system one, Dr. Lee explains. It can be triggered by exposure to ultraviolet light, infection, genetics, and other factors. There are a range of topical and oral medications, as well as laser treatments, that can help shrink blood vessels and prevent inflammation, Dr. Shamban adds.
Lupus
One of the main indicators of the autoimmune disease lupus is a butterfly-shaped rash across the bridge of the nose and cheeks, says Dr. Halim, which may be confused for blushing. Treatment should be discussed with a doctor—other main symptoms are fatigue, fever, and joint pain, per Mayo Clinic.
Menopause
“Menopause symptoms can often include hot flashes and the sudden rush of heat or blushing,” says Dr. Shamban. “When our hormones spike or dip, it affects the part of the brain that that controls our temperature. Hot flashes are often most intense on the face, neck, and chest.”