If you’re a frequent flusher, you know that it’s not a girlish, rosy glow, but more of a splotchy magenta rash that can spread like tie-dye from the chest up.

Invariably it seems to occur at the most inopportune moment and at the drop of a hat. But blushing can actually have many complex physical and emotional triggers, all of which stimulate the sympathetic nervous system. This may activate your body’s fight-or-flight response, causing your blood vessels to vasodilate and turning you beet red.


Physically induced blushing may occur when the body gets too hot—because the weather is steamy, you’re exercising, or you have a fever. It helps cool you down by dissipating heat through the surface of the skin. “Hundreds of tiny blood vessels instantaneously open up, flooding the skin with blood,” says Richard Fried, a dermatologist and clinical psychologist in Yardley, Pa. “The vessels act like emergency release valves to prevent the body from overheating.”

Blushing can also be the result of an emotional response, such as anxiety, fear, or embarrassment. When this happens, your body releases hormones, like epinephrine (adrenaline). “This boosts circulation, increasing blood flow to your face,” says Michael Gnatt, an internist at Johns Hopkins Community Physicians, in Rockville, Md.

Some foods and medications can cause blushing, too. Eating a spicy burrito, for instance, can accelerate blood flow to the skin. Also, medications like Ritalin and Adderall (taken for ADHD) and niacin (a B vitamin taken to reduce cholesterol) can set your heart racing and produce a flush. Some medical conditions, such as hyperthyroidism (overactive thyroid), may do the same, says New York dermatologist and psychiatrist Amy Wechsler.

Why Do Some of Us Blush More Than Others?
“Some people may just have more facial blood vessels that can vasodilate,” says Wechsler. But though chronic blushers aren’t necessarily more anxious than everyone else, the agita caused by blushing itself can make the problem worse. “Once you feel your face becoming hot and red, it may perpetuate more embarrassment and blushing,” explains Fried. In fact, just the thought that you might blush can create enough anxiety to trigger a medical condition called erythro-phobia, or fear of blushing.

Preventive Measures and Treatment Options
Manage stress. Research has indicated that relaxation techniques, like meditation and deep breathing, may quiet down a stimulated nervous system and lower blood pressure associated with anxiety. “When you’re focusing on your breathing, you’re not focusing on anything else,” says Wechsler. That mental shift may help turn down the dimmer switch on blushing—or prevent it in the first place.

Chill out. “Drinking a glass of cold water may help cool down your body and normalize your coloring when a flush sets in,” says Wechsler. She also suggests placing a cold compress of water or milk on your skin to constrict blood vessels.

Consider cosmetic and medical solutions. “Two of the main methods a doctor uses to treat excessive blushing are pulsed-dye lasers, to get rid of excess facial blood vessels, and beta-blockers, to slow the heart rate and stop the adrenaline rush that pumps blood to the skin,” says Fried.

Beta-blockers, such as propranolol, are prescribed to control high blood pressure, but a very low dose (10 or 20 milligrams), Fried adds, “may take the jittery edge off for people with flush-prone skin.” Since a beta-blocker can cause drowsiness, Wechsler warns her patients not to take one for the first time when they have to attend or speak at an event. “Try it out at home first,” she says, “or you could be trading one problem for another.”