Red-Faced and Miserable

Photo by Robyn Gallagher - - For illustration only

Reader’s Question

I have a very big problem. I can’t sit in a group and have a normal conversation. If I start saying something, even something very normal, my facial expressions change, and my face turns red! And if someone says something about me, even something quite normal, then the same thing happens.

I can’t even share a joke in a group. This happens even when I’m talking to a single person. If someone challenges me for something I mentioned in conversation, the same also happens. My facial expressions make it look like someone has insulted me.

My red face is so obvious that others can see it easily. Please help me. This is one of my biggest problems in my life, and I want to get rid of it.

Psychologist’s Reply

Excessive facial blushing can be a source of embarrassment. Besides that, the anxiety people tend to experience when their face reddens generally only makes the situation worse.

Most professionals believe that facial blushing is caused by an overactive sympathetic nervous system. This system regulates the degree to which blood vessels dilate. In persons with a tendency to blush facially, certain environmental triggers (like being put on the spot or being the center of some attention) cause nerves in the face to over-react and instruct the blood vessels to dilate excessively, causing blushing. Sometimes, the blushing is accompanied by a burning or tingling sensation called hyperpyrexia.

There are several established treatments for excessive facial blushing. Certain medications such as beta-blockers can help, as can medications (e.g., SSRIs and anxiolytics) and psychological treatments (e.g., cognitive-behavioral therapy and neurolinguistic programming) that can reduce the anxiety that most often accompanies and triggers the blushing. In some rare but necessary circumstances, surgical intervention may be required.

It would be best to visit with a physician with special training regarding facial blushing and its treatment. In the meantime, remember that the anxiety and embarrassment you feel, while understandable, only increases the likelihood and extent of your suffering. So, do your best to be more at peace with your situation while you seek some help to deal with it.

Please read our Important Disclaimer.

All clinical material on this site is peer reviewed by one or more clinical psychologists or other qualified mental health professionals. Originally published by on and last reviewed or updated by Dr Greg Mulhauser, Managing Editor on .

Ask the Psychologist provides direct access to qualified clinical psychologists ready to answer your questions. It is overseen by the same international advisory board of distinguished academic faculty and mental health professionals — with decades of clinical and research experience in the US, UK and Europe — that delivers, providing peer-reviewed mental health information you can trust. Our material is not intended as a substitute for direct consultation with a qualified mental health professional. is accredited by the Health on the Net Foundation.

Copyright © 2023.