Erythrophobia: Fear of Blushing

A self-fulfilling phobia

Woman covering her face with her hands

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Erythrophobia, or the fear of blushing, is a relatively complex phobia to overcome. Blushing is a physiological response to, among other things, anxiety and embarrassment. This makes erythrophobia one of the few self-perpetuating phobias, meaning that the more you worry about it, the more likely you are to experience your object of fear.

And, unlike a specific phobia with a clear object that you can avoid or become desensitized to (arachnophobia, for example), blushing is difficult to control and occurs in response to a wide variety of social situations. In extreme cases, erythrophobia can be very life-limiting and isolating if the fear causes you to avoid social interaction altogether.

How the Blushing Response Works

Blushing occurs automatically, like the fight or flight response, and is an involuntary reaction triggered by the ​sympathetic nervous system. When we are anxious or embarrassed, our bodies are flooded with epinephrine, also known as adrenaline, which causes us to experience very real physiological symptoms.

In addition to increasing the heart rate, suppressing the digestive system, and inhibiting pain, epinephrine may also act as a vasodilator on certain blood vessels. It causes blood vessels to widen, improving the flow of blood and oxygen throughout particular regions of the body.

Blushing is an unfortunate side effect of the vasodilation of certain veins in the face. As these blood vessels in the face grow wider, the increased circulation causes the cheeks to redden. Vasodilation sometimes occurs for other reasons, including alcohol consumption and certain medical conditions.

No matter what the underlying cause, those with erythrophobia are likely to become anxious and embarrassed when it occurs. This leads to a vicious cycle in which the blushing is likely to become worse and worse.

Social Phobia

The fear of blushing can be a symptom of social anxiety disorder (social phobia). The fear generally is not of the blushing reaction itself, but rather of the attention that it might draw from others. If we are anxious or embarrassed, the last thing we want is further attention.

The blushing is usually accompanied by a variety of negative thoughts that all focus on how we might be perceived. This, in turn, heightens the level of blushing, which further fuels the negative thoughts and then causes us to feel even more anxious or embarrassed.

Even if nothing embarrassing has happened, or people aren't focusing on you, the phobia may cause you to fear that you are the center of attention in a bad or uncomfortable way.

Symptoms

Ironically, the strongest symptom of the fear of blushing is generally further blushing. As you perceive that you are losing control of the situation, you will likely grow redder and redder.

In addition, you may experience such common phobia symptoms as shaking, sweating, increased heart rate, and difficulty breathing normally. You might stumble over your words or find it impossible to continue a conversation at all.

Over time, you might begin to develop anticipatory anxiety, in which you dread finding yourself in a situation that might cause you to blush.

You might begin to avoid certain social situations or, in extreme cases, avoid going out at all. You might also develop additional social phobias, such as stage fright or the fear of eating in front of others, because of a fear that those activities might trigger a blushing reaction.

A phobia diagnosis requires that the symptoms be life-limiting and last longer than six months. Additionally, the fear or anxiety must be out of proportion to the actual danger, and the object of your fear causes extreme distress or avoidance behaviors.

Treatment

Treatment depends on the severity and complexity of the symptoms. Often, the fear is not actually of the blushing response itself, but of the reactions that you perceive others might have to your blushing. Brief therapy options, such as cognitive-behavioral therapy (CBT), treat the phobia by teaching you new thought patterns and behaviors that help lessen the fear. Medications are also available and are most often used in addition to therapy.

As this is a less concrete fear than other specific phobias, treatment like exposure therapy or desensitization may be more complicated, as you have to become more comfortable in the situations that provoke blushing and their aftermath, rather than with blushing itself. But with the help of a therapist, you can overcome this fear.

In addition to therapy and medication, surgery is available to limit blushing in rare instances but is not generally a recommended method for treating erythrophobia.

2 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. Rot M, Rot M, Moskowitz D, De jong P. Intrapersonal and interpersonal concomitants of facial blushing during everyday social encounters. PLoS ONE. 2015;10(2):e0118243. doi:10.1371%2Fjournal.pone.0118243

  2. Stefaniak T. Erythrophobia--problems of diagnostics and treatment. Pol Przegl Chir. 2012;84(6):322-7. doi:10.2478/v10035-012-0054-8

Additional Reading
  • American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th Ed.). Washington, DC.

  • Social Anxiety Institute. Is Blushing a Symptom of Social Anxiety?

By Lisa Fritscher
Lisa Fritscher is a freelance writer and editor with a deep interest in phobias and other mental health topics.