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To Blush or Not to Blush

Blushing is the main complaint of many who seek help for their social anxiety

Have you ever spilled coffee over your boss? Have you ever been confronted about stealing the company’s paper clips? Has your boss ever praised you for your excellent work during the company’s annual review? And have you ever been subjected to the indignity of singing “Old MacDonald Had a Farm” to your workmates during an away day team-building exercise? All a part of the normal trials and tribulations of the modern-day corporate employee.

But each of these scenarios has a different emotional and psychological focus. In order of scenario they are, ineptitude, guilt, pride, and self-consciousness. Yet they all have one thing in common – they’re all situations that are likely to make you blush. Blushing is entirely out of your control – you can’t make yourself blush, and you can’t stop yourself blushing. What is it, and why is it important?

Blushing is a reddening of the cheeks and forehead that, if you’re unlucky, can also extend to the ears, neck, and upper chest. It seems to be produced by a combination of factors. The face has an extensive network of veins in its subcutaneous layers that hold a large volume of blood, and these blood vessels are particularly close to the surface in the cheeks. Activation of the sympathetic nervous system triggers receptors in the facial area that in turn cause vasodilation. This increases blood flow and causes the blush area to redden.

Blushing is very distinctive, and differs from many other forms of facial reddening caused by such things as physical exertion, alcohol consumption, or a Friday night lamb vindaloo at the local Indian restaurant. Blushing isn’t triggered by one particular emotion, but it does accompany a range of self-conscious emotions such as shame, guilt, shyness, and pride. It represents the psychological state of “embarrassment”, especially when accompanied by a feeling of self-consciousness and ambivalent arousal – ambivalent arousal is a tendency to want to flee from the embarrassing situation when this would be socially inappropriate.

Blushing has particular relevance for those who are socially anxious and is the main complaint of one of three people who seek help for their social anxiety[1]. Many individuals who are socially anxious fear to blush in social situations because they believe others will judge them negatively, and this is often a factor that leads them to avoid social situations. Even in other cultures, blushing is often perceived negatively. For example, Taijin Kyofusho (TKS) is one of Japan’s most common phobias. Literally translated it means “the fear of interpersonal relations”, but while blushing in social anxiety disorder relates to the fear of oneself being embarrassed in front of others, TKS sufferers are fearful of embarrassing others with their blushing.

The difference in fear focus between westerners and Japanese folk almost certainly originates in differences in the cultural focus in Japan and the West. Western societies espouse individualism, while Japanese and many other Asian cultures embrace collectivism. The westerner as an individual is the one who is embarrassed by his/her blushing because others are watching, but the Japanese blusher is concerned about the reactions of the group and worried about causing offense by blushing (which could bring shame on family and friends).

But the socially anxious person’s perception of their own blushing may be largely in their head. Studies suggest that social anxiety is highly correlated with self-perceived blushing, but not with physiological measures of blushing. That is, the socially anxious individual believes they blush more than non-socially anxious individuals, but this isn’t upheld by physiological measures of their actual blushing[2]—yet another example of how erroneous beliefs about the self and the world act to maintain anxiety.

Because blushing is closely associated with self-consciousness, it’s often been assumed that children can’t blush until they develop self-consciousness. But a study by Milica Nikolić and colleagues from the University of Amsterdam found differently[3]. They asked 4½-year-old children to sing a song of their choice in front of an audience. Their performance was video-recorded and played back to them in front of the audience. They asked parents to report their children’s social anxiety levels and also took physiological measures of blushing during the performance and during the watching-back task.

They found that blushing, in combination with a low number of positive shy expressions (shyness expressed in a positive way with a coy smile and aversion of gaze), was associated with heightened social anxiety. They concluded that blushing appears to be an early indicator of social anxiety in children as young as 4½-years.

But studies such as this raise some interesting questions about the function of blushing. Nikolić and colleagues argue that both blushing and positive shy expressions serve an evolved appeasement function in social situations, they serve to weaken other people’s negative reactions to the blusher’s behaviour and to make observers bond and empathize with them. A blush as an appeasement signal has a number of effects. It tells others that we’re ashamed or embarrassed, that we’re aware that something is not right, and that we’d probably like to put things right. It shows that we’re not a brazen or shameless person, that we’re communicating appeasement and providing a nonverbal apology[4]. In the context of appeasement, blushing has a number of benefits for the blusher. A person who blushes after a mishap is often liked more than someone who doesn’t blush is considered more positively by others and promotes trust between themselves and their audience[5].

If blushing has such an adaptive function, why do so many socially anxious people hate blushing? Why is the act of blushing both a source and a consequence of anxiety? This may be related to a heightened sensitivity to evaluation by others, with socially anxious individuals being biased towards believing that all evaluation by others is likely to be negative. It’s not clear where this bias might come from, although blushing is frequently experienced by the blusher in situations considered as embarrassing or shameful, and perceived as embarrassing by the observer as well – emotional experiences that are likely to be evaluated as negative and to imbue the blush itself with negative valence.

In addition, because blushing is often a source of shame and anxiety, many social anxiety sufferers believe that people interpret a blush as a sign of social incompetence, weakness, or loss of control[6]. These acquired beliefs may often override the adaptive value of the blush, and lead to many individuals seeking to avoid social situations where they might blush, and to interpreting blushing catastrophically when it does happen. My advice? Blush with confidence. There are likely to be more benefits than costs.


[1] Fahlén, T. (1997). Core symptom pattern of social phobia. Depression and Anxiety, 4, 223–232.

[2] Nikolić M, Colonnesi C & de Vente W (2015) Blushing and social anxiety: A meta-analysis. Clinical Psychology Science & Practice, 22, 177-193.

[3] Nikolić M, Colonnesi C, de Vente W & Bögels SM (2016) Blushing in early childhood: Feeling coy or socially anxious? Emotion, 16, 475-487.

[4] Crozier R (2010) The puzzle of blushing. The Psychologist, 23, 390-393.

[5] Aan het Rot M, Moskowitz DS & de Jong PJ (2015) Intrapersonal and interpersonal concomitants of facial blushing during everyday social encounters. Plos One, DOI:10.1371/journal.pone.0118243.

[6] Edelmann RJ (1990) Embarrassment and blushing: A component-process model, some initial descriptive and cross-cultural data. In WR Crozier (ed) Shyness and embarrassment: Perspectives from social psychology (pp205-229). Cambridge University Press.