Blushing, Facial & Gustatory Hyperhidrosis

Facial blush is a physiologic (normal) response to a variety of emotional stimuli. Blushing is caused by over stimulation of the sympathetic nervous system. The mechanism is involuntary and anxiety may aggravate it, but blushing may also occur with or without stress or anxiety. Patients with this condition were born to blush excessively.

Physiologic blush occurs more frequently in some individuals than others but generally occurs only in special situations, coming on quickly and fading rapidly. Individuals with facial blush, with or without facial hyperhidrosis, characteristically experience a glowing red face that occurs more frequently than physiologic blush. The blush is intense, constant and lasts for a prolonged period of time. Prior to onset, patients usually feel facial heat. The face and neck will usually glow a bright red colour. The glow may start over the cheeks, radiate onto the forehead and neck, and also cover the ears. Individuals with facial blush may respond with exaggerated blushing to a multitude of stimuli. A triggering stimulus may be internal or external and often is exceedingly subtle. A person with this condition may even be alone at home, reading a book or watching a film, and the facial blush may come on unexpectedly with no apparent stimulus. The person with facial blush often stands out in a crowd. A constantly blushing and glowing red face attracts attention and is often misinterpreted by others to mean that the individual is sick or embarrassed.

Facial blushing may occur independently or in combination with sweating of the hands, face and scalp, armpits, or feet. The most common symptom occurring in combination with blushing is hand sweating. Patients with severe facial blush often have some degree of hyperhidrosis involving their hands. It is common for the patient to focus on their facial blush, leaving them unaware of how much their hands actually sweat. Many patients who undergo surgery for severe facial blush realize, only after the operation, that for years they had also been modifying their behaviour because of cold, clammy and discoloured hands.

Facial and gustatory sweating may occur independently or in combination with blushing. The aggravating stimuli are the same as with blushing, spicy foods also playing a part in stimulating gustatory hyperhidrosis. Facial sweating usually involves the scalp, back of the neck, forehead and into the eyes, cheeks and over the upper lip.

Hyperhidrosis Treatments

The stronger Aluminium Chloride antiperspirants will help control Facial Hyperhidrosis, care should be taken, however, to avoid skin dehydration by using a skin moisturiser during the day. Low dose medication with an anticholinergic or Beta-blocker may also help. Botox is effective in treating facial hyperhidrosis but will cause a stiffness of facial expression and the treatment lasts only six to twelve months. Surgery can be effective for the control of facial blush but careful consideration of the side effects is essential, compensatory sweating can occur and there is a risk of Horner's syndrome (drooping eye-lid).

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