Someone says your name in a meeting and you feel the heat rising up your neck. You no longer hear the question: all you can think about is everyone looking at your red face. The next day, before you go in, you are already wondering whether it will happen again, and you look for a seat at the back.

That fear has a name: erythrophobia, the fear of blushing. This guide explains why we blush, why fearing a blush makes the experience worse, when it is part of social anxiety, which treatment works and which test can help you see whether there is something more going on.

Why we blush

Blushing is a normal reaction. In a classic review of social blushing, Leary and colleagues proposed that we blush when we receive social attention we do not want. Think of being praised in public, making a mistake in front of others or suddenly having everyone turn to look at you.

The interesting thing is that blushing does not always count against you. In two experiments by Dijk, de Jong and Peters, participants read about someone who had committed a transgression or a mishap and then saw a photo of them, with or without a blush. In most cases they rated the person who blushed more favourably, on qualities such as sympathy or how trustworthy they seemed. The authors conclude that, after a mistake, a blush works as a signal that helps save face.

What is erythrophobia?

Erythrophobia is not a diagnosis in its own right but a name for an intense fear of blushing in front of others. It is usually part of social anxiety: the NHS lists among its signs always worrying about doing something you think is embarrassing, such as blushing, sweating or appearing incompetent. One study of blushing in social phobia describes it as its most prominent symptom.

What sets it apart from ordinary blushing is not how red you go, but everything around it: worrying beforehand, constant monitoring during and going over what happened afterwards.

Fear makes the blush feel bigger

This is the finding that most reassures people who live with it. In a study by Mulkens and colleagues, 57 women with high or low fear of blushing went through two awkward social situations while the colour and temperature of their faces were measured. There were no differences in how much they actually blushed. The difference lay in how they experienced it: those with a high fear of blushing believed they had blushed more.

Another study, by Gerlach and colleagues, found something similar in people with social phobia: those who mainly complained of blushing did not blush more than other people with social phobia, although their hearts were beating faster. That is why treatment focuses less on the face and more on self-focused attention: the more you monitor whether you are blushing, the more you notice it and the harder it is to follow the conversation.

When the fear of blushing is social anxiety

The NHS points out that social anxiety is more than shyness: it is a fear that does not go away and affects everyday activities, self-confidence, relationships and work or school life. It is worth paying attention if:

  • You avoid meetings, presentations, dates or group meals for fear of blushing.
  • You worry a lot before, during and after social situations.
  • You rely on crutches to hide it: make-up, scarves, looking at the floor or avoiding being spoken to.
  • You find it hard to do things while others are watching because you feel judged.
  • The fear is making you give up opportunities at work, in your studies or in your relationships.
Woman smiling as she listens to a friend at a café table, with her attention on the conversation

Blushing, rosacea or another cause

Not all facial redness is emotional. The NHS describes rosacea as redness across the nose, cheeks, forehead, chin, neck or chest that comes and goes and lasts a few minutes, sometimes with the face feeling warm, hot or painful, and it can come with stinging when using water or skincare products. Over time the redness can become permanent. If you go red when nobody is around, if the redness does not go away or if you notice stinging, see your doctor.

Is there an erythrophobia test?

There is no specific erythrophobia test, because it is not a diagnosis in itself but a form of social anxiety. What we do have at MyPsicoTest is the Social Anxiety Test, and one of its statements is exactly this: "In social situations I blush and feel that everyone can tell."

There are 15 statements about the last month, answered in about four minutes and split into three areas of five:

  • Fear of judgement: worrying about what others think and going back over what you said afterwards.
  • Avoidance of situations: what you stop doing so as not to expose yourself.
  • Physical symptoms: blushing, trembling hands or voice, sweating or a racing heart when you are the centre of attention.

The score ranges from 0 to 60 and comes broken down by area, so you can see whether your anxiety shows up mainly in thoughts, in avoidance or in your body. As the test page itself explains, a high score on physical symptoms usually signals that blushing, trembling or sweating have become the heart of the problem. You do not need to sign up, and your answers are not sent to any server. If your fear centres on speaking in front of a group, Fear of public speaking: why you freeze and when it is social anxiety may help too, and all the questionnaires, free and anonymous, are in the psychological tests catalogue.

How to get over the fear of blushing

The NHS considers cognitive behavioural therapy the best treatment for social anxiety, and studies specifically on the fear of blushing point the same way.

What the studies say

One of the most studied techniques is task concentration training: learning to direct your attention outwards, to the conversation and what you are doing, instead of to your face and your sensations.

  • In a trial by Mulkens, Bögels and colleagues with 31 people whose main problem was the fear of blushing, both exposure and task concentration training reduced the fear, and a year later people were still improving. Strikingly, the fear went down even though the blushing measured on their faces did not change.
  • In another trial by Bögels with 65 people with social phobia and a fear of blushing, trembling or sweating, both options, task concentration training or applied relaxation followed by cognitive therapy, worked very well, and after a year the combination with task concentration training reduced the fear of physical symptoms more.
  • In a trial by Härtling and colleagues with 82 people, intensive group therapy over two weekends worked with both cognitive therapy and task concentration training: at six months, between 69% and 73% of those who completed treatment no longer met the criteria for social anxiety disorder.

Medication is another option: the NHS mentions SSRI antidepressants for social anxiety, always prescribed by a doctor. If you want to know what therapy is like, we explain it in Therapy for anxiety: when to see a psychologist and what works for each type of anxiety.

What you can start trying

  • Put your attention outside yourself. The NHS suggests focusing on what people are saying rather than assuming the worst.
  • Stop hiding it. Crutches bring relief in the moment, but they stop you from finding out that nothing bad happens if people see you blush.
  • Expose yourself step by step. Break difficult situations down into smaller parts and build up confidence with each one.
  • Remember the evidence. You probably notice it more than others do, and a blush after a mistake tends to win sympathy.
  • If anticipation eats up the days before, Anticipatory anxiety: what it is, symptoms and how to stop dreading what might happen may help.

What about surgery for blushing?

There is an operation, endoscopic thoracic sympathectomy, that has been used to treat facial blushing. A systematic review found no controlled trials, and the studies that existed were of poor quality: up to 10% of patients had immediate complications and up to 90% developed compensatory sweating below the chest. In a 14-year follow-up of 1,700 people who had the operation, 80% had compensatory sweating and 13.5% regretted having it. Before considering it, it is worth trying psychological treatments, which address the fear and not just the blush.

At the end of the test you will find our recommendation of a licensed psychologist who works with anxiety and self-esteem, online too.

If your result worries you or you want a professional assessment, you can talk to Xènia Capel Salcedo, a licensed psychologist (COPC reg. 14982), who offers a free first consultation call and online therapy from anywhere.

MyPsicoTest team · Updated: