Do your cheeks turn crimson when you're feeling nervous? There could be a way to make sure it never happens again…
If you've never had a problem with blushing, you might think it extreme to go under the knife to make it stop. But for people who suffer from excessive blushing, it's more than just a bit embarrassing.
For 32-year-old Lindsay, an American woman who works in sales, the blushing got so bad that it was hurting her career - so she decided to make a change.
Lindsay is on the right
Lindsay remembers her face and neck getting red as a teenager, whenever she felt nervous or uncomfortable. But the symptoms escalated when she graduated from university and started her first job as a sales representative for a home furnishings company.
'It happened at least once a week, and there was nothing I could do to control it,' she explains. 'It definitely affected my confidence with my sales, and I think it hurt my chances of getting a promotion.'
Lindsay describes her symptoms as a heat that travelled up her neck to the top of her head. She could feel it coming on and could easily tell when her face was flushed without looking in a mirror. And when people pointed it out (which happened more often than you might think), it only made it worse.
'If I had to give a presentation at work, people would often comment on it and say, “Why is your face so red?” It made me feel like I looked immature and made it harder for me to be taken seriously.'
It was 2004 when Lindsay, 22 at the time, discovered there was a surgery available that may be able to put an end to her blushing, for good.
'At first when I went to research it, I was just looking to see if there were other people who dealt with it and how they were coping,' she says. 'Then I found out about the surgery.'
The surgery she discovered was endoscopic thoracic sympathectomy, or ETS.
'There are nerves in the body called sympathetic nerves that are part of the autonomic nervous system,' says consultant plastic surgeon Gary Ross, who performs this procedure at BMI The Alexandra Hospital in Manchester.
'These nerves control the way our blood vessels dilate and constrict.'
He explains that ETS, performed under general anaesthetic, requires a surgeon to make small incisions under the armpits in order to reach specific nerves in the chest and stop them from working. 'Excessive facial sweating, blushing and hand sweating can all be treated by ETS,’ he says.
After reading about the surgery, Lindsay desperately wanted to have it done. But first she had to convince her family – and her doctor – that it was the right decision.
‘When I first told my mom about the surgery, she was against it because she was worried,’ she says. ‘But I told her I was doing it with or without her support, and she eventually came around.’
Convincing her family doctor was a different story. In order to have the surgery covered by her insurance she had to have her GP recommend it. (In the UK, the NHS does not cover ETS for facial blushing.)
‘My family doctor thought it was an elective surgery and that it wasn't necessary,’ Lindsay says. ‘So I wrote him a letter describing how it was affecting my life. I poured my heart out and made him see that this was a real medical issue - not just a little vanity. After reading it, he changed his mind.’
According to the NHS, ETS has about a 80 to 90 per cent success rate in curing excessive blushing – but it’s not without risks. These include injury to the chest, droopy eyelids or (most commonly) compensatory sweating in the back, legs and other areas of the body.
Lindsay is centre
Despite the high success rate, there are some experts who argue that ETS should not be a patient's first choice. Professor Robert Edelmann, author of the book Coping with Blushing, argues that ETS should only be used in rare cases. ‘The majority of people who have a phobia of blushing do not actually blush more [than other people], they are just more afraid of and concerned about blushing,’ he says. ‘Thus, ETS is only effective because as they think they no longer blush, their concern about doing so decreases. There are well-establish psychological therapies that can do the same without the need for surgery.’
While Ross agrees that patients should consider other options, he’s seen first-hand how helpful the surgery can be. ‘Patients should initially seek advice from their GP and should consider all the alternatives,’ he says. ‘Often people’s lives can be devastated by excessive facial sweating and excessive blushing, and where one is severely affected in this way ETS surgery is an option that can improve patient’s lives.’
David Greenstein, consultant vascular surgeon for Spire Bushey Hospital, estimates that he has performed the procedure on around 800 patients in the UK – and he’s also witnessed the positive impact it can have. ‘Overall about 85 per cent say their quality of life has significantly improved,’ he says. ‘They feel "liberated." One in 50 patients may regret the surgery due to the unwanted side effects. So each case has to be taken on an individual basis.’ Lindsay was one of the lucky patients.
Now, 10 years later, she says having the surgery is one of the best decisions she ever made. Though she does experience sweating on her back as a side effect, she says it’s well worth the benefits. She can’t recall a time since having it done that her face has turned red – and her confidence at work has greatly improved.
‘To people that say ETS is an unnecessary or silly procedure, I’d say “You can't know until it's happening to you how much it can affect your day-to-day life,”’ she says. 'If you’re considering having it done, you should do the research on your own. But for me, it changed my life.’