Those who blush know when blushing is about to happen. The environment, the context, the people involved…there is a plethora of minor factors that they recognise and know will end with blood rushing to their face, sweat beading on their forehead and a rising sense of panic in the pit of their stomach. 

Those who blush also know that schools are an absolute nightmare for blushers, a fact backed by research. 

“Blushing occurs in social situations in which people are exposed to others’ attention and worry about their evaluation,” says Milica Nikolic, an assistant professor in developmental psychopathology at the University of Amsterdam. 

“Children, similarly to adults, blush when being exposed to others - standing in front of the class, performing in front of others or meeting a new group of peers. 

“Even having Happy Birthday sung to you, or being praised in front of others, can cause children to blush.”

What is less known by blushers and non-blushers alike, though, is what can be done about blushing and how pupils who suffer can be better supported in schools. So let’s try and fix that. 

The first thing to note is that we all blush, though it can be “seen” more easily in some than others (those with darker skin are frequently told they “don’t blush”, when that is obviously not the case: as Felix Konotey-Ahulu wrote in a 2004 paper: “Not being able to ‘see’ the rush of blood does not mean it has not happened”).

Likewise, symptoms are much broader than you might imagine: the NHS lists low mood and swelling of the neck, among others (nhs.uk/conditions/blushing). 

So even though the child in front of you may not have “gone red”, that doesn’t mean they are not blushing. 

The fear factor

Another important point is that it is not the blushing itself that causes problems for students but the fear of blushing, or erythrophobia as it is known.

“Blushing is harmless but anxiety about blushing can be a major problem because it can prevent people from doing things that they would otherwise enjoy and/or benefit from,” says Peter Drummond, a professor of psychology at Murdoch University in Australia, who has published multiple studies on blushing and social anxiety.

“In a school setting, if you are frightened of blushing, you might avoid joining in or speaking up, and lose an opportunity to contribute and receive feedback. 

“It might also be difficult to attend to what’s going on in class if you’re constantly scanning for signs of blushing, like your face warming up, feeling your heart race or breaking out into a sweat.”

Nikolic says that blushers “even avoid social events, such as play dates and birthday parties, and they have difficulties making friends. This can all eventually contribute to the condition called social anxiety disorder”. 

She adds that children who blush frequently “feel lonely and suffer because they cannot form close relationships with others, and this also influences their school or academic performance, even long-term, if the disorder is not treated.”

Not everyone who blushes will have these negative consequences and we know from research that some of us blush more frequently than others. 

It’s at the more persistent end that schools may wish to get involved, as negative impacts will be more pronounced. 

Triggers for these blushers tend to be similar. “The strongest triggers for blushing are emotions such as embarrassment, guilt and shame, but people can also blush with surprise and joy - the key seems to
be finding yourself to be the unwanted centre of attention,” Drummond says.

“A very similar physiological reaction happens during anger and while exercising: basically, blood vessels in the facial skin dilate,” he adds. “During exercise, this releases heat from the body into the environment, which makes us feel good. Maybe that’s
one of the reasons why we blush during uncomfortable emotions.”

Another reason, though, may be that it acts as a warning system. “It could be that blushing signals to others that we’re feeling uncomfortable and we don’t want to cause any more trouble,” he says. 

Nikolic says that it is also thought that blushing after doing something wrong “is adaptive, because it helps us communicate to others that we care about social norms and about others’ opinions of us”. 

“This appeases other people, increases interpersonal liking and decreases the possibility of social rejection after doing something wrong,” she adds. 

As to what age blushing begins, it’s earlier than you might think. The lab in which Nikolic is based at the University of Amsterdam was one of the first in the world to study blushing in children. It started just a few years ago but results are already starting to come to light. 

“Importantly, we found that children who blush more when exposed to others’ attention are more likely to avoid social situations
in which they could be exposed to others’ evaluation, such as standing up in front of the class, performing or talking in front of others, even talking to an unknown peer,” she says. 

“We found this relation in early childhood, around the age of 4, which means that already at this early age, children who blush do not like to be exposed and avoid such social situations.”

So, what can schools do to better support children who blush? 

Understanding is your first go-to option as a teacher. Acknowledging that a child is uncomfortable and talking to them privately about their fears and the triggers is important. 

Also key is coming up with a joint plan for how the blushing may be mitigated, be that through preparation for tasks, smaller group work or other elements that would make the pupil feel more comfortable.

Further treatment 

For some children, though, this will not be sufficient and, if the impact of blushing is pronounced and persistent, external help may be required. 

Nikolic’s team at the University of Amsterdam recently compiled a review on the treatment options for fear of blushing, and concluded that cognitive behavioural therapy is the most effective approach.

“Instead of reducing blushing, the treatment is focused on dealing with the fear of blushing,” Nikolic explains. “The idea is that blushing itself is not problematic but rather the thoughts and the emotions that children have about it.” 

Paul Kenny, Ward-Coleman professor and chair at the Icahn School of Medicine at Mount Sinai, New York, says that, in some cases, drugs that “attenuate physiological responses to anxiety, which are regulated by the autonomic nervous system, can reduce the incidence of blushing”. 

“Such drugs include so-called beta blockers, which decrease many physiological responses to anxiety, including blushing, elevated heart rate, shaky hands and sweating,” he says. 

These might sound like extreme methods of dealing with an issue you may think is pretty benign or that could be overcome with a form of exposure therapy. But that’s because people tend to misunderstand how serious the issue is, says Kenny. 

He says that the negative consequences of those who experience “intense and frequent blushing” is often dismissed by society “because there are no overt physical health consequences, and the response is usually dismissed simply as a sign of shyness”. 

“However, the awkwardness and embarrassment experienced by the affected individual can be intense,” he says.

Support for students who blush, then, is not just about support, it’s about this recognition Kenny talks about: blushing isn’t benign and it’s not funny - it’s serious, and students who blush need your help. 

Chris Parr is a freelance journalist