` How does anyone get this self-conscious? Can you imagine someone saying 'Doctor, I really think you should destroy my ability to blush with cosmetic surgery'?
` That's a big 'WTF' on my list.
` So... what do Dijk and Jong have to say about it?
The Lancet 2006; 367:2059
DOI:10.1016/S0140-6736(06)68922-8Surgical treatment for blushing
Although we agree with Marios Nicolaou and colleagues (April 22, p 1297)1 that fear of blushing can be a very embarrassing complaint, the suggestion that it might be helpful to use surgery to inhibit people's ability to blush altogether seems unwise for at least four reasons.
First, evidence suggests that people who fear blushing do not blush more intensely than non-fearful individuals.2,3 Fear of blushing seems to reflect a fearful preoccupation irrespective of actual blushing, and there are no solid data on which to base the idea that self-reported blushing propensity is a neurophysiological aberration.
Second, there is no clear empirical evidence to support the effectiveness of surgical treatment, since all published evidence comes from uncontrolled, retrospective studies. Third, as argued previously by Drummond,4 there is a reasonable chance that surgical intervention causes undesirable side-effects such as compensatory sweating.
Fourth, and perhaps most importantly, transection of sympathetic nerves in blushing-phobic individuals would be conceptually similar to removing the (pounding) heart in patients with panic disorder. There is convincing evidence that displaying moral emotions via blushing serves important psychological functions, and has clear remedial effects that are more pronounced than those of motor signs of shame and embarrassment.5 Hence, taking away the ability to blush implies suboptimum functioning in interpersonal behaviour.
We declare that we have no conflict of interest.Affiliations
1. Blushing: an embarrassing condition, but treatable. Lancet 2006; 367: 1297-1299.
2. Blushing and physiological arousability in social phobia. J Abnorm Psychol 2001; 110: 247-258.
3. Is there less social anxiety then meets the eye? Emotion experience, expression, and bodily responding. Cognition Emotion 2004; 18: 631-662.
4. A caution about surgical treatment for facial blushing. Br J Dermatol 2000; 142: 194-195.
5. Communicative and remedial effects of social blushing. J Nonverbal Behav 1999; 23: 197-218.
a. Department of Clinical and Developmental Psychology, University of Groningen, 9712 TS Groningen, Netherlands
` In sum: People who want cosmetic surgery to stop them from blushing clearly have a mental problem, not a physical problem, and trying to surgically alter themselves would probably cause a physical problem and perhaps more mental problems!
` I mean, who are these people that are so afraid of blushing? I talked to a girl once who wanted to be 'circumcised or something' because she couldn't stand her own natural lubrication ruining her panties when she became horny. Apparently, she said, this was part of her obsessive compulsion to clean everything.
` As Dave Barry would say; I am not making this up.
` What is it with people? What causes them to be so self-conscious? Once, I watched an episode of Extreme Makeover - I was brave! - and the people looked absolutely normal! The guy had crooked teeth and needed braces, I think, because his chin was set too far back. Instead, they filed his teeth down, put caps on them, and filled his chin in with fat, thereby eliminating any possibility that he might actually have his teeth rearranged to allow him to bite properly!
` Not only that, he didn't look that much different - or better - afterward! Neither did the woman. And yet they seemed to be ecstatic when the bandages came off! I mean, why does anyone put up with people implying to them that they don't look good enough?
` That can be very problematic to people with mental conditions, and can even cause mental conditions such as anorexia! And now... blushing?
` I mean, how many people have had to at least talk with plastic surgeons in order for this issue of 'I can't stand it when I blush' to become important enough to publish a paper about it?
` Really, I think their problem is that they feel stressed and think that this will make them feel better. It might, but I think the best thing to do is get rid of the stress!