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Most horror stories have a lot of blood, but this one has a cruel and merciless amount.

No, it’s like a horror movie in which the blood spills out in buckets. But it can be a horror for those involved as it forms deep, pernicious pools in cheeks and reddens faces with the heat of a thousand suns until the bad guy in the story turns and says, “Aw, you’re blushing!”

If you don’t get why blushing is the stuff of nightmares, then you need to talk with Lily McCausland, 23, a freelance production assistant.

“The physical nature of my blushing truly feels like a furnace turning on,” she said. “My face gets prickly at first and then, depending on the severity of the emotion, full-sunburn red. I always know when I’m about to blush because it always comes right at the moment I need it to not.”

That’s the thing about blushing: It happens when you really wish it wouldn’t. And then it gets worse because you’re thinking about it.

Generally speaking, there’s nothing dangerous about everyday situations that make blushers blush, which means that there’s no reason for our sympathetic nervous system to fire up and increase blood flow. And yet, it happens.

A natural response

Dr. Tanya Azarani, a psychiatrist and psychotherapist in New York City, explained that blushing is part of the body’s fight-or-flight response. It happens when we feel feelings of shame, self-consciousness or anger, which usually occurs when we feel we’ve been caught violating social norms.

“When a real or imagined social transgression triggers feelings of shame, adrenaline is released from the adrenal glands, causing vasodilation of the blood vessels in the face and neck. As more blood flushes the face, a red complexion and the sensation of warmth develops,” she said.

There’s a scientific reason that we blush more when we know we’re blushing: “The more anxious we feel about our blushing, the more neurologically aroused we become, and the more neurologically aroused we are, the more we blush, leading to a vicious self-perpetuating cycle.”

If you blush a lot and it causes emotional distress and interferes with your daily life, it could be a sign of a deeper social anxiety disorder. Azarani explained that “people with social anxiety disorder fear social situations where they may be judged.”

But there are ways to deal with it besides staying home or hiding behind crew necks and turtlenecks.

“Ultimately, cognitive behavioral therapy is the best treatment for pathological blushing,” Azarani said. It’s also best for treating erythrophobia, which is the fear of blushing, and treating social anxiety disorders.

Cognitive behavioral therapy, or CBT, is a common form of therapy. For blushers, Azarani explained, CBT can help you “look at the relationship between your worries about blushing, your thoughts and the way you behave when anxious about blushing,” which provides a long-term solution, rather than just the short term of taking a pill.

And, yes, there are pills. But Azarani warned that while they can help reduce blushing frequency in the short run, they “may actually reinforce anxiety in the long run by preventing you from learning how to manage blushing-related anxiety on your own.”

Surgery an option

In extreme cases, there is even surgery.

“Endoscopic thoracic sympathectomy is a surgical procedure in which a portion of the sympathetic nerves in the upper chest are destroyed to prevent signals from the brain from reaching nerves in the face that cause blushing,” Azarani said.

But, in doing so, other nerves that regulate body temperature, heart rate and sweating can be disrupted, which can lead to some side effects that, frankly, sound worse than blushing (that includes something called “disturbing compensatory sweating”).

But there is good news: The next time you start to blush, don’t think of your blush as a double-crossing cheek-heater. Because guess what? People like people who blush!

Studies have shown that blushers are perceived as more genuine and trustworthy. The blushing communicates a sense of humility, Azarani said, which “in turn evokes compassion and trust in the observer, motivating them to accept rather than reject the blusher.”