Flushing and blushing are the result of transient cutaneous vasodilatation that is usually physiological in nature. A blush signifies a psychosocial response to an experienced emotion, whereas a flush is a thermoregulatory response to increased body temperature. Frequent blushing can be associated with considerable anxiety and, in some cases, social phobia. Excessive flushing may be associated with topical agents, food or alcohol intake, or rarely with underlying systemic disease. Clinical features useful in defining the diagnosis include the environmental setting in which the vascular reaction occurs, the extent and pattern of cutaneous involvement, and the presence of associated systemic symptoms. If an underlying systemic disorder is suspected, relevant investigations may be required. Understanding of the mechanisms by which these cutaneous reactions occur has increased, but treatment options remain limited.
Keywords flush, blush, vasodilatation, thermoregulation, catecholamines, histamine, prostaglandins, menopause, carcinoid syndrome, phaeochromocytoma, mastocytosis, rosacea, social anxiety, α‐adrenoreceptor agonists