Most of us go red when, for example, we receive a compliment or have to give an impromptu speech - it’s perfectly normal. But what would you do if you blushed so often that you ended up avoiding people? It’s a problem that Enrique Jadresic, professor of psychiatry at the University of Chile, is all too familiar with. Now, having had an operation to relieve his condition, he has written a book, When Blushing Hurts (IUniverse), both to encourage patients to seek help and to educate doctors in how to treat the problem.

Jadresic started noticing his blushing at 14 and the problem grew steadily worse. He could improve his symptoms by taking beta blockers but he would still frequently receive comments from patients and friends such as, “There you go up the cherry tree again, doctor”. Worse, it was impacting on his career.

Then one day, he read about an operation that could help stop blushing.

The operation, called an endoscopic transthoracic sympathectomy, involves cutting or clamping part of the sympathetic nerve - the nerve that causes sweating and blushing when stimulated. “After the operation,” says Jadresic, “I no longer turned bright red whenever I heard someone say my name.” Most experts think the cause of severe blushing, also known as pathological blushing or erythrophobia, is psychological. Once someone begins to get embarrassed about going red they enter a vicious circle: they notice that they blush in embarrassing situations so begin to get anxious about blushing in the future. The more they worry, the more easily they blush; this leads to blushing in “normal” situations, which can appear strange to others (why are they blushing? Do they fancy me? What have they been up to?). Many people with this problem develop social anxiety disorder and, indeed, blushing is a recognised symptom of this condition.

The sympathetic nervous system is usually activated in dangerous or frightening situations, causing the pupils to dilate, the heart to beat faster, and the blood vessels in the skin to fill up causing sweating and blushing. Therefore, cutting the part of the sympathetic nerve that supplies the skin in the face should stop the face turning red when embarrassed.