Guidance
The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Endoscopic thoracic sympathectomy for primary facial blushing, in February 2014.
Description
Blushing or facial reddening is an involuntary reaction, usually as a result of a strong emotional response that stimulates the sympathetic nervous system to increase the flow of blood to the skin of the face. People with facial blushing may also have hyperhidrosis (excessive sweating).
Conservative treatment for facial blushing includes oral medications such as beta-blockers or anticholinergics. When anxiety is the cause of blushing psychological treatments such as cognitive behavioural therapy may be used.
If blushing fails to respond to conservative medical treatment or behavioural therapy, then surgical sympathectomy is an option: this can be done either by open or endoscopic approaches. Endoscopic sympathectomy is now usually the preferred technique.
Coding and clinical classification codes for this guidance.