A number of conservative treatment methods are readily available, such as anticholinergic medications, antidepressants, psychotherapy, acupuncture, and facial creams and ointments. However, in severe cases, these treatments have little or no effect. .

The relationship between facial blush and the autonomic nervous system has been known since the beginning of the last century. However, it was only after Dr. Ehard Kux developed endoscopic access to the autonomic nervous system from the thorax, at the end of the 1930s in Germany, that the surgical treatment of facial blush could be regarded as a therapeutic option in severe cases of blush that had resisted the more conventional treatments. For many years, this surgical treatment involved blocking the second ganglion of the thoracic sympathetic chain (T2) by either cutting it or attaching a titanium clip to stop the nervous impulses from reaching the blood vessels of the face. In general, this approach enjoyed a success rate of around 90%. However, because there was a strong possibility of increasing the amount of sweating in other parts of the body, especially on the trunk and legs--a condition known as compensatory sweating—many patients and surgeons were reluctant to submit themselves to or perform the surgery.

Having performed endoscopic surgeries of the thoracic autonomic nervous system for more than 18 years in partnership with Dr. Peter Kux, the nephew of Dr. Ehard Kux, Dr. João Bosco V. Duarte has developed a new surgical technique for treating facial blush with a high success rate. Furthermore, the possibility of developing compensatory sweating with this new method is very small.

This surgical procedure is done on an ambulatory basis and lasts approximately 30 minutes.

To-date, all patients who have been operated on using this new technique have been able to return to their normal activities the day after the surgery.  In other words, they can go to work, drive a car, practice sports, and so forth. Moreover, they report having felt the positive effects of the surgery immediately after the procedure, and they leave the clinic feeling happier and more confident than they have in many years.