Extreme blushing, blotchy skin when nervous

I'm a well-adjusted, attractive 24-year old girl living in NYC. I've always been an anxious person...sweaty palms, racing heart rate, flushing easily, but now I feel like it's getting worse and interfering in my life. I was recently prescribed beta-blockers for interviewing because I had botched so many by turning red and not being able to express myself. Using the beta-blocker I finally aced some interviews and got my dream job. That was good, but I can't take beta-blockers every day and I'm worried that my non-stop nervousness is holding me back big time in everyday life and work. For example, when I have to present my ideas or am just talking to my bosses I turn bright red--it's very noticeable and embarrassing. It makes me feel incompetent and like a weirdo. In social situations (at work and outside of work) if I'm meeting someone new or talking about something that brings up any feelings at all, my pale skin gets all blotchy on my chest, shoulders and back--so much so that people ask what's wrong with me and are distracted from what I'm saying. The thing that is most frustrating to me is that my spirit is very outgoing and social--but my body betrays me! I wish there was something I could do to lessen it. I know I can't make it go away completely and that no one is perfect, but I can't even get through one day without turning bright red 5 times and have my heart race constantly--ending in migraine headaches and an inability to concentrate. I'm wondering if I have an anxiety disorder? Should I start by going to a psychologist or psychiatrist?

Additional background: a few years ago I lost my best friend and took antidepressents--this is about when my blushing, blotchy skin symptoms became more prounounced. During that period I had several full-blown anxiety attacks. Also, my dermatologist recently told me I might have early roseaca because I turned red during the exam (but I think it was just being nervous because normally my skin is smooth and clear).

[Roger Gould, M.D.]

You should be seeing a psychiatrist because a combination of some mild anti anxiety medication and talk therapy will help you greatly. I have an office in new york, and if you email me, I will help you find a therapist.