The angst and embarrassment of adolescence often come roaring back in adulthood with the red-faced symptoms of rosacea, a widespread but poorly understood facial disorder now estimated to affect 14 million Americans. The National Rosacea Society has designated April as Rosacea Awareness Month to alert the public to the warning signs of this conspicuous and potentially serious condition, and to emphasize the importance of seeking medical help before it becomes increasingly intrusive on daily life.

"Most people expect to leave facial skin problems behind when they reach adulthood, so they're often puzzled and frustrated by the onset of rosacea," said Dr. John Wolf, chairman of dermatology at Baylor College of Medicine. "While the early signs of the disorder may come and go unexpectedly, without treatment it tends to grow more persistent and severe, posing a substantial impact both physically and on people's emotional, social and professional lives."

Although rosacea can strike at any age, in a recent NRS survey of 1,391 patients, 44 percent said this chronic and often complex disorder first appeared between the ages of 30 and 50, while 39 percent reported that the condition began after age 50 and for 17 percent it developed before age 30.

For many people, rosacea starts as a temporary redness on the cheeks, nose, chin or forehead that at first might be mistaken for a sunburn. Over time, the redness tends to become ruddier and more prolonged, and visible blood vessels may appear. Left untreated, bumps and pimples often develop, growing more extensive over time.

In severe cases, especially in men, the nose may become swollen and bumpy from excess tissue. This is the condition, called rhinophyma, that gave the late comedian W.C. Fields his trademark bulbous nose. In many rosacea patients, the eyes are also affected, feeling irritated and appearing watery or bloodshot.

While rosacea is not life-threatening, its effect on the most visible part of the body -- the face -- can take a steep emotional toll. In surveys by the National Rosacea Society, nearly 70 percent of rosacea patients said the disorder had lowered their self-confidence and self-esteem, and 41 percent reported it had caused them to avoid public contact or cancel social engagements. Among rosacea patients with severe symptoms, nearly 70 percent said the disorder had adversely affected their professional interactions, and nearly 30 percent said they had even missed work because of their condition.

Adding to the embarrassment is the common myth that rosacea sufferers, who often have a red face and nose, are heavy drinkers. In fact, while alcohol may aggravate the condition, the symptoms can be just as severe in a teetotaler. Another common misconception is that rosacea is caused by poor hygiene, while in reality it is unrelated to personal cleanliness.

The good news is that, while rosacea cannot be cured, it can be effectively controlled with medical therapy and lifestyle changes," Dr. Wolf said. Individuals with any of the following warning signs of rosacea are urged to see a dermatologist for diagnosis and appropriate treatment:

• Redness on the cheeks, nose, chin or forehead.

• Small visible blood vessels on the face.

• Bumps or pimples on the face.

• Watery or irritated eyes.

Because the underlying causes and other key aspects of rosacea are unknown, the National Rosacea Society conducts a research grants program to encourage and support greater scientific knowledge of the potential causes and other key aspects of this poorly understood disorder. The society is now funding a growing number of research studies on rosacea that may lead to improvements in its treatment, management and potential cure or prevention.

During April and throughout the year, people who suspect they may have rosacea can call the society's toll-free number at 1-888-NO-BLUSH to receive information on rosacea. Information and materials are also available on the society's Web site at www.rosacea.org or via e-mail at rosaceas@aol.com.