For many individuals with rosacea, every social occasion can feel like a minefield no matter how mild their condition, according to a new survey by the National Rosacea Society (NRS). April has been designated as Rosacea Awareness Month by the NRS to alert the public to the early warning signs of this chronic and conspicuous facial disorder now estimated to affect more than 16 million Americans.

"Rosacea's impact on appearance can be a disabling blow to the emotional and social lives of those who suffer from this poorly understood condition," said Dr. Mark Dahl, chairman of the NRS Medical Advisory Board. "In addition, the stress of facing friends, family and co-workers can act as a trigger for flare-ups, leading to a tailspin that can become increasingly difficult to bear."

Fortunately, for individuals who recognize rosacea's warning signs and seek medical help, diagnosis and appropriate therapy can bring their signs and symptoms under control and keep its social and emotional effects at bay.

According to the new NRS survey of 801 rosacea patients, most feel the negative social impact of their condition regardless of which rosacea subtype they may have. While 61 percent of those with only subtype 1 (erythematotelangiectatic) rosacea, characterized by facial redness, said their rosacea had inhibited their social lives, the number rose to 72 percent among those who reported their redness was moderate or severe. Seventy-seven percent of patients with the bumps and pimples of subtype 2 (papulopustular) rosacea alone noted that their social life had been negatively impacted, and 85 percent of patients whose symptoms included subtype 3 (phymatous) rosacea, involving thickening of the skin, had been negatively affected. Among the respondents who had the eye irritation of subtype 4 (ocular) rosacea, 71 percent said the disorder's effects had inhibited their social lives.

The most common complaint, cited by 50 percent of the respondents, was having to refuse food or drink they normally would enjoy for fear of triggering a rosacea flare-up. Forty-three percent said they had been the subject of stares, misconceptions, rude comments or jokes, and 39 percent had refused or canceled social engagements because of rosacea's effects on appearance. Other common complaints included not participating in physical activities they would enjoy, reported by 37 percent, and avoiding new or different experiences, cited by 28 percent.

Adding insult to injury is a common myth that rosacea sufferers, who often have a red face and nose, may be heavy drinkers. In fact, while alcohol may aggravate rosacea, these 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.

Although the cause of rosacea is unknown, a vast array of lifestyle and environmental factors can trigger flare-ups of signs and symptoms in various rosacea sufferers. Common rosacea triggers include sun exposure, emotional stress, hot or cold weather, wind, heavy exercise, alcohol, spicy foods, heated beverages, humidity, certain skin-care products and many others.

"The good news is that medical therapy, combined with trigger avoidance, can help to reduce rosacea's impact on most patients," Dr. Dahl said. The survey results bear this out, as 63 percent of the respondents reported improvement in their social lives following medical therapy.

Rosacea usually first strikes individuals between the ages of 30 and 60, and may initially resemble a simple sunburn or an inexplicable blush. Suddenly, without warning, a flush comes to their cheeks, nose, chin or forehead. Then just when they start to feel concerned, the redness disappears.

Unfortunately, it happens again and again, becoming ruddier and lasting longer each time — and eventually visible blood vessels may appear. Without treatment, bumps and pimples often develop, growing more extensive over time, and burning, itching and stinging are common.

In severe cases, especially in men, the nose may become enlarged from the development of excess tissue. This is the condition that gave comedian W.C. Fields his trademark red, bulbous nose. In some people the eyes are also affected, feeling irritated and appearing watery or bloodshot. Severe cases of this condition, known as ocular rosacea, can result in reduced visual acuity.

Among the most famous rosacea sufferers is former President Bill Clinton, whose doctors disclosed that he had this condition in The New York Times. Others reported to have suffered from the disorder include Princess Diana, financier J.P. Morgan and the Dutch painter Rembrandt.

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

During April and throughout the year, people who suspect they may have rosacea can visit the NRS website or call its toll-free number at 1-888-NO-BLUSH to obtain comprehensive information on the disorder.