Without special precautions, you may be heading for a flare-up this summer as sun, stress and hot weather were cited as the most common rosacea tripwires in a new survey conducted by the National Rosacea Society. The survey of 1,066 rosacea patients provides the most comprehensive ranking to date of the multitude of things that may trigger or aggravate the signs and symptoms of rosacea in various individuals.

Sun exposure ranked as the number one rosacea tripwire, with 81 percent of all the survey respondents indicating it aggravated their rosacea and 63 percent listing it as their first, second or third most likely factor leading to a flare-up. Coming close behind, 79 percent reported emotional stress as a rosacea trigger, and 64 percent ranked it within their top three aggravating factors. Hot weather was cited by 75 percent of those responding, with 57 percent noting it as their first, second or third most likely trigger for a rosacea flare-up.

Wind, exercise and alcohol were also cited as frequent problems for rosacea patients. Exposure to wind causes flare-ups for 57 percent of the respondents, while exercise was mentioned by 56 percent and alcohol was noted by 52 percent.

Several other factors were also found to be very common among the survey respondents. Hot baths affected 51 percent, and cold weather was mentioned by 46 percent. Spicy foods were listed by 45 percent of those responding and humidity affected 44 percent. Indoor heat and skin-care products both were noted by 41 percent, and heated beverages caused flare-ups for 36 percent.

Additional rosacea tripwires cited by survey respondents include cosmetics (27 percent), medications (15 percent), medical conditions (15 percent), certain fruits (13 percent), marinated meats (10 percent), certain vegetables (9 percent) and dairy products (8 percent).

Survey respondents also mentioned a wide variety of other factors. Many noted hormone-related conditions such as menopause and menstrual cycle, or emotional factors such as anger, excitement, embarrassment or depression.

"Even though many rosacea sufferers are affected by the same triggers, the overall variety of responses to this survey illustrates the need for patients to identify and avoid the specific factors that cause their individual conditions to flare up," said Dr. Joel Bamford, associate professor of dermatology at the University of Minnesota-Duluth. "Fortunately, what affects one person with rosacea may not necessarily affect another."

To help rosacea patients identify and avoid their individual tripwires, the National Rosacea Society offers a free patient diary checklist and booklet on "Coping with Rosacea."