BARRINGTON, Illinois (July 17, 2003) -- From hot peppers to horseradish, strong flavored fare may have no place on the plates of many people with rosacea. A new survey by the National Rosacea Society has identified a broad range of hot spicy foods that often trigger or aggravate this red-faced, acne-like facial disorder affecting an estimated 14 million Americans.

"While spicy foods have been widely recognized as a common trigger factor for rosacea, the list of such food items may be much larger than previously believed," said Dr. Jerome Z. Litt, assistant clinical professor of dermatology at Case Western Reserve University.

In the survey of more than 500 rosacea patients, published in Rosacea Review, 61 percent of those affected by spicy foods listed hot peppers as a trigger for their rosacea signs and symptoms. This was followed by 52 percent for Mexican-style foods, 47 percent for chili and 46 percent for salsa.

However, it is not just the typical south-of-the border dishes that can lead to a rosacea outbreak. Forty-four percent of the survey respondents were affected by hot sausage and 43 percent said Cajun-style foods had triggered or aggravated their rosacea.

Spicy ingredients that often lead to rosacea flare-ups include some obvious ones like hot sauce, affecting 66 percent of the survey respondents, and chili powder for 49 percent. However, in the "pepper" family of spices, red pepper was overwhelmingly more prone to cause a reaction, reported by 53 percent of the respondents. In contrast, more common "table" black pepper was listed by only 22 percent, while paprika had affected 15 percent and white pepper 14 percent.

Horseradish causes a rosacea outbreak for 32 percent of the respondents, followed by barbecue sauce at 28 percent and tomato sauce at 25 percent. Monosodium glutamate (MSG) was listed by 24 percent as a contributor to flare-ups, just ahead of curry, listed by 23 percent. Vinegar triggers or aggravates rosacea in 19 percent of the respondents, while marinated meat was listed by 18 percent. Mustard affects 13 percent, onions 13 percent and garlic 11 percent.

Fortunately, over 90 percent of those surveyed said they were able to modify their eating habits to avoid spicy foods and ingredients that trigger or aggravate their condition, and 87 percent said this had helped reduce their rosacea flare-ups.

Rosacea typically begins at any time after age 30 as a flushing or redness on the cheeks, nose, chin or forehead that may come and go. Over time, the redness tends to become ruddier and more persistent, and small dilated blood vessels may appear. Without treatment, bumps and pimples often develop, and in severe cases, the nose may become swollen from excess tissue. In many patients, the eyes are also affected, feeling irritated and appearing watery or bloodshot.

Although the cause of rosacea remains a mystery, its signs and symptoms may be effectively controlled with medical therapy and lifestyle changes to avoid factors that may aggravate the condition.

"If hot spicy foods aggravate your rosacea, it is still possible to have a little sizzle in your meal," Dr. Litt said. "Patients should try substituting other foods and spices that may not cause their rosacea to flare up."

Red pepper or chili powder, for example, can be substituted with two parts cumin and one part oregano. Traditional salsa can be replaced with a fruit version made from 2 large ripe peaches cut into small cubes, 1/4 cup orange juice, 1 tsp balsamic vinegar, 1/2 tsp ground cinnamon, 2 tsp chopped fresh mint and 1 cup fresh raspberries all gently mixed together.

To help rosacea patients identify and avoid their individual tripwires, the National Rosacea Society offers a patient diary checklist free to members. To join the Society and receive this material or other information on rosacea, write the National Rosacea Society, 111 Lions Dr., Ste. 216, Barrington, Illinois 60010, or call its toll-free number at 1-888-NO-BLUSH. Information and materials are also available on the society's Web site at www.rosacea.org, or via e-mail at info@rosacea.org.