Rosacea may be incurable, but it doesn't have to be out of control. Medical therapy along with the right lifestyle choices can help you get a grip on this chronic but manageable disorder.

"People don't realize the variety of minor things that can increase blood flow in the face and aggravate rosacea," said Dr. Jonathan Wilkin, a leading authority on rosacea now with the U.S. Food and Drug Administration. "The right lifestyle plan combined with medication allow most patients to achieve substantial control."

In contrast to many medical conditions, rosacea often follows a pattern of flare-ups and remissions. It usually begins as a flushing or redness on the cheeks, nose, chin or forehead that may come and go.

Over time, the redness may become more pronounced and persistent and, left untreated, can progress to pimples and bumps, tiny visible blood vessels called telangiectasia and sometimes an enlarged nose from excess tissue.

While telangiectasia and excess tissue must be treated surgically with lasers or other techniques, compliance with medical therapy combined with avoiding those lifestyle factors that may trigger flare-ups can eliminate the redness, bumps and pimples -- and also may halt progression of the condition to more severe consequences. Identifying harmful lifestyle factors is an individual process, however, because what may cause a flare-up in one person may have no effect in another.¹

For instance, some of the most common tripwires appear to be sun, stress, hot weather, alcohol, spicy foods, exercise, hot baths, cold or windy weather and hot beverages. According to surveys, these tripwires affect anywhere from 61 to 36 percent of all rosacea sufferers.

Humidity and certain skin care products were also found to be common tripwires, while a wide range of other factors were reported by 5 to 10 percent of rosacea sufferers. These include certain fruits, vegetables, dairy products, drugs and medical conditions.

Because each rosacea sufferer will rarely be affected by every possible factor, many find it useful to keep a diary to help identify and then avoid those factors that come into play in their particular case.

"It doesn't mean you have to change your whole life," Dr. Wilkin said. "The goal is moderation, like cutting back to one cup of moderately hot coffee a day instead of four hot cups."

The National Rosacea Society has developed a Patient Diary Checklist of the most common factors that may lead to a flare-up, in order to provide a systematic way for patients to pinpoint their personal triggers. Available from the Society at no charge, patients are advised to use the diary checklist to monitor their condition daily for several weeks to look for items that coincide with flare-ups. By developing a routine you can follow each day to minimize harmful lifestyle factors and ensure proper use of medication, you give yourself the best chance of effectively controlling your condition.

"Your face is your social signature," Dr. Wilkin said. "When you can get it clear, you feel better about your whole self."

Associated References

1. Wilkin JK. Recognizing and Managing Rosacea. Drug Therapy. 1993;June:41-49.