Shoppers beware. Everyday items you put in your grocery cart could end up registering a rosacea flare-up. That's why reading food and skin-care product labeling before getting to the check-out line, and planning a grocery list in advance, may help sufferers learn to better manage their condition.

Rosacea is characterized by flare-ups and remissions that often relate to individual tripwires -- and these can often be found on store shelves. Sufferers are advised to identify and avoid those factors that seem to aggravate their individual conditions, and to use that knowledge while they shop.

In a National Rosacea Society survey of more than 400 rosacea patients, many items typically found in a grocery store were common among the factors they listed as frequent triggers for rosacea flare-ups. These especially included spicy foods, alcoholic beverages, thermally hot drinks and skin-care products. Items cited less often as major trigger factors, but frequently included on grocery lists, are certain fruits, drugs, dairy products and vegetables.

Why do some foods and beverages prompt flare-ups in certain individuals? As a rule, anything consumed that brings on flushing can be a culprit.

While many rosacea sufferers react to spicy foods such as pizza or salsa, some may be particularly sensitive to foods containing histamine or those that release histamine in the body. These include tomatoes, spinach, eggplant, cheese, chocolate, chicken livers, citrus fruits, bananas, raisins, figs, avocados, yogurt and sour cream. Some sufferers also may react to foods high in niacin, such as liver and yeast (bread is OK).

In a recent survey published in Rosacea Review, many patients also reported their condition was sensitive to common skin-care products found at the grocery store, such as astringents, soaps, exfoliants, perfume, moisturizers, shaving cream, hairsprays and sunscreen. Alcohol topped the list as the most frequently irritating skin-care ingredient. Other commonly cited irritants included witch hazel, fragrance, menthol, peppermint and eucalyptus oil.

Although the list of possible rosacea triggers may be long, what may cause a flare-up in one person may have no effect in another. That's why complying with long-term medical therapy and identifying your personal tripwires -- including possible foods, beverages and skin-care products -- are essential to long-term control. Once identified, paying attention at the grocery store can help you avoid those items that affect your particular condition.

Many sufferers have found it useful to keep a diary to help identify and avoid their individual tripwires. A Patient Diary Checklist and list of foods reported to trigger flare-ups in various rosacea sufferers can be obtained by writing the National Rosacea Society.