When Jose Vega Aquino of Puerto Rico started using a popular cream to treat his acne, instead of seeing an improvement in his skin, his face became inflamed with red, sore pimples.

"There was itching, dryness and redness," Aquino said. "Any gesture, even a laugh, was very painful."

He discontinued using the acne treatment but the redness and pain persisted. "I stopped using my contacts and tried to hide behind my glasses. I felt terrible," he said.

Aquino went out of his way to avoid social activities and professional appointments, a difficult task for an internal auditor working in a bank.

Fortunately, a good friend of Aquino's persuaded him to see a dermatologist who diagnosed rosacea and put him on oral and topical antibiotics. "The therapy has remarkably improved my condition," Aquino said.

In addition to his therapy, Aquino has modified his lifestyle. He tries to avoid extreme variations in weather and temperature, which can be a challenge when you live on a tropical island and work in an air-conditioned office. He exercises regularly and keeps a damp, cool towel nearby when he feels a flush coming on.

"Your face is your presentation card, so you have to take care of it," Aquino said. "When you make the effort, you'll be happier."