For many, summer is the most awaited time of the year with its promise of sunny weather and outdoor activities. Yet for 14 million Americans with rosacea, it may be a season of despair unless special precautions are taken to prevent rosacea flare-ups.

"The warmer months can be particularly challenging for many rosacea patients because of the increased number of potential environmental and lifestyle factors that may cause flushing and thereby aggravate the condition," said Dr. Richard Odom, professor of Dermatology at the University of California - San Francisco. In fact, a National Rosacea Society survey found that more than half of rosacea patients said their symptoms were at their worst during the summer.

The intense sun, hot weather and increased physical activities may pose the biggest problems. In National Rosacea Society surveys, 61 percent of rosacea sufferers ranked sun exposure as their top rosacea tripwire, while 53 percent cited hot weather and 39 percent said vigorous exercise was their leading cause of flare-ups.

Among patients affected by exercise, outdoor activities most often identified as rosacea triggers include running (55 percent), cycling (46 percent), swimming (46 percent), gardening (45 percent), tennis (44 percent) and golf (39 percent).

Even foods commonly found at an outdoor barbecue have been reported by some sufferers to aggravate their facial condition. These commonly include spicy foods and alcoholic beverages, and for some may include such items as tomatoes, citrus fruits and marinated meats.

"Summer is one time to be particularly cautious about protecting yourself from potential rosacea tripwires and to be diligent about taking your medication as prescribed," Dr. Odom said. The good news is that, for the vast majority of rosacea sufferers, lifestyle modifications and compliance with medical therapy have successfully reduced their flare-ups.

To help avoid rosacea flare-ups this summer, consider taking the following precautions:

• Protect your face from the sun at all times by using a sunscreen with an SPF (sun protection factor) of at least 15. Apply the sunscreen liberally and periodically while outdoors.
• Wear a hat or visor that protects your face from the sun.
• Stay cool. Whenever outdoors, carry a water bottle or spray bottle filled with cold or cool water. Take a drink and periodically spray your face. You can also chew on ice chips.
• When exercising outdoors, pick your time wisely. Avoid strenuous outdoor activity from 10 a.m. to 2 p.m., when the sun is hottest. Exercise in the early morning or early evening when temperatures are cooler, or in an air-conditioned room. Avoid strenuous workouts on extremely hot, humid days.
• Break up your physical activity to avoid becoming overheated. Exercise for shorter intervals, with a cool-down break in between.
• Stay away from summer foods that aggravate your particular condition.
• Continue your medical therapy and be sure to pack your medication when going on vacation.

A Patient Diary Checklist is available to help sufferers identify and avoid rosacea tripwires that affect their individual conditions, and the booklet "Coping with Rosacea" provides further lifestyle management tips.