Today's expanding knowledge of the signs and symptoms of rosacea can help unmask this widespread but little-known facial disorder now affecting an estimated 14 million Americans. April was designated Rosacea Awareness Month by the National Rosacea Society to encourage those who may suffer from this often embarrassing and potentially serious condition to seek diagnosis and treatment before it increasingly disrupts their daily lives.

"It's been called the 'great pretender' because, especially in its early stages, people frequently confuse rosacea with other conditions such as a sunburn or acne, and fail to seek medical help," said Dr. Larry Millikan, chairman of dermatology at Tulane University. "The key is to educate the public on the signs and symptoms, and the need for prompt diagnosis and treatment before it becomes progressively more severe and intrusive."

Despite its prevalence, however, medical data indicate that less than 10 percent of those with rosacea are receiving treatment. Often characterized by relapses and remissions, rosacea typically first appears at any time after age 30 as a redness on the cheeks, nose, forehead or chin that may come and go. Over time, the redness becomes ruddier and more persistent, and telangiectasia (visible blood vessels) may appear.

Left untreated, papules (bumps) and pustules (pimples) often develop, and in severe cases, the nose may grow swollen and bumpy from excess tissue. In many rosacea patients the eyes are also affected, feeling gritty and appearing watery or bloodshot.

In a new survey of 1,618 rosacea patients by the National Rosacea Society, many respondents also said they had suffered from facial discomfort, such as burning, stinging or itching. Moreover, while rosacea is usually considered a facial disorder, 19 percent said their signs and symptoms had occurred beyond the face, including 15 percent on the neck, 6 percent on the chest, 5 percent on the scalp and 4 percent on the ears.

Rosacea is more frequently diagnosed in women, but tends to be more severe in men. While it may occur in all segments of the population, it is especially common in people with fair skin who flush or blush easily -- and there is evidence that a tendency toward rosacea may be inherited.

Perhaps even more devastating than its physical effects, rosacea often inflicts significant emotional and social damage. In recent surveys by the National Rosacea Society, nearly 70 percent of rosacea patients said this unsightly disorder had lowered their self-confidence and self-esteem, and 41 percent reported it had caused them to avoid public contact or cancel social engagements.

"The good news is that, while rosacea cannot be cured, it can be effectively controlled with medical therapy and lifestyle changes," Dr. Millikan said. "It is essential for anyone with signs of rosacea to see a dermatologist for diagnosis and appropriate treatment before their condition reaches more serious stages."

The National Rosacea Society has established a research grants program to encourage and support greater scientific knowledge of this poorly understood disorder. The Society is now funding a growing number of new studies of rosacea that may lead to improvements in its treatment, management and potential cure or prevention.