Nobody likes to be on the hot seat. Yet that's where many with rosacea may find themselves this summer unless they take special care to prevent the common rosacea pitfalls of the hot season.

"The sun and hot weather both tend to exacerbate rosacea, and can make outdoor activities especially challenging for people with this condition," said Dr. James Del Rosso, assistant clinical professor of dermatology, University of Nevada School of Medicine. "Fortunately, there are steps that can be taken to minimize these effects."

In a recent survey of 1,066 rosacea patients, sun exposure was identified as the most common rosacea tripwire, affecting 81 percent of respondents, and hot weather caused rosacea flare-ups for 75 percent. Other common rosacea trigger factors that may tend to increase in the summer include wind, hard exercise and humidity.

"Summer may indeed be the time when many rosacea patients need to make the most lifestyle adjustments," Dr. Del Rosso said. He noted that most rosacea tripwires seem to be related to flushing, which in turn may trigger or aggravate the signs and symptoms.

"There are two types of flushing reactions," he explained. "Blood vessels may be dilated directly by certain exogenous (external) agents, such as heat, alcohol or some drugs, or they may be dilated in response to the autonomic (involuntary) nervous system." Warm temperatures often lead to flushing regulated by the autonomic nerves, which also control sweating. There are many causes of flushing, but if due to rosacea, the redness is commonly found in the central face. With sun exposure, there is also increasing evidence that this may trigger the production of natural substances in the body - such as vascular endothelial growth factor (VEGF) - that might play a significant role in rosacea. Here is a "Top Ten List" of summer lifestyle modifications to help rosacea patients enjoy the season while controlling flare-ups:

1. Avoid the midday sun from 10 a.m. to 2 p.m.

2. Retreat often to air-conditioned environments when the temperatures are hot, and ventilate stuffy spaces with fans.

3. Wear sunscreen at all times to protect from sun exposure.

4. Try lightweight, loose-fitting clothing to avoid heat and a hat to protect from the sun.

5. Always drink plenty of fluids on hot days or add a sports drink to your diet.

6. Avoid becoming overheated, which can lead to flushing and flare-ups. Facial flushing can be reduced in many ways, for example, with ice chips that are held in the mouth, or by applying an ice-soaked compress to the face. In some instances simply drinking ice water can lower mouth temperatures - and in turn facial flushing.

7. Use an ice pack around your neck or sweat bands soaked in cold water around your wrists and head to keep down body temperature.

8. Exercise during the morning or evening when temperatures are cooler.

9. Umbrellas are not just for rain; try one to stay out of the sun at the beach and other locations.

10. Don't take a break from your rosacea treatment plan while you're on vacation; be sure to pack your medications and special skin-care products - and avoid all known tripwires.

Associated Reference

1. Wilkin JK. The red face: flusing disorders. Clinical Journal of Dermatology. 1993;11:211-223.