Insensitive questions about facial appearance can be a double whammy for rosacea sufferers — the questions may not only cause embarrassment, but can lead to stress that may make the symptoms even worse. Fortunately, however, rosacea patients can usually bring this potentially destructive cycle to a halt by reacting positively, according to psychologists familiar with dermatological disorders.

"While rosacea sufferers have earned the right to their feelings about the physical and emotional demands of their disorder, the more desirable option is to embrace and master techniques that can diminish these negative feelings," said Dr. Richard Fried, a dermatologist and clinical psychologist who serves as director of Yardley Dermatology Associates near Philadelphia.

"Instead of considering such questions inappropriate, they can be viewed as a positive sign that others care enough to ask about your condition," said Dr. Ted Grossbart, a clinical psychologist at Harvard Medical School and author on the psychological aspects of dermatological conditions. "Rosacea patients can maintain their self-confidence by using these situations constructively as opportunities to educate others about the disorder."

Questions are best answered directly, Dr. Fried advised, letting people know that rosacea is a complex, non-contagious skin problem that is becoming better understood. Many factors may contribute, including the innate immune system of the skin.

"Rather than responding to questions with self-consciousness or anger, tell them you're glad they asked because most people don't know about this condition," Dr. Grossbart said.

Rosacea patients can also help their fellow sufferers by dispelling some of the myths or false assumptions that may surround the signs and symptoms. Some people associate red faces and noses with heavy drinking, and acne-like symptoms with poor hygiene. In fact, rosacea is entirely unrelated to hygiene, and while alcohol can aggravate the condition, it can be just as severe in a non-drinker.

"Feeling vulnerable or fearful of other people's thoughts gives them immense power over your emotions, when what they think is not really something that can harm you," Dr. Fried said. "Rosacea patients can also take control of their psychological well-being through such techniques as yoga, tai chi, progressive muscle relaxation, guided imagery, hypnosis, cognitive behavioral psychotherapy, meditation, self-talk and square-box breathing."

He emphasized that such measures, together with dermatologic treatment, can all lead to improved skin appearance and function, as well as emotional health.