Q. Does caffeine in coffee or tea cause rosacea flare-ups?

An estimated 14 million Americans suffer from rosacea, but most of them don't know it. April has been designated Rosacea Awareness Month by the National Rosacea Society to alert the public to its warning signs and to spotlight the new standard subtypes -- the "four faces of rosacea" -- to encourage early diagnosis and treatment.

When Pearl Poole first found out she had rosacea, she couldn't believe her misfortune.

"I had acne as a teenager and it was detrimental to my self-esteem," Pearl said. "I already had a shy and sensitive nature."

She learned to live with her acne, though. "I couldn't wear makeup, so I tried to look my best in other ways," she said. "Although I wasn't a social butterfly, I did find true love and have a wonderful family."

Yet it was another blow to her self-esteem when she began developing signs of rosacea in her early 50s.

Since the arrival of spring naturally draws people outside, here are some tips for enjoying outdoor exercise while minimizing rosacea flare-ups.

• Consider the potential for a rosacea flare-up. Over-exertion is a common rosacea trigger for many. In a survey of rosacea patients, exercise caused flare-ups in 55 percent of runners, and 46 percent of cyclers and swimmers. In contrast, golf only caused flare-ups for 29 percent of those participating.

   

Certain medications themselves can trigger or aggravate rosacea signs and symptoms, according to Dr. John Wolf, chairman of dermatology at Baylor College of Medicine.

"Rosacea can worsen for some patients from taking vasodilator drugs because of their ability to dilate the blood vessels," he said. "Beta blockers and niacin (vitamin B3) may also cause blood to rush to the face, resulting in a rosacea flare-up."

Rosacea is often much more than a cosmetic problem and may need to be recognized by a broader spectrum of the medical community, according to a new survey by the National Rosacea Society.

In the survey of 2,113 rosacea patients, 45 percent said they were prompted to seek diagnosis and treatment because of the emotional, social or professional consequences of their condition, while 37 percent were motivated by the physical discomfort of rosacea symptoms. Only 33 percent of the respondents were motivated by changes in appearance alone.

Whether certain proteins made by the immune system may trigger the onset of rosacea is the subject of a study sponsored by a National Rosacea Society research grant and conducted by Dr. Richard Gallo, associate professor of dermatology and pediatrics at the University of California - San Diego and Dr. Masamoto Murakami, postdoctoral scientist, Veterans Medical Research Center. While acting to protect the body, the proteins also may trigger some of rosacea's symptoms, the researchers hypothesize.