When Jose Vega Aquino of Puerto Rico started using a popular cream to treat his acne, instead of seeing an improvement in his skin, his face became inflamed with red, sore pimples.

"There was itching, dryness and redness," Aquino said. "Any gesture, even a laugh, was very painful."

He discontinued using the acne treatment but the redness and pain persisted. "I stopped using my contacts and tried to hide behind my glasses. I felt terrible," he said.

Once thought of as a rare mysterious malady, rosacea is now the fifth most common diagnosis made by dermatologists, according to figures recently published in Skin and Allergy News.

Although the frequency of rosacea diagnosis ranks only behind that of such well-known skin disorders as acne, dermatitis, psoriasis and actinic keratosis, it was not until recent years that rosacea has become widely identified as one of the most common dermatological conditions.

Q. Sometimes my rosacea flare-ups look like mosquito bites and itch. Is this common?

A. A rosacea flare-up is characterized by a more intense outbreak of redness, bumps or pimples. For some sufferers, the bumps caused by rosacea may resemble mosquito bites. For others, these bumps are generally redder in appearance. It is not uncommon for rosacea patients to itch from dry skin, which can be helped by using a moisturizer.

Such diverse items as chocolate, tomatoes and citrus fruits ranked surprisingly high along with such well-known rosacea tripwires as hot spices, alcohol and heated beverages in the first comprehensive survey to detail specific foods that frequently aggravate the symptoms of this disorder.

At a symposium during a recent meeting of the American Academy of Dermatology, Dr. Mark V. Dahl, chairman of Dermatology, University of Minnesota, noted that to ensure the effectiveness of topical antibiotic therapy for rosacea, patients must spread the medication over the entire face.

"Some patients may apply topical therapy to individual papules and pustules, much as they may have treated acne when they were younger," said Dr. Dahl. "It is important to use this medication over the entire face as a preventive measure for it to be useful."

Socializing can be intimidating any time of year for rosacea sufferers worried about flare-ups. The fast pace of the holidays can intensify the anxiety. Here are some tips to make "good vibrations" during this festive season.

• Don't minimize the importance of consistent medical therapy and lifestyle changes to avoid factors that may aggravate your individual condition. Patients who use medication as prescribed and avoid rosacea tripwires report the best success in controlling their symptoms.