Physicians recently discussed new advances in the understanding of how rosacea develops in the body, opening the way for potential improvements in its effective care, during the summer meeting of the American Academy of Dermatology in New York.

Dr. David E. Cohen, professor of dermatology at New York University, outlined current knowledge of the disease process of rosacea, providing a map of the development of rosacea at the cellular level.

Although the progression of rosacea can vary substantially from one individual to another, flushing and persistent redness are by far the most common early signs of the disorder, according to a new survey conducted by the National Rosacea Society.

Two recent studies, funded by individual donations to the National Rosacea Society (NRS), have discovered potential key factors in the development of rosacea that open new possibilities for important advances in its treatment and prevention.

A malfunction in part of the body's nervous system may be linked to the redness as well as the bumps and pimples of rosacea, according to a recently completed study by Dr. Akihiko Ikoma and colleagues at the University of California-San Francisco.

The many potential signs and symptoms of rosacea may so closely mimic other skin disorders that it has often been called "The Great Impostor." The National Rosacea Society (NRS) has designated April as Rosacea Awareness Month to alert the public to the warning signs of this chronic and conspicuous condition and to emphasize the importance of seeking medical help.

Although rosacea has been classified into four common patterns of signs and symptoms known as subtypes, most rosacea patients experience a progression in their disorder from one subtype to another, according to a new survey by the National Rosacea Society.

In the survey of 1,231 rosacea patients, 72 percent reported that their rosacea had evolved from one subtype to another, and 77 percent said they had experienced more than one subtype at the same time.

Q. Will I eventually get all four subtypes of rosacea?

A. The four subtypes of rosacea, designated by the new standard classification system, identify common patterns of signs and symptoms. Individual patients may have all of the signs of a certain subtype, or just some of them. Others may have characteristics of more than one subtype at the same time.

A new survey by the National Rosacea Society demonstrated the wide variability of rosacea from one patient to another, while mapping the early development of its many potential signs and symptoms.

Q. My rosacea seems to get worse in the fall and spring. Why would this be so?

What happens when you aggravate rosacea? For those afflicted with this widespread disorder, contact with their personal trigger events -- which may include any of a wide array of environmental or lifestyle factors usually associated with flushing - can set into motion the physiological process whose outward signs are recognized as rosacea.

Q. I have had rosacea for several years and now I've noticed that one of my cousins looks as though she has symptoms of the disease. How do you tell someone you think they have rosacea?