Rosacea is a skin disease that can cause persistent redness, small red bumps, tiny blood vessels and, in more advanced stages, a bulbous red nose and puffy cheeks. It frequently begins as a tendency to flush or blush easily.

When rosacea first develops, according to the American Academy of Dermatology, the redness may come and go. However, when the skin stays red and does not return to its normal color, and when pimples and enlarged blood vessels become visible, it's recommended to see a dermatologist.

Rosacea rarely reverses itself and can worsen without treatment. Susan Snyder, an aesthetician based in Kakaako, said the company whose products she uses, Sothys Paris, reported that about 10 percent of the population suffers from rosacea. According to Sothys, in a Gallup survey 78 percent of Americans do not know rosacea exists, meaning they do not recognize the signs and symptoms or seek medical attention in the earliest stages.

WHO IS AT RISK?

Most commonly, fair-skinned adults between the ages of 30 and 60 develop rosacea. However, it can affect men and women of any age and sometimes even children. Since it may be associated with menopause, the AAD said women are diagnosed more often than men. These women may begin to notice an extreme sensitivity to cosmetics.

It is a myth that rosacea is an indicator of alcoholism.

In Hawaii, even olive-skinned people have been diagnosed with rosacea.

Jacci Delaneaux of Hawaii Kai, who is hapa and has olive skin, was surprised by the diagnosis.

Lynda Sakraida of Tantalus, who has fair skin and blue eyes, was not surprised when her dermatologist, Carla Nip-Sakamoto, said the cause of her redness was rosacea. "She loaded me up with acne-type lotions made for rosacea," Sakraida said. "That was my biggest problem, my face was always broken out Today, when my cheeks start breaking out, I use something she gives me called 'Clinagel' by Galderma. Works really well." She also uses a foundation with a yellow base to offset the redness.

AVOID THE TRIGGERS

The redness of rosacea can be triggered by alcoholic drinks, hot drinks, spicy foods, caffeine, humidity, stress, skin care products and some medications. Exercise can also exacerbate rosacea so it's advised to exercise in a cool environment and avoid overheating.

Sun protection is critical for those with rosacea. Sun exposure should be limited and a broad-spectrum sunscreen with SPF 15 or higher should always be used and reapplied every two hours.

A National Rosacea Society survey cited these irritants: alcohol, witch hazel, fragrance, menthol, peppermint, clove oil, salicylic acid and eucalyptus oil.

Facial cleansing for those with rosacea should be soothing and calming.

Dermatologists say to avoid rubbing, scrubbing, exfoliating or massaging the face. Even wash cloths can bring on the flush. It's helpful to the rosacea patient, and the physician, to keep a diary of flushing episodes, noting associated foods, products, activities, medications and other triggers.

TREATMENTS

A dermatologist may prescribe creams, lotions, foams, washes, gels and pads that contain various antibiotics and retinoids. Other treatments include oral antibiotics, laser surgery and electrodesiccation (treatment with a small electric needle).

On a superficial level, green- or yellow-tinted primers or makeup may help to mask the redness.

Dermatologists warn that skin care products and cosmetics can cause flare-ups. In a National Rosacea Society survey of 1,066 patients, 41 percent reported that certain skin care products aggravated their condition and 27 percent said some cosmetics caused flare-ups.

A number of skin care companies have introduced lines they claim target extremely sensitive skin. Among them are Sothys Clarte & Confort line, LaRoche-Posay's Rosaliac, DDF Redness Relief, Murad Redness Therapy and Jurlique Soothing Herbal Recovery Gel.

Rosacea patients should look for products designated for sensitive skin and avoid anything that stings, burns or irritates. It's wise to test any new product in a peripheral area such as the neck or arm before applying it to the face.

For more information: http://www.skincarephysicians.com/rosaceanet or http://www.rosacea.org.