Your daily use of sunscreen while skiing may be the key to the reduction of symptoms. Many rosacea patients are extremely sensitive to the sun, and while you might not think the New England sun is particularly strong, the incidental exposure you get at home may be enough to trigger a flare-up.

In addition to medical therapy, rosacea patients are often advised to use sunscreen daily year-round.

Granulomatous rosacea is considered a variant of rosacea, and is characterized by hard yellow, brown or red bumps or nodules, which typically are on the face but may appear anywhere. It can be severe and lead to scarring and may appear without other obvious signs of rosacea. This condition is relatively rare, and may require special treatment.

Various antibiotics and other therapies may be effective. A dermatologist will be best able to select appropriate therapy for each individual case.

In severe cases, a beta-blocker may sometimes be prescribed to help reduce emotionally triggered flushing that is controlled by the autonomic nerves -- the nerves that control functions such as heart rate. This type of flushing usually results from emotional stress such as embarrassment, presenting a talk or performing on a test or onstage. Often, the blushing is accompanied by a sensation of the heart beating, a more rapid pulse, dry mouth and a feeling of tightening of facial skin. The dosage of the beta-blocker is generally lower than for other medical conditions and the heart rate needs to be monitored to avoid too slow a pulse. Patients with peripheral vascular disease or asthma may need to avoid these treatments.

Rosacea patients may also experience “dry flushing,” which is redness without concomitant sweating. Niacin, alcohol and some medications may cause this kind of flushing. Beyond avoidance of such trigger factors, in severe cases specific treatment such as aspirin or other nonsteroidal anti-inflammatory drugs for niacin flushing may be prescribed to help control this type of flushing.

After starting topical therapy for rosacea, it often takes a few weeks before improvement begins to be seen. Once your rosacea is under control, it is important to continue therapy on a long-term basis in order to help maintain remission.

Rosacea patients are also advised to identify and minimize environmental or lifestyle factors that may exacerbate the condition and trigger flare-ups of signs and symptoms. Rosacea triggers vary from one person to another, and some of the most common include sun, stress, hot or cold weather, wind, alcohol and spicy food. The length of a flare-up can also vary substantially among patients and circumstances, and may typically range from a few days to several weeks.

Yes, moisturizer may be used after applying topical medication without affecting the therapeutic outcome of your prescription. In fact, moisturizer may often be of help in preventing the burning, stinging, itching and irritation associated with rosacea.

I usually advise my patients to wait five to 10 minutes after applying a topical medication before applying a moisturizer, and then wait another five to 10 minutes before applying makeup. This will give your skin a chance to better absorb the medication and keep it from coming off on your fingers as you apply the moisturizer. Waiting before applying makeup may in turn improve cosmetic results.

For more information, see the Skin Care & Cosmetics section.

While many rosacea patients are affected by environmental factors that change with the seasons, what affects one person may not affect another. Although rosacea symptoms are exacerbated by sun exposure and heat in a great number of patients, it may be that you are particularly sensitive to wind or frigid weather and these winter elements aggravate your rosacea.

It is helpful to keep track of your flare-ups so you can pinpoint and avoid your individual triggers. Some of the other common rosacea triggers include emotional stress, alcohol, hot baths, spicy foods, heated beverages, indoor heat and certain skin-care and cosmetic products.

Common eye symptoms of ocular rosacea may include a watery or bloodshot appearance, dryness, foreign body sensation, burning or stinging, itching, light sensitivity, blurred vision, and visible blood vessels or redness of the eyelid. While ocular rosacea is usually mild, in severe cases the cornea may be affected, often accompanied by a deep boring pain and potential loss of visual acuity.

Individuals with severe ocular symptoms are advised to see an ophthalmologist for appropriate diagnosis and therapy. If the cornea becomes infected, without treatment severe ocular rosacea may lead to scarring within the eyelid and reduction in vision from corneal ulcers.

It is possible to have the redness, bumps and pimples of subtype 2 papulopustular rosacea without the facial flushing often present with subtype 1. While the flushing of subtype 1 is often seen before or at the same time as subtype 2, rosacea does not necessarily develop this way in every patient.

The best advice is to see your dermatologist for a professional diagnosis of your condition and appropriate therapy. Regardless of whether you have rosacea, your signs and symptoms may become progressively more severe without proper care and medical treatment.

Rosacea can present itself in different ways in different individuals. While patients typically exhibit similar signs and symptoms on both sides of the face, rosacea may also appear on one cheek or another part of the face only. Without effective treatment, however, over time the signs and symptoms may develop in other areas of the face as well.

It would be advisable for you to see a dermatologist for a professional examination to determine the correct diagnosis and appropriate therapy.

Although a facial may be a good way to pamper yourself, it should be handled with special care if you have rosacea. It may be appropriate to talk to your dermatologist about your individual case, and be sure the facial will be performed by a licensed aesthetician who has worked with patients with skin conditions such as rosacea. Let the aesthetician know of any types of products or ingredients that irritate your skin. It may be wise to steer clear of steam, hot towels or other sources of heat that can stimulate flushing. Also avoid coarse cleansers, skin peels and exfoliation procedures, all of which may be too harsh for the sensitive skin of rosacea patients.

Although it is possible to have rosacea on your scalp, it is unusual for the disorder to manifest itself there.

It's also possible that you suffer from seborrheic dermatitis, which often occurs in addition to rosacea. Seborrhea is a common, chronic inflammatory skin disorder, generally confined to areas where sebaceous (oil) glands are most prominent. The condition is not harmful or contagious, but it can be uncomfortable and unsightly. Scaling and redness are the two dominant characteristics of seborrheic dermatitis. If it develops on the scalp, it can range from a mild case of dandruff to thickened scaling patches and may have an itching sensation.

Seborrheic dermatitis may be the most common skin condition to occur at the same time as rosacea. Although the two disorders are unrelated, a clinical study found that 26 percent of patients with rosacea also had facial seborrheic dermatitis and 28 percent had seborrheic dermatitis of the scalp.

Let your dermatologist know about your itchy scalp so that he or she can accurately diagnose and treat your condition. If you have concurrent disorders, more than one therapy may be necessary.

Avoiding individual rosacea triggers should not compromise a healthy lifestyle.

Although strenuous exercise can trigger a rosacea flare-up in some people, many rosacea patients have found ways to modify their workout routines to avoid this problem. Try working out more frequently but for shorter intervals to minimize flushing. Keep cool indoors by running a fan or opening a window. If outside, work out in the early morning or late evening when weather is cooler. You can also help prevent flushing by keeping a damp towel on your neck, misting your face with a spray bottle, drinking cold fluids or sucking on ice chips.

Although certain foods may cause a flare-up in some individuals, not every potential trigger affects every rosacea patient. An easy way to learn what may affect your individual case is by keeping a rosacea diary. A diary booklet is available free of charge from the National Rosacea Society.

Yes, there may be a connection. It is widely observed that rosacea may be initiated or aggravated by menopause or at perimenopause, the time before menstrual periods end when estrogen levels begin dropping. Both menopause and rosacea are associated with flushing, and these can be indistinguishable. However, heat is a potential trigger factor for rosacea flare-ups, and the hot flashes associated with these conditions may prompt flushing episodes in women who already have or are at risk for rosacea.

While ocular rosacea is most frequently diagnosed when signs and symptoms of rosacea are also present on the skin, eye symptoms of rosacea may occur before skin manifestations in some patients. If your hot flashes become unmanageable and you need to seek medical treatment, be sure to tell your physician about your ocular rosacea and any medications you are taking. This will help avoid any adverse drug reactions and ensure that you receive appropriate therapy.

Although the redness usually found in rosacea is often masked by darker skin, other potential rosacea symptoms -- such as bumps, pimples, stinging and eye irritation -- are just as noticeable in patients of all skin types. Be sure to let your doctor know about your persistent redness, as well as any other symptoms you may be experiencing. He or she may need to adjust your skin care regimen and recommend medical therapy.

As hot weather is one of the most common factors that trigger rosacea flare-ups, you may need to make an extra effort to avoid the sun and heat or at least limit your exposure during midday as those two elements are often rosacea triggers. Other options when possible may be to drape a cool, damp towel around your neck and chew on ice chips if you feel yourself starting to flush. You can also lightly mist your face with a spray bottle filled with cold water. In addition to sunscreen, wearing a wide-brimmed hat outdoors also may be helpful.

To cover visible redness, you may want to consider using a green-toned, color-corrective moisturizer or makeup foundation. Sheer green or yellow foundation or pre-foundation creams can also help neutralize the appearance of redness and keep it from showing through.

While there is no medical therapy that targets the burning feeling in your face, avoiding products that burn or sting and following a careful skin-care regimen can substantially reduce or eliminate the problem.

Burning or stinging is a common aspect of rosacea, and stinging reactions to facial products may be especially common in patients with subtype 1 (erythematotelangiectatic) rosacea, characterized by flushing and redness.

Because sensitivities may vary among individuals, the best way to determine what may irritate your particular condition is to try a product on a peripheral area such as the neck to see if a reaction occurs. If you have a reaction, avoid the product and note the ingredients. In addition, formulations are now available that are designed to soothe sensitive skin and avoid irritation, and you may wish to try these with the same self-test.

In addition to identifying and avoiding any skin-care and cosmetic products that cause stinging, the cornerstone to ensuring that skin remains calm and non-reactive is a daily facial skin-cleansing routine that avoids irritation. Moderation in temperature and touch is the watchword: wash the face with water that is lukewarm; use a gentle, non-soap cleanser; and use the fingers rather than the rougher washcloth.

You may not know that skin is more sensitive when wet, and therefore should be completely dry before applying medication to avoid irritation. Initially wait up to 30 minutes after washing before applying topical therapy or skin-care products. Later, the 30 minutes may be reduced by five-minute increments until you have identified the minimal time you need to avoid stinging. Wait five to 10 minutes after applying topical therapy before following up with moisturizers or cosmetics.