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.

Patulous follicles (the medical term for enlarged pores) are one of the characteristics of subtype 3 (phymatous) rosacea, which most commonly involves the nose but may also affect the cheeks, chin, forehead and ears. One possible explanation for the follicles' appearance is that protein excreted by the connective tissue beneath the skin builds up faster than the lymphatic drainage system can remove it. As the fluid builds up, the tissue becomes hard and thickened and may have the appearance of an orange peel, with sebaceous oil glands mimicking the pitted surface.

Fortunately, the enlarged pores often improve or return to normal following successful therapy.

Topical and oral antibiotic therapy may be prescribed for mild cases, but more severe cases may sometimes be treated with isotretinoin, which is an oral medication typically used for severe acne. Clinical studies have shown that patients' large sebaceous glands were diminished in size and number during isotretinoin therapy. There is also evidence that retinoids, topical medications with many of the same properties of isotretinoin, may decrease skin thickening and sebaceous gland enlargement. Spironolactone, a mild diuretic with anti-androgen properties, can also be used to decrease pore size.

When phymatous changes caused by rosacea become too severe, resulting in contour changes such as a bulbous nose, surgical therapy or laser therapy may be indicated. It is important to follow your doctor's instructions and prescribed medical therapy carefully, as well as to avoid your own personal environmental and lifestyle triggers, in an effort keep your rosacea from progressing to this stage.

While rare, cases of rosacea during childhood have been reported in the medical literature. Whether your son has rosacea or not, he may benefit from seeing a dermatologist for a proper examination, diagnosis and treatment as may be appropriate.

Be sure to tell the doctor about your wife’s rosacea, since the condition tends to run in families. Let the doctor know about his flushing, as this may or may not be present during the examination. Also, if your son experiences any eye discomfort, make sure the doctor is informed of this as ocular rosacea may be especially important to identify and treat during childhood.

Taking your son to a physician would be a wise move because the emotional toll of anything that affects the face can be high, especially during adolescence, when self-image is often closely tied to physical appearance. An accurate diagnosis and appropriate treatment could not only benefit his emotional well-being, but may help prevent further signs and symptoms from developing.

Lasers have been found to be a very effective treatment for visible blood vessels (telangiectasia) in many rosacea patients. A laser emits wavelengths of light aimed at the tiny visible vessels just beneath the skin, and heat from the laser's energy builds in the vessels, causing them to diminish in size. Generally, at least three treatments are required at six-week intervals, depending on the severity of the telangiectasia.

As effective as lasers may be in eliminating the spidery veins so common to rosacea patients, however, the treatment is not a cure and the underlying disease process will still be there. Especially if the patient does not follow his or her prescribed medical therapy and avoid individual rosacea triggers, particularly exposure to the sun, new visible blood vessels may develop over time. Additional touch-up laser therapy may then be needed.

The first step is to seek the care of an eye specialist who is familiar with ocular rosacea. Successful contact lens wear depends on a healthy eye surface, and your eye doctor (ophthalmologist) can ensure that you do not have any inflammation present, that your eyelid glands are functioning normally and that you have an adequate tear supply. If any symptoms of ocular rosacea are present, your eye doctor should take steps to bring the symptoms under control before fitting you with contact lenses.

Both gas permeable and soft contact lenses are options for rosacea patients, though there are advantages and disadvantages to both. The smaller size of gas permeable lenses allows for greater tear exchange and debris removal, but the harder lens may be more traumatic to the surface of the eye. Soft lenses, while more comfortable for many people, tend to "steal" fluid from eye, potentially leading to inflammation. Loosely fitting, soft lenses with low water content may help to prevent this problem. I also recommend frequent replacement of soft lenses to reduce protein and oil buildup on the surface of the lens.

Regardless of the type of lens chosen, artificial tears can extend the wearing time for rosacea sufferers, particularly older patients who have dry eyes. Even so, some patients may only be able to wear their contact lenses for a limited amount of time.

Contact lens solution also plays an important role in a rosacea patient’s ability to successfully wear contacts. It is imperative to keep the surface of the lens as clean as possible, and I typically recommend a hydrogen peroxide-based cleansing system for soft contact lens wearers. In addition, you should discuss a hygiene routine with your eye doctor to keep the eyelid glands clear of debris and functioning normally to ensure a successful experience with contacts.

Close monitoring of your corneal surface by your eye doctor before and after lens fitting is strongly advised to be sure that the lenses are not damaging the corneal surface in any way. If at any time your eye becomes red or painful, you should immediately remove the lens and consult your eye doctor before inserting the same lens. Never wear your lenses longer than recommended and be certain to keep them clean and follow the hygiene recommendations made by your doctor and the lens manufacturer.

Rosacea shares certain signs and symptoms with a variety of disorders, and dermatologists usually distinguish between similar conditions by looking for a typical pattern or combination of symptoms unique to one or the other.

Though they are distinct disorders, seborrheic dermatitis is the most common facial skin disorder to occur along with rosacea. Seborrheic dermatitis is a chronic and frequently recurring inflammatory condition that is characterized by a red, scaly or itchy rash often found in the creases around the nose, the inner eyebrows or as dandruff on the scalp. While the two conditions share facial redness, a pattern of flaking, itchy rash and excessive oiliness points to seborrheic dermatitis.

Other signs and symptoms of rosacea that may occur with other conditions include the bumps and pimples of acne vulgaris; the redness and irritation of contact dermatitis; the flushing of carcinoid; and the facial butterfly-shaped red rash of the autoimmune disorder lupus erythematosus.

As always, it is important to consult a physician in order to get accurate diagnosis and appropriate treatment. If you have concurrent disorders, more than one therapy may be necessary.

While medical treatments are available that can control its various signs and symptoms, there is currently no cure for rosacea. However, news reports of new therapies are often so glowing as to seem to suggest to readers that a cure may be possible. Although there are products that can be very effective in achieving control and even remission, there are no therapies that are proven to permanently eradicate the signs and symptoms of rosacea.

The most reliable source of accurate information about any drug approved by the U.S. Food and Drug Administration may be the product information sheets included with the drug itself, and this information is also typically available for viewing online. It is important to read the package insert carefully. Per U.S. Food and Drug Administration regulations, information about prescription drugs must be carefully worded in order to precisely describe the therapy's action, risks and benefits.

Product information will include the therapy's indications -- that is, what condition or signs and symptoms it is useful for; its dosage and how it is administered; possible adverse reactions it may cause; contraindications -- the specific circumstances when it should not be used; as well as a wealth of further information on clinical testing in which the drug's effectiveness and possible effects, and other data, were assessed. Importantly, product information may not make claims about its effects that have not been established in testing.

Although no currently approved therapies can claim to permanently cure rosacea, a treatment regimen that might include avoidance of specific triggers along with medications may lead to very long-lasting remissions in many patients.

You are not alone in your distress. In addition to its physical signs and symptoms, one of the most serious consequences of rosacea may be the emotional anguish that comes from its effects on personal appearance.

A key first step is to seek medical help and consult a dermatologist, who can determine whether you have rosacea and prescribe or recommend appropriate therapy. While rosacea has no cure, treatments are available to control or eradicate its signs and symptoms. The effects of rosacea on appearance can be further minimized with lifestyle changes, proper skin care and cosmetics.

It's also important to keep personal appearance in proper perspective, and to obtain psychological help if needed. Emotional stress itself is a common trigger for rosacea flare-ups in many patients. Facing the disorder armed with the knowledge, coping skills and therapy to bring it under control will help to break the cycle of emotional distress from rosacea that may contribute to continued flare-ups.

Itching, watering and a gritty feeling in the eyes all may be symptoms of ocular rosacea, and additional care may be appropriate. While potential eye symptoms of rosacea are often very mild, significant cases should be diagnosed and treated by an ophthalmologist in order to avoid long-term visual consequences.

Ocular rosacea has been observed in up to 50 percent of rosacea patients, and other symptoms may include red eye, burning or stinging, light sensitivity and blurred vision. Dry eye and the occurrence of styes, a plugging or infection of the meibomian glands responsible for secreting tears to lubricate the eye, are also common manifestations of rosacea-related ocular disease, and other possible complications include reduced visual acuity due to corneal damage.

An ophthalmologist can prescribe medication and other measures to relieve eye symptoms and prevent the disorder from causing serious harm. Successful management of the eye manifestations of rosacea commonly requires systemic treatment in addition to local ocular therapy.

Not that we know of. Even patients with rhinophyma usually can breathe well through their noses.

Although the exact cause of rosacea is unknown, various theories about the disorder's origin have evolved over the years, and some share common characteristics with chronic nasal blockage.

Chronic nasal obstruction has many causes. Typical stuffy nose is commonly associated with inflammation of the mucous membranes of the nose from various causes, often allergies or viruses. When the mucosa becomes inflamed, the blood vessels inside the membrane swell and expand, causing the turbinates -- small, shelf-like, bony structures that are covered by the mucous membranes -- to become enlarged and obstruct the flow of air through the nose.

Although theories about rosacea's cause also involve inflammation and swelling of blood vessels, the mucous membranes of the nose and mouth are not affected. The eyelids can become inflamed from ocular rosacea, but exactly how this happens is speculative. Also, the occurrence of stuffy nose does not usually trigger attacks of rosacea, although frequent nose blowing may temporarily aggravate flushing.

I commend you on wanting to be thoroughly prepared when you meet with your dermatologist. To aid in proper diagnosis and selection of appropriate therapy, tell your doctor of any signs or symptoms that may not be visually apparent or present at your office visit.

If you experience significant flushing, try to identify when and how this occurs. Also, tell your doctor if you've had long-term extensive sun exposure in your job or lifestyle, as this may lead to redness and visible blood vessels from photodamage instead of rosacea.

You should also let your doctor know about facial burning, stinging, itching, swelling or tightening as these may be addressed in tailoring treatment and care for your individual case. In addition, you might ask about any environmental or lifestyle factors that seem to trigger flare-ups of symptoms. Make a list of things to discuss so you don't forget.

This is also a good time to relate any other concerns you may have about your condition. Be sure to let your doctor know if it has a significant effect on your personal or professional life, so this can be considered in developing appropriate care.

Spicy foods can cause flushing and rosacea flare-ups in many individuals, and frequent occurrence may contribute to a worsening of rosacea. Like the air in an inflated balloon, the greater volume of blood in the facial blood vessels that is present during flushing results in greater tension on the blood vessel walls, as well as on tissue that holds the vessels in place. If repeated, vessel walls and supporting tissue may lose their elasticity, resulting in a worsening of rosacea, including persistent redness and/or swelling that may not clear as quickly as in the past.

NOTE: In a National Rosacea Society survey of more than 1,000 individuals with rosacea, 45 percent reported that spicy foods caused rosacea flare-ups in their individual cases. In another patient survey, food items reported to commonly trigger rosacea included hot peppers, Mexican-style foods, chili, salsa, hot sausage and Cajun-style foods, while specific ingredients or seasonings found to be common rosacea tripwires in the surveys included hot sauce, chili powder, red pepper and cayenne.

House dust mites are just one of the many varieties of the microscopic member of the spider class that live in soil or water, or coexist with animals or insects. Technically known as Dermatophagoides farinae, the house dust mite feeds on minute particles of organic matter, including the skin cells shed by people every day that make up a large component of household dust. While house dust mites may be vacuumed away or killed by sunlight, the humid home environment is often an ideal environment.

Our newly published study, funded by the National Rosacea Society, demonstrated for the first time that these invisible organisms may be a cause or exacerbating factor in rosacea. Published in the British Journal of Dermatology, we identified Bacillus oleronius as a bacteria associated with Demodex mites. We found that B. oleronius stimulated an immune system response in almost 80 percent of patients with papulopustular rosacea, suggesting that the bacteria rather than the mites could be responsible for the inflammation associated with the condition, a hypothesis supported by the fact that effective treatment includes antibiotics that destroy B. oleronius.

Although rosacea symptoms usually appear primarily on the forehead, nose, cheeks and chin rather than the eyebrow area, like many rosacea sufferers, you may have sensitive, easily irritated skin. Gentle skin care is key, and pulling and tugging should be avoided. For example, you should wash your face gently with a non-irritating cleanser and avoid abrasive materials such as a rough washcloth or loofah, and blot, rather than rub, your face dry with a soft towel.

You may want to experiment with different methods of shaping your brows to find a less irritating procedure such as chemical or laser hair removal, or using a gel to control unruly hairs.