While sipping hot coffee, running laps or a day at the beach may cause the average person to flush harmlessly, such innocuous deeds can wreak havoc on the face of a rosacea sufferer. Because rosacea is characterized by flare-ups and remissions as it grows increasingly more severe, sufferers of this conspicuous and embarrassing disorder are advised to identify and avoid those factors that seem to aggravate their individual conditions.

Although there is an astonishing array of environmental and lifestyle factors that may trigger rosacea flare-ups in various individuals, what affects one sufferer may not affect another. According to a National Rosacea Society survey of 1,066 rosacea patients, the most common rosacea trigger factors are sun exposure, emotional stress, hot weather, wind, heavy exercise, alcohol, hot baths, cold weather, spicy foods, humidity, indoor heat, certain skin-care products, heated beverages and certain cosmetics.

The National Rosacea Society offers a rosacea diary booklet to help rosacea sufferers determine which factors come into play in their individual cases, as well as booklets that provide comprehensive information on the disorder. Identifying and eliminating rosacea triggers, along with faithful compliance with medical therapy, can help rosacea sufferers keep their condition under control and symptoms at bay.

Here are tips for avoiding some common rosacea triggers.

Weather-Related Triggers

Sun exposure, hot weather, humidity, cold and wind have all been known to aggravate rosacea for some individuals. The following are defense strategies sufferers can use:

• Always protect the face from the sun. Wear a sunscreen with an SPF (sun-protection factor) of 15 or higher year round. Wear a broad-brimmed hat. Minimize midday exposure to the sun (from 10 a.m. to 4 p.m.) during summer months.
• Stay in a cool, air-conditioned environment on hot, humid days. If this is impossible, those affected should sip cold drinks and try not to overexert themselves. If necessary, chew on ice or spray the face with cool water.
• Combat cold by covering the cheeks and nose with a scarf. Rosacea sufferers also may don a ski mask when participating in outdoor sports or activities, as well as cover up on windy days. If these conditions aggravate their rosacea, limiting their time outdoors may also help.
• Use a moisturizer daily during cold weather. This protects against the naturally drying effects of cold and wind.

Stress

Emotional stress ranks high on the list of rosacea triggers. When feeling overwhelmed, rosacea sufferers can try some of the following stress reducers:

• Take care of the whole self. Eat healthy, exercise moderately and get the right amount of sleep. It may also help to cut down on caffeine.
• When under stress, try deep-breathing exercises. Sufferers should inhale and count to 10, then exhale and count to 10, repeating the exercise several times.
• Use visualization techniques. Sitting in a quiet place, closing the eyes and visualizing a beautiful vacation spot or favorite painting or scene can reduce stress. The picture should be held for several minutes to feel its peacefulness and beauty.
• Stretch out and relax all the muscles. Stretching muscles starting at the top of the head and working down to the toes is a whole-body stress reliever.

Foods and Beverages

Steaming hot soup or coffee, spicy nachos, a glass of red wine -- no matter how appetizing they sound, these foods and beverages may be a problem for some rosacea sufferers. In a survey of 3,151 rosacea sufferers affected by foods and beverages, 48 percent said wine irritated their condition, hard liquor was a trigger for 37 percent and beer was cited by 26 percent. Heated beverages such as coffee affected 35 percent. Hot liquids or spicy foods can also cause flushing and trigger flare-ups in many cases, and such diverse items as chocolate, tomatoes and citrus fruits also ranked high as potential rosacea triggers. These tips will help sufferers select rosacea-friendly meals:

• Avoid "hot" spices such as white and black pepper, paprika, red pepper and cayenne, which are common rosacea triggers. Try these flavor substitutes: for chili powder, 2 tsp cumin, 1 tsp oregano; for poultry seasoning, 1/2 tsp sage, 1/2 tsp coriander, 1/4 tsp thyme, 1/8 tsp allspice, 1/8 tsp marjoram; for curry powder, 4 tsp coriander, 2 tsp turmeric, 1 tsp cinnamon, 1 tsp cumin, 1/2 tsp basil or oregano, 1/2 tsp cardamom.
• Approach foods containing histamine carefully, such as cheeses, ciders and vinegars; some Asian foods; processed beef and pork; and canned fish products. They may aggravate rosacea for some sufferers. Taking an antihistamine about two hours before a meal may help counter the effects. Likewise, taking an aspirin may be helpful when eating niacin-containing foods such as tuna, peanuts and soy sauce. But rosacea patients must remember that antihistamines may cause drowsiness, especially when combined with alcohol.
• Reduce the heat in beverages. Decreasing the temperature may be all that is necessary for rosacea sufferers to keep enjoying coffee, tea and hot chocolate, for example. Or they may reduce the number of cups from three or four to one or two instead.

Exercise

While exercise is part of a healthy lifestyle, for 83 percent of 1,261 patients in a survey by the National Rosacea Society, working out caused their rosacea to flare up. Moderation is the key, and 97 percent of those who made some changes in their exercise routines were successful in avoiding aggravating their rosacea. Sufferers should take these precautions:

• Avoid high-intensity workouts that cause overheating and bring on flushing. Instead replace them with low-intensity routines.
• Try exercising for shorter, more frequent intervals. For instance, exercise for 15 minutes three times a day, rather than exercising all at once.
• When exercising outdoors during warm weather, choose early morning or early evening hours when it is cooler. No matter what time of day, most people with rosacea should protect their face from the sun and avoid hot weather.
• When exercising indoors, make sure the room is well ventilated. Run a fan, open the window for a breeze or turn on the air-conditioning to avoid overheating.
• Try to stay as cool as possible when exercising. Rosacea sufferers might drape a cool, damp towel around their necks, drink cold fluids or chew on ice chips. They can also keep a bottle filled with cool water to spray the face.

In addition to avoiding rosacea triggers, medical therapy is available to help maintain remission and reverse the signs and symptoms of the disorder. Anyone who suspects they may have rosacea is urged to see a dermatologist for diagnosis and appropriate treatment.

For comprehensive information on rosacea, visit the National Rosacea Society Web site at rosacea.org, or call its toll-free number at 1-888-NO-BLUSH. Information and educational materials are also available by writing the National Rosacea Society, 111 Lions Dr., Ste. 216, Barrington, Illinois 60010 or via e-mail at info@rosacea.org.

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