Midlife pimples, persistent redness and a flushed face—if that’s what you see in the mirror, you may be one of more than 16 million American adults with rosacea. This common skin disease appears between ages 30 and 60, with most experiencing it for the first time in their 30s and 40s.

Rosacea symptoms vary from person to person but include:

• Persistent redness, like a slight sunburn that doesn’t fade.
• Acne—like pimples.
• Enlargement of tiny facial veins.
• Stinging or burning of the skin.
• Eye irritation and styes.
• An enlarged, bulbous and bumpy nose.

Because of its effects on personal appearance, rosacea causes significant psychological and social stress. According to the National Rosacea Society, more than 90 percent of rosacea sufferers say their condition lowers their self—esteem, and over 40 percent report that it causes them to avoid public contact and social engagements.

Rosacea Myths and Reality

Doctors aren’t quite sure what causes rosacea, but it occurs when your skin’s hair follicles and sebaceous oil glands—the tiny organs that lie beneath the skin—become inflamed. In some people, an overgrowth of skin bacteria and microscopic skin mites produces rosacea.

Genetics are a big factor, too. In a recent survey by the National Rosacea Society, nearly 40 percent of rosacea patients said they could name a relative with similar symptoms. Rosacea appears most commonly among fair-skinned Europeans, but people of Asian, Hispanic or African descent suffer some of the most severe cases.

A common myth claims that alcohol abuse causes rosacea, but that’s untrue. Additional rosacea triggers include stress, spicy foods, hot beverages, weather extremes, hot baths and showers, and hormonal changes, primarily in perimenopausal women.

Coping with Rosacea

There's no permanent cure in many cases, but there are a number of ways to put rosacea in remission and minimize its impact.

First, learn to avoid triggers and reduce stress, both physical and emotional. Keep a food log to track your meals and symptoms, and avoid complex skin care products that contain retinol, alpha hydroxy acid, and vitamins C and E. These cosmetics often promise to rejuvenate skin, but they’re largely ineffective and can cause flushing and irritation in rosacea patients.

If rosacea tends to run in your family it’s good to use only gentle skin care products, protect yourself from the sun and talk to your doctor right away if excessive blushing develops.

Consult a Dermatologist

Early treatment is key. Because rosacea develops gradually and progressively, longstanding cases don’t respond well to treatment, and sometimes the skin damage is irreversible. So call a dermatologist when symptoms first appear—particularly if you’re a woman approaching menopause. When rosacea develops in perimenopausal women, it should be addressed early for best success. Your dermatologist can coordinate care with your primary care doctor or gynecologist.

Doctors usually treat rosacea first with topical agents such as metronidazole gel, but your physician may also suggest oral antibiotics like doxycycline. There's also evidence the herbal remedy feverfew can help relieve rosacea symptoms. The goals of treatment are to reduce redness, which can cause embarrassment, and to stop disease progressing.

New medications can now target the mites involved in rosacea, as well as diminish redness by constricting facial blood vessels. You may also benefit from cosmetic laser procedures to shrink dilated capillaries.