Many of us covet just-flushed cheeks—a hallmark of good healthy and vitality—but if you’re one of an estimated 16 million Americans with rosacea, a chronic skin disorder marked by a ruddy, red complexion, life may not be so rosy. In a study conducted by The National Rosacea Society, 76 percent of respondents said it dashed their self-confidence and 41 percent reported it had caused them to cancel social engagements or avoid hanging out in public.

Even though the skin condition affects about five percent of the population, rosacea is often misunderstood. “Rosacea is one of the most under-diagnosed skin conditions affecting adults,” says Fredric Brandt, M.D. a dermatologist based in New York and Miami. In fact, a Gallup survey found that nearly 70 percent of Americans have no knowledge of its existence, including how to recognize and treat it. Here’s the 411 on rosacea:

What it is—and is not: Redness on the cheeks, nose, chin or forehead are telltale signs of rosacea. The skin condition is often accompanied by small visible blood vessels on the face, acne or watery, irritated eyes.

Rosacea is a progressive disease. It’s kind of like that closet you keep meaning to organize, which only gets worse when left unattended. If you take care of rosacea early on, though, it can be managed. The problem is, most people mistakenly identify rosacea as another skin issue. Leslie Baumann, M.D., a dermatologist, researcher and author, says she comes across many patients who simply think they just have abnormally sensitive skin. “I rarely have a patient come in and say ‘I have rosacea,’” she says. “They say, ‘My skin is always red,’ instead.”

Adds Dr. Brandt, “The pimple component of rosacea erroneously leads people to believe they only have acne, and they can inadvertently use skincare products that will just worsen it. These include products that contain benzoyl peroxide or other drying ingredients, which will only make matter worse. The main difference between an acne pimple and a rosacea one is the former tends to have pus in the center, while rosacea pimples are just red bumps.”

Who gets rosacea: Unlike acne, the cause of rosacea is unknown. Though anyone can get it, rosacea is far more common in fair-skinned people and those of Celtic descent, and usually appears after the age of 30.

What triggers it: Researchers have found a laundry list of potential triggers. Some of the most common ones include sun exposure, hot or cold weather, wind, spicy foods, heavy exercise or sweating, hot baths, saunas, fragrance, hormones, certain skincare products and alcohol, especially red wine (start learning to love tall glasses of iced tea).

How to manage it: Natural methods can help control the redness, according to Amy Wechsler, M.D., YouBeauty Dermatology Advisor. “Whole milk compresses help with inflammation. Managing stress on one’s own and avoiding the things that trigger rosacea [like spicy foods].” Also, start incorporating omega-3 fatty acids in your diet—it can help boost your skin’s natural defenses against inflammation.

If you’d rather hit the drugstore than go au natural, don’t be tempted to fill your cart with any old cream that’s marked with an “anti-redness” label. Many of them contain hydrocortisone or other steroids that may temporarily shrink dilated blood vessels, but eventually become larger and lead to even more redness, notes Dr. Baumann. Instead, look for products that contain caffeine, green tea, feverfew (an herb that helps decrease redness), chamomile or mushroom extract. Dr. Baumann suggests Aveeno Ultra-Calming Daily Moisturizer, which contains feverfew; Replenix CF with caffeine and green tea, which helps constrict blood vessels, making them less visible; and Eucerin Redness Relief with licorice extract to reduce inflammation.

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And be sure to pop into your dermatologist’s office on a regular basis. “Most people will benefit from a dermatologist’s care,” says Dr. Wechsler. Since rosacea is a progressive skin condition, it’s important to make regular visits to your derm, who can prescribe effective treatments that slow down the disorder significantly. Prescription topical antibiotics like Metrogel and Noritate or sulfur drugs, such as Klaron and Plexion, can combat irritation and redness. A newer, non-steroidal anti-inflammatory cream, Atopiclair, that has no effect on the immune system and “is also showing promising results,” says Dr. Brandt. In more moderate to severe cases, you may be prescribed an oral antibiotic, such as Oracea, to take once a day.

Lasers and light therapy treatments: Pulsed dye lasers like VBeam are the “gold standard to treat the extra blood vessels,” says Dr. Wechsler. The laser is absorbed by the red blood cells, and then the visible vessels are destroyed, leaving your face clearer. Jenny Kim, M.D., Ph.D., an associate professor at the David Geffen School of Medicine at UCLA, says Intense Pulse Light (IPL) therapy works wonders in evening out your complexion. “IPL is not a laser, but a range of light that is picked up by the skin,” explains Dr. Kim. “It’s similar to the pulsed-dye lasers, which damages blood vessels to improve redness.” Both methods can cost anywhere from $400 to $500 per session, and generally require a series of four to five sessions scheduled every two weeks.

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Although laser and light treatments can be more costly, they have some benefits over prescription treatments. “Topicals can be very irritating to skin,” Dr. Kim says. “Antibiotics can have adverse effects, like resistance to microbes and oral antibiotics can induce yeast infections in women, cause abdominal discomfort or photosensitivity.” Plus, it’s nice to get an IPL treatment once a month, rather than having to apply topical ointments once every day. Dr. Brandt adds that treatment time for lasers and lights takes about 20 minutes. “IPL is one of the best treatments for rosacea,” he says. “It has such positive results that you will look much better afterwards.” Which means you should get your LBD ready since there will be no more excuses to hide out at home.

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