http://www.rosacea.org/rr/
Rosacea and Temperature Triggers
1
. Which of the following sources of heat have ever triggered a rosacea flare-up? (Check all that apply.)
Which of the following sources of heat have ever triggered a rosacea flare-up? (Check all that apply.)
Sun exposure
Hot weather
Heavy clothing
Heavy exercise
Indoor heat
Hot bath
Heated beverages
Menopausal hot flashes
Other
2
. Do you go outside less frequently since your rosacea diagnosis in an effort to avoid a flare-up?
Do you go outside less frequently since your rosacea diagnosis in an effort to avoid a flare-up?
Yes
Somewhat
No
3
. How often do you leave a heated room in an effort to avoid a flare-up?
How often do you leave a heated room in an effort to avoid a flare-up?
Frequently
Sometimes
Never
4
. Have you changed your exercise routine since your rosacea diagnosis in an effort to avoid a flare-up?
Have you changed your exercise routine since your rosacea diagnosis in an effort to avoid a flare-up?
Yes
Somewhat
No
5
. Do you bathe/shower in cooler water since your rosacea diagnosis in an effort to avoid a flare-up?
Do you bathe/shower in cooler water since your rosacea diagnosis in an effort to avoid a flare-up?
Yes
Sometimes
No
6
. What other actions do you take to avoid temperature-related rosacea outbreaks?
What other actions do you take to avoid temperature-related rosacea outbreaks?
7
. Has avoiding heat reduced your rosacea flare-ups?
Has avoiding heat reduced your rosacea flare-ups?
Yes
Somewhat
No
8
. Are you:
Are you:
Male
Female
9
. Are you:
Are you:
Under 30
30-39
40-49
50-59
60-69
over 69
10
. Comments:
Comments:
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