Rosacea is a common, but often overlooked, skin condition of uncertain etiology that can lead to significant facial disfigurement, ocular complications, and severe emotional distress. The progression of rosacea is variable; however, typical stages include: (1) facial flushing, (2) erythema and/or edema and ocular symptoms, (3) papules and pustules, and (4) rhinophyma. A history of exacerbation by sun exposure, stress, cold weather, hot beverages, alcohol consumption, or certain foods helps determine the diagnosis; the first line of treatment is avoidance of these triggering or exacerbating factors. Most patients respond well to long-term topical antibiotic treatment. Oral or topical retinoid therapy may also be effective. Laser treatment is an option for progressive telangiectasis or rhinophyma. Family physicians should be able to identify and effectively treat the majority of patients with rosacea. Consultation with subspecialists may be required for the management of rhinophyma, ocular complications, or severe disease. (Am Fam Physician 2002;66:442.)