Rosacea and acne are two of the most common skin conditions that affect individuals of all ages, yet they are frequently misunderstood and mistaken for one another. The following guidance from the board-certified dermatologists at Advanced Dermatology, P.C. details the distinctions and optimal treatments for both conditions.
What Is Rosacea vs Acne?
Rosacea and acne are both common skin conditions, but they are distinct in their causes, symptoms, and treatment approaches. While both can cause pimples and redness, rosacea is defined by the Cleveland Clinic as a chronic inflammatory condition most often affecting adults, whereas acne is typically related to clogged pores and excess oil production, frequently seen in teenagers and young adults.
Is Rosacea a Form of Acne?
Dr. Suzanne Friedler, a board-certified dermatologist, stated, “Rosacea tends to look a lot like acne, making it hard to determine which one you are actually dealing with.”
“Rosacea is an inflammatory condition very similar in appearance to acne, but heat is the main trigger,” Friedler said. “The skin becomes red like in acne, and papules and pustules can also appear,” she said.
Although rosacea and acne share some visible similarities, rosacea is not a form of acne. The two conditions have different triggers, characteristics, and underlying mechanisms. Rosacea is an inflammatory disorder with an as-yet unclear cause, according to the American Academy of Dermatology, while acne is primarily related to oil glands and bacterial overgrowth.
Why Rosacea and Acne Are Often Confused
Many people confuse rosacea with acne because both can cause red bumps, pimples, and facial redness. However, the distribution, triggers, and appearance of each are different. Proper diagnosis is essential to ensure effective treatment.
Rosacea vs Acne Differences Dermatologists Look For
Dermatologists evaluate several factors to distinguish between rosacea and acne, including age of onset, skin sensitivity, presence of blackheads or whiteheads, types of lesions, and associated symptoms like flushing or visible blood vessels.
Rosacea vs Acne Symptoms Compared
- Rosacea: Persistent redness, visible blood vessels, facial flushing, sensitive skin, papules, and pustules (but no comedones).
- Acne: Blackheads, whiteheads, papules, pustules, nodules, oily skin, and sometimes scarring.
What Does Rosacea Look Like Compared to Acne?
Rosacea often appears as diffuse redness with small red bumps and visible capillaries, mainly on the cheeks, nose, chin, and forehead. Acne presents as blackheads, whiteheads, inflamed pimples, and sometimes cysts, usually affecting the T-zone and jawline.
Facial Redness, Pimples, and Flushing Explained
While both conditions can cause pimples, only rosacea commonly leads to pronounced facial flushing and persistent redness. Acne may cause redness around pimples, but rarely causes overall facial flushing.
Can Rosacea Look Like Acne?
Yes, especially in its papulopustular form, rosacea can mimic acne with red bumps and pustules. However, the absence of blackheads and the presence of persistent redness and sensitivity help differentiate the two.
Papules and Pustules in Rosacea vs Acne
Both conditions may cause papules (red bumps) and pustules (pus-filled bumps). In rosacea, these lesions appear on a background of redness and are not accompanied by blackheads. In acne, papules and pustules are often mixed with comedones.
How Skin Sensitivity Helps Differentiate Rosacea
Rosacea-prone skin tends to be more sensitive, with burning, stinging, or irritation triggered by skincare products, weather, or certain foods. Acne-prone skin is less likely to react in this way.
Is It Acne or Rosacea? How to Tell at Home
Check for persistent redness, frequent facial flushing, and sensitivity, which are hallmarks of rosacea. If you see blackheads or experience oily skin, it’s more likely to be acne. However, a professional diagnosis is the best way to ensure proper treatment.
Early Signs That Point to Rosacea
- Frequent or prolonged facial redness
- Flushing triggered by heat, spicy foods, or alcohol
- Sensitive or easily irritated skin
- Visible blood vessels
Common Clues That Suggest Acne Instead
- Presence of blackheads and whiteheads
- Oily skin
- Pimples or cysts on the face, chest, or back
- Scarring or dark spots after breakouts
How Dermatologists Diagnose Rosacea vs Acne
Dermatologists use clinical evaluation, patient history, and physical examination to distinguish between the two conditions.
Dermatologist Acne vs Rosacea Diagnosis Process
A dermatologist will ask about your symptoms, triggers, and skin history, and will closely examine the skin’s appearance and distribution of lesions.
Rosacea Diagnosis and Clinical Evaluation
Rosacea is diagnosed based on persistent redness, visible vessels, and the presence of papules or pustules without comedones. Flushing and burning sensations also support the diagnosis.
Mask Acne vs Rosacea: What Changed After Face Coverings
The increased use of face masks during the COVID-19 pandemic led to a rise in both mask-induced acne (“maskne”) and flare-ups of rosacea.
How Masks Trigger Acne Breakouts
Masks create a warm, humid environment that contributes to clogged pores, increased oil production, and bacterial growth—leading to acne breakouts in the covered areas.
Why Masks Can Worsen Rosacea Symptoms
Masks can irritate sensitive rosacea-prone skin by trapping heat and moisture, causing friction, and increasing skin redness and flare-ups.
If your mask-induced breakouts are actually rosacea, Friedler suggested that a board-certified dermatologist can provide topical and oral therapies that will help. She also advised wearing masks that are made with a material that keeps the skin cooler: “I’d recommend either 100% cotton with a tight weave or a surgical mask. Avoid polyesters and other synthetic fabrics.”
Rosacea vs Acne Treatment Differences
The treatment approaches for rosacea and acne differ significantly.
Why Acne Treatments Can Worsen Rosacea
Some acne treatments (like benzoyl peroxide or strong retinoids) can be too harsh for rosacea-prone skin, causing irritation or worsening redness.
Dermatologist-Recommended Treatments for Rosacea
- Topical anti-inflammatory medications (e.g., metronidazole, azelaic acid)
- Oral antibiotics for moderate to severe cases
- Laser therapy for visible blood vessels
- Gentle skincare and trigger avoidance
Acne Treatment Options Based on Severity
- Over-the-counter benzoyl peroxide or salicylic acid
- Prescription topical or oral antibiotics
- Topical retinoids
- Hormonal therapy or isotretinoin for severe cases
When to See a Dermatologist for Rosacea or Acne
Consult a dermatologist if you are unsure about your diagnosis, experience persistent redness or breakouts, or if over-the-counter treatments are not effective.
Signs Over-the-Counter Treatments Are Not Enough
- No improvement after several weeks
- Increasing redness, sensitivity, or scarring
- Worsening breakouts despite treatment
Why Early Diagnosis Improves Skin Outcomes
Early, accurate diagnosis and treatment prevent complications, reduce the risk of scarring, and improve long-term skin health. Living with rosacea or acne long-term involves ongoing management and lifestyle modifications.
Trigger Management and Flare-Up Prevention
- Identify and avoid personal triggers (foods, weather, stress)
- Use gentle skincare products
- Protect skin from sun exposure
Long-Term Skin Care Plans From Dermatologists
Dermatologists can create tailored, long-term skincare plans to minimize flare-ups, adjust treatments as needed, and support healthy skin.
Rosacea vs Acne FAQs
Understanding the key differences between rosacea and acne is essential for accurate diagnosis and effective management.
Can a Dermatologist Tell the Difference Between Acne and Rosacea?
Yes, dermatologists are trained to distinguish between these conditions based on clinical features and history.
Does Rosacea Always Cause Redness?
Persistent facial redness is a hallmark of rosacea, but some individuals may experience more bumps or visible vessels than redness.
It is also important to note that rosacea in darker skin tones might not present with visible redness, according to the American Academy of Dermatology. However, though the feeling of warmth, the presence of bumps, and thickened skin on the nose will nonetheless be noticeable.
Can You Have Acne and Rosacea at the Same Time?
It is possible to have both conditions simultaneously, which can make diagnosis and treatment more complex.
Why Does Rosacea Often Appear in Adults?
Rosacea typically develops in adults between the ages of 30 and 50. Its causes are not fully understood, but genetics and environmental factors play a role.
Will Acne Products Make Rosacea Worse?
Many acne products can irritate rosacea-prone skin. It’s important to use gentle, dermatologist-recommended treatments if you have rosacea or sensitive skin.
For personalized care services and expert diagnosis, schedule a consultation with the dermatology specialists at Advanced Dermatology, P.C