How to Tell If Your Acne is Actually Rosacea

Curated by Claudia Shannon / Research Scientist / ishonest

What Is Acne Rosacea?

When we think of rosacea, we typically think of redness—and that’s accurate, but the condition can involve present itself in different ways. In addition to red facial skin, rosacea can also sometimes entail "bumps and broken blood vessels on nose, chin, cheeks, and foreheads," says Redondo Beach, CA-based board- certified dermatologist Annie Chiu. When rosacea is not treated, Chiu explains, it can cause small red bumps that sometimes contain pus, cysts, dilated blood vessels, and eye irritation.

What Is Acne Vulgaris?

Acne vulgaris is the technical term for the condition we picture when we hear "acne." Simply put, it’s a skin condition in which the pores (hair follicles) of the skin clog up and become inflamed. "Depending on the degree of severity, this can lead to blackheads (comedones), pimples, cysts, and scars occurring in groups," Chiu notes.

How Does Acne Rosacea Compare to Acne Vulgaris?

While acne rosacea is typically concentrated on the face, acne vulgaris can also affect areas like the back and chest. It is the most common skin disease in adolescence and young adulthood.

"While the two are often confused by patients given their looks, both conditions are distinct," says Chiu. "Rosacea typically can resemble a combination of pimples, rashy skin, and redness. While acne also causes redness, it appears as whiteheads, blackheads, and hard lumps in severe cases. Unlike rosacea, the redness is isolated to the pimple."

According to Miami-based board-certified dermatologist Jeremy Green, one way to tell whether you may have acne or rosacea is to note the distribution. "If the redness and bumps involve primarily cheeks and nose, it could be rosacea. Also, patients who only have rosacea (not acne) tend to have minimal or few comedones in these areas," he says.

What Causes Acne Rosacea?

Rosacea can be genetic (which usually means multiple family members have it). One theory, Green explains, is that patients with rosacea have a "hypersensitivity to a particular mite (demodex folliculorum) that lives on all of our skin." Finally, having rosacea also means paying attention to the various triggers that can lead to flare-ups, from the inevitable (emotional stress, heat) to the ones that you can at least try to avoid (alcohol, spicy foods, caffeine, and sun exposure).

What Causes Acne Vulgaris?

Acne vulgaris results from the overproduction of sebum from the oil glands in the skin. The oil glands are attached to your hair follicles and release oil into your pores. "Excess sebum clogs the pores along with dead skin, leading to buildup in the pores and hair follicles," explains New York City-based board- certified dermatologist, Morgan Rabach. “This build p can lead to materials rupturing under the skin, and along with bacteria that comes from the skin, causes more inflammation under your skin as inflammatory cells come to the area to clear the debris.”

Anything that increases the sebum can lead to acne vulgaris—this can include a genetic predisposition for acne and hormonal variants. "Male hormones called androgens lead to increased sebum, and fluctuations of hormones lead to oil buildup,” Rabach says. Cortisol, the hormone released in stress, also leads to increased sebum. Finally, certain medications can lead to breakouts including lithium, hormones, iodine, and steroids.

Read more on: acne, rosacea

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