Rosacea and acne are skin conditions that affect 16 million and 50 million Americans respectively, according to the American Academy of Dermatology. Considering how common they are, it's likely that you've dealt with one or the other in your lifetime. But papulopustular rosacea, also known as acne rosacea, is a related yet entirely different skin condition, so named because it combines the features of each. Think of it like a turducken, a cronut, or one of those Taco Bell tacos that has Doritos on it — except on the skin.
We asked experts to break down everything you need to know about papulopustular rosacea, including why it's known as acne rosacea, how the condition manifests, when to seek out a dermatologist's help, and what you and your doctor can do to treat it.
Symptoms, treatment options, and personal experiences for various physical, mental, and health conditions and concerns.
"Papulopustular rosacea is a manifestation of rosacea that presents with inflamed red bumps and pustules on the forehead, nose, cheeks, and chin," says Mark Jackson, board-certified dermatologist and president-elect of the American Acne & Rosacea Society.
Symptoms of papulopulstular rosacea include the same symptoms as standard rosacea, such as redness, burning, or stinging on the face, and blushed-looking skin; however, those symptoms are combined with acne, which can include red bumps or the pus-filled whiteheads known as pustules.
Acne rosacea most often presents around the center of the face, such as the cheeks and middle of the forehead, but some cases can affect the entire face, says dermatologist Rachel Nazarian of Schweiger Dermatology Group in New York City. Other cases may present with no physical symptoms at all.
"Many patients experience no symptoms, but oftentimes patients feel their skin flushes, is hot, itchy or feels more sensitive. Over time, with repeated flares, the face may appear more consistently puffy and red," she says.
As with standard rosacea, the underlying cause of acne rosacea is not fully understood. What we do know, Nazarian says, is that it's a subtype of rosacea involving dysregulation of the inflammatory pathways in the skin.
We may not understand where acne rosacea stems from, but there are certain triggers that can worsen the condition and cause the immune system to overreact, leading to the symptoms of the condition. According to Jackson, triggers include stress, spicy foods, alcohol, hot beverages, extreme heat and cold, and other factors.
The National Rosacea Society (NRS) has an even longer list of triggers, which includes weather factors (sun, strong winds, cold, humidity), lifestyle triggers (saunas, hot baths, exercise), food triggers (liver, avocados, spinach, vinegar, sour cream), and many more.
While the list is extensive, not every known trigger will cause a flare-up in every case, and patients may also notice triggers that aren't on this list. The NRS recommends keeping a diary of your lifestyle and diet along with your flare- ups, so you can help identify and avoid triggers.
While it's easy enough to tell if your skin is flushed, breaking out, or both, a confirmed diagnosis of papulopustular rosacea will likely require a dermatologist's trained eye. "Acne and rosacea are often difficult to distinguish and require evaluation by a board-certified dermatologist," says Nazarian. "There are many subtleties in the morphology and distribution of acne and rosacea lesions that aid physicians in making the correct diagnosis. This is why we spend so many years studying the disease before we are fully trained dermatologists." A dermatologist will be able to categorize your pimples and determine exactly what type of acne you have. In tandem with your rosacea symptoms, the place on your face where the flushes and breakouts occur, and other factors, a dermatologist will be able to assess your particular condition.
"Attempting to self-diagnose or be treated by anyone else, like an aesthetician or other non-physician, only delays the correct diagnosis and treatment," Nazarian says.
A comprehensive acne rosacea treatment will address both the breakouts and the rosacea symptoms. "Typical treatment includes adopting a good skin-care regimen, incorporating sun protection, and moisturizer use," says Jackson. Since sunlight is a common rosacea trigger, sunscreen is a key step that most rosacea patients should work into their skin-care routines.
Treatment will also include avoiding triggers, to minimize the chance of acne rosacea flare-ups in the first place. "For many people, this involves avoiding certain food, alcohol, or temperatures," says Nazarian.
Dermatologists may also prescribe prescription medications, such as topical anti-inflammatories, which Nazarian says work by constricting blood vessels to prevent repeated flushing. Other treatments may include topical antibiotics, low-dose oral antibiotics, or lasers designed to decrease inflammation and redness. "Lasers are wonderful options for recalibrating your skin and reversing damage from chronic rosacea," says Nazarian.
- How to Identify and Treat Rosacea, According to Experts
- How to Tell If Your Bloodshot Eyes Are Actually Ocular Rosacea
- How to Wear Blush If You Have Rosacea, According to the Pros
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