Rosacea vs. Lupus: What Are the Differences?

Rosacea and lupus are both inflammatory conditions that can cause rashes and redness on the face. Because of the similarities in their effects on the skin, they can be mistaken for one another.

However, lupus is an autoimmune disease that can also affect other parts of the body, such as the blood, joints, heart, lungs, and other organs.

Rosacea mainly affects the skin but can also affect the eyes, causing them to appear watery or bloodshot and producing dry or burning sensations. Eye symptoms may separate lupus from rosacea.

This article will explore the differences between rosacea and lupus, including their symptoms, causes, diagnosis, treatment, and prevention.

Symptoms

Symptoms of lupus and rosacea can resemble one another. Flushing, redness, and rashes on the skin of the face are common in both conditions. However, there are distinct differences in each condition.

Lupus

Lupus symptoms span the entire body and include:

• Arthritis with painful or swollen joints
• Fever
• Fatigue
• Hair loss
• Sun sensitivity
• Sores in the mouth or nose
• Pain when taking deep breaths from inflammation around the lungs or heart
• Heart problems
• Kidney damage (which causes changes to kidney function)
• Inflammation of the blood vessels
• Infection

A distinctive red butterfly-shaped rash across the bridge nose and cheeks (but not in the nasolabial folds from the nostrils to the lips), called a malar rash, may be seen in systemic lupus erythematosus.

In discoid lupus, round, scaly, red, and thick lesions may appear on the face, scalp, and other areas of the body. These can cause scarring and may be darker or lighter than the nearby skin.

Rosacea

Rosacea symptoms mainly affect the face. They include:

• Redness on the face: May begin as hot blushing but turns rough and scaly over time
• Rashes that develop into red or pus-filled bumps that look like acne
• Thickening skin that primarily affects the nose, causing it to enlarge
• Eye irritation: Dry, watery, bloodshot, and itchy eyes may feel like there is something in them.

Causes

Though both lupus and rosacea rashes can be triggered by sunlight, the underlying cause of each disease is different.

Rosacea

Although scientists know that inflammation contributes to the symptoms of rosacea, the exact cause is unknown. Genetic and environmental factors are believed to play a role in the development of the disease.

Heightened skin sensitivity to environmental factors such as the sun or microbes that live on the skin may be the cause of the inflammation that triggers symptoms.  

Lupus

Lupus is a complex autoimmune disease where the body’s immune system attacks healthy tissues and organs. The exact cause is unknown. Scientists theorize that the immune system is triggered by genetic, environmental, immune, and inflammatory influences in lupus.

Diagnosis

While lupus and rosacea can be mistaken for one another, it is important to talk to a healthcare provider about your symptoms to receive a proper diagnosis.

Rosacea

There is no specific test for rosacea. Your healthcare provider will take a complete medical history and may conduct tests to rule out other causes of skin rashes and eye symptoms.

Lupus

A lupus diagnosis requires both symptoms and positive markers on certain clinical tests. Your healthcare provider will ask about your symptoms, take a full medical history, and conduct various blood and urine tests.

Because lupus can cause many different symptoms, your healthcare provider may conduct further tests to rule out other diseases.

Treatment

Proper diagnosis for rosacea and lupus are important because treatment for each varies.

Rosacea

While there is no cure for rosacea there are treatments to improve symptoms and prevent further complications. Treatment for rosacea includes lifestyle modifications such as avoiding triggers like the sun, treating the skin with gentle cleansers, and using sunscreen regularly.

Medications such as topical retinoid creams, lubricating eye drops, antibiotics, and other oral medications may also be used in a treatment plan.

Lupus

Treatment for lupus depends on the severity of the disease. People with mild-to-moderate lupus may be prescribed antimalarials like Plaquenil (hydroxychloroquine sulfate) or corticosteroids to reduce inflammation. In addition, they may use non-steroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) to help with pain and inflammation.

In people with more severe disease, high-dose corticosteroids and immunosuppressants like methotrexate may also be prescribed.

While there is no cure for lupus, the goal of treatment is to slow the progression of the disease and prevent further damage to the body’s tissues.

Prevention

There are steps you can take to minimize the impact of rosacea and lupus symptoms on your life.

Rosacea

Identifying and then avoiding the triggers of your rosacea symptoms can help prevent symptoms from worsening.

Keeping a diary of when symptoms worsen and what you consumed or did before exacerbating symptoms can help identify triggers.

Common rosacea triggers are:

• Spicy foods
• Alcohol
• Hot drinks
• Cosmetics
• Soaps
• Medications that widen blood vessels
• Sun exposure
• Extreme heat or cold

Lupus

Life with lupus can be physically and emotionally difficult; however, there are steps you can take to minimize its effects on your life.

Learning to recognize the signs of a flare, or worsening of symptoms, such as increased fatigue, pain, or fever, can help you learn to scale back on your activities and seek the help of your healthcare provider to prevent the flare or help you come out of it faster.

Quitting smoking, eating a healthy and well-balanced diet, and regular exercise can also help with symptoms. Avoid the sun and do your best to lower stress in your life.

Some people may also find that talking to a professional mental healthcare provider or joining a support group can help with the emotional aspects of living with the disease.

Summary

While lupus and rosacea are both inflammatory diseases that can cause rashes and redness on the face, they are distinctly different.

Rosacea affects the skin, while lupus is a systemic (whole-body) disease. Diagnosis requires a careful review of symptoms and various tests to rule out other conditions.

Treatment for each varies based on symptoms and severity and may include medications and lifestyle changes.

Recognizing the triggers for rosacea can help minimize symptoms, while lupus prevention requires a more comprehensive plan that includes medications, avoidance of triggers, and lifestyle modifications such as quitting smoking.

 A Word From Verywell

If you are experiencing redness, flushing, or rashes on your face and think you may have lupus or rosacea, you must speak to your healthcare provider to determine the exact cause.

A proper diagnosis can help minimize symptoms and prevent further damage and complications from either disease.

While seeking a diagnosis for any disease can be scary, talking to your healthcare provider about your concerns can help you understand your symptoms and learn to live well with your condition.