Could Your Acne Really Be Rosacea?

Rosacea can't be cured, but it can be controlled

Rosacea can sometimes be mistaken for acne. The symptoms can be similar: pimples across your cheeks, nose, and chin.

You might assume your adult breakouts are just run-of-the-mill acne, but could it actually be rosacea instead?

Young Asian woman worry about her face when she saw the problem of acne and scar by the mini mirror.
Boyloso / Getty Images

Is Rosacea a Type of Acne?

Rosacea is not a form of acne vulgaris, although it sometimes can be hard to distinguish from common acne. To confuse the matter, rosacea is sometimes called "acne rosacea," or even "adult acne."

Like acne vulgaris, rosacea is a disorder of the pilosebaceous unit or what we commonly call the pore. It can cause tiny pimples, just like acne does.

But rosacea is not caused by the same factors as acne vulgaris and is a skin disorder in its own right.

If you have fair skin, you're more prone to developing rosacea. Interestingly, it is more common in women, but men tend to develop more severe forms.

What Does Rosacea Look Like?

Rosacea often begins as redness or flushing of the face. Small, red, pimple-like bumps can form on the face, but unlike with common acne, there typically are no blackheads or comedones. Capillaries may be visible on the skin, contributing to the red appearance of the face.

If rosacea isn't treated it can progress, and the redness and bumpiness become more severe. The skin takes on a coarse, lumpy look, and the nose can become larger and more bulbous (think W.C. Fields).

Luckily, most cases of rosacea don't become this serious. For many people, rosacea stays mild, and the redness never progresses to papules and general skin bumpiness.

Although there is no lab test for either skin condition, your dermatologist will be able to make a diagnosis through a simple visual inspection.

Sometimes it's hard to tell if you have adult acne or rosacea. If you've noticed changes in your skin, you should make an appointment with a dermatologist.

Some people with rosacea also develop redness and grittiness in the eyes, called ocular rosacea. Eye problems are sometimes overlooked, so make it a point to tell your healthcare provider if you have redness of the eyes, tearing, blurred vision, sore or gritty feeling eyes.

Rosacea vs. Acne

Many people who have the beginning stages or mild rosacea oftentimes don't even realize they have the disorder. They chalk up redness to a ruddy complexion, and women may get used to covering it with makeup. Or they assume the papules are adult acne breakouts and buy an over-the-counter acne treatment. But rosacea and acne do have some distinct differences.

Rosacea
  • Develops later in life, typically after the age of 30

  • Confined to the center of the face (cheeks, nose, chin, and forehead)

  • Frequent flushing or redness across the forehead, cheeks, nose, chin, and neck

  • Visible blood vessels under the skin on the face

  • Thickened skin, especially on the nose

Acne Vulgaris
  • First develops during the teenage years

  • Can occur anywhere on the face, neck, back, upper arms, and shoulders

  • Does not cause flushing

  • Does not cause visible blood vessels

  • Does not cause noticeable thickening of skin

Causes

Healthcare providers still aren't sure exactly what causes rosacea. But there are a few theories.

Some experts believe that rosacea appears because of sensitive blood vessels that dilate too easily. Other research suggests that the Helicobacter pylori bacterium or the microscopic Demodex mite plays a role. We do know that rosacea tends to run in families.

While we don't know exactly what causes rosacea, we do know that certain things can trigger rosacea breakouts and make symptoms worse. Common rosacea triggers include:

  • Sun exposure
  • Eating spicy foods
  • Drinking hot beverages or alcohol
  • Exposure to extremely hot or cold weather

Emotional stress is another major trigger.

Treatment

Rosacea and acne treatments can be similar. Topical antibiotics prescribed for acne and some acne medications like Finacea (azelaic acid) can also help rosacea.

But don't try to treat rosacea on your own with over-the-counter acne products. Some can aggravate rosacea and leave your skin feeling even worse.

Rosacea can't be cured, but it can be successfully controlled. Your best option is to see a dermatologist. Whether you have adult acne or rosacea, your dermatologist will help you create the perfect treatment plan to clear your skin.

Was this page helpful?
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Zhou M, Xie H, Cheng L, Li J. Clinical characteristics and epidermal barrier function of papulopustular rosacea: A comparison study with acne vulgaris. Pak J Med Sci. 2016;32(6):1344-1348. doi: 10.12669/pjms.326.11236

  2. Rainer BM, Kang S, Chien AL. Rosacea: Epidemiology, pathogenesis, and treatment. Dermatoendocrinol. 2017;9(1):e1361574. doi: 10.1080/19381980.2017.1361574

  3. Reinholz M, Ruzicka T, Steinhoff M, et al. Pathogenesis and clinical presentation of rosacea as a key for a symptom-oriented therapy. J Dtsch Dermatol Ges. 2016;14 Suppl 6:4-15. doi: 10.1111/ddg.13139

  4. Gravina A, Federico A, Ruocco E, et al. Helicobacter pylori infection but not small intestinal bacterial overgrowth may play a pathogenic role in rosacea. United European Gastroenterol J. 2015;3(1):17-24. doi: 10.1177/2050640614559262