Understanding the subtleties between rosacea and acne may help you discover which condition you’re experiencing and how best to treat your symptoms.

Skin conditions can be frustrating. Oftentimes, there’s an overlap of symptoms, making it difficult to know what might actually be going on.

Rosacea and acne, for example, aren’t the same thing, but both can cause red, purple, or, brown discoloration, as well as irritation and breakouts.

When you see pimples, it’s natural to assume you’re dealing with common acne, or acne vulgaris, the type that usually emerge during adolescence.

Rosacea can also cause acne-like breakouts, however, and knowing the difference between these conditions can help you find an effective course of treatment.

Rosacea is a chronic inflammatory skin condition that primarily affects the face and neck. It’s most common among adults between 30 and 50 years old and is more prevalent in females and people with fair complexions.

Symptoms of rosacea include:

  • flushing or facial discoloration (usually red, brown, or purple)
  • skin thickening
  • appearance of thin blood vessels
  • skin flushing
  • bumps and pimples
  • burning, itching, or stinging sensation
  • eye irritation
  • dry or scaly skin
  • facial edema (swelling)

Rosacea has four different subtypes, classified by how they affect your skin:

  • Papulopustular: areas of swelling, discoloration, and acne-like papules and pustules
  • Erythematotelangiectatic: flushing with discoloration and visible blood vessels
  • Ocular: irritated, red eyes, possibly with swollen eyelids
  • Phymatous: areas of thickened, bumpy skin

When most people think of acne, they’re thinking of acne vulgaris, an inflammatory skin disorder that affects as many as 85% of people between 12 and 24 years old.

It’s caused when oil glands in the skin, sebaceous glands, become clogged. This backup of oil and shedding skin cells creates an environment for bacteria to thrive, and eventually, the walls of the plugged gland break down, spilling into the surrounding tissue.

This process causes inflammation and creates a pimple.

Symptoms of acne include the appearance of:

  • cysts
  • nodules
  • pustules
  • papules
  • blackheads and whiteheads
  • red, purple, or brown discoloration
  • itching
  • localized swelling

Small differences between rosacea and acne may offer insight until you receive a diagnosis from your dermatologist.

In general, the presence of comedones (blackheads and whiteheads) is a defining feature of acne that isn’t seen in rosacea, though both conditions can feature papules and pustules.

The level of discoloration in your skin is also a clue. Acne breakouts typically have localized discoloration directly around blemishes. Discoloration and flushing in rosacea, on the other hand, tend to be widespread.

Unlike rosacea, acne isn’t limited to your face and neck. It’s also commonly found on the back and shoulders. If your skin concerns are on your face and neck only, or if your eyes are involved, rosacea could be the more likely culprit.

Lastly, both acne and rosacea can have triggers that can cause them to worsen or flare up. Rosacea skin, however, is notoriously hypersensitive. You may notice your symptoms worsen even from minor exposures, like being out in the wind or having a glass of wine.

Does rosacea look like acne?

Some rosacea — but not all — can look like acne. Papulopustular rosacea, once called “acne rosacea,” features facial discoloration accompanied by swollen bumps and pustules.

Can you have acne and rosacea?

You can have rosacea and acne at the same time. A dermatologist will evaluate your skin to determine if one, or both, conditions are causing symptoms.

The underlying causes of rosacea and acne are not well understood.

Mainstream theories in rosacea suggest it could be part of a systemic inflammatory immune response or dysfunction in your nervous system and vascular system.

Rosacea can involve altered innate immunity or changes to the immune environments you were born with, like your skin microbiome. Research indicates that genetics also plays a major role in rosacea development for many people.

Acne is just as mysterious as rosacea, even though the process of how a pimple develops is straightforward.

Experts believe acne is influenced by a number of factors that encourage excessive oil production, bacteria growth, and improper shedding of skin cells.

Your regular diet, endocrine changes related to puberty, and circulating hormones may all factor in. You might be more likely to experience acne if your parents had it or if you’re taking certain medications.

Rosacea and acne are both inflammatory skin disorders that can feature breakouts, discoloration, and irritation. Due to these similarities, some treatment options work for both conditions, including:

Beyond these overlapping treatments, however, the management of rosacea and acne becomes very different.

Rosacea treatment

Rosacea isn’t curable. Treatment aims to manage your symptoms and prevent them from becoming worse as time goes on.

In addition to the treatments shared with acne, rosacea-specific options include:

Acne treatment

Acne treatment is about preventing new acne from developing and helping active blemishes heal. To accomplish this, many acne treatments work to counteract excess oil production, bacteria overgrowth, and impaired skin cell shedding.

Acne-specific treatments that do this include both prescription and over-the-counter products containing:

When topical medications aren’t enough to manage your acne, your dermatologist may recommend:

Rosacea and acne are separate skin conditions that can both cause breakouts. While it can be challenging to tell them apart, only acne features blackheads and whiteheads, also known as comedones.

Because you can experience acne and rosacea at the same time, speaking with a dermatologist ensures a proper diagnosis and optimal treatment approach.