Eczema and acne are two unrelated skin conditions. Their symptoms can look similar, making it hard to distinguish between them.

Acne causes pimples to erupt. Eczema causes a red or discolored, bumpy rash, which may look like pimples.

Eczema and acne have different causes and treatments. It’s possible to have both at once, although when this occurs, it’s usually on different areas of your face and body.

Eczema is also known as atopic dermatitis. It is most commonly found in children, but can occur to people of any age.

The underlying cause of eczema is not completely understood. The following, all seem to play a role.

  • genetics
  • immune system
  • environmental factors

People with this condition have skin that is very dry, on certain areas of the body or face. This is caused by a skin barrier, which does not effectively retain moisture.

Common symptoms of eczema include:

  • itchy rash
  • dry skin
  • leathery skin (lichenification)
  • swelling
  • soreness
  • raised, pimple-like bumps that may ooze and bleed if scratched

Eczema is an umbrella term that refers to a group of seven skin conditions. Each type is earmarked by:

  • itching
  • inflammation
  • rash

The rash sometimes has raised bumps, which may seem like pimples.

The seven types of eczema are:

Eczema flare-ups are caused by allergens or irritants in the environment. These triggers activate your immune system, causing inflammation and eczema symptoms.

Acne is not triggered by an immune system response. If you have acne, hormonal changes such as those associated with puberty, may be the cause.

People with acne often have oily skin due to an oversecretion of sebum (oil) by the sebaceous gland. This causes the pores to become clogged with:

  • excess oil
  • dead skin cells
  • bacteria

Acne breakouts can cause:

  • pimples
  • blackheads
  • whiteheads
  • cysts
  • nodules

Unlike acne, if you have eczema, your skin does not produce as much oil as it should. It also does not hold on to water. These factors can lead to very dry skin.

One of the main differences between eczema and pimples is itching. Eczema can cause uncontrollable itching, whereas pimples do not.

It is possible to have pimples and eczema at the same time in different locations. For example, you may have pimples on your face and shoulders but eczema on your:

  • hands
  • elbows
  • eyelids

Since eczema is associated with dry skin and pimples are associated with oily skin, it is less common to have both conditions at the same time and in the same location.

You may, however, have both at the same time but in different spots on your:

  • face
  • back
  • shoulders
  • chest

For example, you may have acne pimples in your t-zone (nose and forehead) but an eczema rash on your cheeks.

A doctor, such as a dermatologist, will be able to diagnose both conditions.

How is eczema diagnosed?

Your doctor will examine your skin, and review your medical and family history. They will ask about symptoms such as itching and try to identify triggers.

Your doctor may also do a patch test to rule out skin conditions that look like eczema, such as ringworm.

How is acne diagnosed?

Acne is also diagnosed through a visual examination and intake questionnaire.

Your doctor may also ask about menstrual history to determine if there is an underlying cause such as polycystic ovary syndrome.

A dermatologist or other doctor can prescribe treatment options for either or both conditions.

How is eczema treated?

There is no cure for eczema. Flare-ups often come and go seemingly on their own. They may dissipate completely as you age.

Your doctor may recommend medications to:

  • curb flare-ups
  • suppress your immune system
  • control itch

The medications include:

  • oral or topical corticosteroids
  • topical nonsteroidal anti-inflammatory creams
  • oral or topical calcineurin inhibitors

Other treatments for eczema include:

  • Wet dressings. This technique is usually done in a hospital setting. It involves topical application of corticosteroids, plus wet bandages.
  • Light therapy. This technique uses controlled amounts of sunlight or exposure to controlled amounts of artificial UVA and UVB light.

How is acne treated?

Your doctor will recommend treatments designed to reduce breakouts and avoid scarring.

Medications for acne typically reduce sebum production, so that your skin is less oily. Some medications also reduce skin bacteria.

Your doctor may recommend a regimen that includes medicated cleansers and topical gels. Oral medications may also be given.

Drugs you may be given for acne include:

  • topical retinoids
  • topical salicylic acid
  • oral and topical antibiotics
  • oral contraceptives (birth control pills)

Salicylic acid is sometimes used to treat both acne and eczema.

Salicylic acid works by softening keratin, a protein found in skin. It may loosen the dry, scaly skin caused by eczema.

It may also slow down the shedding of skin cells in follicles reducing clogged pores and acne breakouts.

Lifestyle habits that keep skin healthy, such as drinking lots of water, may be beneficial for both conditions.

A 2016 research review and a 2020 research review indicated that taking probiotics, such asLactobacillus, may help reduce acne breakouts and eczema flare-ups. Eating probiotic-rich foods, such as yogurt, may also be beneficial.

A small 2012 study showed that eating foods that contain omega-3 fatty acids, or taking supplements like fish oil may benefit inflammatory acne.

A 2015 research review showed that omega-3 fatty acids may also have some benefit for eczema, although a 2016 research review on eczema and omega-3 was mixed, and not conclusive.

Eczema and acne can make skin uncomfortable and even painful.

Further, damage to skin, such as scarring or hyperpigmentation (darker patches of skin than usual) may also result. Since both conditions are visible, they may cause:

  • embarrassment
  • depression
  • anxiety
  • social isolation

Eczema and acne are two skin conditions which have unrelated causes.

Acne is earmarked by pimples. The red or discolored rash associated with eczema is sometimes mistaken for pimples, although the two are dissimilar.

Each condition is typically treated with different medications. An exception to this is salicylic acid, which may have benefits for both pimples caused by acne and eczema.