Rheumatoid arthritis (RA) is a chronic autoimmune condition that can cause inflammation in multiple areas of your body. People with RA generally experience painful swelling in their joints, often several joints at the same time.

RA usually affects your:

  • wrists
  • hands
  • feet
  • knees

However, it can also affect tissues in your:

  • lungs
  • eyes
  • heart
  • skin

Since RA can affect the skin, you might be wondering whether it could cause acne or similar concerns.

Learn more below about whether there’s a connection between RA and acne. This article also looks at other skin conditions related to RA, plus treatments for acne and management options.

There isn’t much scientific evidence to show acne is related to RA. People who have RA and acne may be experiencing the two conditions independently.

However, research has shown that RA is related to certain other skin conditions. We discuss these in greater detail below.

RA and certain types of acne are inflammatory conditions.

RA is a type of autoimmune, inflammatory arthritis. This means that if you have RA, you have higher levels of inflammation in your body, particularly in your joints.

Though acne may not be related to RA, it’s also an inflammatory condition.

People with acne most commonly experience skin lesions on their:

  • face
  • upper arms
  • back
  • trunk

According to a 2020 review, causes of acne can include:

  • genetic factors
  • hormonal conditions
  • overexposure to sunlight
  • certain medications
  • restrictive clothing

If you have RA, you may develop other skin conditions, including the following:

Rheumatoid nodules

Around 25 percent of people with RA develop rheumatoid nodules. Typically these nodules only develop in those who test positive for rheumatoid factor or anti-CCP (cyclic citrullinated peptide) antibodies in their blood.

Rheumatoid factor is a protein your immune system produces. It can trigger inflammation, resulting in the destruction of healthy body tissues, especially in the lining of your joints.

Rheumatoid nodules occur most often in white males and can range in size from several millimeters to a few centimeters across.

They usually appear on the extensor surface (area on the outside of a joint) of the arms around the elbow and on pressure points like the fingers and heels. Rheumatoid nodules can also occur in the lungs.

Rheumatoid vasculitis

This is a serious complication of RA that happens in less than 1 percent of people with the condition. It occurs in severe and long-term RA.

Rheumatoid vasculitis causes inflammation in small and medium blood vessels throughout the body — usually those that bring blood to nerves, organs, and skin.

It can present in different ways on the skin, including skin ulcers and blood spots.

Felty’s syndrome

Felty’s syndrome is a combination of:

  • splenomegaly (enlarged spleen)
  • leucopenia (fewer white blood cells)
  • arthritis

It occurs in less than 1 percent of people with RA and can cause:

  • rheumatoid nodules
  • leg ulcers
  • darkening of the skin on the shins and ankles

Granulomatous dermatitis

Granulomatous dermatitis is a plaque-like rash that can be painful and itchy. It usually appears on the trunk and insides of the thighs, but it can develop anywhere on the body.

This condition is uncommon and usually develops only with severe RA in people who test positive for rheumatoid factor.

Medication effects on the skin

RA medication can also cause skin changes, such as rashes. Ask your doctor about possible side effects of your medication and what to do if any occur.

Check with your doctor if you’re living with RA and experience skin changes. These could relate to RA or be reactions to RA medication.

If your doctor diagnoses acne, they may suggest an acne treatment.

Your doctor may also refer you to a dermatologist, who specializes in the diagnosis and treatment of skin conditions. They can answer your questions about treatment outlook and side effects.

Topical treatments for acne

Topical treatments for acne include:

  • Retinoids: remove dead skin cell buildup
  • Antibiotics: kill skin bacteria
  • Azelaic acid: removes dead skin and kills bacteria
  • Benzoyl peroxide: reduces skin bacteria

Oral medication for acne

Oral treatments for acne include:

  • Antibiotics: fight bacterial infection
  • Hormonal therapies: help acne flares that hormones have triggered
  • Isotretinoin: helps prevent clogged pores and reduce swelling

Other therapies for acne

There are also other acne therapies you can ask about, including:

  • Light therapy: kills bacteria using particular wavelengths of light
  • Manual extraction: a healthcare provider removes whiteheads and blackheads with special equipment
  • Chemical peel: removes surface skin

Therapies for skin conditions in RA

If you have a skin condition with RA, your doctor can recommend treatment based on the type and severity.

Generally speaking, healthcare professionals focus on preventing infection and helping increase comfort for people with RA.

A skin rash may be a sign that your RA treatment isn’t working properly, so treatment for your rash may start with changing your treatment for RA.

You can help your acne treatment work better by practicing good skin care habits, such as:

  • Wash your face twice daily and after sweating.
  • Shampoo daily if you have oily hair.
  • Avoid picking or popping acne and touching your face.
  • Use an oil-free moisturizer so your skin won’t overproduce oil.
  • If you wear makeup, use products that are oil-free.
  • Get enough sleep.
  • Practice stress management.

If you have an RA skin rash, an over-the-counter (OTC) medication may ease the pain. Options include acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil or Motrin).

Ask your doctor to recommend an OTC medication or a prescription medication if you are experiencing severe discomfort.

There doesn’t appear to be a connection between RA and acne, but scientific evidence on this topic is limited. More research needs to be done in this area before a conclusion can be reached.

However, RA is associated with other skin conditions, such as rheumatoid vasculitis. If you’re experiencing skin changes with RA, speak with your doctor.

If you are experiencing acne — whether or not you have RA — speak with a healthcare professional to determine the best treatment for you. Topical, oral, and other treatments are available.

Good skin care and lifestyle habits, like regular face washing and stress management, can also help.