Eczema vs. Rosacea: How to Tell the Difference

Symptom comparison chart

Here’s a quick look at how the symptoms of eczema, rosacea, and psoriasis compare. We’ll discuss the symptoms of eczema and rosacea more in depth later.

Appearance

Eczema and rosacea are both chronic conditions that may flare up and recede over the course of years. It may be possible to have both conditions simultaneously.

Eczema and rosacea can affect people of any age. However, rosacea is uncommon in babies, children, and teens. Rosacea most commonly starts during middle-age and is typically more noticeable in people with fair skin. Women are also more prone to developing rosacea.

Unlike rosacea, eczema often starts early in life and may be outgrown once a child reaches adulthood. It’s also possible to get eczema for the first time as an adult. A person with any skin type may get eczema.

Eczema

People with eczema may have:

• dry skin
• itching
• swelling
• red bumps that may or may not ooze
• red or brownish-gray patches
• prolonged scratching can cause thick, leathery skin (lichenification)

Eczema can occur on areas of the body or face, such as:

• crook of the elbows
• back of the knees
• back of the neck
• eyelids
• around the mouth

Children may be prone to more widespread outbreaks of eczema that include:

• front of the legs
• chest
• stomach
• back
• cheeks

Rosacea

There are four subtypes of rosacea. Each type has specific symptoms. You can have several subtypes simultaneously.

Erythematotelangiectatic rosacea

This type causes:

• redness across the nose and central area of the face
• it may spread outwards to the cheeks, if not treated
• visible blood vessels

Papulopustular rosacea

This type causes:

• pus-filled blemishes which look like whiteheads on the cheeks, chin, and forehead
• swollen, red bumps on those same areas of the face

Ocular rosacea

This type affects the eyes. It causes

• watery, bloodshot eyes
• a stinging sensation
• sensitivity to light
• cysts or sties on the eyelids
• broken blood vessels on the eyelids

Phymatous rosacea

This type is rare and usually occurs in men. It causes:

• thickened skin on the nose, making it appear bulbous
• redness
• bumps

Causes

Eczema is also known as atopic dermatitis. Its exact cause is unknown. However, a combination of genetic and environmental factors seems to be at cause. If you have eczema, you may have a gene mutation which stops your skin from maintaining a top layer protective barrier. This allows moisture to escape and bacteria and irritants to enter skin more readily.

People with eczema have triggers that cause outbreaks. These vary from person to person, but may include chemicals found in the environment and in products, such as soap.

Rosacea often runs in families, although the exact cause of this condition is unknown. Some possible causes include:

• overabundance of Demodex, a microscopic skin mite
• follicle irritation
• sun damage of the skin’s connective tissues
• abnormal or unusual immune or inflammatory response to specific triggers, which may include extreme temperatures, wind, spicy foods, alcohol, and exercise

Both eczema and rosacea may be exacerbated by emotional triggers like stress.

Treatments

Cures don’t as yet exist for either eczema or rosacea. For that reason, treatment for both conditions centers upon symptom control.

Eczema and rosacea are more easily managed when you can identify and avoid your specific triggers. This isn’t always possible, but can help eliminate flare-ups.

Rosacea

Treatments for rosacea include:

• topical medications that reduce redness by constricting superficial blood vessels
• topical antiseptics that shrink pimples and skin bumps
• topical or oral antibiotics that reduce skin bumps and pimples
• antiparasitic creams that reduce the population of Demodex on skin
• laser treatments may be used to reduce redness and shrink enlarged blood vessels

Eczema

Treatments for eczema include:

• topical corticosteroid creams that reduce itching
• moisturizers that reduce dry skin
• antibacterial cream if you have a bacterial skin infection
• oral corticosteroids that reduce and control inflammation
• laser therapy to reduce skin inflammation
• an injectable biologic medication to treat severe eczema

When to talk with a doctor

Eczema affects around 20 percent of infants. It’s not contagious, but it can become infected when scratched. If your baby has a rash or dry, irritated skin that itches, they should be seen by a pediatrician. Their doctor will be able to make a diagnosis and provide treatment.

Skin conditions can worsen over time when not treated appropriately. If you have a rash that doesn’t respond easily to at-home treatment, talk with a medical professional. You may need to see a specialist, such as a dermatologist, who can differentiate between eczema, rosacea, and psoriasis, plus prescribe medications that reduce flare-ups.

The bottom line

Eczema and rosacea are two chronic skin conditions that flare-up and recede. Environmental triggers and stress may have an impact on both conditions.

Rosacea is most commonly seen on the face in adults.

Eczema is most commonly seen on certain parts of the body, although it may also occur on the face. It usually starts in infancy or childhood, but may also affect adults.

Both conditions have similar symptoms, such as itchy, red skin. There are also symptoms that are specific to each.

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