Differentiating Acne Vulgaris vs. Acne Rosacea

Isotretinoin: Approved only to treat severe acne, this medication may be an option. It has been shown to reduce the redness and acne-like breakouts. Because isotretinoin can cause serious side effects, including severe birth defects, it’s not an option for every patient. You can find more information at, Isotretinoin: The truth about side effects.

The first step to finding an effective treatment is knowing what you’re up against. If you’re unsure if those red bumps on your face are acne, rosacea, or a little of both, here’s how to figure it out.

Acne and rosacea are among the most common skin conditions out there. But despite their prevalence, finding an effective treatment can be a challenge—especially when they’re mistaken for each other.

How to Tell if Your 'Acne' Might Actually Be Rosacea | SELF

Does this look like acne rosacea? : Rosacea

Approximately half of all people with rosacea also develop eye problems or ocular rosacea. (3) “This is a form of rosacea that affects the eyes, and it occurs in about 50 to 70 percent of patients with rosacea,” notes Ilyas. “It may or may not be associated with rosacea of the skin.”

If you need an antibiotic, it will generally be prescribed to get the rosacea under control. Once under control, most patients use another treatment to maintain results.

Another possible side effect of this medication is skin lightening. If your rosacea caused patches of darker skin on your face, you may not mind this side effect. Should you notice skin lightening, be sure to tell your dermatologist immediately.

Rosacea treatment: Acne-like breakouts

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Antibiotics are great at reducing inflammation, which is why dermatologists may prescribe them for acne or rosacea. Topical antibiotics like clindamycin or metronidazole can calm mild surface redness, while oral antibiotics (usually doxycycline) reduce inflammation from within. Some people with acne or acne-like rosacea symptoms may also benefit from using topical treatments containing sulfur or sodium sulfacetamide, the AAD says.

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Don’t forget, patience is key.

A good rule of thumb to remember is that, for the most part, rosacea is triggered externally and acne is triggered internally. If your flare-ups happen after a run in cold, windy weather, or when you drink coffee, for instance, it’s probably rosacea; if they happen around your period or after a medication change, it’s probably acne.

So how do you distinguish the two? “The main distinguishing feature between acne and rosacea would be comedones, [which] are very specific for acne,” Jennifer Manusco, M.D., a dermatologist at the University of Michigan, tells SELF. Comedones, which may be open or closed, are visibly clogged pores that aren’t inflamed (meaning they aren’t red, swollen, or painful).

Acne vulgaris and acne rosacea are two commonly seen rashes that affect the face. While the two are often confused by patients given their looks, both conditions are characteristically distinct in the ways the can affect the skin.

How to Tell if Your Acne Might Actually Be Rosacea

Acne Rosacea

Metronidazole: Available as a gel or cream, this treatment has been used for more than 60 years to treat the acne-like breakouts of rosacea. Research studies show that it can effectively reduce both the redness and the acne-like breakouts.

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Medications you apply to your skin

Laser or light therapy: These can effectively treat the redness and acne-like breakouts. However, it’s important to know a few things about this treatment option.

As usual with skin products and treatments, you’re not likely to see immediate results. And, unfortunately, things may get worse before they get better. “Some products, particularly topical retinoids and benzoyl peroxide, can irritate and may temporarily worsen acne and even rosacea,” Dr. Manusco explains. “But if you persist with treatment, you can see improvement.”

Acne Vs. Rosacea

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To get the best results from treatment, it helps to make some lifestyle changes. To find out what dermatologists recommend, go to:

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Take a closer look at your bumps.

Before and after treatment for acne-like breakouts of rosacea: After 3 laser treatments (right), this woman has less redness and fewer acne-like breakouts. If your rosacea causes breakouts that look like acne, you have some effective treatment options. Here’s what your rosacea treatment plan from a dermatologist may include:

The exact cause of rosacea is unknown, but scientists do know that the blood vessels within the skin of people with rosacea are unstable and more reactive than those who don’t have the condition. (2,3) Some experts believe rosacea could be due to a dysregulation of the immune system as well as a genetic predisposition.

Rosacea or Something Else

3 Ways To Tell If It's Rosacea Or Acne | The Dermatology Office

Images
Images used with permission of the Journal of the American Academy of Dermatology. (J Am Acad Dermatol 2015;73:333-6.)

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Get to know your triggers.

Azelaic acid: Most patients apply this medicine twice a day — in the morning and again in the evening.

Other triggers include emotional stress and certain foods and drinks, such as red wine and spicy dishes. (3)

Differentiating Acne Vulgaris vs. Acne Rosacea

Skin Conditions That Look Like Acne

Your dermatologist will also want to change your treatment as needed to reduce the possibility of long-term side effects.

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Getting the best results from treatment

Findings from 6 research studies show that between 70% and 80% of patients have had noticeably less rosacea with azelaic acid. Some patients saw complete clearing.

Also, Demodex mites — microscopic organisms that normally inhabit hair follicles in low numbers — appear to be more numerous in those with rosacea, explains Anna D. Guanche, MD, a board-certified dermatologist based in Calabasas, California. On average, these patients have more Demodex mites per pore, says Dr. Guanche. This may contribute to the red bumps of rosacea.

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