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Rosacea vs. Acne: How to Tell The Difference

Kristin Hall

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 1/09/2021

From painful pimples to redness, irritation and discoloration, dealing with skin problems can be a highly frustrating experience, especially when they’re persistent or difficult to get rid of. 

Rosacea and acne are two common skin conditions that can affect your face and body. Both are commonly linked with redness, breakouts and increased sensitivity, making it often difficult to tell one apart from the other.

Although rosacea and acne can look similar, they’re generally treated in different ways, making it important to identify what’s affecting your skin before you use medication. 

Below, we’ve explained what rosacea and acne are, as well as the symptoms you may notice if you’re affected by either condition. 

We’ve also listed the key differences between rosacea and acne, from symptoms to the severity of each skin condition. Finally, we’ve explained what you should do if you have acne or rosacea, from over-the-counter products to prescription treatments and more. 

What Is Rosacea?

Rosacea is a chronic skin disease that usually affects the face. It can cause several symptoms, including redness of the face, visible blood vessels and lesions similar to those that form during an acne breakout.

An estimated 14 million Americans are affected by rosacea. While the exact cause of rosacea isn’t known, the condition often runs in families, meaning genetics likely play a part in your risk of developing rosacea at some point in life.

There are four different types of rosacea, each with slightly different symptoms:

  • Type 1, Vascular rosacea. This type of rosacea causes red areas of skin to develop on the face, possibly with small, visible blood vessels.

  • Type 2, Inflammatory rosacea. This type of rosacea causes facial redness and small bumps similar to acne. The bumps caused by this type of rosacea may be red (papules) or filled with pus (pustules).

  • Type 3, Phymatous rosacea. This type of rosacea causes the skin to thicken. It may also become bumpy, with bumps typically developing around the nose.

  • Type 4, Ocular rosacea. This type of rosacea can cause inflammation of the eyes and eyelids. The skin may or may not have visible symptoms.

In addition to the symptoms listed above, rosacea may cause the skin to become swollen, dry, itchy and flaky. Skin that’s affected by rosacea might feel more sensitive and become irritated more easily than unaffected skin.

People with rosacea often experience more than one type of the disease. Like with many other skin diseases, the symptoms of rosacea can vary significantly from one person to another. 

What Is Acne?

Acne is a common skin condition that can affect the face and body. It can vary in severity from a few small, non-inflamed lesions to large-scale, persistent acne breakouts with infected, inflamed and painful acne lesions.

Similar to rosacea and other skin conditions, there are several different types of acne:

  • Comedonal acne. Comedones are a type of non-inflamed acne. Closed comedones are known as whiteheads, while open comedones are called blackheads. Comedonal acne is typically mild, without significant redness, inflammation or pain.

  • Inflammatory acne. Some acne lesions can become inflamed, infected and red. These are referred to as papules. Some inflamed acne lesions contain pus. These are referred to as pustules.

  • Nodular acne. When inflamed acne lesions are large and painful to the touch, they may be referred to as nodular acne.

  • Cystic acne. When severe, inflamed acne develops deep within the skin, it’s referred to as cystic acne.

Acne develops when your hair follicles, or pores, become clogged with a mix of sebum (a type of oil that’s secreted by your sebaceous glands), dead skin cells and other substances that can accumulate on the surface of your skin.

Numerous different factors can affect your risk of developing acne. For example, you may have a higher chance of developing acne before and during your period, if you’re prescribed specific medications, if you’re a smoker or if you’re feeling stressed.

We’ve talked more about the factors that can contribute to acne in our full guide to the causes of acne breakouts

Key Differences Between Rosacea and Acne

Although rosacea and acne can look similar, they’re very different skin conditions, complete with different causes and treatments. 

If you’ve noticed breakouts, redness or other common symptoms of rosacea and acne, the best option is to talk to a healthcare professional or certified dermatology practitioner. They’ll be able to inspect your skin and tell you whether your symptoms are caused by rosacea or acne.

You can also use the list of key differences below to differentiate between rosacea and an acne breakout:

  • Breakouts. Acne and rosacea can both cause you to experience breakouts of pimples or pimple-like lesions that affect your face and body.
    Acne breakouts usually feature a variety of types of pimples, including blackheads. You may also notice whiteheads, papules, pustules and cystic acne. Rosacea, on the other hand, typically causes pimple-like breakouts without any blackheads.

  • Oily skin. Acne is directly caused by high levels of sebum — a natural oil that’s produced by your body to keep your skin moisturized and protected. Because of this, acne is often associated with oily skin, especially around your forehead, nose and chin.

Rosacea is not related to oily skin. If you have rosacea, you may have normal, dry or oily skin.

  • Redness. Acne can cause redness, although it’s usually limited to the area of skin close to acne lesions. You may notice redness in the areas affected by breakouts, with the rest of your face retaining its normal skin tone.
    Rosacea can cause redness to develop across your entire face, including on your nose, chin, cheeks and forehead. Based on the type and severity of your rosacea, the redness may be temporary or permanent.

  • Visible blood vessels. Certain types of rosacea, such as vascular rosacea, may make your blood vessels more visible than normal. Acne does not typically affect your blood vessels.

  • Skin texture. Acne and rosacea can both affect your skin texture. If you have severe or recurring acne, you may develop a bumpy skin texture over time due to scarring caused by your acne breakouts.
    While rosacea doesn’t cause scarring, it can cause large pores that may be visible when you look at your face in a mirror.

  • Age and race. Acne affects people of all ages, but it’s most common during your teens and early in adulthood. People of all races and skin tones can get acne.
    Rosacea, on the other hand, tends to develop in people 30 years of age or older. While people of all races and skin tones can develop rosacea, it’s most common in people with a fair skin tone.

  • Affected areas. Acne typically develops on your face and jawline, although it may also affect your chest, neck, back and shoulders.
    Rosacea tends to affect your face and eyes. Redness from rosacea may also spread to your neck, scalp, chest and back.

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How to Treat Rosacea

If you think you might have rosacea, it’s best to talk to a dermatology practitioner or healthcare professional. There’s no medical test for rosacea. Instead, they will typically diagnose rosacea by examining your skin and eyes to look for symptoms.

Currently, there’s no cure for rosacea. However, making changes to your lifestyle may help to control your symptoms and make your rosacea less severe. You may need to:

  • Identify and avoid your rosacea triggers. Rosacea is often triggered by factors in your environment, such as heat, spicy foods, wind or alcohol. When you’re exposed to these triggers, your rosacea symptoms may become more severe.
    If you’re affected by rosacea, identifying your triggers and taking steps to avoid them can make dealing with flare-ups much easier.

  • Change your skincare routine. Certain types of skincare products can irritate your skin and may cause your rosacea symptoms to flare up.
    You may need to switch from your current skincare products to mild products formulated for sensitive skin. Making certain changes to your skincare habits, such as washing your skin gently instead of scrubbing, may also help to prevent irritation and rosacea.

  • Use sun protection. Sunlight is one of the most common causes of rosacea flare-ups, making it important to protect your skin from the sun to avoid redness and acne-like breakouts.
    Make sure to apply an SPF 30+ sunscreen before you spend any time in the sun. Other steps, such as wearing a wide-brimmed hat, avoiding peak sunlight hours and spending time in the shade, can also reduce your risk of experiencing rosacea flare-ups.
    Depending on your symptoms and the severity of your rosacea, using medication may provide additional relief. Some medications used to treat rosacea are available over the counter, while others may require a prescription. Medications used to treat rosacea include:

  • Sodium sulfacetamide and sulfur. Commonly available in over-the-counter treatments for rosacea, these ingredients can help to treat the acne-like breakouts and redness that often develop during rosacea flare-ups.

  • Brimonidine. Gels that contain brimonidine can help to improve the redness that occurs during a rosacea flare-up.

  • Azelaic acid. Topical creams and gels containing azelaic acid can help to limit rosacea flare-ups and reduce acne-like pimples and nodules.

  • Antibiotics. Some antibiotics, including metronidazole, tetracycline and others, can help to treat redness and acne-like breakouts. You may need to use antibiotics in combination with other treatments to control your rosacea.

  • Retinoids. Topical retinoids may help to control rosacea and prevent flare-ups. These medications may cause irritation when used in the short term and should be used only if recommended by a healthcare professional.

If you have severe or persistent rosacea, your dermatologist may suggest laser therapy. This is an effective option for treating rosacea. However, it’s quite costly and often requires follow-ups to maintain your results over the long term.

How to Treat Acne

Acne can be treated using a variety of medications. Some of these can be purchased over the counter, while others may require a prescription. 

Over-the-counter products and medications for treating acne include:

  • Cleansers. If you only have mild acne, a cleanser may be more than enough to reduce your risk of experiencing breakouts. Our Deep Sea Cleanser is formulated to keep your skin healthy and hydrated while preventing acne breakouts.

  • Benzoyl peroxide. A topical antiseptic, benzoyl peroxide stops the bacteria that cause acne from multiplying on your skin. It’s a common ingredient in many over-the-counter cleansers, creams, gels and other products for treating acne.

  • Salicylic acid. Topical salicylic acid treats acne by unblocking clogged hair follicles and reducing swelling and redness. Just like benzoyl peroxide, it’s a common ingredient in over-the-counter cleansers, creams and other acne treatments.

  • Azelaic acid. Azelaic acid treats acne by killing acne-causing bacteria and reducing the production of keratin. Like salicylic acid and other treatments, it’s available in a variety of over-the-counter acne cleansers, creams, gels and other products.

  • Over-the-counter retinoids. Retinoids such as adapalene work by regulating skin cell turnover and preventing dead skin cells from clogging your pores.

Prescription medications for treating acne include:

  • Tretinoin. A topical retinoid, tretinoin unclogs pores and peels away the outermost, older layers of your skin. Used regularly, tretinoin is highly effective at getting rid of acne and preventing it from coming back.
    We’ve talked more about how tretinoin works and its effects on acne in our full guide to tretinoin as an acne treatment.

  • Clindamycin. A topical antibiotic, clindamycin kills the bacteria that can cause infected, inflamed acne to develop. We’ve talked more about how it works, its effects and more in our guide to clindamycin for treating acne.

  • Hormonal birth control. Several birth control pills, including Yaz®, Estrostep® and Ortho Tri-Cyclen®, are approved by the FDA for treating acne. We’ve talked more about these medications in our guide to birth control and acne.

  • Isotretinoin. Isotretinoin is an oral medication that’s used to treat nodular acne, a type of severe acne. It’s highly effective at treating acne. However, it can cause a range of side effects, including dry, irritated skin and lips.

    If you’re prescribed isotretinoin, you’ll usually need to keep in regular contact with your dermatologist to monitor your progress and stay on top of side effects.

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In Conclusion

Although rosacea and acne can look similar, they’re distinct conditions that usually need to be treated differently.

If you’ve noticed redness and acne-like symptoms, you can use the list of differences above to identify whether you have rosacea or acne. 

If you’re still not sure whether you have rosacea or acne, to your healthcare provider. They‘ll be able to check your skin and let you know what’s affecting you, as well as the steps you can take to stop your breakouts and enjoy clearer skin that’s free of acne and redness.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.