How to Tell if Your “Acne” is Actually Rosacea

Trying to heal the skin of its imperfections is a constant struggle. It’s even more challenging when you are having trouble even identifying what exactly the problem is. There’s a lot of symptom overlap between different skin conditions, and so it gets tricky to properly diagnose yourself and find adequate treatment.

Two of the most common skin conditions are acne and rosacea, and it’s just our luck that they are also two of the most similar symptom-wise. What do you do if your skin is covered in red bumps, and you can’t quite dial down on what exactly is causing it? Keep reading as we go deeper into your pores to distinguish acne from rosacea so you can know your skin and find the right treatment.

Appearance of Acne vs. Rosacea

For many, rosacea will present only in redness and flushing, but the most common type of rosacea also comes with bumps that can highly resemble acne. This is where the confusion kicks in. If both acne and rosacea are chronic skin conditions that show up as inflammatory, red bumps, how do you distinguish acne from rosacea?

The main distinguishing factor between acne and rosacea is that acne specifically comes along with comedones, and rosacea does not. Comedones are visibly clogged pores that can either be open, which results in a blackhead, or closed, which results in a whitehead. Comedones aren’t inflamed, red, swollen, or painful.

What about those bumps that are swollen and inflamed? Papules, small tender red bumps, and pustules, papules with pus at the tip, are also common inflammatory skin conditions. Are those all a sign of rosacea? Not necessarily. Both acne and rosacea can result in pustules and papules, so it’s the comedones you need to look out for in order to properly diagnose your acne.

The location of your breakouts is also a helpful indicator for drawing the line between acne and rosacea. Rosacea is localized in the center of the face around the cheeks, nose, forehead, and chin with redness spread across a large surface area, whereas acne can fall anywhere on the face and body depending on the specific cause with the redness limited to the bumps and pimples.

Read more about different acne placements and their causes here.

Causes of Sensitive Skin Conditions

It can also be helpful to look at what is triggering your skin outbreaks. Rosacea is often triggered by sun, heat, alcohol, spicy foods, or strong emotional outbreaks. While the exact cause is unknown, many physicians believe it has to do with an inability for the skin to regulate heat, which leads to expanded blood vessels, and thus, redness.

Acne, however, is oftentimes triggered by excess oil production, which can be genetic or from hormonal and pH imbalances, medications, diet, stress, or exposure to bacteria. This excess oil clogs pores, infects them with bacteria, and causes inflammation.

As aforementioned, acne is often hormonal so it’s most likely to occur during puberty and teenage years, whereas rosacea typically occurs in people thirty and older.


If left untreated, rosacea can lead to even more severe redness and bumps, the skin will begin to thicken and look coarse and lumpy, and the nose can expand and become more bulbous.

Acne typically heals by itself over time as long as proper skin care measures are taken, however severe acne can result in scarring in the form of pits and pockmarks.

None of these are ideal scenarios so it’s crucial that you narrow down your symptoms and find proper treatment.

Treatment Differences

While there aren’t any complete cures for either acne or rosacea, there is a multitude of treatment options for both. Even though the symptoms of acne and rosacea are similar, it’s not always the best option to use the same products to treat them. Some over the counter acne treatments, like those that contain retinoids or benzoyl peroxide, can further irritate skin with rosacea while others, like azelaic acid, are recommended for the treatment of both acne and rosacea.

Your doctor may prescribe anti-inflammatory antibiotics. Some, like doxycycline and tetracycline, can be healing for both conditions, but others are targeted for either acne (like Accutane) or rosacea (like brimonidine).

In both cases, reducing behaviors that trigger either acne or rosacea is the optimal option for reducing symptoms. For example, if you notice eating spicy food leads to flushed cheeks, then cut back on the chile powder, or if you always break out in acne when you’re stressed, then try meditation, breathing exercises, or other ways to manage your stress.

Gentle skincare can also be your best friend when managing both acne and rosacea. With so many other factors contributing to breakouts, the last thing you want is for the products that are supposed to be cleaning and caring for your skin to further irritate them. Stay away from harsh ingredients like Sodium Lauryl Sulfate, fragrances, botanicals, essential oils, witch hazel, salicylic acid, parabens, phthalates, and formaldehyde, and reach for hypoallergenic skin care formulated specifically for sensitive skin.

When trying out new products, give the products a couple of weeks to work, and if you notice things getting worse, then stop using them.

Acne and Rosacea can both be chronic and unpredictable, making them equally difficult to live with. However, putting a magnifying glass up to your symptoms to find out which one you are affected by will make it much easier to find an adequate treatment that can relieve your skin from redness and inflammation, and relieve your mind from the stress of uncertainty.

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