Is It Acne Or Rosacea? How To Spot The Difference, According To Derms

When red bumps form on your face, alarm bells may go off in your head that scream: Treat it! Pop it! Dry it out with topicals! You're not alone—we all experience that initial wave of anxiety when an unwanted blemish pops up (that always just happens to appear before an important event or plans to see old friends). 

"Acne is caused by a combination of excess oil production, overgrowth of acne-causing bacteria in the skin, sticky skin cells that block the pores, and inflammation," board-certified dermatologist Joshua Zeichner, M.D., says.  

While you can place blame on underlying factors for acne, rosacea typically reacts to the external factors in your life. "The skin is extra sensitive and overly reactive to the environment. Patients typically develop facial redness, flushing, and commonly complain of burning or stinging," Zeichner adds.

When you think of acne, red inflamed bumps may come to mind. But just because you have pimples doesn't mean you have true acne. Those red, inflamed bumps also show up in severe rosacea cases, which is why the two are commonly confused. 

"The inflammation caused by rosacea can lead to acne in some patients, called acne rosacea," says board-certified dermatologist Adarsh Vijay Mudgil, M.D. "This is where there is significant overlap, which can understandably lead to confusion."

The distinction is important because the two skin conditions require totally different treatments. While rosacea patients should work on calming the inflammation by avoiding potential triggers (like sun, caffeine, and spicy foods, to highlight a few), acne patients might need to tailor topical treatments depending on the type of bumps they have. 

The main kicker is that people with acne develop a combination of blackheads and whiteheads along with those quintessential red bumps and pimples. Rosacea patients, on the other hand, might experience those red bumps, but they won't come to a "head," so to speak.

Once you've figured out what those red bumps actually mean, it's time to talk treatments. While both conditions can require oral medication in severe cases, it's always a good idea to talk with your derm about the best plan of action for your acne or rosacea (plus, it never hurts to get a second medical opinion on which condition you actually have). 

With rosacea, the key is avoiding those obvious environmental triggers that spark your flare-ups, along with gentle cleansers and moisturizers to calm the inflammation. With acne, the road toward clear skin is a little more customized depending on the type of acne you have—whether it's a congested forehead, cystic pimples along the jaw, or a smattering of blemishes along your hairline.