Acne and Rosacea the top 8 difference

Nov 20, 2023
Acne and RosaceaAcne and Rosacea

Acne and rosacea can be both common skin conditions that, while often similar in appearance, are characterized by distinct causes and features. Acne typically occurs during the teenage years, results from hair follicles that are blocked, and can manifest across a variety of parts of the body.

Rosacea usually begins in adulthood and manifests as skin redness and, sometimes, red, swollen bumps. Both of these conditions can be distressing emotionally and may affect self-esteem. An understanding of the differences between them is crucial to ensure a correct diagnosis and efficient treatment.

What is Acne?

Acne is a very common skin condition that is characterized in the form of pimples, spots as whiteheads, blackheads, and blackheads, and sometimes deeper lesions known as Nodules and cysts. It’s mostly an inflammation of the oil glands in the skin (sebaceous glands) and hair follicles.

Figure 01: Acne

Common Locations:

  • Face: Specifically, the forehead cheeks, chin, and nose.
  • The body: The back, chest, and shoulders are among the commonly affected areas.

Main Triggers and Causes:

  • Hormonal Fluctuations: particularly when menstruation is occurring, puberty, and often due to polycystic-ovarian disorder (PCOS).
  • Bacteria Propionibacterium acnes could cause the development of lesions that are inflamed.
  • Sebum Overproduction: When the skin produces an excess amount of oil.
  • Clogged Hair Follicles: Skin cells that are dead could cause clogged pores, leading to acne.
  • Other Factors: Diet, medications, and stress may also influence.

 What is Rosacea?

Rosacea is a long-lasting inflammation of the skin that is most commonly seen in the facial area. It’s characterized by flushing, redness, obvious blood vessels, and occasionally pimple-like bumps. Contrary to acne, it does not cause blackheads and is mostly affecting adults.

Figure 02: Rosacea

Typical Areas of Occurrence:

  • Face: Particularly the center of the face, which includes the cheeks, nose forehead, and chin.

Primary Causes and Factors:

  • Anomalies of the Blood Veins: Small blood vessels expand below the skin’s layer.
  • Genetics: The family history of a person can play an important role.
  • The triggers for environmental events: Temperatures that are extreme, winds, or fluctuations in humidity.
  • Additional Factors: Some skin microbes (like Demodex folliculorum), bacteria, and even foods that are spicy and alcoholic can cause rosacea to worsen.

Both conditions show up in the face and appear like one another, they differ in root causes and presenting symptoms. Being aware of these differences can help in determining a more precise diagnosis and treatment that is effective.

Acne and Rosacea in the comparison chart

Here’s a concise comparison chart detailing the differences between acne and rosacea:

Aspect Acne Rosacea
Typical Onset Age Adolescence, but can continue into adulthood Adults, usually after age 30
Primary Locations Face, chest, back, and shoulders Central face (cheeks, nose, forehead, and chin)
Main Symptoms Blackheads, whiteheads, pimples, oily skin, and possibly scarring may occur as symptoms. Redness, flushing, visible blood vessels, papules, pustules, and swelling
Causes Overactive sebaceous glands, hormonal fluctuations, bacteria Vascular changes, inflammation, possible mite involvement
Common Triggers Hormones, certain foods, stress, medications Sun exposure, spicy foods, alcohol, temperature changes, stress
Treatment Topical treatments, antibiotics, retinoids, hormonal treatments Topical treatments, antibiotics, laser therapy, skin care products
Prevention & Self-Care Regular cleansing, avoiding pore-clogging products, managing stress Avoiding personal triggers, sun protection, gentle skincare

This chart provides a high-level overview of the key differences between acne and rosacea. It’s important to note that while there are general distinctions, individual experiences can vary, and a dermatologist’s assessment is essential for accurate diagnosis and treatment.

Brief overview of both acne and rosacea

Acne as well as rosacea are both skin inflammation conditions, however, they are distinct in their appearance the causes, as well as how they are treated.

Acne is among the most frequent skin disorders which is particularly prevalent among teens however, it can also affect people of all ages. It is distinguished by the appearance of blackheads, pimples, and whiteheads and may lead to nodules and cysts.

Most often, they appear on the chest, and face as well as the back and shoulders and back, acne is triggered by hormonal changes, excessive production of oil (sebum), and the accumulation of skin dead cells and the growth of bacteria. The treatment options are diverse in terms of topical products available over the counter to prescription medicines and treatments dependent on the extent and the nature of the acne.

Rosacea generally for adults, manifests as visible redness along with visible blood vessels mostly in the skin. It can also cause pus-filled, swollen bumps. Factors like blood vessel irregularities and genetic predisposition, as well as environmental triggers, and specific foods and drinks, can trigger the rosacea.

The treatment of rosacea is mainly based on identifying and eliminating individual triggers. This may be a combination of oral medication, and laser or light treatment to treat chronic redness and obvious blood vessels.

Understanding the difference between these conditions is essential for a correct diagnosis and treatment. delay or ineffective treatment can cause the progression of the symptoms, scarring, and a negative impact on the health and quality of life.

Clinical Presentation and Symptoms of Acne and Rosacea


Clinical Presentation:

  1. Appearance:
    • blackheads: The comedones are in open form, and appear as dark, small spots.
    • Whiteheads: Closing comedones are small flesh-colored, whitish, or tiny bumps.
    • The papules: Tiny, red bumps that are raised.
    • Pustules: Soft, red bumps dotted with white pus at their tip.
    • Nodules: The largest, most painful lumps that are solid beneath the skin’s surface.
    • Cysts: The most painful, deep cysts that are pus-filled beneath the skin.
  2. Areas of Occurrence:
    • Most commonly affects the face, focusing on the cheeks, forehead chin, nose, and forehead.
    • It is also common to see it on the back, chest, and shoulders.
  3. Associated Symptoms:
    • Tenderness and pain in the areas affected.
    • Dark spots or scarring may be visible after the healing of lesions.
    • The peeling, itching, and dry skin may also be seen.


Clinical Presentation:

  1. Appearance:
    • Erythema (Redness): Redness that persists in the face’s central area and often resembles sunburn or blush.
    • Papules or Pustules: Small bumps that are red and raised often full of pus that resembles acne.
    • Visible Blood Vessels (Telangiectasia): Appearance of blood vessels that are small on the face.
    • Rhinophyma: The appearance of enlargement and thickening of the skin on the nose (usually in more severe cases).
  2. Specific Areas on the Face:
    • The central facial region, including the forehead, cheeks, nose, and chin is the most commonly affected.
  3. Associated Symptoms:
    • Eye issues: Dry, red, or dry eyes. swelling of the lids (ocular rosacea).
    • Skin sensitivities: burning or stinging sensation, particularly when applying products for topical use.
    • Flare-ups: Symptoms of heightened swelling, redness as well as the appearance of papules or pustules.

Differentiating Features:

  • While both rosacea and acne can be associated with papules or pustules, the absence of comedones (blackheads as well as whiteheads) is an eminent characteristic of rosacea.
  • The high prevalence of telangiectasia and erythema also assists in distinguishing the appearance of rosacea from acne.

Awareness of these features and symptoms that accompany them is vital to ensure proper diagnosis and treatment in preventing any potential complications and improving the standard of living for those affected by these ailments.

Pathophysiology of Acne and Rosacea

The pathophysiology that causes the two conditions, acne as well as rosacea involves a complex interplay of many factors. Here’s the breakdown:


  1. Sebaceous Gland Activity & Sebum Production:
    • Androgens (hormones) boost the size and function of sebaceous (oil) glands within the skin.
    • This causes an overproduction of sebum (oil).
  2. Follicular Hyperkeratinization:
    • This is a reference to the unusual shedding of skin cells in hair follicles.
    • Instead of shedding, the cells become stuck together, causing an obstruction within the hair follicle and forming a plug referred to by the name of a camedone (blackheads and whiteheads).
  3. Bacterial Growth:
    • The bacteria Propionibacterium acnes is a common skin-related bacterium.
    • When it gets stuck in the hair follicles, they multiply within the sebum-rich environment.
    • The bacterium makes substances that cause inflammation. It transforms the sebum into irritative acidic fatty acids.
  4. Inflammation:
    • In response to bacteria and the irritative fatty acids, the body releases the white blood cells.
    • This can cause swelling, redness, and pus that are typical of acne cysts and pimples.


  1. Vascular Changes:
    • One of the main theories is that there is a problem with the blood vessels in facial areas causing them to dilate excessively.
    • This causes an increase in the circulation of blood near the skin’s surface, which causes swelling and redness. In time, these blood vessels can grow permanently (telangiectasia).
  2. Inflammatory Factors:
    • The body is able to increase certain immune system-related factors that are found in the skin, which can lead to inflammation.
    • The precise reason for this rise is unknown, it is a factor in the papules, redness pustules, swelling, and redness seen in Rosacea.
  3. Skin Microbes:
    • Although this skin mite Demodex folliculorum is common on the skin of everyone, those who suffer from rosacea have higher levels.
    • The role this mite plays in rosacea isn’t completely clear however there is some speculation that its presence in greater numbers or the presence of bacteria could cause inflammation.
  4. Skin Barrier Dysfunction:
    • Rosacea skin may have an impaired barrier function that could result in increased irritation and skin sensitivity.
  5. Environmental & External Triggers:
    • Factors such as UV radiation, alcohol, spicy food, and stress can trigger symptoms of rosacea. The precise mechanism isn’t always obvious, but it could result in an aggravation of already hypersensitive and reactive blood vessels, as well as a skin barrier.

Both conditions cause inflammation and may appear like they are similar, but their mechanisms are quite different. Understanding these differences is crucial for a targeted and effective treatment.

Common Triggers of Acne and Rosacea

Both rosacea and acne may be caused by a variety of triggers, but the exact causes of the condition can differ greatly. Here’s a list of the most common triggers for each:


  1. Hormonal Changes:
    • Menstrual cycles, puberty, pregnancy, and other conditions such as polycystic Ovarian Syndrome (PCOS) can cause increased levels of orrogens which in turn increase oil production.
  2. Diet:
    • Certain studies suggest that food items that have a high glycemic value and dairy may cause the appearance of acne in certain people.
  3. Stress:
    • Stress can cause adrenal glands to release more hormones that can boost the production of oil on the skin, which can lead to acne breakouts.
  4. Certain Medications:
    • Corticosteroids androgens or lithium are often the culprits.
  5. Cosmetics:
    • Cosmetics containing oil or heavy ingredients can make pores appear blocked. It is recommended to search to find “non-comedogenic” or “oil-free” labels.
  6. Physical Factors:
    • Friction from screens on phones and neck collars that are tight or backpacks may result in or worsen acne.
  7. Environmental Factors:
    • The high humidity and the pollution levels can trigger breakouts for certain people.


  1. Sun Exposure:
    • Ultraviolet (UV) radiation may cause an increase in blood vessel size, which could be a significant trigger for many people.
  2. Hot or Spicy Foods & Drinks:
    • They can trigger blood vessels to expand, which can cause the amount of redness.
  3. Alcohol:
    • In particular, alcohol-based drinks can trigger flare-ups in certain individuals.
  4. Temperature Extremes:
    • Moving from a cold place to one that has warm saunas and hot baths may trigger signs of rosacea.
  5. Stress & Strong Emotions:
    • Fear of embarrassment, anxiety, or other intense emotions can cause the appearance of flushing as well as other signs.
  6. Cosmetics:
    • Certain hair and skin products for hair and skin care, specifically ones that contain alcohol, witch-hazel, or scents, can cause Rosacea.
  7. Medications:
    • The dilation of blood vessels by drugs such as blood pressure medications, could cause rosacea.
  8. Physical Exertion:
    • A strenuous exercise routine can cause flushing and rosacea flare.
  9. Hot Beverages:
    • Hot tea or coffee may cause flushing and cause symptoms in certain.

Understanding the triggers that are specific to each person is essential for those suffering from rosacea or acne. Eliminating or reducing the triggers will help to manage the symptoms and help reduce flare-ups.

Treatment Options for Acne and Rosacea

Both rosacea and acne come with various treatments, ranging from topical medication to physical and oral treatments. The type of treatment you choose is based on the extent and nature of the condition and the person’s particular conditions and requirements.


  1. Topical Treatments:
    • Retinoids: These are products that contain tretinoin adapalene or tazarotene. They aid in unblocking pores.
    • Benzoyl Peroxide: It kills bacteria and eliminates dead skin cells from the pores.
    • Salicylic Acid: Helps clear blocked pores, and decreases swelling and irritation.
    • Azelaic Acid: It helps reduce inflammation and clear pores.
    • Topical Antibiotics: Like clindamycin help kill bacteria on the skin.
  2. Oral Treatments:
    • Antibiotic Oral: Like tetracyclines for reducing the growth of bacteria and combat inflammation.
    • Oral Contraceptives: Certain birth control pills aid in regulating hormones, thereby lessening acne.
    • Anti-androgen Agents: Like spironolactone, they prevent androgens from stimulating oil glands.
    • Isotretinoin: For acne that is severe This potent medication treats and stops acne by reducing pores of oil.
  3. Physical Treatments:
    • Laser Therapy and Light: Targets the deep layers of the skin, without harming the skin surface.
    • Chemical Peels: Utilizes an acid that is strong to peel off the upper layer of skin.
    • Extract: Removes whiteheads and blackheads.


  1. Topical Treatments:
    • Metronidazole: Reduces inflammation.
    • Azelaic Acid: Reduces redness and inflammation.
    • Ivermectin: It reduces the inflammation of your body and has anti-parasitic effects that target the Demodex mites.
    • Brimonidine, Oxymetazoline: The blood vessels are constricted, decreasing the appearance of redness.
  2. Oral Treatments:
    • oral antibiotics: Like tetracycline minocycline, doxycycline, and tetracycline to reduce inflammation.
    • Isotretinoin: It is used to treat severe rosacea that isn’t responding to other treatments. It’s predominantly used to treat acne but may assist in certain rosacea instances.
  3. Physical Treatments:
    • Laser, and Intense Pulsed Light (IPL) Therapy: Used to reduce the redness and visible blood vessels.
    • Dermabrasion: specifically for people suffering from rhinophyma It’s a method to eliminate excess skin and to reshape the nose.
    • Electrosurgery: It uses electric energy to cut away tissue and shape the nasal area (for rhinophyma).

Both conditions typically require a mix of treatments tailored to the patient’s specific needs. Monitoring and regular visits with a dermatologist are essential to determine the efficacy of the treatment and to make the necessary adjustments. It’s important to remember that even though treatments are highly effective, they may not completely cure the condition, but instead help to alleviate symptoms and manage them.

Prevention and Self-Care of Acne and Rosacea

Although both rosacea and acne aren’t always completely preventable, there are certain methods that can reduce flare-ups and decrease the intensity of breakouts. Self-care practices also are essential to the general management of these ailments.



  1. Select the best products for your skin: Look for “non-comedogenic” or “oil-free” labels to ensure that they don’t clog pores.
  2. Cleanse your skin regularly: Especially after sweating and exercising or applying the use of heavy makeup.
  3. Avoid touching frequently on your face frequently: The contact can bring in bacteria, oils, and.
  4. Prevent sunburn: A few acne therapies could make your skin sensitive to the sun’s rays. Make sure you apply sunscreen as required.


  1. Refrain from popping pimples: This can push the infection deeper into the skin and lead to marks.
  2. The face should be cleaned gently: Scrubbing too hard could cause irritation to the skin.
  3. Make use of makeup that is oil-free: And ensure you take off your makeup prior to bed.
  4. Be aware of your diet: Although the connection between diet and acne is still a subject of debate there are some who find a reduction in dairy or other high-glycemic food items useful.
  5. Control stress: The stress of life can cause acne to worsen.



  1. Avoid triggers and identify them: Recognizing what causes flare-ups and how to avoid triggers can be helpful.
  2. Protect your skin: Wear a broad-spectrum sunscreen with an SPF of 30 or more.
  3. Be aware of cosmetics for skin: Beware of products that can burn, sting, or cause redness.


  1. Soft skin: Apply a soft cleanser and do not scrub.
  2. Moisturize: It helps combat any dryness caused by some medication for rosacea.
  3. Beware of overheating: Try to stay cool and stay clear of saunas or vigorous exercise during hot weather.
  4. Be prepared for cold and wind: Use a scarf or a ski mask during winter.
  5. Avoid the consumption of alcohol and spicy food: If they’re identified as triggers for you personally.
  6. Control stress: The stress of life can become an important trigger for many.

For both of these conditions, it’s essential to have regular appointments with dermatologists. They can offer advice on preventive measures that are tailored to the specific needs of each patient as well as monitor the progression of the condition and alter treatments if required.


Acne, as well as rosacea, are both skin disorders that can dramatically affect the health and quality of life. While both may show similar symptoms, including pimples and redness their root causes triggers, treatments, and causes differ significantly. A proper diagnosis is essential to ensure proper management.

Self-care and prevention play crucial aspects in preventing the two conditions. Regular consultation with dermatologists can assist in resolving symptoms, understanding triggers, and choosing appropriate routines for skin care, which can assist those living a positive life and a healthier complexion.