Rosacea vs. Acne: Differences and Treatments Explained (With Pictures)

If you’re dealing with red pimples on your face, acne may seem like the obvious explanation. But another common skin condition — rosacea — can look very similar, especially on the cheeks and nose.

Although rosacea and acne both cause facial breakouts, they differ in important ways, including symptoms, triggers, and treatment options. Here’s how to tell them apart.

What is acne, exactly?

Acne is a common skin condition that causes pimples on the face and other parts of the body, like the chest and back. It’s most common during adolescence and early adulthood, but adults and babies can get acne, too.

Common types of acne

There are a few different types of acne, and it’s common to have more than one at a time. Here are the main acne types:

• Comedonal acne: These are clogged pores that form whiteheads and blackheads.

• Inflammatory acne: Red, violet, or brown bumps (papules) may contain pus (pustules).

• Nodulocystic acne: These large, deep bumps under the skin (nodules) may be filled with pus (cysts).

Acne images

Here’s what different types of acne look like in different skin tones.

Inflammatory acne on the cheek.

Cystic acne with scarring.

What rosacea looks and feels like

Rosacea is a chronic skin condition that’s often mistaken for acne or sunburn. It can cause skin that appears:

• Red

• Flushed

• Rough

• Bumpy

Rosacea most commonly affects the cheeks, chin, and forehead, but it can affect other areas of the face, too. It typically develops after age 30.

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• Facial redness can be confusing. Learn how rosacea fits into the many reasons your face might flush — and when redness could signal something more serious that deserves a check-in with a healthcare professional.

• Ready to treat rosacea more effectively? Explore prescription and over-the-counter creams, gels, pills, and laser options so you can talk with your dermatologist about a treatment plan tailored to your symptoms and skin goals.

• Try an acne-friendly skin routine: Get step-by-step tips on cleansing, moisturizing, sun protection, and spot treatments so you can support breakouts gently — without harsh products that can make sensitive or redness-prone skin feel worse.

Types of rosacea

Rosacea is now classified and diagnosed based on common symptoms people experience. But historically, rosacea was divided into these four types:

• Erythematotelangiectatic: redness and flushing (harder to see on darker skin tones)

• Papulopustular: acne-like bumps that are red, violet, or brown and can be filled with pus

• Phymatous: thickened, bumpy, and discolored skin, usually on the nose

• Ocular: eye symptoms, like swollen eyelids or redness, burning, or itching

Rosacea pictures

Here’s what different types of rosacea look like on different skin tones.

Phymatous rosacea (skin thickening) on the nose.

Ocular rosacea.

Rosacea vs. acne: How to tell the difference

Acne and rosacea can both cause a bumpy rash on the face, but there are some key differences between them. Here are some ways to tell them apart:

• Acne causes whiteheads and blackheads, while rosacea causes bumps and pus-filled bumps but no blackheads.

• Rosacea often causes facial flushing; acne doesn’t.

• Rosacea can affect the eyes; acne doesn’t.

• Acne can appear on the chest, back, and shoulders, while rosacea is usually limited to the face.

• Acne is most common in teenagers and young adults, while rosacea is more common after the age of 30.

Rosacea vs. acne at a glance

Here’s a side-by-side look at how acne and rosacea compare.

What causes acne and rosacea?

For the most part, acne and rosacea have different causes.

Causes of acne

Acne happens when pores get clogged with oil and dead skin cells, which can lead to a bacterial infection and inflammation. Different factors can contribute to acne, including:

• Hormonal changes (like during puberty, menstruation, or pregnancy)

• A diet high in sugar or high-glycemic foods

• Certain medications (like testosterone or corticosteroids)

• Stress

Causes of rosacea

Scientists don’t know the exact cause of rosacea. So far, studies show that it’s most likely a combination of a few different factors, including:

• Inflammation caused by an overactive immune system

• Environmental factors, like chronic unprotected sun exposure

• An unbalanced skin or gut microbiome (including Demodex mites that normally live on the skin, and other microorganisms on the skin or in the gut)

• Widening of small blood vessels in the skin, which leads to background redness and more noticeable flushing

• Your genetics, meaning it can run in families

Can you get both rosacea and acne at the same time?

Yes, it’s possible to have both at the same time, but it’s not common. The typical age range for rosacea is between 30 and 60 years old, while acne is more common in teens and young adults. However, it’s possible to develop hormonal acne later in life, too, at times when rosacea is also more common.

How acne and rosacea treatments differ

Acne and rosacea are treated differently, but there’s some overlap — especially for moderate-to-severe cases.

Treatment for mild acne and rosacea

Treating mild acne and rosacea includes a combination of over-the-counter (OTC) and prescription creams applied to the skin (topical). Here are some common options for each:

• Rosacea treatments: Treatment for rosacea include topical antibiotics that reduce skin inflammation and rosacea pimples (like Metrogel), and medications that reduce flushing by narrowing blood vessels (like Mirvaso).

• Acne treatments: OTC treatments (like benzoyl peroxide) and prescription antibiotics (like clindamycin) that fight bacteria, and topical retinoids that unclog pores and improve skin cell growth (like Retin-A) can help treat acne.

Treatment for moderate-severe rosacea and acne

For moderate-severe acne and rosacea, there’s some overlap in the medications used to treat both conditions. These treatments are often combined with topical medications. Examples include:

• Antibiotic pills that fight bacteria and lower inflammation, like doxycycline

• Isotretinoin (Accutane or Claravis), an oral retinoid that reduces inflammation and helps skin cells grow normally

Comparing treatment for acne and rosacea

Here’s a closer look at specific treatments for acne and rosacea.

How do I prevent rosacea and acne?

Managing stress can help reduce flares of both acne and rosacea. Techniques like meditation, breathing exercises, or spending time outdoors are helpful.

Here are some other tips for preventing rosacea and acne flares.

Ways to prevent acne

These daily habits can help lower your risk of acne breakouts:

• Wash your face twice a day with your fingertips and a gentle cleanser.

• Use a gentle moisturizer (opt for noncomedogenic products that won’t clog your pores).

• Minimize your intake of sugar, high-glycemic foods, and dairy products.

• Exercise regularly.

• Limit the amount of makeup you wear, and opt for noncomedogenic products.

• Don’t pick or touch your face.

Ways to prevent rosacea

Rosacea is a chronic condition with periods of flares followed by periods of relief (remissions). The best way to prevent rosacea is to avoid its triggers. In practice, this could mean that you:

• Reduce or avoid sun exposure.

• Limit or avoid alcohol, spicy foods, and hot beverages.

• Avoid warm environments, like saunas.

What happens if you don’t treat rosacea or acne?

Most people with acne will grow out of it eventually — with or without treatment. But if your acne is severe, not treating it could mean you’re left with permanent scarring that can be hard to get rid of.

If you don’t treat rosacea, it tends to get worse over time. This means that facial flushing can lead to permanent redness and spider veins. You may also develop thickened areas of skin and vision problems (if rosacea affects your eyes).

Untreated acne and rosacea can also affect more than your skin. Both conditions can take a toll on your emotional well-being and contribute to:

• Depression and anxiety

• Low self-esteem

• A lower quality of life

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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