Acne Rosacea vs Acne Vulgaris: What’s the Difference?

If you’ve ever looked in the mirror and wondered why your face is covered in angry red bumps, you’ve probably assumed it’s just acne. But what if it’s not?

Many people spend years treating what they think is regular acne, only to find out they actually have rosacea. Or vice versa. The frustrating part is that these conditions can look surprisingly similar, but they need completely different approaches to clear up.

Acne Rosacea vs Acne Vulgaris: At a Glance

	Acne Vulgaris	Acne Rosacea
Age of Onset	Usually teens, can continue into adulthood	Typically starts after 30
Location	Face, chest, back, shoulders	Central face (cheeks, nose, chin, forehead)
Appearance	Blackheads, whiteheads, red bumps, cysts	Red bumps, no blackheads/whiteheads, persistent redness
Skin Type	Usually oily	Often sensitive, may be dry
Scarring	Can leave permanent scars	Rarely scars

What is Acne Rosacea?

Rosacea is a chronic inflammatory skin condition that affects around 6% of the population. Unlike regular acne, rosacea isn’t caused by clogged pores or bacteria. Instead, it’s linked to problems with your blood vessels and possibly an overactive immune response. This is why you’ll see that persistent redness that just won’t go away, even when you don’t have active bumps.

Types of Rosacea

There are four main types of rosacea: 

1. Erythematotelangiectatic Rosacea (ETR): This is the mildest form. Your face looks red, flushed, and sometimes you can see small blood vessels (spider veins) on your cheeks and nose. Your skin might feel hot, tight, or like it’s burning.
2. Papulopustular Rosacea: This one looks more like acne, which is where the confusion starts. You’ll get red bumps and sometimes white-topped pimples, but unlike acne, there are no blackheads or whiteheads. The bumps tend to come and go in flares.
3. Phymatous Rosacea: This is the most severe type, where your skin actually thickens and becomes bumpy. It most commonly affects the nose (rhinophyma), giving it a swollen, bulbous appearance. This type is more common in men.
4. Ocular Rosacea: Your eyes become red, dry, itchy, and feel like there’s sand in them. Your eyelids might be swollen, and you could develop styes frequently.

What Causes Rosacea?

The leading theory is that it’s a combination of genetics, an overactive immune system, and problems with the blood vessels in your face. Some research also points to microscopic mites called Demodex that live on everyone’s skin – people with rosacea seem to have more of them, or their skin reacts more strongly to them.

What we do know for sure are the triggers that can set off a flare-up:

• Sun exposure 
• Hot weather or extreme temperature changes
• Spicy foods and hot drinks
• Alcohol (especially red wine)
• Stress and strong emotions
• Certain skincare products (especially ones with alcohol, fragrances, or harsh ingredients)
• Hot baths or saunas
• Vigorous exercise
• Certain medications (like blood pressure drugs that dilate blood vessels)

Common Symptoms of Rosacea

People with rosacea may experience: 

• Persistent redness in the centre of your face
• Bumps and pimples that come in waves
• Visible blood vessels on your cheeks and nose
• Eye irritation and dryness
• Burning or stinging sensations
• Rough, dry skin texture
• Skin that reacts badly to many products

What is Acne Vulgaris?

Acne vulgaris is a common skin disease that causes breakouts, affecting 1 in 4 young adults in the UK. Unlike rosacea, acne happens when your pores get clogged with oil, dead skin cells, and bacteria.

Your skin naturally produces oil to keep itself moisturised. Sometimes dead skin cells don’t shed properly and mix with this oil, creating a plug in your pore. When bacteria gets involved, you get inflammation and a pimple forms.

Types of Acne Vulgaris

• Comedonal Acne: This is the mildest form – blackheads and whiteheads without much inflammation. Blackheads are open comedones (the dark colour comes from oxidation, not dirt), while whiteheads are closed comedones where the pore is completely blocked.
• Inflammatory Acne: You’ll see papules (small red bumps), pustules (pimples with white heads), and sometimes larger, deeper nodules. This type is more likely to leave scars if not treated properly.
• Cystic Acne: The most severe form, with large, deep, painful lumps under the skin. These cysts can be as big as a marble and often leave permanent scars. This type usually needs prescription treatment.

What Causes Acne Vulgaris?

Unlike rosacea, we understand acne pretty well. It comes down to four main factors:

1. Excess Oil Production: Your sebaceous glands produce too much oil, usually due to hormones. This is why acne often starts during puberty when hormone levels fluctuate.
2. Clogged Pores: Dead skin cells that should naturally shed become sticky and mix with oil, creating plugs in your hair follicles.
3. Bacteria: P. acnes bacteria feed on the oil in clogged pores. As they multiply, they cause inflammation and turn a clog into an inflamed pimple.
4. Hormones: Androgens increase oil production. This is why acne often flares around menstrual cycles, during pregnancy, or when starting or stopping birth control.

Common Symptoms of Acne

These usually present as acne breakouts in the form of:

• Blackheads and whiteheads (comedones)
• Red, inflamed bumps (papules)
• Pus-filled pimples (pustules)
• Large, painful lumps under the skin (nodules or cysts)
• Oily skin, especially in the T-zone
• Scarring from previous breakouts
• Post-inflammatory hyperpigmentation (dark spots after pimples heal)

The Difference Between Rosacea and Acne 

Looking at your face in the mirror trying to figure out what’s going on? These are the dead giveaways that’ll tell you whether you’re dealing with acne or rosacea.

Age and Demographics

Acne typically starts in your teenage years when your hormones are all over the place. Some people keep dealing with it into adulthood, but it almost always begins when you’re young.

Rosacea is different. It usually doesn’t show up until you’re in your 30s or 40s. It’s more common in women, though men tend to get more severe cases.

Location and Appearance

Acne can appear anywhere there are oil glands, usually affecting the face, chest, back, and shoulders. On your face, it tends to appear in the T-zone, where your skin produces the most oil.

Rosacea stays in the centre of your face – your cheeks, nose, chin, and forehead. You won’t see it on your chest or back.

The easiest way to tell them apart is to look for blackheads and whiteheads. If you see them, it’s acne. Rosacea never causes blackheads or whiteheads.

Triggers and Patterns

Acne is mostly caused by what’s happening inside your body – hormones and genetics are the main factors. Stress might make it worse, but the root causes are internal.

Rosacea has clear external triggers. Most people know exactly what sets off their flare-ups – alcohol, spicy food, sun exposure, or stress.

Skin Texture and Sensitivity

Acne-prone skin is usually oily, especially in areas where you break out. It can typically handle various products, though some acne treatments can be drying.

Rosacea-prone skin is more sensitive. It often feels tight, dry, or burns easily. Many regular skincare products can trigger rosacea flare-ups.

Acne & Rosacea Treatment Options

Getting this wrong can worsen your skin or cause it to flare up. 

For Acne:

• Over-the-counter products like salicylic acid and benzoyl peroxide
• Prescription retinoids like Epiduo and Differin Gel
• Oral antibiotics like Doxycycline and Lymecycline 
• Hormonal treatments like birth control
• Chemical peels

For Rosacea:

• Gentle, fragrance-free products
• Prescription antibiotic gels like Rozex
• Oral antibiotics for bumps like Tetralysal
• Laser treatments for visible blood vessels

Acne treatments focus on drying out skin and unclogging pores. Rosacea treatments work to reduce inflammation and calm the skin. Using harsh acne products on rosacea will make the redness and irritation worse.

Get Treatments for Acne and Rosacea Online 

Now that you know which condition you’re dealing with, it’s time to get the right treatment. Click2Pharmacy makes it simple to get prescription treatments for both acne and rosacea without the wait.

Our qualified prescribers can assess your skin through our online consultation and prescribe effective treatments for your specific needs.

We offer prescription treatments for:

• Acne: retinoids, topical antibiotics, oral medications
• Rosacea: antibiotic gels and oral treatments

Complete our online consultation, upload photos of your skin, and get the right prescription treatment delivered to your door.