Difference Between Acne and Rosacea

Difference Between Acne and Rosacea

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They may be mistaken because of the similarities but these are two different skin conditions and therefore should be treated differently. I will share with you some of the differences and treatments. I do have an article on rosacea just click on the link preceding this if you would be interested in reading it.

Rosacea is a neurovascular disorder.

What Acne looks like
The forehead of a teenage boy with acne
What Rosacea looks like
Rosacea on a lady’s cheek

It is common that rosacea is not present with the small bumps that are seen with acne. Additionally, the person’s age and the location of redness are clues. Rosacea most often is an adult disease that is mainly located on one’s nose, chin, and forehead. Acne and rosacea can coexist at the same time.

Individuals who suffer from rosacea may have a significant acne component and this can be easily confused. Therefore it is important to see a dermatologist for proper diagnosis. Raised areas of the skin tissue that are less than one centimeter around are called papules. The small bumps on the skin that may contain pus are referred to as pustules.

Rosacea will probably have an underlying redness that is related to flushing and therefore looks different from acne. Individuals who suffer from acne normally do not have the accompanying redness. Persistent redness along with flushing are indicators of rosacea.

Both of these conditions are inflammatory. The treatments for rosacea and acne are similar.

Treatments vary and caution is needed when using certain creams. Please read the labels as you need to avoid irritants that contain acids. Rosacea sufferers are cautioned against using common acne treatments such as alpha hydroxy acids, and topical retinoids. Additionally, the caution extends to topical exfoliants, toners, and alcohol-containing products.

From a distance, rosacea and acne look very much alike. The fact is rosacea is so similar to acne that it is often referred to as acne rosacea.

The main symptoms of acne are pimples, cysts, whiteheads(small, round, white bumps on the skin’s surface), and blackheads all over the face.
While a rosacea patient manifests many of these symptoms, there are many key differences between acne and acne rosacea.

Rosacea is a chronic disorder that usually shows up in the central portion of the face and the symptoms are redness, flushing, and blushing. Rosacea can result in a bulb-like looking nose called rhinophyma and even involve the eyes.

While acne is most commonly seen in teens, rosacea occurs much later.

Unlike in patients with rosacea, acne patients have blackheads, and sometimes even bumps and pimples on their arms.
Acne can be caused by many factors that cause the blocking of hair follicles and bacterial infections. Rosacea on the other hand appears to be linked to a defect within the body’s natural system.


Acne could also be a skin condition that happens when your hair follicles become plugged with oil and dead skin cells. Effective acne treatments are available, but acne is often persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to happen.

Depending on its severity, acne can cause emotional distress. According to the American Academy of Dermatology, acne is the most common skin condition in the U.S. Although acne isn’t a life-threatening condition, it is often painful, particularly when it’s severe.

Acne that appears on your face can affect your self-esteem and, over time, may cause permanent physical scarring.

There are many effective treatments for acne that reduce both the number of pimples you get and your chance of scarring.

Symptoms of Acne

Acne is often found almost anywhere on your body. It most ordinarily develops on your face, back, neck, chest, and shoulders. If you’ve got acne, you’ll typically notice pimples that are white or black.
Blackheads open at the surface of your skin, giving them a black appearance due to oxygen within the air.

Whiteheads are closed slightly below the surface of your skin, giving them a white appearance.
While whiteheads and blackheads are the foremost common lesions seen in acne, other types also can occur. Inflammatory lesions are more likely to cause scarring of your skin.

These include:

Papules are small, red, raised bumps caused by inflamed or infected hair follicles.
Pustules are small red pimples that have pus at their tips.
Nodules are solid, often painful lumps beneath the surface of your skin.
Cysts are large lumps found beneath your skin that contain pus and are usually painful.

Four main factors cause acne:

Excess oil (sebum) production
Hair follicles clogged by oil and dead skin cells

Acne typically appears on your face, forehead, chest, upper back, and shoulders because these areas of skin have the foremost oil glands. Hair follicles are connected to oil glands. The follicle wall may bulge and produce a whitehead. A blackhead may appear as if dirt is stuck in pores. But actually, the pore is congested with bacteria and oil, which turns brown when it’s exposed to the air.

Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation deep inside hair follicles produce cystlike lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren’t usually involved in acne.

Certain things may trigger or worsen acne:

  • Hormonal changes. Androgens are hormones that increase in boys and girls during puberty and cause glands to enlarge and make more sebum (yellowish oily substance). Hormone changes during midlife, particularly in women, can lead to breakouts too.
  • Diet. Studies indicate that consuming certain foods — including carbohydrate-rich foods, such as bread, bagels, and chips — may worsen acne. Further study is needed to examine whether people with acne would benefit from following specific dietary restrictions.
  • Stress. Stress doesn’t cause acne, but if you have acne already, stress may make it worse.

Some Acne Myths

  • Chocolate and greasy foods. Eating chocolate or greasy food has little to no effect on acne.
  • Hygiene. Acne isn’t caused by dirty skin. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse.
  • Cosmetics. Cosmetics don’t necessarily worsen acne, especially if you use oil-free makeup that doesn’t clog pores and remove makeup regularly. No oily cosmetics don’t interfere with the effectiveness of acne drugs.

Risk Factors with Acne

People are most at risk for developing acne during puberty. During this time, your body undergoes hormonal changes. These changes can trigger oil production, leading to an increased risk of acne. Hormonal acne related to puberty usually subsides or at least improves when you reach adulthood.

You may also feel depressed or stressed because of your acne. This just makes the acne worse.

Acne Diagnosis

If you have symptoms of acne, your doctor can make a diagnosis by examining your skin. Your doctor will identify the types of lesions and their severity to determine the best treatment. You may also want to consult with a dermatologist.

Treatment of Acne

If you’ve tried over-the-counter (nonprescription) acne products for several weeks and they haven’t helped, ask your doctor about prescription-strength medications.

A dermatologist can help you:

  • Control your acne
  • Avoid scarring or other damage to your skin
  • Make scars less noticeable

Acne medications work by reducing oil production and swelling or by treating bacterial infections. With most prescription acne drugs, you may not see results for four to eight weeks. It can take many months or years for your acne to clear up completely.

The treatment regimen your doctor recommends depends on your age, the type and severity of your acne, and what you are willing to commit to. For example, you may need to wash and apply medications to the affected skin twice a day for several weeks. Topical medications and drugs you take by mouth are often used in combination. Treatment options for pregnant women are limited due to the risk of side effects.

Talk with your doctor about the risks and benefits of medications and other treatments you are considering. Make follow-up appointments with your doctor every three to six months until your skin improves.

Topical and Oral medications

Please consult with your doctor or dermatologist for the best medications.

Bottom line. Do not apply or use any of these treatments without consulting with your doctor or dermatologist.

Treating children

Most studies of acne drugs have involved people 12 years of age or older. Increasingly, younger children are getting acne as well. The FDA has expanded the number of topical products approved for use in children.

If your child has acne, consider consulting a pediatric dermatologist. Ask about drugs to avoid in children, appropriate doses, drug interactions, side effects, and how treatment may affect a child’s growth and development.

Alternative Treatments For Acne

Apply apple cider vinegar

Apple cider vinegar is made by fermenting apple cider, or the unfiltered juice from pressed apples.

Like other kinds of vinegar, it’s known for its ability to fight many types of bacteria and fungi.

Apple cider vinegar contains organic acids, such as citric acid, that have been found to kill acne.

Research has shown that succinic acid, another organic acid, suppresses inflammation caused by acne, which may prevent scarring.

While certain components of apple cider vinegar may help with acne, there’s currently no evidence to support its use for this purpose. Some dermatologists advise against using apple cider vinegar at all, as it may irritate the skin.

How to use it

  1. Mix 1 part apple cider vinegar and 3 parts water (use more water for sensitive skin).
  2. After cleansing, gently apply the mixture to the skin using a cotton ball.
  3. Let sit for 5–20 seconds, rinse with water and pat dry.
  4. Repeat this process 1–2 times per day, as needed.

It’s important to note that applying apple cider vinegar to your skin can cause burns and irritation. If you choose to try it, use it in small amounts and dilute it with water.

Take a zinc supplement

Zinc is an essential nutrient that’s important for cell growth, hormone production, metabolism, and immune function.

It’s relatively well-studied compared with other natural treatments for acne.

Research indicates that people with acne tend to have lower levels of zinc in their blood than those with clear skin.

Several studies have also shown that taking zinc orally may help reduce acne.

For example, a 2014 review found that zinc is more effective at treating severe and inflammatory acne than treating moderate acne.

The optimal dosage of zinc for acne has not been established, but several older studies have observed a significant reduction in acne using 30–45 mg of elemental zinc per day.

Elemental zinc refers to the amount of zinc that’s present in the compound. Zinc is available in many forms, and they contain varying amounts of elemental zinc.

Zinc oxide contains the highest amount of elemental zinc at 80%.

The recommended safe upper limit of zinc is 40 mg per day, so it’s probably best to not exceed that amount unless you’re under the supervision of a medical doctor.

Taking too much zinc may cause adverse effects, including stomach pain and gut irritation.

It’s also important to note that applying zinc to the skin has not been shown to be effective. This may be because zinc is not effectively absorbed through the skin.

Make a honey and cinnamon mask

Honey and cinnamon have the ability to fight bacteria and reduce inflammation, which are two factors that trigger acne.

A 2019 study found that the combination of honey and cinnamon bark extract exerted antibacterial effects against acne.

Other research has indicated that honey on its own can block the growth of or kill acne.

However, this finding doesn’t necessarily mean that honey effectively treats acne.

A study of 136 people with acne found that applying honey to the skin after using antibacterial soap was no more effective at treating acne than using the soap on its own.

While the anti-inflammatory and antibacterial properties of honey and cinnamon may reduce acne, more research is needed.

How to make a honey and cinnamon mask

  1. Mix 2 tablespoons of honey and 1 teaspoon of cinnamon to form a paste.
  2. After cleansing, apply the mask to your face and leave it on for 10–15 minutes.
  3. Rinse the mask off completely and pat your face dry.

Spot treat with tea tree oil

Tea tree oil is an essential oil that’s extracted from the leaves of Melaleuca alternifolia, a small tree native to Australia.

It’s well known for its ability to fight bacteria and reduce skin inflammation.

What’s more, several studies have found that applying tea tree oil to the skin.

Another small study found that, compared with benzoyl peroxide, participants using a tea tree oil ointment for acne experienced less dry skin and irritation. They also felt more satisfied with the treatment.

Given that topical and oral antibiotics can cause bacterial resistance if used long-term for acne, tea tree oil may be an effective substitute.

Tea tree oil is very potent, so always dilute it before applying it to your skin.

How to use it

  1. Mix 1 part tea tree oil with 9 parts of water.
  2. Dip a cotton swab into the mixture and apply it to the affected areas.
  3. Apply moisturizer if desired.
  4. Repeat this process 1–2 times per day, as needed.

Apply green tea to your skin

Green tea is very high in antioxidants, and drinking it can promote good health.

It may also help reduce acne. This is likely because the polyphenols in green tea help fight bacteria and reduce inflammation, which are two main causes of acne.

There isn’t much research exploring the benefits of drinking green tea when it comes to acne, and more studies are needed.

In one small study with 80 women, participants took 1,500 mg of green tea extract daily for 4 weeks. By the end of the study, women who took the extract had less acne on their noses, chins, and around their mouths.

Research has also found that drinking green tea may lower blood sugar and insulin levels, which are factors that can contribute to the development of acne.

Many studies also indicate that applying green tea directly to the skin may help with acne.

Research shows that the main antioxidant in green tea reduces sebum production, fights inflammation, and inhibits the growth of bacterial acne in individuals with acne-prone skin.

Multiple studies have found that applying green tea extract to the skin significantly reduces sebum production and pimples in those with acne.

You can buy creams and lotions that contain green tea, but it’s just as easy to make your own mixture at home.

How to use it

  1. Steep green tea in boiling water for 3–4 minutes.
  2. Allow the tea to cool.
  3. Using a cotton ball, apply the tea to your skin or pour it into a spray bottle to spritz it on.
  4. Allow it to dry, then rinse it off with water and pat your skin dry.

You can also add the remaining tea leaves to honey and make a mask.

Apply witch hazel

Witch hazel is extracted from the bark and leaves of the North American witch hazel shrub. It contains a chemical called tannins, which has strong antibacterial and anti-inflammatory properties.

That’s why it’s used to treat a broad range of skin conditions, including dandruff, eczema, varicose veins, burns, bruises, insect bites, and acne.

Currently, there appears to be very little research on Witch hazel’s ability to treat acne specifically.

In one small study funded by a skincare company, 30 individuals with mild or moderate acne used a three-step facial treatment twice daily for 6 weeks.

Witch hazel was one of the ingredients in the second step of the treatment. Most participants experienced significant improvement in their acne by the end of the study.

Research also suggests that witch hazel may fight bacteria and reduce skin irritation and inflammation, which can contribute to acne.

How to use it

  1. Combine 1 tablespoon of witch hazel bark and 1 cup of water in a small saucepan.
  2. Soak the witch hazel for 30 minutes and then bring the mixture to a boil on the stove.
  3. Reduce to a simmer and cook, covered, for 10 minutes.
  4. Remove the mixture from the heat and let it sit for an additional 10 minutes.
  5. Strain and store the liquid in a sealed container.
  6. Apply to clean skin using a cotton ball 1–2 times per day, or as desired.

It’s important to note that commercially prepared versions may not contain tannins, as they are often lost in the distillation process.

Moisturize with aloe vera

Aloe vera is a tropical plant whose leaves produce a clear gel. The gel is often added to lotions, creams, ointments, and soaps.

It’s commonly used to treat abrasions, rashes, burns, and other skin conditions. When applied to the skin, aloe vera gel can help heal wounds, treat burns, and fight inflammation.

Aloe vera contains salicylic acid and sulfur, which are both used extensively in the treatment of acne. Research has found that applying salicylic acid to the skin reduces acne.

Several studies have also indicated that aloe vera gel when combined with other substances like tretinoin cream or tea tree oil, may improve acne.

While research shows promise, the anti-acne benefits of aloe vera itself require further scientific research.

How to use it

  1. Scrape the gel from the aloe plant out with a spoon.
  2. Apply the gel directly to clean skin as a moisturizer.
  3. Repeat 1–2 times per day, or as desired.

You can also buy aloe vera gel from the store, but make sure that it’s pure aloe without any added ingredients.

Take a fish oil supplement

Omega-3 fatty acids are healthy fats that offer a multitude of health benefits.

You must get these fats from your diet, but research shows that most people who eat a standard Western diet don’t get enough of them.

Fish oils contain two main types of omega-3 fatty acids — eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

High levels of EPA and DHA have been shown to decrease inflammatory factors, which may reduce the risk of acne.

In one study, 45 individuals with acne were given omega-3 fatty acid supplements containing both EPA and DHA daily. After 10 weeks, their acne decreased significantly.

There’s no specific recommended daily intake of omega-3 fatty acids. The 2015–2020 Dietary Guidelines for Americans recommends that healthy adults consume around 250 mg of combined EPA and DHA each day.

You can also get omega-3 fatty acids by eating salmon, sardines, anchovies, walnuts, chia seeds, and ground flax seeds.

Exfoliate regularly

Exfoliation is the process of removing the top layer of dead skin cells. You can use chemicals to achieve this or exfoliate mechanically by using a brush or scrub to physically remove the cells.

Exfoliation may improve acne by removing the skin cells that clog pores.

It may also make acne treatments for the skin more effective by allowing them to penetrate deeper, once the topmost layer of skin is removed.

Currently, the research on exfoliation and its ability to treat acne is limited.

Some studies suggest that microdermabrasion, a method of exfoliation, can improve the skin’s appearance, including some cases of acne scarring.

In one small study, 38 patients with acne received eight microdermabrasion treatments at weekly intervals. The participants with acne scars showed some improvements following the treatments.

Another small study found that six weekly microdermabrasion treatments helped stimulate skin repair.

While these results indicate that exfoliation may improve skin health and appearance, more research is needed on acne.

There are a wide variety of exfoliation products available, but you can also make a scrub at home using sugar or salt.

Note that mechanical exfoliation, such as with harsh scrubs or brushes, can be irritating and damage the skin. As such, some dermatologists recommend gentle chemical exfoliation with salicylic- or glycolic-acid-based products.

If you choose to try mechanical exfoliation, be sure to gently rub your skin to avoid damaging it.

How to make a scrub at home

  1. Mix equal parts sugar (or salt) and coconut oil.
  2. Gently rub your skin with the mixture and rinse well.
  3. Exfoliate as often as desired, up to once daily.

Follow a low glycemic load diet

The relationship between diet and acne has been debated for years.

Research suggests that dietary factors, such as insulin and glycemic index, may be associated with acne.

A food’s glycemic index (GI) is a measure of how quickly it raises your blood sugar.

Eating high-GI foods causes a spike in insulin, which likely increases sebum production. As a result, high GI foods may directly affect the development and severity of acne.

Foods with a high glycemic index include processed foods, such as:

  • white bread
  • sugary soft drinks
  • cakes
  • doughnuts
  • pastries
  • candies
  • sugary breakfast cereals

Foods with a low glycemic index include:

  • fruits
  • vegetables
  • legumes
  • nuts
  • whole or minimally processed grains

In one study, 66 people followed either a normal or low glycemic diet. After 2 weeks, the individuals consuming a low glycemic diet had lower levels of insulin-like growth factor-1 (IGF-1), a hormone involved in acne development.

Another study of 64 people found that those with moderate or severe acne ate diets with more carbohydrates and a higher glycemic load than those without acne.

These small studies suggest that a low glycemic diet may help those with acne-prone skin. Additional larger, longer studies are needed.

Cut back on dairy

The relationship between dairy and acne is highly controversial.

Milk and dairy products contain hormones like IGF-1, which is associated with acne. Other hormones in milk may cause hormonal changes and lead to acne.

One study in people ages 10 to 24 found that drinking whole milk three or more days each week was linked to moderate or severe acne.

In another study including 114 participants, those with acne were found to drink significantly more milk than people who didn’t have acne.

On the other hand, a study involving over 20,000 adults found no association between milk consumption and acne.

Participants self-reported the data in these studies, so more research needs to be done to establish a true causal relationship.

Finally, several research reviews have suggested an association between dairy consumption and acne.

The relationship between milk and acne needs further study.

Reduce stress

The link between stress and acne is not fully understood. The hormones released during periods of stress may increase sebum production and inflammation, making acne worse.

Stress may also affect gut bacteria and cause inflammation throughout the body, which could be linked to acne.

What’s more, stress can slow wound healing, which may slow the repair of acne lesions.

Multiple studies have found an association between stress and acne.

However, each of these studies was relatively small, so more research is needed.

One study in 80 participants found no association between stress intensity and acne. However, it noted that acne severity may be related to people’s ability to cope with stress.

Certain relaxation and stress reduction treatments may improve acne, but more research needs to be done.

Ways to reduce stress

  • get more sleep
  • Engage in physical activity
  • practice yoga
  • meditate
  • take deep breaths

Exercise regularly

There’s little research on the effects of exercise on acne. Still, exercise affects bodily functions in ways that may help improve acne.

For example, exercise promotes healthy blood circulation. The increase in blood flow helps nourish the skin cells, which may help prevent and heal acne.

Exercise also plays a role in hormone levels and regulation.

Several studies have suggested that exercise can decrease stress and anxiety, both of which can contribute to the development of acne.

The U.S. Department of Health and Human Services recommends that adults get 150 minutes of aerobic exercise and engage in strength training activities two days per week.

This can include walking, hiking, running, and lifting weights.

Please consult with your doctor before using any alternative remedies

Thank you for reading


Comments are welcome

2 thoughts on “Difference Between Acne and Rosacea”

  1. I wish I had this great information when my daughter was younger!  She had terrible acne.  Over-the-counter prescriptions were useless, as were antibiotics.  Prescription creams burned her skin.  We had no access to more natural treatments such as tea tree oil, zinc tablets, homemade masks and the others that you mention.  She finally saw a doctor who told her the harsh chemicals in the acne medications were actually making her acne worse (because of her sensitive skin).  I hope these treatments you list (including the natural ones) are a help to those who suffer from this condition!

    • Hi Cynthia,

      Thank you for your comment. I am not very fond of OTC or prescription medications, mainly from personal use. There are conditions where it is necessary to take those prescriptions, but they should be researched before use. I believe in herbal and natural treatments.

      Best wishes,



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