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Lupus rash vs. rosacea, what’s the difference?

These conditions may look similar, but they’re very different.

Curology Team Avatar
by Curology Team
Updated on Jul 31, 2023 • 9 min read
Medically reviewed by Laura Phelan, NP-C
Rash
Curology Team Avatar
by Curology Team
Updated on Jul 31, 2023 • 9 min read
Medically reviewed by Laura Phelan, NP-C
We’re here to share what we know — but don’t take it as medical advice. Talk to your medical provider if you have questions.

Both lupus rash and rosacea exhibit similar symptoms, such as facial redness and skin sensitivity. However, they originate from two completely different underlying causes—and they require different treatment! 

Here, our expert dermatology providers will explain the differences between lupus rash and rosacea, so you can learn how to recognize their telltale signs and gain a better understanding of the conditions.

What is lupus rash? 

Systemic lupus erythematosus (SLE), or lupus, is a chronic autoimmune disease that can impact various parts of your body, such as your skin, kidneys, and lungs. With lupus, your immune system, which typically protects your body from infections and diseases, mistakenly targets and attacks its own tissues. 

This autoimmunity leads to inflammation and, in some cases, irreversible tissue damage, potentially affecting vital organs such as your heart.¹

If you have lupus, you will likely experience alternating periods of illness (flares) and wellness (remission). The severity of your lupus flares can range from mild to serious, and their occurrence is unpredictable.²

Causes

Lupus is a complex autoimmune disease, and its exact cause remains unknown. However, researchers have identified several factors that may contribute to the development of the disease. 

These factors include:³

Gender: Women are significantly more likely to develop lupus than men, with women getting the disease about nine times more often than men. 

Age: Lupus most commonly affects individuals between 15 and 45 years old. However, it can also occur in childhood or later in life.

Genetics: Certain genes play a role in the development of lupus. These genes carry instructions for proteins that may affect your immune system.

Environmental factors: Exposure to certain environmental factors, such as viral infections, sunlight, specific medications, and smoking, may trigger lupus in susceptible individuals.

Immune and inflammatory influences: When your body fails to remove damaged or dead cells normally, this could prompt your immune system to continuously fight against itself, leading to an autoimmune response and the development of lupus. 

Now that we have explored the potential causes of lupus, let's delve into the various symptoms you may experience if you have this condition.

Symptoms

The symptoms you experience with lupus may differ significantly, depending on which of your body systems are affected. Most individuals with lupus have a mild form of the disease, characterized by episodes known as flares. During these flares, signs and symptoms worsen before improving or even disappearing entirely for some time.

The most common signs and symptoms of lupus include:⁴

  • Fatigue.

  • Fever.

  • Joint pain, stiffness, and swelling.

  • A butterfly-shaped rash on your face, covering your cheeks and bridge of the nose, or rashes elsewhere on the body.

  • Pain when breathing deeply.

Woman Checking her Skin

Lupus symptoms can vary greatly for everyone, so you should always consult a healthcare professional for a comprehensive evaluation.

Treatments

It’s crucial to have a thorough discussion with your medical provider about the potential benefits and risks of various available treatment options to determine the most appropriate course of action for you. You will also need to stay in touch with your medical provider as you will likely need to adjust medications or dosages over time to manage your symptoms effectively. 

Some of the most commonly used medications to control lupus include anti-inflammatory medications, corticosteroids, immunosuppressants, and antimalarial drugs.⁵

Keep in mind that the treatment approach for lupus is highly individualized, and the most effective plan for one person may not be suitable for another. Regular consultations with a medical provider are crucial to ensure the optimal management of this complex autoimmune disease.

Now that we’ve explored lupus in-depth, let's shift our focus to another skin condition often confused with lupus rash: rosacea. Understanding the differences between these two conditions is crucial to ensure proper diagnosis and treatment.

What is rosacea? 

Rosacea is a common, chronic skin condition that primarily affects the face. It’s characterized by redness, flushing, visible blood vessels, and in some cases, acne-like bumps. The symptoms of rosacea may come and go, with periods of flare-ups and remission.⁶

Causes

Contrary to some misconceptions, rosacea is neither caused by poor hygiene nor contagious. The exact cause of rosacea remains unknown, but it may be influenced by factors such as an overactive immune system, heredity, or a combination of both.⁷

UV radiation has been identified as one of the most frequently reported triggers of rosacea, so it may have a role in developing the condition.⁸ A correlation has also been observed between rosacea and Demodex mites. These tiny microscopic organisms live on human skin and are generally harmless; however, their numbers tend to be higher in people with rosacea.⁹

While rosacea can affect anyone, it occurs more commonly in certain groups. These include middle-aged and older adults, women, and individuals with fair skin.¹⁰

Symptoms

The signs and symptoms of rosacea are diverse and can vary from person to person. Some of the most common symptoms include redness that typically affects the central facial region, facial flushing, acne-like bumps, and eye irritation.¹¹

If you suspect you have rosacea, consult a medical provider for a proper diagnosis and appropriate treatment.

Rosacea treatments

Woman Outside Smiling

When you see your medical provider, they will recommend various rosacea treatment options based on your specific needs and symptoms. 

The most common treatments for rosacea include:¹²

Topical products: Common ingredients in topical treatments include metronidazoleazelaic acid, and ivermectin, which can help reduce inflammation and treat affected areas. Custom skincare formulations prescribed by dermatology providers with proven ingredients can help control the symptoms of rosacea.

Sunscreen: Protecting your skin from UV light is crucial, as sun exposure can make rosacea symptoms worse.

Oral medications: For example, the antibiotic doxycycline is often used to help control inflammation and address bacterial overgrowth.

Retinoids: For individuals with severe rosacea, oral compounds related to vitamin A may be prescribed.

Laser therapy: Laser therapy can help reduce the visibility of enlarged blood vessels.¹³

Your rosacea treatment plan needs to be personalized to your specific needs and symptoms. Consult a healthcare professional for an accurate diagnosis and appropriate treatment options.

How do I know if I have lupus rash or rosacea? 

Woman Enjoying the Sun

Distinguishing between a lupus rash and rosacea can be challenging, as both conditions can cause facial redness and other similar symptoms. However, there are three main differences, as discussed above, that may help you determine which condition you may have.

  1. Lupus rash often presents as a butterfly-shaped rash on your face that covers your cheeks and the bridge of your nose, while rosacea typically causes redness in your central facial area and may include visible blood vessels or acne-like bumps.

  2. Lupus is a systemic autoimmune disease that can affect multiple organs, leading to a range of symptoms beyond skin manifestations. Symptoms such as joint pain, fatigue, fever, and kidney problems are common in lupus but not in rosacea.

  3. Rosacea symptoms often include facial flushing, visible blood vessels, and eye irritation, which are less common in lupus.

Despite these differences, it’s essential to consult a healthcare professional for a proper diagnosis. A dermatology provider can evaluate your symptoms, perform necessary tests, and provide an accurate diagnosis to ensure you receive the appropriate treatment for your condition.

Treat rosacea with Curology

Do you have rosacea? Curology can help. We combine prescription ingredients in a personalized formula to target your skin needs.

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Get your personalized skincare routine with Curology

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After a consultation with a licensed medical provider, who will evaluate your skin and medical history and determine if Curology is right for you, you will receive a personalized topical formula designed to help manage your rosacea symptoms. Sign up for a trial* and experience Curology's custom formula for rosacea today!

FAQs

Can lupus rash be mistaken for rosacea?

Yes, lupus rash can be mistaken for rosacea, as both conditions cause facial redness and share similar symptoms. However, lupus is a systemic autoimmune disease, while rosacea is a skin condition. Consulting a healthcare professional is crucial for proper diagnosis and appropriate treatment.

What does a lupus rash on your face feel like?

A lupus rash on the face may feel warm to the touch and appear as a butterfly-shaped rash across the cheeks and bridge of the nose. It can be itchy, scaly, or painful and may be raised or flat. The severity and sensations vary among individuals, making it essential to consult a healthcare professional for accurate diagnosis and treatment.

• • •

P.S. We did the homework so you don’t have to:

  1. Maidhof W, Hilas O. Lupus: an overview of the disease and management options. P T. (April, 2012)

  2. Maidhof W, Hilas O. Lupus: an overview of the disease and management options. P T. (April, 2012)

  3. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Systemic Lupus Erythematosus (Lupus). National Institutes of Health. (n.d)

  4. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Systemic Lupus Erythematosus (Lupus). National Institutes of Health. (n.d)

  5. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Systemic Lupus Erythematosus (Lupus): Diagnosis, Treatment, and Steps to Take. National Institutes of Health. (n.d)

  6. Farshchian M, Daveluy S. Rosacea. StatPearls Publishing. (2022, Sep 30)

  7. American Academy of Dermatology. ROSACEA: WHO GETS AND CAUSES (n.d)

  8. Morgado-Carrasco D, et al. Impact of ultraviolet radiation and exposome on rosacea: Key role of photoprotection in optimizing treatment. J Cosmet Dermatol. (November 2021)

  9. Gonzalez-Hinojosa D, et al. Demodex and rosacea: Is there a relationship? Indian J Ophthalmol. (January 2018)

  10. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Rosacea. National Institutes of Health. (n.d)

  11. Farshchian M, Daveluy S. Rosacea. StatPearls Publishing. (2022, Sep 30)

  12. Farshchian M, Daveluy S. Rosacea. StatPearls Publishing. (2022, Sep 30)

  13. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Rosacea. National Institutes of Health. (n.d)

Laura Phelan is a board-certified Family Nurse Practitioner at Curology. She earned her Masters of Science in Nursing at Benedictine University and went on to get her post-master’s certificate as a Family Nurse Practitioner at the University of Cincinnati.

*Subject to consultation. Subscription required. Results may vary. 

• • •
Our medical review process:We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.
Our policy on product links:Empowering you with knowledge is our top priority. Our reviews of other brands’ products in this post are not paid endorsements—but they do meet our medically fact-checked standards for ingredients (at the time of publication).
Our thoughts on sun protection: *Sunscreen is only one part of UV protection—cute sun hats and shades are also recommended.
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Curology Team

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Laura Phelan, NP-C

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