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Seborrheic dermatitis vs. rosacea: What you need to know

Multiple skin conditions can look like rosacea—that’s why a proper diagnosis is so important.

Curology Team Avatar
by Curology Team
Updated on Mar 11, 2024 • 9 min read
Medically reviewed by Elise Griffin, PA-C
Skin-texture-enlarged-pores-part-womans
Curology Team Avatar
by Curology Team
Updated on Mar 11, 2024 • 9 min read
Medically reviewed by Elise Griffin, PA-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.

In this article

Similar symptoms to rosacea
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Summary

  • Rosacea is a chronic condition that often causes persistent redness and frequent flushing, typically on the nose and cheeks.

  • Certain symptoms of rosacea can overlap with other skin conditions like eczema or seborrheic dermatitis.

  • A professional diagnosis is often needed to determine if you’re experiencing rosacea or another skin condition.

  • Acne, psoriasis, and keratosis pilaris are examples of skin conditions that you may mistake for rosacea.

  • Identifying your triggers, making lifestyle changes, and applying topical creams may help you manage rosacea symptoms.

Everyone’s skin is unique, which is something we’re all about celebrating. But it’s also one of the reasons it’s not always easy to figure out what’s going on with your skin, especially because different conditions can have similar-looking symptoms.

What looks like acne may actually be rosacea, which can present with acne-like symptoms. And, what you think may be rosacea could actually just be a rosacea look-alike, like eczema or seborrheic dermatitis. It may sound overwhelming to figure it all out, but don’t stress! We’re here to help.

Here we’ll explore what other skin concerns look like rosacea, highlight the similarities and differences between these conditions, and talk about why getting a proper diagnosis from a licensed dermatology provider is so important. After all, an important first step in treating any skin condition is knowing what it is.

Similar symptoms to rosacea

Rosacea is a chronic condition that often causes persistent redness and frequent flushing in a symmetric pattern on the face, usually on the nose and cheeks but sometimes on the ears, chin, and neck. Sometimes it also results in visible blood vessels (aka telangiectasias). But it can also include other symptoms similar to those with other skin conditions, which may leave you wondering: Do you have rosacea or something else? Let’s take a look at some similar symptoms:¹

  • Acne-like lesions: Papules (red bumps) and pustules (pus-filled bumps) may form where you experience redness—generally across the nose and cheeks. Acne symptoms can be similar to some of those associated with rosacea, but what causes the two conditions are quite different (more on that in a bit).

  • Persistent redness: Facial flushing or reddened skin² is one of the rosacea’s most common symptoms, but a rash-like appearance or redness is also typical for many types of dermatitis, including seborrheic dermatitis and eczema. Redness from rosacea is typically found across the nose, cheeks, and forehead, and it may also be accompanied by visible blood vessels at the skin’s surface. Eczema, however, can occur elsewhere on the body, and seborrheic dermatitis typically occurs where oil glands are most prominent.

  • Burning sensation: Burning can be a symptom of rosacea, as well as psoriasis. Psoriasis can cause silvery scales, while rosacea doesn’t.

People with rosacea may experience another skin condition simultaneously, which makes it even more challenging to diagnose rosacea . If you’re experiencing any of these symptoms, a proper diagnosis from a dermatologist or licensed dermatology provider can help determine whether it’s rosacea, another condition whose symptoms are similar to those caused by rosacea, or both.

Skin conditions that may look like rosacea

Experiencing facial redness, breaking out in acne-like lesions, or having patches of dry skin doesn’t necessarily mean you have rosacea. It could also be:

Acne

Both acne and rosacea are inflammatory skin conditions, but what causes them is quite different. What causes rosacea isn’t fully understood, but flare-ups are triggered by things like spicy food, hot beverages, and sunburn, and those triggers can vary for everyone. Acne occurs when pores become clogged with excess oil (sebum) and dead skin cells.³ Bacteria feed on the oil and thrive, causing an inflammatory response.⁴

Acne appears as open and closed comedones (blackheads and whiteheads), papules, pustules, nodules, and cysts.⁵ Lesions typically appear on the face, neck, back, chest, and shoulders. This is different from rosacea, where whiteheads and blackheads (comedones) do not occur, and acne-like lesions usually occur in conjunction with persistent redness and flushing on the center of the face.⁶

acne vs. rosacea questionnaire

Keratosis pilaris

This common skin condition causes small red, pink, or white bumps on areas including the upper arms, cheeks, thighs, or buttocks that, while noticeable, are harmless and painless. They can form when the body overproduces keratin (a protein in hair, skin, and fingernails) and blocks hair follicles.⁷

Psoriasis

This skin condition causes skin cells to multiply at an increased rate, which can result in dry, reddish patches of skin that sometimes have white silvery scales. It usually appears on the scalp, elbows, knees, and lower back. Like rosacea, it flares up and seemingly resolves, only to later flare up again. Like rosacea, there’s currently no cure, but it is treatable.⁸

Eczema

Itchy, dry, and scaly skin are all characteristics of eczema.⁹ Unlike rosacea, eczema can affect other areas of the body, and itchiness is a common symptom. If you’re looking for help with dry, itchy skin, you may want to start by using an ultra-hydrating product like Curology’s Cream Moisturizer, which uses 6 ingredients to help restore your skin barrier.

Rosacea, however, doesn’t typically cause your skin to itch. According to the National Eczema Association, atopic dermatitis is the most common form of eczema and is usually triggered by environmental factors like extreme heat or cold, detergents, skincare products, metals (like nickel), and other chemicals.¹⁰

Seborrheic dermatitis

To help figure out if you may have rosacea or seborrheic dermatitis, take a look at where your symptoms occur. Seborrheic dermatitis appears in symmetrical patterns in areas with many sebaceous glands (sometimes on the nose and cheeks, much like rosacea), but unlike rosacea, it’s also common on other areas including the scalp and chest.¹¹ Seborrheic dermatitis shows up as red patches or plaques with yellowish-greasy scales.¹² Rosacea can coexist with seborrheic dermatitis, making it difficult to diagnose.

Lupus

Like rosacea, this autoimmune disease can cause redness across the central face,¹³ but that’s where their similarities end. That’s important to keep in mind because if lupus is misdiagnosed as rosacea, getting necessary care can take longer. Lupus is diagnosed using a combination of tests, while rosacea is diagnosed via a visual exam of diagnostic and major criteria, including flushing, papules and pustules, telangiectasia, persistent redness, and ocular (eye) symptoms.¹⁴

Closeup-shot-rosacea-redness-on-cheek

Let the experts help

Seeing a licensed professional to get the right diagnosis and the proper rosacea treatment is the most effective way to manage rosacea. The same goes for many of rosacea’s potential look-alikes, like eczema and psoriasis. Without dermatological intervention, signs of rosacea can worsen.¹⁵ A dermatology provider can perform a physical exam and consider your medical history to diagnose the condition and rule out symptoms of other skin conditions like those we’ve mentioned here. Key parts of the process will include identifying your triggers, making lifestyle changes, and applying topical creams to help manage the symptoms.

If you are, in fact, experiencing rosacea, Curology can prescribe topical medications to help you manage symptoms. We’ll also help guide you in your makeup choices, give you the 411 on vitamins for your skin, and educate you on the effective use of a broad-spectrum Everyday Sunscreen*—all things that promote healthy, clear skin. We’re here for you!

Curology can help you treat symptoms of rosacea

Dermatologist Dr. David Lortscher founded Curology in 2014 to make affordable, effective skincare accessible. Currently, our team of physician assistants, nurse practitioners, medical doctors, and doctors of osteopathic medicine address skincare concerns related to acne, rosacea, hyperpigmentation, and signs of aging.

Curology Product

When it comes to treating rosacea specifically, Curology uses clinically proven ingredients like ivermectin, metronidazole, and azelaic acid. If you’re experiencing rosacea, one of our licensed dermatology providers can create a personalized rosacea skincare routine through custom treatment** and dedicated guidance. We work with our patients from day one, and we’re here to answer any questions along the way.

Get your personalized skincare routine with Curology

Get your personalized skincare routine with Curology

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Becoming a Curology member is easy. Just answer a few questions and snap some photos of your skin concerns so our licensed dermatology providers can get to know your skin. If Curology is right for you, you’ll be paired with a licensed dermatology provider who can prescribe your personalized prescription formula.***

FAQs

What is often misdiagnosed as rosacea?

Acne, keratosis pilaris,¹⁶ psoriasis, eczema, seborrheic dermatitis, and lupus are often misdiagnosed as rosacea.¹⁷

Can seborrheic dermatitis look like rosacea?

Facial flushing or reddened skin is one of rosacea’s most common symptoms.¹⁸ However, a rash-like appearance or redness is also typical for many types of dermatitis, including seborrheic dermatitis, so the two may sometimes appear similar.¹⁹

Is it rosacea or seborrheic dermatitis?

Both skin conditions can have symptoms like redness and a rash-like appearance.²⁰ But seborrheic dermatitis typically shows up where your oil glands are the most prominent,²¹ while rosacea typically appears across the nose, cheeks, and forehead.²² If you are having trouble figuring out which one you may have, seek help from a professional, like a licensed dermatology provider at Curology.

Can you have both seborrheic dermatitis and rosacea?

Rosacea can coexist with seborrheic dermatitis, making it difficult to diagnose.²³

How do you calm a rosacea flare-up fast?

Identifying your triggers, making lifestyle changes, and applying topical creams can help manage your symptoms. But to figure out which tools may work best for you, consult a licensed dermatology provider to get their advice.

• • •

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

  1. National Rosacea Society. Red Skin & Rashes Are Not Always The Result Of Rosacea. (2016, June 6).

  2. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. (2023, August 8).

  3. National Rosacea Society. Red Skin & Rashes Are Not Always The Result Of Rosacea. Ibid.

  4. Toyoda, M. and Morohashi, M. Pathogenesis of acne. Med Electron Microsc. (March 2001).

  5. Sutaria, A.H., et al. Acne Vulgaris. StatPearls. (2023, August 17).

  6. National Rosacea Society. Acne Or Rosacea? A Case of Mistaken Identity. (2013, November 4).

  7. Pennycook, K.B. and McCready, T.A. Keratosis Pilaris. StatPearls. (2023, June 26).

  8. Nair, P.A. and Badri, T. Psoriasis. StatPearls. (2023, April 3).

  9. Nemeth, V. and Evans, J. Eczema. StatPearls. (2022, August 8).

  10. National Eczema Association. What is Eczema? (n.d.).

  11. Tucker, D. and Masood, S. Seborrheic Dermatitis. StatPearls. (2023, February 16).

  12. Johnson, S.M., et al. Recognizing Rosacea: Tips on Differential Diagnosis. JDD. (September 2019).

  13. Rad, S.N. and Vashisht, P. Malar Rash. StatPearls. (2023, September 4).

  14. Gallo, R.L., et al. Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee. JAAD. (January 2018).

  15. National Rosacea Society. When To See A Doctor About Rosacea. (n.d.).

  16. Pennycook, K.B. and McCready, T.A. Keratosis Pilaris. StatPearls. Ibid.

  17. National Rosacea Society. Red Skin & Rashes Are Not Always The Result Of Rosacea. Ibid.

  18. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

  19. Tucker, D. and Masood, S. Seborrheic Dermatitis. StatPearls. Ibid.

  20. National Rosacea Society. Red Skin & Rashes Are Not Always The Result Of Rosacea. Ibid.

  21. Tucker, D. and Masood, S. Seborrheic Dermatitis. StatPearls. Ibid.

  22. Farshchian, M. and Daveluy, S. Rosacea. StatPearls. Ibid.

  23. National Rosacea Society. Red Skin & Rashes Are Not Always The Result Of Rosacea. Ibid.

Elise Griffin is a certified physician assistant at Curology. She received her Master of Medical Science in physician assistant studies from Nova Southeastern University in Jacksonville, FL.

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• • •
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 thoughts on sun protection: *Sunscreen is only one part of UV protection—cute sun hats and shades are also recommended.
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Elise Griffin, Physician Assistant Curology

Elise Griffin, PA-C

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