Oct 24, 2022 · 6 min read
Everyone’s skin is unique, which is something we’re all about celebrating—but it’s also one of the reasons why figuring out what’s going on with your skin isn’t always easy, 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 currently don’t treat every condition mentioned here, but we’re here to help by sharing the facts.
We’ll explore what else looks 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 to know what it is.
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). It can also include other symptoms similar to those with other skin conditions, such as: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 skin 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 anywhere 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, making diagnosing rosacea even more challenging. 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.
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. Bacteria feed on the oil and thrive, causing an inflammatory response.² Acne appears as open and closed comedones (blackheads and whiteheads), papules, pustules, nodules, and cysts. 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.³
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.⁴
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.⁵
Eczema: Itchy, dry, and scaly skin are all characteristics of eczema. Unlike rosacea, eczema can affect any area of the body, and itchiness is its most common symptom. 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.⁶
Seborrheic dermatitis: 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. Seborrheic dermatitis shows up as red patches or plaques with yellowish-greasy scales.⁷ Rosacea can coexist with seborrheic dermatitis, making it difficult to diagnose.
Lupus: Like rosacea, this autoimmune disease can cause redness across the central face, but that’s where their similarities end. That’s important to keep in mind because if lupus is misdiagnosed as rosacea, receiving 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.⁸
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.⁹ 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 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 sunscreen—all things that promote healthy, clear skin. We’re here for you!
Dermatologist David Lortscher founded Curology in 2014 to make affordable, effective skincare accessible to everyone. 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.
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 will create a personalized rosacea skincare routine through custom treatment and dedicated guidance. We work with our members from day one, and we’re here to answer any questions along the way.
Becoming a Curology member is easy. Just answer a few questions and snap some selfies so we can get to know your skin. If Curology is right for you, you’ll be paired with a dermatology expert who will prepare your personalized prescription formula. Included in your trial month is our cleanser, moisturizer, and any other skincare products your provider believes will benefit your skin. We’re so confident you’ll see positive skin changes that the first month is on us. Just pay $4.95 (plus tax) to cover shipping and handling.*
National Rosacea Society. Red skin and rashes are not always the result of rosacea. (2016, June 6).
Toyoda M., et al. Pathogenesis of acne.Medical Electron Microscopy. (March 2001).
National Rosacea Society. Acne or rosacea? A case of mistaken identity. (2013, November 4).
Keith B. Pennycook; Tess A. McCready. Keratosis Pilaris. StatPearls Publishing. (January 2022).
Pragya A. Nair; Talel Badri1. Psoriasis. StatPearls Publishing. (January 2022)
National Eczema Association. What is eczema? (n.d.)
Johnson S.M., et al. Recognizing rosacea: Tips on differential diagnosis. Journal of Drugs in Dermatology. (September 2019).
Richard L. Gallo, MD, PhD, et all. Journal of the American Academy of Dermatology. Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee. (2017, October 28).
National Rosacea Society. When to see a doctor about rosacea. (n.d.).
* Subject to consultation. Subscription is required. Trial is 30 days. Results may vary.
Nicole Hangsterfer, PA-C