Urgent Care / Skin / Rosacea and Acne
If you're an adult with redness across your cheeks and nose, flushing, and small red bumps but no blackheads, it may be rosacea rather than acne. The two are easy to confuse, but they're treated differently, and some common acne products can irritate rosacea. Getting the diagnosis right is what makes treatment work.
What are rosacea and acne?
Rosacea is a long-term skin condition that mainly affects the center of the face. It usually starts after age 30, and it often comes and goes in flares. It's more common in people with fair skin, but it affects all skin tones, and it can be harder to spot on darker skin. It isn't contagious and it isn't caused by poor hygiene.
Acne starts in the hair follicles and oil glands. Pores get clogged with oil and dead skin, which leads to blackheads, whiteheads and inflamed pimples. Acne is most common in teens, but many adults have it too, especially women, often along the jawline and chin.
How can you tell them apart?
Look closely in good light and compare:
| Rosacea | Acne | |
|---|---|---|
| Blackheads and whiteheads | No | Yes, usually |
| Redness | Persistent redness and flushing in the center of the face | Mostly around individual pimples |
| Where | Cheeks, nose, chin, forehead | Face, jawline, chest, back |
| Feel | Burning, stinging, sensitive skin | Tender pimples; skin often oily |
| Visible small blood vessels | Common | Not typical |
| Eyes | May be dry, gritty, red or irritated | Not affected |
| Typical age | Usually over 30 | Often teens and young adults, but any age |
The single most useful clue is blackheads and whiteheads. Rosacea bumps can look like pimples, but rosacea doesn't cause clogged pores.
Some people have both conditions at once. And other things can cause facial redness too, which is one reason an exam helps.
What triggers rosacea?
Rosacea flares often follow a trigger. Common ones include:
- Sun and heat, which is hard to avoid in Florida
- Hot drinks and spicy food
- Alcohol, especially red wine
- Stress and strong emotions
- Hard exercise
- Wind and cold
- Some skin and hair products, especially those with fragrance, alcohol or harsh exfoliants
Triggers vary from person to person. Keeping a simple diary for a few weeks can help you find yours.
Why it matters: harsh scrubs, strong drying products and some medicated creams can make rosacea worse. Steroid creams, in particular, can worsen rosacea. Ask before putting a prescription cream on your face.
What can you do at home?
These steps help sensitive skin, whether it's rosacea or acne:
- Wash with a gentle, fragrance-free cleanser and lukewarm water, then pat dry
- Use a fragrance-free moisturizer suited to sensitive skin
- Wear sunscreen every day. A broad-spectrum SPF 30 or higher is a good choice, and mineral sunscreens are often easier on sensitive skin.
- Wear a wide-brimmed hat and seek shade in the middle of the day
- Skip scrubs, toners with alcohol and products that sting
- Don't squeeze or pick bumps
- Track and avoid your triggers where you can
How are rosacea and acne treated?
Both conditions are very treatable, though rosacea is long-term and usually managed rather than cured. Your clinician decides what's appropriate for your skin and your health. Options may include:
For rosacea:
- Prescription creams or gels that calm bumps and redness
- Antibiotic medicines, applied to the skin or taken by mouth, used for their anti-inflammatory effect
- A referral for laser or light treatments for persistent redness and visible blood vessels
- Eye care if rosacea affects your eyes
For acne:
- Prescription creams or gels that unclog pores, such as retinoid-type creams
- Topical antibiotics, often combined with other ingredients
- For more severe or stubborn acne, pills that your clinician may discuss with you, or a referral to a dermatologist
Treatments for both take time to work, and a good skin care routine helps them work better.
What does a video visit at MD Care look like for facial redness?
Your face is easy to show on camera. During the visit, your clinician will:
- Ask when the redness and bumps started and what seems to trigger them
- Look closely at your skin, checking for blackheads, whiteheads, flushing and blood vessels
- Ask about your eyes, your skin care products and any creams you've used
- Review your medications and health history
- Recommend a plan and, when appropriate, send a prescription to your pharmacy
Face a window or a bright lamp, and take off makeup before the visit. Photos taken during a flare are helpful, since redness can come and go. You can also read about rashes and skin conditions we see by video.
A video visit is $50 without insurance, with no membership. A $20 message visit with photos may work for some follow-ups, when your clinician agrees it's appropriate. If you have Medicare, we confirm your coverage before your visit, and you pay your plan's share. Most patients are seen within three hours, and you need to be in Florida at the time of your visit. See pricing and Medicare.
When should you be seen in person?
Get in-person care the same day, ideally with an eye doctor or at an emergency room, if you have:
- Eye pain, sensitivity to light or blurred or reduced vision
- A very red eye along with facial redness
See a clinician in person soon if:
- A red, swollen area on your face is painful, warm and spreading, especially with fever
- A spot on your face is changing, bleeding or not healing. This needs a hands-on skin check.
Call 911 if your face, lips or tongue swell suddenly, or you have trouble breathing or swallowing.
Can adults get acne?
Yes. Adult acne is common, especially in women. The presence of blackheads and whiteheads is the main clue that it's acne rather than rosacea.
Does rosacea go away?
Rosacea is a long-term condition, but treatment and avoiding triggers can keep it well controlled for many people.
Can I use my old acne products on rosacea?
Ask first. Some acne products are too harsh for rosacea and can make redness and stinging worse.
Can rosacea affect my eyes?
Yes. Ocular rosacea can cause dry, gritty, red or irritated eyes. Eye pain or vision changes need same-day in-person care.
Does Medicare cover a visit for rosacea or acne?
Medicare can cover a visit to diagnose and treat a skin condition. Coverage for some treatments, especially cosmetic procedures, may be limited. We confirm your coverage before your visit.
Redness or bumps you can't figure out?
Show your skin to a Florida-licensed clinician by video, from home.
Sources
- American Academy of Dermatology (AAD). Rosacea: signs and symptoms; Acne: signs and symptoms. aad.org.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Rosacea; Acne. niams.nih.gov.
- MedlinePlus, U.S. National Library of Medicine. Rosacea. medlineplus.gov.
This article is for general information and isn't medical advice. It doesn't replace an evaluation by a clinician. MD Care is not for emergencies: if you have a medical emergency, call 911 or go to the nearest emergency room.
