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What's the difference between acne and rosacea?

Ask a dermatologist

Nearly everyone has gone through the frustration of acne, a skin conditionthat causes your faceto becovered with small pimples and red shiny skin. However, if these traditional acne symptoms also include constantly red nose and cheeks, rushes of redness, tiny veins, or bloodshot eyes with no blackheads or whiteheads, then what you might be suffering from is not acne, but rosacea.

“From a distance rosacea and acne look very similar, so it can be difficult for an individual to tell the difference between the two,” says Dr. Mary McKenzie, a Dermatologist at North York General Hospital.
 
NYGH Dermatologist Dr. Mary McKenzie

NYGH Dermatologist Dr. Mary McKenzie
 
The Canadian Dermatology Association recognizes acne's main symptoms as blackheads, whiteheads, pimples, and cysts, which usually appear on the face and neck but can include shoulders, back and arms. Acne typically occurs in the teenage years while rosacea usually occurs later in life.

A number of lifestyle factors can trigger rosacea to flare, including hot and cold weather, sun exposure, stress, and hot or spicy food and drinks. “Patients with rosacea have more unstable and reactive blood vessels in the affected areas,” says Dr. McKenzie.
 
Acne occurs when hair follicles are blocked by an oily substance (sebum), dirt, and dead skin cells.

Acne occurs when hair follicles are blocked by an oily substance (sebum), dirt, and dead skin cells.
Image: Acne and Rosacea Society of Canada

Rosacea is a chronic skin disorder that usually shows up on your cheeks and nose and can result in a swollen nose (rhinophyma) and even involve the eyes.
 
Rosacea is a chronic skin disorder that usually shows up on your cheeks and nose and can result in a swollen nose (rhinophyma) and even involve the eyes. Image courtesy of Dr. Benjamin Barankin

Treatment

Once you and your doctor have identified whether you have acne or rosacea, it becomes easier to manage and treat.

The Canadian Dermatology Associationsays that there is no cure for rosacea and, if left untreated, it can worsen over time. A dermatologist can prescribe various forms of treatment and recommend which skin care products and cosmetics are best. Rosacea sufferers should use mild, non-perfumed products. “The goal is to control redness and inflammation and sometimes a mild skin cleanser can help,” says Dr. McKenzie. “Some people have found anti-redness creams offered by cosmetics firms to be helpful in covering the redness." In severe cases, she adds, prescription creams and gels, oral antibiotics and laser surgery may be suggested.

For acne, there are non-prescription over the counter (OTC) and prescription medicines available. OTC treatments can include topical cleaners, creams and gels. “Whichever non-prescription treatment you try, stick with it for at least six to eight weeks to see improvements in your skin,” says Dr. McKenzie. She also suggests seeking treatment for moderate or severe acne sooner rather than later as this is crucial to getting it under control and limiting the chances of permanent scarring.

Prescription treatments for acne include topical formulations and oral medication such as antibiotics, retinoids, or hormone medications.
 
March 1, 2017
 
This article first appeared in the March 2017 issue of The Pulse, North York General Hospital's community newsletter. Subscribe to receive 10 issues per year.

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