Is It Rosacea or Something Else?

The best way to find out if you have rosacea or something else is to consult a dermatologist. But you can get a better idea of what you may be experiencing if you understand the other common culprits.

Rosacea, sometimes called acne rosacea, is a chronic inflammatory skin disease. Rosacea can be mild to severe, and over time, the redness (or flushing) can spread from your cheeks and nose to your chin and forehead.

• Thickening of the skin around the nose
• Bumps or pimples
• Blushing or flushing (can be temporary or persistent)
• Skin sensitivity
• Enlarged blood vessels

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“A distinctive form is rhinophyma, when the nose enlarges and develops large nodules; similar changes can sometimes occur on other facial areas, such as the chin,” says Viktoryia Kazlouskaya, MD, PhD, a dermatologist at Dermatology Circle in New York City.

• Chest
• Ears
• Forehead
• Neck
• Scalp
• Eyes

“I routinely have patients of color who have seen numerous other doctors, but have had their diagnosis missed simply because their skin type didn’t show the classic ‘rosy cheeks,’” says Dr. Ilyas.

• Dry, swollen skin
• Patches of darker skin or discoloration
• Hard yellow or brown bumps around your mouth or eyes
• Skin sensitivity

Several other conditions can produce the skin redness and acne-like bumps of rosacea. Here’s how to spot them.

Acne

Cutaneous Lupus

Eczema

Because eczema can lead to reddened skin, it can sometimes be confused with rosacea. A major difference is the itching and scaly feel that eczema causes.

• Rash
• Itchiness
• Dryness
• Blisters

“Usually associated with a scaly rash and intense itching. Many patients have a history of eczema since childhood and often experience it on other body sites. Sensitive skin is also common,” says Dr. Kazlouskaya.

Seborrheic Dermatitis

This skin condition is often found on the scalp, causing red patches and scaly dandruff. It can also develop on other parts of the body, including the face and the nose, so it’s sometimes mistaken for rosacea.

• Eyebrows
• Forehead
• Creases around the nose
• External ear canal

Psoriasis

Another skin condition that can lead to skin sensitivity and redness is psoriasis. The most common type of psoriasis is called plaque psoriasis.

• Elbows
• Knees
• Lower back
• Scalp

“Psoriasis can affect the face but more typically appears on the scalp, trunk, and extremities, especially the knees and elbows. It is characterized by well-demarcated areas covered with silvery scales,” says Kazlouskaya.

Perioral Dermatitis

• Red or inflamed rash
• Skin scaling
• Pustules
• Sensitivity to skin care

Demodex Folliculitis

“Demodex is a normal skin mite that sometimes increases in density and triggers inflammation,” says Kazlouskaya. “Demodex folliculitis presents as itchy inflammatory bumps and pustules.”

While these are two separate conditions, microscopic organisms that normally inhabit hair follicles in low numbers appear to be more numerous in those with rosacea, says Anna Guanche, MD, a board-certified dermatologist based in Calabasas, California.

“It is always a good idea to see a board-certified dermatologist for advice and treatment options. A consultation is especially important when symptoms are not manageable with simple avoidance measures and gentle skin care,” says Kazlouskaya.

“Usually, a clinical examination is sufficient to diagnose rosacea, as its features are quite distinct,” says Kazlouskaya. “Dermatologists are trained to recognize it during their specialized training, and additional testing is rarely necessary unless the presentation resembles another condition or the treatment trial is ineffective.”

• Rosacea is commonly confused for other conditions, as some co-occur or have overlapping symptoms
• Appearance of rosacea differs depending on your skin tone
• Early detection of rosacea is important, as quick treatment is effective in preventing future flares or triggers