Differentiating Acne Vulgaris vs. Acne Rosacea

Acne vulgaris is what most people think of when they hear acne. However another type of acne, called acne rosacea (usually referred to as just rosacea) needs a different type of treatment then acne vulgaris. It is important to be able to differentiate the two diagnoses.

Introduction to Differentiating Acne Vulgaris vs. Acne Rosacea

Acne vulgaris and acne rosacea are two commonly seen rashes that affect the face. While the two are often confused by patients given their looks, both conditions are characteristically distinct in the ways the can affect the skin.

Acne Vulgaris

Acne vulgaris (commonly referred to as acne) is a common skin disease in which hair follicles become clogged with dead skin and oils resulting in inflammation. Acne has a varied etiology which includes genetics, hormonal function, bacterial growth, and other causes.

Clinically, ance can be identified by open or closed comedones, and/or by erythematous papules and pustules on the face, as well as erythema on the surrounding skin. Likewise, acneiform scarring may also occur which may or may not present with comedones.

Acne Rosacea

Acne rosacea (commonly referred to as rosacea) is a common skin disease which is characterized by redness, papules, pustules, and swelling. Commonly mistaken for acne vulgaris in its early stages, acne rosacea is a relapsing condition, which can be exacerbated by sun exposure, heat, alcohol, strong emotions, caffeine, and spicy foods.

Clinically, rosacea is largely identified by the intense reddening of the skin (the erythema is caused by dilation of the superficial vasculature of the face). Likewise, rosacea does not typically present with comedones.

Unlike acne vulgaris, rosacea is typically localized commonly over the central face (i.e. medial cheek, nose, forehead, and chin). 

Acne Vulgaris vs. Acne Rosacea


Acne Vulgaris

Acne Rosacea

Chronic Inflammatory Disease




Papules and Pustules


Areas Affected


Central Face (flush areas)






Sun, heat, alcohol, strong emotions, caffeine, spicy foods





Rhinophyma is a consequence of non-treated and sometimes retreatment-resistant rosacea due to granulomatous infiltration of the skin within the nose. If severe, the nose will be severely enlarged. It is characterized by enlarged pores and thickened skin. Papules on the nose and related rosacea in the surrounding areas of the face are often observed. It is more common in men. 



























Consult the Expert

Jennifer Chen

Dr. Chen is a Clinical Assistant Professor and Dermatologist at Stanford University Hospital and Clinics.

Clinical Pearl

When you have concern for rosacea, be sure to screen for ocular involvement. Patients with ocular rosacea may say they have a gritty, burning or foreign body sensation in their eyes. The eyes may be red (image below) and irritated. They are more likely to have styes (hordeolums) and be at risk of infection.