Pustules from Rosacea: Key Differences from Acne Explained

When you are struggling with red and pus-filled bumps in the center of your face, your first thought is probably to treat them like acne. However, red pustules from rosacea are also small, red, and filled with pus like traditional pimples.

If your pimples aren’t responding to normal acne treatment and are accompanied with a general redness and sensitivity, your acne may actually be pustules from rosacea.

What Are Pustules from Rosacea?

Rosacea is a skin condition that often shows up as redness on your face. Pustules from rosacea are small, pus-filled bumps that can appear on the skin during a papulopustular rosacea flare-up. Rosacea pustules are formed when inflammation is triggered in the skin and leads to the development of these pus-filled bumps. 

The pustules from rosacea are different from acne in that they are primarily driven by inflammation and typically lack comedones (blackheads and whiteheads) that are characteristic of acne. Managing these pustules often involves anti-inflammatory treatments and addressing the underlying triggers. 

Unlike acne, rosacea pustules are typically accompanied by other symptoms like facial redness, visible blood vessels, and may be triggered by factors like stress, diet, and changes in the weather. While it can be tempting to pop these pustules, try to avoid doing so because popping them can exacerbate inflammation, potentially leading to more severe irritation or scarring.

What is Papulopustular Rosacea?

Papulopustular rosacea is a subtype of rosacea that often gets mistaken for acne due to its similar appearance. It is sometimes called inflammatory rosacea or acne rosacea. While classic rosacea primarily involves facial redness and visible blood vessels, papulopustular rosacea also includes red bumps (papules) and pus-filled bumps (pustules), resembling acne. Papulopustular rosacea can include common symptoms of rosacea such as skin sensitivity and flushing. 


Rosacea can sometimes cause breakouts that resemble acne. Treatment options include: azelaic acid, sulfur based ingredients, topical ivermectin, doxycycline, isotretinoin, antibiotics. Light therapy and laser can help reduce redness and treat breakouts. Avoiding known triggers such as sun exposure, stress, alcohol and spicy food can help with symptoms. #dermatologist #rosacea #acne #drwong #doctor #fyp #skincare #rosaceaskincare #skintok

♬ Peaceful and joyful pop with ukulele and whistle(1322918) – 314P

The exact cause of all types of rosacea, including papulopustular, isn’t fully understood. However, it is believed to involve a combination of genetic, environmental, and immune system factors. Potential triggers for rosacea such as sun exposure, emotional stress, hot or cold weather, wind, alcohol, spicy foods, certain skincare products, microscopic mites, and bacteria can exacerbate this skin condition. Additionally, there’s some discussion about a link between rosacea and the gut, but more research is needed to understand these connections fully. 

Rosacea vs. Acne

Rosacea pustules may look like acne, but they’re different beasts and each need their own special approach. Keep in mind that these conditions are not mutually exclusive; it is possible to have both acne and rosacea. Because their treatments will differ, it’s important to differentiate between acne and rosacea by consulting a dermatologist for proper diagnosis if you are unsure. 

Understanding what’s acne and what’s rosacea will help you to give your skin the care it deserves. Here are some key differences of rosacea vs. acne:

Age of Onset

Acne most commonly begins during puberty, a time when hormonal changes lead to increased oil production and the potential clogging of skin pores. This makes acne a common struggle among teenagers, but for many people, particularly women, it can continue into or start in adulthood. Rosacea, on the other hand, is rare in adolescents and typically emerges after the age of 30. Sometimes adults unexpectedly dealing with rosacea will confuse it with late-onset adult acne.


Acne can manifest on various parts of the body, but is most frequently seen on the face, chest, and back. These areas are prone to higher oil production, contributing to the development of pimples. Rosacea primarily targets the central portion of the face, including the cheeks, nose, forehead, and chin. This concentration on the face, particularly in areas prone to flushing, is the distinctive feature of rosacea. 

Types of Blemish

Papulopustular rosacea shows up as red patches, swollen red bumps and pus-filled pustules on the face that may resemble acne, and visible tiny blood vessels. Some people with rosacea may also experience skin thickening, especially around the nose. However, unlike acne, papulopustular rosacea typically lacks open and closed comedones and deeper cysts or nodules that come from clogged pores and bacteria. 

Skin Texture

The texture of your skin can provide clues to differentiate between acne and rosacea. Acne-prone skin often appears oily and may have a greasy surface, contributing to the blockage of pores. Rosacea-affected skin is typically dry and sensitive, with a tendency to react to skin products or environmental factors, leading to irritation and redness.

Facial Redness

Rosacea skin may feel tender and appear flushed, which is less common in acne. This condition is often accompanied by other symptoms of rosacea such as facial redness and visible blood vessels. In darker skin tones the redness of rosacea can be less visible but the papules and pustules will be noticeable. Rosacea often includes a burning or stinging sensation, especially when topical products are applied or certain triggers affect the skin.


Rosacea 101. What questions do YOU have about roaacea?

♬ original sound – Sandra Lee, MD


The triggers for acne and rosacea vary significantly. Acne is often influenced by oil production and hormonal changes, especially during puberty, pregnancy, or certain menstrual phases. Rosacea’s flare-ups can be prompted by a range of external factors including certain foods (like spicy dishes), temperature changes, stress, and alcohol consumption. Understanding and avoiding personal triggers is a critical part of managing rosacea.

How to Get Rid of Rosacea Pustules?

Differentiating between rosacea and other skin conditions like acne is the first step to getting rid of pustules from rosacea, and consulting a dermatologist will ensure you get an accurate diagnosis and the most effective treatment plan. Since the cause of rosacea is not fully understood, ongoing management and treatment are often necessary. Work closely with your doctor on your rosacea so they can help monitor the effectiveness of the treatment and make adjustments as needed.


Back with another very commonly asked question, something we see every day in my practice: how to treat rosacea. #rosacea #dermatologist #skincare #facecare

♬ original sound – Dr. Mamina Turegano, MD

Treating rosacea pustules involves a combination of lifestyle changes, over-the-counter products, and medical treatment such as:

Gentle Skincare

Rosacea skin can be super sensitive. Keep a simple skincare routine and opt for gentle face cleansers and moisturizers and avoid anything that’s too harsh or abrasive. Some brands have sensitive skin or “anti-redness” lines that are better for rosacea.

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Azelaic Acid

Rosacea is characterized by inflammation and redness. Azelaic acid reduces inflammation by inhibiting free radicals, which are reactive molecules that can cause inflammation in the skin. By doing so, it helps to reduce the redness and swelling associated with rosacea.

You can get serums and creams with azelaic acid over the counter while higher strengths are available by prescription.

Sun Protection

Protecting your face from the sun with a broad-spectrum sunscreen with at least SPF 30 is crucial, even on cloudy days. If your skin is sensitive to sunscreen, look at gentle formulations with physical filters like zinc oxide. 

Avoid Triggers

This can vary from person to person, so keeping a diary of what you eat, drink, and do can help identify what sets off your rosacea. Avoid triggers that can cause your flare-ups, such as sun exposure, extreme temperatures, stress, alcohol consumption, spicy foods, and certain skin or hair products.

Professional Help

A dermatologist can offer prescription treatments like topical creams or oral medications to target rosacea and those persistent bumps. These medications help manage symptoms and reduce the number of flares. Laser treatment can be used to remove visible blood vessels and reduce redness. A dermatologist can recommend the most suitable laser option based on your skin type and individual case of rosacea.

Remember, whether it’s pustules from rosacea or acne that is behind the breakouts on your face, understanding your skin is key. Differentiating rosacea from acne, learning your triggers, and seeking professional help are crucial steps. Stay proactive, embrace gentle skincare, and you’ll learn how to work with your skin to keep it healthy in no time.

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