Acne Vulgaris vs Rosacea
Acne Vulgaris and Rosacea are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Acne Vulgaris vs Rosacea at a glance
- Acne Vulgaris: Chronic inflammatory disorder of the pilosebaceous unit driven by androgens, sebum, keratinization, and Cutibacterium acnes.
- Rosacea: Chronic centrofacial inflammatory dermatosis with flushing, persistent erythema, telangiectasias, papules/pustules, and ocular involvement.
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Side-by-side comparison
| Feature | Acne Vulgaris | Rosacea |
|---|---|---|
| At a glance | Chronic inflammatory disorder of the pilosebaceous unit driven by androgens, sebum, keratinization, and Cutibacterium acnes. | Chronic centrofacial inflammatory dermatosis with flushing, persistent erythema, telangiectasias, papules/pustules, and ocular involvement. |
| Classic presentation | Mixed comedonal and inflammatory lesions in seborrheic distribution (forehead, nose, cheeks, chin, upper chest and back).; Visible facial, chest, or back… | Centrofacial distribution sparing periocular and perioral skin; absence of comedones distinguishes from acne.; Episodic flushing in response to triggers,… |
| Workup / key labs | Clinical diagnosis based on lesion morphology and distribution. Severity graded as mild (comedonal ± few inflammatory papules), moderate (numerous… | ROSCO 2017 phenotype-based criteria. Diagnostic: persistent centrofacial erythema OR phymatous changes. Major: flushing, telangiectasia, papules/pustules,… |
| Imaging | Not indicated for routine acne; Pelvic ultrasound if PCOS suspected | Not indicated |
| First-line treatment | Mild comedonal: topical retinoid — tretinoin 0.025-0.1%, adapalene 0.1-0.3%, tazarotene 0.05-0.1% (apply at night; avoid in pregnancy except adapalene… | General: trigger avoidance, daily broad-spectrum sunscreen SPF ≥30, gentle non-soap cleansers, fragrance-free moisturizer; Persistent erythema: topical… |
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