Can acne treatments be used for rosacea?

Rosacea and acne are two common but very different skin conditions. However, they are sometimes confused by patients due to similarities like redness, pimples, and inflamed areas. Given these apparent resemblances, many wonder if the same acne treatments can be used for rosacea. This article clarifies the mechanisms of each condition, the risks of confusion, and suitable solutions.

1. Understanding rosacea

Rosacea is a chronic inflammatory skin condition primarily affecting the face (cheeks, nose, forehead, chin). Its main symptoms include:

  • Persistent redness or flushing.

  • Small red bumps (papules) or inflammatory pustules.

  • Sensation of warmth, burning, or stinging.

  • Visible small blood vessels (telangiectasias).

Unlike acne, rosacea is not caused by excess oil or clogged pores. It results from chronic inflammation, often made worse by environmental, hormonal, or dietary factors.

2. Key Differences between Acne and Rosacea

Characteristic Acne Rosacea
Common Age Adolescence Adult (30-50 years old)
Affected Areas Face, back, chest Central face (cheeks, nose, forehead)
Type of Lesions Blackheads, whiteheads, red bumps, pustules Red bumps, pustules, redness, visible blood vessels
Excess Sebum Yes No
Clogged Pores Yes No
Main Causes Hormones, excess oil (sebum), bacteria (C. acnes) Inflammation, blood vessels, environment, genetics

This distinction is crucial for choosing the right treatment, as not all acne treatments are suitable for rosacea.

3. Acne treatments and their compatibility

a. Topical retinoids

Derivatives of Vitamin A (retinol, tretinoin, adapalene) are very effective for acne, but can be irritating for the sensitive skin of patients with rosacea. Their use can cause redness, burning, and a worsening of symptoms. Therefore, they should be avoided in active rosacea.

b. Benzoyl peroxide

Benzoyl peroxide eliminates the bacteria responsible for acne and reduces comedones and papules. However, for rosacea, it is too aggressive: it irritates the skin and intensifies redness.

c. Topical antibiotics

  • Acne: clindamycin, topical erythromycin to reduce bacteria.

  • Rosacea: certain antibiotics like topical metronidazole, clindamycin, or ivermectin are effective, but only at specific concentrations and in specific formulations. Products intended for acne may be too concentrated or irritating.

d. Oral antibiotics

  • For severe acne, tetracyclines (doxycycline, lymecycline) are often used at high doses.

  • For rosacea, lower, anti-inflammatory doses are preferred. Acne doses are too strong and unnecessary, and can cause side effects.

4. Risks of using acne treatments on rosacea

  • Severe irritation: redness, stinging, burning.

  • Worsening of inflammation: papules and pustules can become more visible.

  • Skin imbalance: over-treatment of beneficial bacteria and the skin barrier.

  • Ineffective results: some treatments effective for acne do not reduce the redness or telangiectasias of rosacea.

5. Treatments adapted for rosacea

a. Gentle topical treatments

  • Metronidazole-based gels or creams: reduce inflammation.

  • Topical ivermectin: acts on papules and pustules and has an anti-parasitic effect against Demodex folliculorum.

  • Azelaic acid: anti-inflammatory and slightly antibacterial, well-tolerated.

b. Low-dose oral antibiotics

  • Tetracyclines (doxycycline, lymecycline) at anti-inflammatory doses, effective on inflammatory lesions without eliminating sebum.

c. Protection and complementary care

  • Gentle cleansing, without harsh soap.

  • Tailored Hydration: soothing and non-comedogenic creams.

  • Daily Sun Protection, as the sun exacerbates redness.

  • Avoid Known Triggers: alcohol, spices, heat, stress, certain cosmetics.

6. Conclusion

Generally, acne treatments are not suitable for rosacea, especially retinoids and benzoyl peroxide. Rosacea requires a specific approach, focusing on reducing inflammation, protecting blood vessels, and caring for sensitive skin.

Some antibiotics used for acne can be employed for rosacea, but at specific doses and formulations. It is important to consult a dermatologist to avoid worsening symptoms and to choose a safe and effective treatment plan.

In summary, although both acne and rosacea involve breakouts, their underlying causes are different. Confusing the treatments can lead to severe irritation and disappointing results. An adapted routine, gentle care, and targeted treatments help control flare-ups and maintain skin health.

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