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Home / Rosacea / Papulopustular rosacea

Papulopustular rosacea

Learn about the skin condition which is commonly mistaken for acne

Papulopustular rosacea is a common inflammatory skin condition that is most prevalent in older people.

A close-up of a woman’s face with papulopustular rosacea

It is also known as acne rosacea, due to its resemblance to spots or pimples that affect the skin on the face.

Keep reading to find out the differences between papulopustular rosacea and acne, especially if you are unsure as to which condition is affecting your skin.

What is it?

There are 4 types of rosacea. Papulopustular rosacea is sometimes referred to as the second type (or type 2).

It’s a skin condition that causes red bumps or pimples on the face, often in conjunction with inflammation and redness of the skin (type 1 rosacea).

Sometimes these bumps can be pus-filled, and have noticeable ‘whiteheads’. Because of this, the condition is often mistaken for acne vulgaris.

Papulopustular rosacea is a chronic skin condition that worsens from time to time. Whilst there is no cure, there are many ways of managing it to help reduce your flare-ups.

What causes it?

The cause of acne rosacea isn’t entirely known. However, you are more likely to have it if:

  • you’re over the age of 30
  • you’re fair-skinned and have light hair
  • rosacea runs in your family

Certain factors can also trigger rosacea, which may cause your condition to worsen on occasion. These include things such as:

  • temperature
  • stress
  • sun exposure
  • diet
  • cosmetic products

What are the symptoms?

As suggested by the name, papulopustular rosacea presents with two different types of red bumps: papules and pustules. These resemble an acne-like breakout.

Papules are solid, raised spots that may look red or inflamed.

Pustules are pus-filled bumps which may have a visible ‘whitehead’. Due to this, they are commonly mistaken for acne pimples.

A close-up of papules and pustules

If you have acne rosacea, you may also experience:

  • facial redness and flushing (skin rash)
  • a burning or stinging sensation
  • visible blood vessels on the face
  • broken blood vessels on the face
  • raised, scaly red patches on the skin

These include symptoms of other rosacea types, as it is very common to experience more than one kind at the same time.

How does it vary in severity?

Papulopustular rosacea can vary in severity. Your condition will likely be mild most of the time, but may occasionally become more severe during a flare-up.

The table below shows images of mild and severe cases of papulopustular rosacea.

Mild rosacea Mild rosacea:
Bumps are smaller and lie close to the skin.
Some papules are visible but no pustules.
Severe rosacea Severe rosacea:
Bumps/spots are larger and more significantly raised. Visible pustules as well as papules.

Severe cases are most likely to take place during a flare-up. With treatment and by avoiding your triggers, you should be able to manage your condition so that your symptoms remain mild most of the time.

If you find yourself constantly struggling with severe rosacea, speak to a healthcare professional about alternative treatment options.

How is it different from acne?

Due to the pustules that are caused by papulopustular rosacea, it is easy to mistake your skin condition for the common condition acne vulgaris.

However, knowing how to tell them apart is important in order to prevent the use of the wrong treatment.

Graphic depicting rosacea vs acne

The main difference between acne vulgaris and papulopustular rosacea is the age groups they affect.

Acne most commonly affects adolescents who have fluctuating hormones during puberty. However, people with rosacea are generally adults (between 30 and 65).

Rosacea vs acne comparison

Both type 2 rosacea and acne vulgaris cause:

  • spots/bumps on the face and neck
  • pus-filled bumps (pustules)
  • facial redness

However, their differences are highlighted in the following table:

Papulopustular rosacea Acne vulgaris
  • Mostly affects those over 30
  • Redness is found in other areas of the face
  • Only affects areas found on the face
  • Worsens due to temperature changes or other triggers
  • Only causes whiteheads, not blackheads
  • Mostly affects teenagers
  • Redness is only around the pimples
  • Is often found in other areas such as the back and chest
  • The condition generally remains the same
  • Can cause visible blackheads as well as whiteheads

If you’re not sure if your skin condition is rosacea or acne, you can always speak to a healthcare professional for advice.

Alternatively, you might be diagnosed with another type of skin condition that looks like acne.

How can I treat papulopustular rosacea?

If you have papulopustular rosacea, you can try taking general rosacea treatments.

These include:

You can also try the following home remedies to treat and manage your condition:

  • control your diet
  • recognise and avoid your rosacea triggers
  • minimise your use of lotions and cleansers
A recent study Trusted source National Center for Biotechnology Information (NCBI) Government Source Biomedical Research and Literature Go to source showed that frequent use of cleansers resulted in an increased number of rosacea occurrences.

Whilst these cannot completely cure or eliminate your condition, they can help you to manage and be in control of the condition of your skin.

Medically reviewed by Dr. Anand Abbot MRCGP Written by our editorial team Last reviewed 31-03-2024

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Further reading

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