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How To Deal With Papulopustular Rosacea
Papulopustular rosacea is a chronic inflammatory skin condition that can be mistaken for acne. It's one of four types of rosacea—a skin condition that may cause redness and flushing on the face. People with papulopustular rosacea also have pimple-like white heads.
The medical community is not sure what the exact cause of rosacea is, and there are no rosacea treatments that can cure the condition. However, avoiding rosacea triggers (like alcohol and some foods), using a gentle skin routine, applying topical treatment, and taking oral antibiotics can all help treat rosacea symptoms.
Reproduced with permission from © DermNet New Zealand and © Dr. Mashihul Hossain www.Dermnetnz.Org 2023.
What Papulopustular Rosacea Looks Like All types of rosacea cause red or flushed skin, usually on the cheeks or nose. This redness can come and go, but over time, it tends to stay for longer periods. In darker skin tones, it can appear as darker patches of skin or a dusky brown discoloration. It may also cause yellowish-brown bumps around the mouth or eyes. People with papulopustular rosacea have pimple-like whiteheads that can appear with or without the redness and flushing typically associated with rosacea. This rash is often confused for acne papules, or zits, because that's exactly what they look like. These most commonly appear on the: Cheeks Chest Forehead Neck Scalp Skin In addition to these papules, papulopustular rosacea can cause red bumps on the skin, most often on the face. How Is Type 2 Rosacea Different From Acne? Papulopustular rosacea, sometimes called type 2 rosacea, is easily confused with acne. Both cause pustules on the face, but there are subtle differences in how the conditions present, and how they need to be treated. Even healthcare providers can have trouble distinguishing between acne and rosacea, so you should talk with a dermatologist if you suspect you have either condition. These factors can help determine which you have: How long it lasts: Acne is generally chronic and relatively stable; papulopustular rosacea can come and go, depending on triggers. Location of rash: Acne is widespread, whereas papulopustular rosacea is concentrated in the central face, especially the inner cheeks and nose. Presence of blackheads: People with acne often have blackheads in addition to whiteheads; those with rosacea do not. Yuliya Shauerman / Getty Images Flare-Ups and Common Triggers People with papulopustular rosacea often experience periods of more severe rash, followed by periods of clearer skin. However, the flares can also be long-lasting. Rosacea usually flares up in response to triggers. Triggers vary between individuals, but the most common are: Alcohol Dairy Emotional stress Exercise Exposure to the sun and/or ultraviolet light Hot weather Medications (including steroids, niacin, and beta blockers) Spicy foods Skincare products Warm beverages Wind About 1 in 4 people with rosacea say they have a trigger that's not on this list, however, so it's important to be aware of the individual pattern of your rash. Seeing a Dermatologist for a Diagnosis Rosacea should be diagnosed by a dermatologist, a doctor who focuses on the skin. Before your appointment, take pictures of skin changes and note any triggers you believe may be contributing to your rosacea. At the appointment the dermatologist will talk about your health history, perform a physical exam, and check your eyes, which can sometimes be impacted by rosacea. Treatment Options Prescription Medications Four prescription antibiotics can be used topically to treat papulopustular rosacea. These are: Azelaic acid Dapsone Ivermectin Metronidazole These are usually used for three to four months at a time. They are combined with oral antibiotics, including: Clarithromycin Clindamycin Doxycycline Erythromycin Minocycline Oral medications may be given for four weeks to clear up an outbreak. Your healthcare provider might recommend staying on them longer-term as a preventive measure. Nonprescription Medications Since papulopustular rosacea often requires prescription treatment, it's best to ask your healthcare provider before using any over-the-counter (OTC) creams. However, some OTC topical creams (applied to the skin) can help with mild rosacea. These include: Home Remedies Avoiding stress and triggers can help prevent rosacea flare-ups. Having a gentle skin routine and wearing sunscreen daily is also an important part of treating rosacea. Dietary Management Some people find that what they eat or drink triggers flare-ups. These dietary changes may help manage rosacea: Avoid hot or spicy food or drinks. Minimize caffeine. Avoid alcohol. Avoid peppers with the natural chemical capsaicin, which is associated with spiciness. Avoid foods with the natural chemical cinnamaldehyde found in cinnamon, chocolate, and tomatoes. Eat plenty of fiber. Eat probiotic foods like kefir or sauerkraut. Basic Skin Care Routine Establishing a gentle skincare routine is part of rosacea self-care. If you have rosacea, you should: Use gentle cleansing products, avoiding anything harsh or scented. Moisturize using a gentle, scent-free product. Wear sun protection daily, as sun exposure is a significant trigger for rosacea. How to Stay Ahead of Flares Avoiding triggers is the best way to stay ahead of rosacea flares. The two most common triggers for rosacea are sun exposure and stress. Wearing sunscreen every day will go a long way toward reducing your symptoms. Any steps you can take to reduce stress—like creating a mindfulness routine—will also help. Summary Papulopustular rosacea is a chronic skin condition that is often confused with acne. Whereas acne is widespread over the whole face, papulopustular rosacea is most common in the central area of the inner cheeks and nose. Papulopustular rosacea is treated with a combination of oral and topical antibiotics. Creating a gentle skin care routine, identifying and avoiding triggers, and working with your dermatologist can help you mitigate the impact of papulopustular rosacea on your life.8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.NYU Langone Health. Types of rosacea.
American Academy of Dermatology Association. People with darker skin tones can get rosacea.
Stanford Medicine. Introduction to differentiating acne vulgaris vs. Acne rosacea.
Oge' LK, Muncie HL, Phillips-Savoy AR. Rosacea: Diagnosis and treatment. Am Fam Physician.
American Academy of Dermatology Association. People with darker skin tones can get rosacea.
Rivero AL, Whitfeld M. An update on the treatment of rosacea. Aust Prescr. 2018. Doi:10.18773/austprescr.2018.004
American Academy of Dermatology Association. Rosacea diagnosis and treatment.
Weiss E, Katta R. Diet and rosacea: The role of dietary change in the management of rosacea. Dermatol Pract Concept. 2017. Doi:10.5826/dpc.0704a08
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Helpful Report an Error OtherWhat To Know About Rosacea Fulminans
Rosacea fulminans is a rare and severe inflammatory skin condition. It typically starts suddenly, and it mostly affects the central part of the face, including the chin, cheeks, and nose.
Also known as pyoderma faciale, rosacea fulminans manifests as flushed, swollen, and painful nodules and pimples that can merge. These symptoms differ from those of rosacea or acne in that they are more severe and come on rapidly.
The condition primarily affects females of childbearing age. However, the exact cause is unknown.
Successful treatment may involve corticosteroids and isotretinoin (Accutane), though some people may also benefit from stress management and diet modification.
Some potential triggers of rosacea fulminans include:
According to a 2021 literature review, certain dietary factors may also trigger or worsen rosacea symptoms. However, it is important to note that this information is not specific to rosacea fulminans.
Potential dietary triggers include:
The review highlights that dietary triggers may vary significantly from person to person. As a result, healthcare professionals do not recommend specific dietary recommendations to all people with rosacea.
Treatment options for rosacea fulminans may include oral isotretinoin, which is a prescription-only acne medication. Doctors may also prescribe oral or topical corticosteroids.
In a 2016 case study, antibiotics combined with corticosteroids and lifestyle changes also helped resolve a person's symptoms.
Since certain factors may trigger or worsen rosacea, a healthcare professional may also suggest identifying and avoiding triggers. This may involve making the following lifestyle changes:
Combining these strategies with medical treatments, such as corticosteroids and isotretinoin, may improve overall symptom management and quality of life for people with this condition.
A person may benefit from speaking with a dermatologist or another healthcare professional if they:
Promptly seeking medical attention is important to receive an accurate diagnosis and begin treatment. Acting quickly may help a person manage their symptoms and reduce the risk of complications associated with rosacea fulminans, such as scarring and infections.
Additionally, early intervention can help address any emotional distress the person may experience, potentially improving their overall quality of life.
Contacting a dermatologist or another healthcare professional means that a person will receive personalized care and comprehensive management strategies specific to their needs and circumstances.
Rosacea fulminans is a rare and severe inflammatory skin condition that typically affects the central face. Symptoms appear suddenly and may include localized skin color changes, like redness, inflammation, and painful nodules or pimples.
Rosacea fulminans primarily occurs in females, though its exact cause is unknown. Treatment involves corticosteroids, isotretinoin, and sometimes stress management and dietary adjustments.
A person can contact a healthcare professional if they experience any symptoms of rosacea fulminans. Seeking prompt diagnosis and treatment may help resolve symptoms faster and prevent complications.
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