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Expert Answers to Your Rosacea and Acne Problems

Not sure which products are best for your skin problems? Our experts give their top picks for handling acne and rosacea.

In each issue of WebMD the Magazine, our experts answer your questions about skin care, beauty, makeup, hair care, and more. In our January-February 2011 issue, Lindsey Emery, 32, a freelance editor in Portland, Ore., asked about her bumpy skin. We passed her question on to Julie Harper, MD, a clinical associate professor of dermatology at University of Alabama at Birmingham, and Paul M. Friedman, MD, a clinical assistant professor of dermatology at the University of Texas, Houston,  and author of Beautiful Skin Revealed: The Ultimate Guide to Better Skin.

Q: I've noticed small red bumps on my face, jawline, and neck. Could it be rosacea? Or is it acne?

Harper's top picks:

A: Rosacea is most common on the central portion of the face and less common on the neck and jawline. Early on, redness from rosacea may be transient, occurring only after an exposure to a trigger, like spicy foods or red wine, but later becomes persistent. Acne, on the other hand, develops on the jawline and neck as a result of hormonal fluctuations and shows up as both blackheads and whiteheads. If you have one or both conditions, it's important to have an effective but gentle routine.

In the morning, wash your face with lukewarm water and a gentle cleanser like CeraVe Hydrating Cleanser ($11.40), which is infused with ceramides, natural (not synthetic) oils that hydrate.  

Next, apply a treatment cream such as La Roche-Posay Rosaliac Skin Perfecting Anti-Redness Moisturizer ($34). Pumped with soothing xanthine and vitamin B3, this green cream calms irritation and prevents flare-ups.

Apply a sunscreen with SPF 15 or higher. I like Olay Complete All Day UV Moisturizer SPF 15 ($11.99), a 100% oil-, fragrance-, and paraben-free sunscreen that won't clog pores.

At bedtime, cleanse and moisturize again. Try Avène Diroséal Anti-Redness Skincare Lotion ($46), which neutralizes rosy patches while you snooze.

Friedman's top picks:

A: While acne is associated with teens, it persists in many people well into their 30s, 40s, and even 50s. Rosacea, however, tends to plague mostly adults, and women more than men. One type of rosacea in particular (papulopustular) might be confused with acne. Both show up as pinkish-red, raised blemishes and pus-filled bumps on the face. But, if you have whiteheads and blackheads, it's acne.

There are some triggers that aggravate both conditions. Warm weather and sweat, which can be tripwires for rosacea, may also clog pores and indirectly lead to zits. Stress can also cause both conditions to flare up.

Steer clear of cleansers that contain alcohol, menthol, or fragrance. Try Eucerin Redness Relief Soothing Cleanser ($8.99), which is laced with licorice root extract to calm skin. And use a daily broad-spectrum SPF, such as Neutrogena Spectrum+ Advanced Sunblock Lotion SPF 70 ($10.99), infused with feverfew and vitamin E to help reduce flares.

For makeup, try a light foundation such as L'Oréal True Match Super-Blendable Compact Makeup ($10.99) containing silicone, to help lock moisture into skin. Green-tinted makeup like Everyday Minerals Mint Color Corrector ($8), a pressed mineral face powder, can help mask the redness from acne and rosacea.

The opinions expressed in this section are of the experts and are not the opinions of WebMD. WebMD does not endorse any specific product, service, or treatment.

Rosacea or Acne?

Answer these quick questions from Ronald Davis, MD, professor of dermatology at Tulane School of Medicine in New Orleans, to tell if the blemishes on your face are more likely a case of rosacea or acne.

  1.  Do you blush easily?
    1. Yes
    2. No
  2. Do you notice facial itching, stinging, or burning?
    1. Yes
    2. No
  3. Do you have fair skin?
    1. Yes
    2. No
  4. What happens to your skin when you get hot, drink hot beverages, eat spicy foods, or get stressed?
    1. My face gets red
    2. Nothing really happens
  5. Where on your face do you typically break out?
    1. Forehead, nose, and chin
    2. Lower cheeks, chin, jawline, and upper neck
  6. When you break out, do you notice …
    1. Mostly red splotches, small blood vessels, and occasional pimples?
    2. Mostly pimples and some blackheads or whiteheads?

Did you have more 1s? You could have rosacea. More 2s? You could have acne.

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