Keratosis Pilaris
Keratosis pilaris makes small rough bumps, most often on the upper arms and thighs.
← All comparisons
Dermapedia / CompareConditions
Keratosis Pilaris vs Rosacea
Keratosis pilaris is rough, bumpy skin caused by plugged hair follicles. It is a texture problem first and a redness problem second, and it is classically on the upper arms and thighs. Rosacea is flushing and lasting redness on the middle of the face. Rosacea can also cause bumps and pustules. A field of rough follicular bumps favors keratosis pilaris, but texture alone cannot confirm the diagnosis.
At a glance
| The difference | Keratosis Pilaris | Rosacea |
|---|---|---|
| What it is | Keratin plugs blocking hair follicles | Overreactive blood vessels and inflammation |
| What it looks like | Tiny bumps in a rough patch | Redness across the centre of the face |
| How it feels to touch | Rough, like fine sandpaper | Flushing, sometimes with bumps |
| Does it itch or hurt | Usually not | Stings and burns |
| What it does over time | Fades with age | Persists and can worsen |
Rosacea
Rosacea causes lasting redness across the cheeks and nose, sometimes with visible vessels.
Side by side
The differences that matter
What it is
Keratosis Pilaris
Keratin plugs blocking hair follicles
Keratin, the protein in the surface of the skin, builds up and plugs the opening of each follicle. Every bump is one blocked follicle with a trapped hair inside.
Rosacea
Overreactive blood vessels and inflammation
Blood vessels in the central face widen too easily and stay widened. Inflammation follows, and in some people that adds bumps and pustules.
How it works, illustrated
Keratosis Pilaris
Every hair grows out through a small opening in the skin. When the skin around that opening holds enough moisture, old cells loosen and fall away on their own. The opening stays clear, and the hair passes straight through it.
1 / 5→
The skin around each hair follicle is dry, often for inherited reasons, and dry skin does not shed its old cells cleanly. Those cells stay stuck around the opening instead of falling away. This is why moisturizing is half of the treatment and not an optional extra.
←2 / 5→
Those cells and the keratin in them pack into a firm plug that seals the follicle opening. Each plug is one of the bumps you can feel. This is the step that acids like urea, lactic acid and salicylic acid dissolve.
←3 / 5→
The hair that should have grown out of that follicle cannot get through the plug, so it curls up underneath it. That trapped hair is what a dermatologist looks for through a magnifier to confirm the diagnosis, and it is also why picking at a bump feels like there is something in there.
←4 / 5→
The blocked, stretched follicle and the skin right around it become mildly inflamed. That is the pink, red or darker ring around each bump, and it is the part that bothers people more than the roughness does. Scrubbing, picking and hot water all push on this step.
←5 / 5
Rosacea
The blood vessels in the middle of the face open when you are hot, embarrassed or eating something spicy. The immune system stays quiet, the vessels close again within minutes, and the color goes back to normal. Nothing stays visible.
1 / 5→
Sun, heat, spicy food, alcohol and stress reach skin that is already wired to overreact. Fair skin and a family history make that wiring more likely. The same warm room that does nothing to someone else starts the whole chain here.
←2 / 5→
The skin pours out too much of an alarm protein called cathelicidin, and breaks it down the wrong way. That switches inflammation on and keeps it on. This is the step most prescription creams are aimed at.
←3 / 5→
Inflammation makes the vessels open wider, and over years the skin grows more of them. That is the flushing, the redness that stops fading between flushes, and the fine visible threads across the cheeks and nose.
←4 / 5→
The redness stops going away, the skin burns and stings with products other people tolerate, and some people get red bumps and pus-filled spots on top of it. Almost everything on the lists below is pushing on one of these four steps.
←5 / 5
What it looks like
Keratosis Pilaris
Tiny bumps in a rough patch
Small skin-coloured, red or brown bumps packed evenly over a patch, one per follicle. There may be pink around them, but the bumps are the main event.
Rosacea
Redness across the centre of the face
Flushing that comes and goes at first, then a lasting pink or red over the cheeks, nose, chin and forehead. Fine visible blood vessels often appear in it.
Appearance
Keratosis Pilaris
Upper Arms
Small, firm bumps at hair openings across the backs of the upper arms, giving a permanent goosebump feel. Color ranges from skin-toned to red or brown. It is harmless and very common in teenagers.
1 / 3→
Thighs and Buttocks
The same rough bumps on the fronts of the thighs and the buttocks, often more noticeable in winter. Scrubbing hard irritates it without smoothing it. Gentle exfoliating ingredients work better than force.
←2 / 3→
Red Cheeks
Rough bumps with background redness on the cheeks, usually in children, which can be mistaken for acne or eczema. It often fades through the teenage years. Harsh acne treatments tend to inflame it.
←3 / 3
Across skin tones
Keratosis Pilaris
Keratosis pilaris on light skin
On light skin keratosis pilaris looks the way it is usually described: small rough bumps at each hair opening, most of them with a pink ring around them, on the backs of the upper arms and the thighs. The pink is what gets it mistaken for acne, an allergy or irritated dry skin. It is none of those. It is a plug of keratin sitting in the hair opening, it is harmless, and it often eases with age.
1 / 4→
Keratosis pilaris on medium skin
On medium skin there is less contrast to go by. The bumps read tan or light brown against a faintly pink background, so an arm looks a little uneven rather than red, and the roughness is often noticed through a sleeve before it is noticed in a mirror. It usually eases in summer and returns in winter, which is why people tend to credit whatever scrub they were using at the time. Texture is the more reliable check: run a hand over the skin.
←2 / 4→
Keratosis pilaris on brown skin
On deeper skin tones the bumps are often less obvious than the dots around them. Instead of a pink background, each follicle sits in a small brown or gray-brown spot, so the arm reads as speckled rather than red. Anyone looking for the redness in the textbook can miss it completely, and the roughness under a hand is the more reliable clue than anything visible.
←3 / 4→
Keratosis pilaris on deep skin
On deep skin what is left behind usually outlasts the bumps. Friction, scrubbing and picking leave flat dark marks that can take many months to fade, so scrubbing harder trades a bump that was temporary for a mark that lasts far longer. A gentle acid cream reaches the plug without the rubbing, and daily sunscreen on bare arms stops existing marks deepening. Where the marks are already the main complaint, treatment aims at them rather than at the texture.
←4 / 4
Rosacea
Rosacea on deeper skin tones
Rosacea happens in every skin tone, but the sign it is usually diagnosed from is redness, and on deeper skin tones the inflammation reads as dusky, violet, brown, or simply as an area that looks darker than the skin around it. Fine vessels are also much harder to see. The clues that stay reliable are warmth in the middle of the face, swelling, stinging with skincare or sun, and a history of the face heating up with hot drinks, spice, alcohol or exercise.
1 / 4→
Bumps without blackheads
When the redness is hard to see, the bumps are often the first thing noticed, and rosacea on deeper skin tones is commonly treated as acne for years. The check that settles it is the same one used on any skin tone: rosacea does not produce blackheads or whiteheads. Bumps and pus-filled spots on the central face with no comedones point to rosacea, not acne.
←2 / 4→
Granulomatous rosacea
A less common pattern of rosacea that is described more often on deeper skin tones. Instead of pus-filled spots it produces firm, dome-shaped brown or reddish-brown bumps, usually around the mouth and the eyes, on skin that may not look inflamed at all. It is easily mistaken for other bumpy conditions, and it is one of the reasons a biopsy is occasionally needed.
←3 / 4→
Marks left behind on deeper skin
Rosacea inflammation on deeper skin tones leaves flat dark patches where the bumps were, and they can take many months to fade. That is why calming the inflammation early matters more than treating the marks afterward, and why daily sunscreen is part of the plan. Laser and light treatment for vessels and redness is possible on deeper skin tones, but ask a practitioner how often they treat skin like yours and ask for a test patch.
←4 / 4
How it feels to touch
Keratosis Pilaris
Rough, like fine sandpaper
This is the single most useful difference. Close your eyes and run a finger over it and the texture is unmistakable.
Rosacea
Flushing, sometimes with bumps
Flushed rosacea skin feels normal, or sometimes tight and dry. Where there are pustules they are separate spots, not an even grain.
Size
Keratosis Pilaris
One to two millimetres
Each bump is about the size of a pinhead, and they are all much the same size.
Rosacea
Facial color changes, sometimes with bumps
Redness covers whole areas of the face. Any spots are pinhead to small-pea sized and scattered.
Does it itch or hurt
Keratosis Pilaris
Usually not
It can itch a little when the skin is dry, especially in winter. Most people notice how it feels rather than how it stings.
Rosacea
Stings and burns
Rosacea skin often stings with skincare, feels hot during a flush, and reacts to products other people tolerate. Eyes can feel gritty too.
Where it shows up
Keratosis Pilaris
Upper arms and thighs
Backs of the upper arms first, then the fronts of the thighs and the buttocks. In children and teenagers it also appears on the cheeks, which is where it gets confused with rosacea.
Rosacea
The middle of the face
Cheeks, nose, chin and centre of the forehead. It spares the skin around the eyes and the sides of the face.
Where it appears
Keratosis Pilaris
The backs of the upper arms
The classic site, and almost always both arms. The bumps sit at the opening of each hair follicle, which is why the skin feels like fine sandpaper or gooseflesh that does not settle. The buttocks are commonly involved too.
1 / 2→
Fronts of the thighs and the cheeks
The fronts of the thighs come next, and in children the cheeks, where it looks like a permanent rosy flush with a rough surface. It does not appear on the palms or soles, because there are no hair follicles there to plug.
←2 / 2
Rosacea
The middle of the face
Rosacea sits on the central face: the cheeks, the nose, the chin and the skin between the eyebrows. It usually leaves the sides of the face and the skin right around the eyes alone, and that sparing is one of the things that separates it from other facial rashes.
1 / 2→
The eyes, and less often the ears, neck and scalp
The eyes are involved in a large share of cases — gritty, dry, red lids — and that can start before anything shows on the skin. Less often it reaches the ears, the neck, the upper chest or the scalp.
←2 / 2
What sets it off
Keratosis Pilaris
Dry skin and cold weather
Worse in winter, better in summer. Nothing you eat or drink changes it.
Rosacea
Heat, sun, alcohol and spicy food
Also hot drinks, exercise, cold wind and stress. Triggers vary, and most people can name their own within a few weeks.
What it does over time
Keratosis Pilaris
Fades with age
It often starts in childhood, peaks in the teens, and settles down through the twenties and thirties. It is harmless throughout.
Rosacea
Persists and can worsen
Rosacea is a long-term condition. Flushing tends to become fixed redness over years, and untreated inflammation can thicken the skin of the nose in a small number of people.
Treatment
Keratosis Pilaris
Moisturise, then exfoliate gently
A thick moisturiser is the base. Add a cream with urea, lactic acid, glycolic acid or salicylic acid to loosen the plugs. It improves the texture while you use it, and returns when you stop.
Rosacea
Trigger control and prescription creams
Sunscreen and gentle cleansing come first. Metronidazole, azelaic acid or ivermectin cream treat the bumps. Brimonidine narrows vessels for a few hours, and laser or intense pulsed light treats fixed redness and visible vessels.
Keratosis Pilaris
Urea
The single most useful thing for keratosis pilaris, because it does both jobs at once: it holds water in the dry skin and it breaks down the keratin plug. Use 10 to 20 percent on the arms or thighs most days, on damp skin after a shower. It stings a little on cracked skin, and the bumps return within a few weeks of stopping.
1 / 15→
Lactic Acid
Ammonium lactate or lactic acid lotion at around 12 percent does the same two jobs as urea, slightly more gently, and it is often the easier one to keep using daily. Good first choice if urea stings. Like everything here, it manages the bumps rather than ending them.
←2 / 15→
Thick fragrance-free moisturizer
The half of the treatment people skip. Dry skin is step one of the whole process, so an acid cream without a moisturizer works far less well than the two together. Apply within a few minutes of a shower to trap the water in, twice a day, and choose fragrance-free — scent adds redness without adding moisture.
←3 / 15→
Salicylic Acid
Oil-soluble, so it gets down inside the follicle and works on the plug from within rather than at the surface. Useful when the bumps are the main complaint and urea has not been enough. It is drying, so it needs pairing with a moisturizer, and it is not the one to reach for on a child's cheeks.
←4 / 15→
Glycolic Acid
Loosens the dead cells stuck at the surface, which smooths the skin around the bumps. It is the most likely of the acids to sting and to leave the skin pink, so it suits the arms and thighs better than the cheeks. On deeper skin tones, build up slowly, because irritation is what leaves the dark marks.
←5 / 15→
Retinol
Changes how the follicle sheds its cells, so fewer plugs form in the first place. It is slower than the acids and more irritating, so it is usually a second step rather than a first one. Start two nights a week on one arm, and always put a moisturizer over it.
←6 / 15→
Coconut Oil
It moisturizes, and moisture genuinely softens the texture a little, so it is not useless. It cannot dissolve a keratin plug, so it will not clear the bumps, and the widely shared claim that it cures keratosis pilaris is not supported. If you like it, use it as the moisturizer over an acid cream rather than instead of one.
←7 / 15→
Body scrubs and loofahs
Friction cannot reach a plug sitting inside the follicle, so scrubbing removes surface skin without touching the cause. It adds redness, and on deeper skin tones it leaves dark marks that outlast the bumps by months. A soft washcloth used gently while washing is as far as this should go.
←8 / 15→
Pulsed Dye Laser (V-Beam)
Aimed at the redness rather than the texture, so it is for the variant where the background color bothers you more than the bumps. Several sessions are usually needed and the bumps themselves are left much as they were. On deeper skin tones it is less useful and carries more risk of pigment change, so it is not usually the first suggestion.
←9 / 15→
Laser Hair Removal
Removing the hair takes away the thing that gets trapped under the plug, and small studies show the bumps and roughness improve with it. It is expensive for a harmless condition, which is why it is rarely the first plan. It makes most sense for someone already having the area treated for hair.
←10 / 15→
Chemical Peel
A stronger version of the acid creams, applied in a clinic to the arms or cheeks. It can smooth the texture for a while, and the effect fades in the same way, so the daily cream is still needed afterwards. It is an add-on for people who want a faster start, not a replacement for the routine.
←11 / 15→
Microdermabrasion
Sanding the surface has the same problem as a body scrub: the plug sits inside the follicle, below where it reaches. Any smoothness is short-lived, and it adds redness. On deeper skin tones the irritation can leave dark marks, so it is one to skip.
←12 / 15→
Tretinoin
The prescription version of the retinoid idea: it normalizes how the follicle sheds, so plugs form more slowly. It is used when over-the-counter acids have not been enough after six weeks. It is drying and irritating on arms and thighs, so it is introduced two or three nights a week, and it makes the skin more sun-sensitive.
←13 / 15→
Tazarotene
A stronger retinoid cream, occasionally used on stubborn arms when tretinoin has not worked. It is more effective on the plugs and also more irritating, which is the trade-off. It is not used in pregnancy — ask your doctor before starting it if that applies to you.
←14 / 15→
Hydrocortisone
A mild steroid cream used in short courses when the red halo around the bumps is the main complaint, not the roughness. It calms the inflammation for a while and does nothing to the plugs. It is not a long-term answer, because weeks of steroid on thin skin like the cheeks causes its own problems.
←15 / 15
Rosacea
Azelaic Acid
The one over-the-counter active with real evidence behind it in rosacea. At 10 percent it reduces the bumps and some of the redness, and it is better tolerated by reactive skin than acids or retinoids. Start every other night over moisturizer. The 15 percent prescription gel works better if this is not enough.
1 / 22→
Niacinamide
A mild anti-inflammatory that also helps the barrier hold water, which is the part of rosacea it is most useful for. Some people find it takes the edge off redness and stinging. It will not clear bumps and it does nothing for visible vessels, so treat it as support rather than treatment.
←2 / 22→
Green Tea Extract
Sold widely for facial redness on the strength of small studies. It is soothing, it is unlikely to irritate, and some people like how their skin feels on it. There is no good evidence it changes flushing, bumps or visible vessels, so do not let it delay a prescription that would.
←3 / 22→
Warm compresses for the eyes
For ocular rosacea: a warm compress held over closed lids for several minutes, then gentle cleaning along the lash line, done daily. It unblocks the oil glands in the lid margin, which is where the grittiness and the repeated styes come from. It is unglamorous and it has to be kept up, but it is the single most useful thing for the eye side of rosacea.
←4 / 22→
Scrubs, brushes and strong acids
Included because so many people arrive already doing it. Rosacea skin has a damaged barrier, and scrubbing, brushing or layering acids strips it further, which increases redness and stinging. This is not a treatment that works slowly — it makes rosacea worse. Almost everyone improves when the routine gets gentler instead of stronger.
←5 / 22→
Pulsed Dye Laser (V-Beam)
The treatment of choice for visible thread veins and settled background redness — the parts of rosacea that creams and tablets do not touch. It targets the blood in the vessel and closes it. Expect a course of about three sessions rather than one, expect bruising for a few days at stronger settings, and expect occasional top-ups, because rosacea carries on making new vessels.
←6 / 22→
IPL (Intense Pulsed Light)
Light rather than laser, and about as effective as pulsed dye laser for diffuse redness across the cheeks, with less bruising. It is often the better choice when the problem is a general flush rather than a few distinct threads. It needs an experienced practitioner and a test patch on deeper skin tones, because the wrong settings can cause lasting pigment change.
←7 / 22→
Nd:YAG Laser
A longer wavelength that reaches deeper, larger vessels — the thicker blue-red threads beside the nose that pulsed dye laser sometimes leaves behind. It is also the device more often chosen for deeper skin tones, because it passes over surface pigment more safely. It is less useful for general background redness.
←8 / 22→
Fractional CO2 Laser
Used to reshape a nose that has thickened, by removing the excess tissue layer by layer. This is the answer for rhinophyma, since creams and tablets do not reverse it. It is a real procedure with real downtime of a couple of weeks, and results are strongly dependent on who does it.
←9 / 22→
LED Light Therapy
Asked about constantly, usually as a home device. Red and near-infrared light is mildly anti-inflammatory and it is very unlikely to do harm. There is no good evidence it clears rosacea bumps or removes vessels, so it is a pleasant addition rather than a substitute for the treatments that do.
←10 / 22→
Botox (Botulinum Toxin)
Very small amounts injected into the surface of the skin, not the muscle, to reduce flushing and background redness. Early studies are encouraging and dermatologists do use it for stubborn flushing. It is off-label for rosacea, it is not usually covered, and it wears off in a few months.
←11 / 22→
Low-dose Doxycycline
A 40 mg dose taken once a day, deliberately too low to act as an antibiotic — it is used purely for its anti-inflammatory effect, which means it does not drive antibiotic resistance. This is the usual next step for moderate to severe bumps when creams alone are not holding them, and it also helps ocular rosacea. It is normally stepped down to a cream once things settle.
←12 / 22→
Minocycline
An alternative tablet for the bumps when doxycycline does not suit or has not worked. It is used at full antibiotic doses, so it is generally kept for shorter courses. It can cause dizziness, and rarely a blue-gray discoloration of the skin with long use, so it is not the first tablet reached for.
←13 / 22→
Accutane at a low dose
Low-dose isotretinoin under specialist care, for severe bumps that tablets and creams have not controlled, or for early skin thickening. It works well, and it is not a cure — rosacea usually returns after the course. It requires strict pregnancy prevention and monitoring, so it is a considered decision rather than a routine step.
←14 / 22→
Beta blockers for flushing
Low doses of propranolol or carvedilol are sometimes tried when flushing is the dominant problem and nothing else has touched it. The evidence is small studies rather than trials, and they lower blood pressure and slow the heart, so they do not suit everyone. Worth asking about only after triggers, laser and light have been addressed.
←15 / 22→
Ivermectin Cream (Soolantra)
Often the best single treatment for the bumps and pus-filled spots, because it works on the Demodex mites and on the inflammation at the same time. Once a night, a pea-sized amount for the whole face. It usually beats metronidazole head to head, and it does nothing at all for flushing or visible vessels.
←16 / 22→
Azelaic Acid 15% (Finacea)
A prescription-strength gel or foam for the bumps, and one of the better options if your skin is too reactive for other creams. It also helps the marks rosacea leaves behind on deeper skin tones. Expect stinging for the first week or two, which usually settles if you apply it over moisturizer.
←17 / 22→
Metronidazole (MetroGel)
The longest-established prescription cream for rosacea bumps, used once or twice a day, and generally very well tolerated. It is a reasonable first choice and a common maintenance treatment once things are controlled. Newer options often work a little better, and none of them touch the redness itself.
←18 / 22→
Minocycline foam
An antibiotic put on the skin rather than swallowed, for the bumps. It suits people who would rather not take tablets, or who cannot. It is newer and usually more expensive than the older creams, and like them it does nothing for flushing or vessels.
←19 / 22→
Brimonidine (Mirvaso)
A gel that narrows facial vessels and takes the redness down for several hours at a time. It treats nothing — it borrows time, and everything comes back when it wears off. Some people get rebound redness worse than they started with, so test a small area before you use it on the whole face and before any event that matters.
←20 / 22→
Oxymetazoline (Rhofade)
The same idea as brimonidine, using a different vessel-narrowing drug, applied once each morning. Rebound redness is reported less often with it, which is why some people move across after a poor experience. It still only lasts the day, and it does not stop rosacea progressing.
←21 / 22→
Steroid creams
A steroid cream calms rosacea for a few days, then makes it worse. The redness and bumps come back stronger when you stop, so it is easy to keep reapplying and end up in a cycle. Used for weeks, steroids on the face thin the skin, bring out visible vessels and can cause a rosacea-like rash of their own. If one has been prescribed for your face, ask about coming off it rather than stopping suddenly.
←22 / 22
Cost
Keratosis Pilaris
Low
Drugstore moisturisers and acid creams, no prescription needed.
Rosacea
Low to moderate
Prescription creams are inexpensive. Laser and light treatment is a course of clinic visits and is usually cosmetic.
Touch tells you more than sight
Keratosis Pilaris
The rough texture is a useful clue to keratosis pilaris. The surface has an even grain to it, because every follicle in the patch is plugged. It feels like the back of a nail file or the skin of a plucked chicken.
Rosacea
Rosacea can have a smooth or bumpy surface. Some people have mainly flushing and visible vessels; others develop bumps and pustules. Compare the full pattern rather than relying on touch alone.
Why cheeks cause the confusion
Keratosis Pilaris
Keratosis pilaris on the cheeks is common in children and young adults. It makes red, slightly rough cheeks that look permanently windburnt. That looks like early rosacea in a photograph, and it is often treated as rosacea for months before someone touches it.
Rosacea
Rosacea is uncommon before the late twenties. It usually starts between 30 and 50. A red-cheeked eight-year-old almost never has rosacea, and very often has keratosis pilaris.
What each treatment does, and does not do
Keratosis Pilaris
Keratosis pilaris improves with moisture and gentle chemical exfoliation. Urea and lactic acid soften the plugs so the follicle can clear. Scrubbing harder only makes the skin redder. It does not make it smoother. And the bumps come back within weeks of stopping.
Rosacea
Rosacea improves with trigger control and prescription creams. Nothing on a drugstore shelf reduces the redness for long. Sunscreen does the most work of anything, because sun is the most common trigger.
Related topic illustrations
Keratosis Pilaris
Acne
Both start with a blocked follicle, which is why the mix-up is so common on the cheeks and upper back. Keratosis pilaris bumps are small, all the same size, dry to the touch, painless and spread evenly over both arms or both thighs. Acne has blackheads and whiteheads, spots of different sizes, some tender or filled with pus, and it is rarely so symmetrical. Acne treatments do very little for keratosis pilaris.
1 / 2→
Fungal Acne (Malassezia Folliculitis)
This one is confused with keratosis pilaris on the upper back, chest and shoulders, because both are small, even, same-sized bumps at the follicles. Fungal acne itches, which keratosis pilaris usually does not, the bumps have small heads on them, it flares with heat and sweat rather than with winter, and it clears with antifungal treatment. Keratosis pilaris on the back is dry, quiet and constant.
←2 / 2
Rosacea
Acne
This is the mix-up that costs people the most time. Both produce red bumps and pus-filled spots on the face, and plenty of people arrive certain they have adult acne. The difference that settles it is blackheads and whiteheads: acne has them, rosacea does not. Acne also spreads to the forehead, jawline, back and chest, while rosacea stays on the middle of the face and comes with flushing and stinging.
1 / 3→
Seborrheic Dermatitis
Both make the middle of the face red, and the two often sit on the same face at once. Seborrheic dermatitis adds greasy yellowish scale and sits in the folds beside the nose, in the eyebrows and behind the ears, and it usually itches. Rosacea is smoother, has no scale, comes with flushing and bumps, and stings rather than itches. Treating one and not the other is a common reason a face only half improves.
←2 / 3→
Perioral Dermatitis
Both give small red bumps on a red background on the lower face, and both get worse with steroid creams. Perioral dermatitis rings the mouth, the nostrils or the eyes, and it characteristically leaves a clear rim of untouched skin right at the lip border. Rosacea covers the cheeks and nose, spares the skin around the mouth, and brings flushing and visible vessels with it.
←3 / 3
Further reading
Common questions
Questions Patients Ask
How do I tell keratosis pilaris from rosacea on the cheeks?
Touch it. Keratosis pilaris feels rough, like fine sandpaper, because every hair follicle in the patch is plugged. Rosacea can cause flushing with or without bumps and pustules. Also check the backs of the upper arms, where keratosis pilaris almost always shows up too.
Can a child have rosacea?
It is rare. Rosacea usually starts between 30 and 50. Red, rough cheeks in a child or teenager are far more often keratosis pilaris.
Can you have both at once?
Yes. Keratosis pilaris on the arms and rosacea on the face can occur in the same person, and each is treated separately.
Does keratosis pilaris go away?
It usually fades through the twenties and thirties. Creams with urea, lactic acid or salicylic acid smooth it while you use them, but the bumps come back when you stop.
Will exfoliating my cheeks help red bumpy skin?
Only if the bumps are keratosis pilaris, and even then gently. Acid creams and scrubs on rosacea skin usually cause stinging and more redness.
What is the single most useful sign?
A field of rough follicular bumps favors keratosis pilaris; flushing and visible vessels favor rosacea. Neither clue confirms a diagnosis by itself.