Rosacea vs. Eczema: What are the Differences?

Imagine spending a lot on treating a skin condition that you later realize was the wrong diagnosis. Knowing the correct skin problem can save a lot of money in terms of skin care products and time. Here is a detailed review of rosacea vs eczema in terms of symptoms, causes, triggers, and treatments. 

Causes

Though incurable rosacea occurs when there are defects of the blood vessels causing their over dilation this results in the formation of tiny spider veins on the affected area.

The defects result from UV light that can cause the dilation of blood vessels as well as destroy elastin tissue in the process. This leaves the skin very red.

The presence of peptides which are molecules produced from the consumption of alcoholic beverages, spicy foods, excess temperatures and stress.

Eczema is caused by a gene mutation of filaggrin which interferes with the skin’s ability to retain moisture and guard the skin. It also occurs when the body immune system overreacts to an irritating substance.

Location

Rosacea is particular in its appearance and can be spotted on forehead and cheeks. In some cases, however, it may appear on ears, neck, back, and chest.

Eczema may affect the feet, legs, hands, and arms. 

Appearance

Eczema exhibits itself as red or brown patches that appear on the skin. In severe state liquid filled lesions may appear which often bleed.

Rosacea, on the other hand, makes the affected area appear very red. This is mostly due to the damage to the blood vessels which makes the face have tiny veins.  The pustules are small, pus-filled but don’t ooze.

Age

Eczema is usually experienced in children aged 5 years but it may extend to adulthood.

On the other hand, rosacea is usually experienced in adulthood with persons over 30 years.

Dryness

In eczema, the affected skin area is very dry making it flaky and extremely itchy.

Rosacea – the skin exhibits mild dryness due to a disruption of the oil glands

Genetics and hormones

Rosacea tends to affect more men as compared to women. It is also experienced in fair-skinned persons as they tend to blush more than dark skinned.

Inflammation

The affected skin area in rosacea patients usually appears more inflamed due to the inflamed blood vessels.

Eczema patients may exhibit some form of inflammation but it is usually as a result of excessive itching and scratching of the skin

Itchiness

The overreaction of the skin to an irritant makes eczema very itchy as compared to rosacea.

Symptoms

Rosacea

1. Oil cells surrounding the eyelids may increase in size due to dilated blood vessels. The eyelids swell and become engorged a condition known as blepharitis.
2. Ocular rosacea which leads to eye dryness making the eyes sting and burn.
3. Rhinophyma (enlarged red nose) due to enlargement of oil glands causing tissue build up
4. Telangiectasia which mostly affects the face such as nose, eyes, and cheeks creating web-like patterns on the area. The sudden expansion of the tiny blood vessels creates a thread like patterns.

Eczema

1. Excessive itching and scratching
2. Appearance of red fluid-filled bumps
3. Cracked skin which may at times swell.
4. Sleep deprivation and puffy eyelids

Triggers

Rosacea

A change in temperatures including extreme cold or heat causes a dilation of the blood vessels. This is because the body is forced to generate more heat or try to cool itself.

Stress, alcohol, Demodex mites, smoking, spicy foods and presence of Helicobacter Pylori causing stomach ulcers. This ulcer also releases bradykinin a protein that has an effect on blood vessel dilation. Exercise, cosmetics, and medication that contain steroids have also been known to cause blood vessel dilation.

Eczema

It is triggered by very dry skin; the lack of moisture makes the skin susceptible to eczema breakout. The presence of neomycin, bacitracin, and isothiazolinones found in most antibacterial ointments has also been linked to eczema. Harsh soaps and detergents that contain formaldehyde and Cocamidopropyl betaine trigger eczema. Temperature changes, bacterial infections, hormonal imbalance and stress also induce occurrence of eczema.

Subtypes

Rosacea

1. Phymatous rosacea: Also referred to as Rhinophyma it occurs due to excess tissue growth. When sebaceous glands around the nose become enlarged they cause damage to surrounding tissue. The skin thus becomes bumpy and thick.
2. Ocular rosacea: Oil glands surrounding the eyelids help to prevent eye dryness. However, a blockage of these glands may occur due to bacteria, mites present in hair follicles, genes and blood vessel dilation. These results in swollen and itchy eyelids, watery discharge from the eye, bloodshot appearance, burn or sung eyes and a gritty sensation like a foreign body is present. This condition can lead to a high sensitivity to light affecting vision.
3. Papulopustular rosacea: The blockage and subsequent inflammation of the sweat glands and hair follicles leads to this type of rosacea. Experienced mostly by women average 45 years, papules and pustules are present on the skin. The skin experiences redness and swelling and can lead to dry, thick skin. It is very common among fair-skinned individuals and
4. Erythematotelangiectatic rosacea. Occurs due to excessive dilation of the blood vessels leading to red, flush skin with visible blood vessels.

Eczema

1. Contact dermatitis – is experienced when one comes in direct contact with a chemical, latex, nickel or plants and fruits which contain urushiol. It leads to dry, itchy skin that may swell and most often be very sensitive to the sun rays.
2. Stasis dermatitis. Vein problems affect blood circulation on the lower legs and can trigger the occurrence of this type of eczema. The lower legs are usually hardest hit due to the existence of one way valve passage. The pressure build-up may cause fluid leakage resulting in swelling, redness, oozing and itchy pain. It is likely to affect more women than men in their fifties. This is especially due to blood clots, kidney and heart failures, varicose veins and high blood pressure associated with many pregnancies. It initially occurs as ankle swelling.
3. Dyshidrotic eczema. This type of eczema is experienced post-teenage through to adulthood. It occurs due to an allergic reaction to nickel, pollen, cobalt, chromium salts, excessive moisture, and stress. It creates itchy blisters on the feet, toes, and palms. Once the blisters dry up they cause skin cracks. It affects more women than men.
4. Atopic dermatitis– occurs due to an allergic reaction to pollens, chemicals or harsh detergents. This overreaction emanates from the lack of enough filaggrin, a protein that helps to protect the outer layer of skin. This allows the entry of bacteria and loss of moisture leading to the very dry skin.
5. Neurodermatitis. Triggered by stress and anxiety, this form of eczema causes chronic scratching and itching. Affecting more women than men it is usually caused by insect bites and skin irritation from clothes. The skin becomes excessively dry and scaly.
6. Nummular eczema. Prominent in males than females in their fifties. It exists as coin-shaped spots that can be fluid filled on legs, torso, and arms.It results from post-injury or burn and is triggered by chemical irritants, stress, temperature shifts, and dry skin
7. Seborrheic dermatitis. This type mostly targets the oil secretion glands of the body including the scalp area eyelids, ears, eyebrows and sides of the nose. It targets infants under three months and adults over 30 years. Caused by Malassezia fungal infection and immune system problem it creates very red, itchy skin with a lot of dandruff.

Treatment

Eczema

• Over the counter medications that help to moisturize the skin while preventing infections. Such medications contain steroids which help to prevent rash.
• Patients should also take frequent lukewarm baths mixed with oatmeal, vinegar or baking soda to rid of infections and moisturize.
• Consumption of fruits rich in Vitamin D that help to prevent itching and inflammation.
• The consumption of turmeric rich in curcumin compound provides the skin with antioxidant compounds and improves wound healing.
• Recipe: Apply some vegetable shortening on the affected area and wrapping with a plastic wrap for four hours to moisturize the skin.
• Recipe2: Grind some flax seeds and add to oatmeal, smoothies, and salads for omega 3 fatty acids. These acids help to block arachidonic acid associated with causing inflammation.

Rosacea

• Consumption of anti-inflammatory diets that contain anti-inflammatory, vitamins and anti-oxidant compounds. This includes garlic, ginger, onions, and turmeric
• Use of sunscreen to prevent UV ray damage or consumption of foods rich in carotenoids.
• Consumption and use of healthy fats such as coconut, olive, avocados that help fight inflammation.