Distinguishing Seborrheic Dermatitis vs Rosacea: Causes, Symptoms and Treatment

The Relationship Between Seborrheic Dermatitis and Rosacea

Seborrheic dermatitis and rosacea are two common chronic skin conditions that share some similar signs and symptoms. But they have important distinctions in their causes, affected areas, and ideal treatments.

Defining Seborrheic Dermatitis

Seborrheic dermatitis causes red, flaky, greasy patches on areas of the body with oil-producing sebaceous glands like the scalp, face, upper back and chest. Dandruff is a mild form of seborrheic dermatitis limited to the scalp. More severe seborrheic dermatitis results from a reaction to malassezia yeast naturally found on skin.

Defining Rosacea

Rosacea is an inflammatory disorder resulting in facial redness, spider veins, acne-like breakouts, and irritation. It often begins as flushing or blushing that gradually becomes persistent redness. The exact cause is unknown but abnormal immune reactions, genetics, and microorganisms may play a role.

Shared Characteristics

Despite different underlying mechanisms, seborrheic dermatitis and rosacea share some similar outward characteristics, including:

• Redness and flushing of facial skin
• Itching, stinging, or burning sensations
• Plaques and papules resembling acne
• Dry, scaly, flaky skin

The facial redness and rashes in both conditions can appear quite similar at first glance. However, careful evaluation of the distinctive features provides clues to differentiate seborrheic dermatitis from rosacea.

Key Differences Between Seborrheic Dermatitis and Rosacea

While seborrheic dermatitis and rosacea share some general symptoms, understanding the unique characteristics of each condition is key to making an accurate diagnosis:

Location of Skin Involvement

Seborrheic dermatitis can affect oily areas anywhere on the body, but is most common on the scalp, face, chest, and upper back. Rosacea is restricted to the face and especially affects the cheeks, nose, chin, and central forehead.

Appearance of Redness

Seborrheic dermatitis causes red, greasy patches with overlying yellowish scales or crusts. Rosacea reddness is more diffuse, wide-spread, and lacks greasy scales.

Skin Texture

With seborrheic dermatitis, the skin feels oily and looks shiny. Rosacea skin feels dry and looks rough or bumpy like sandpaper.

Flare Triggers

Seborrheic dermatitis flares in response to oil, yeast, and skin fungi. Rosacea outbreaks are often triggered by heat, sun exposure, spicy foods, alcohol, and emotional stress.

Eye Involvement

Seborrheic dermatitis can cause red, greasy eyelid margins. Rosacea frequently involves inflammation of the eyes and eyelids.

Course of Disease

Seborrheic dermatitis comes and goes with periodic flares. Rosacea is chronic with gradual worsening over time if untreated.

Treating Seborrheic Dermatitis vs. Rosacea

Since the underlying causes of seborrheic dermatitis and rosacea differ, management focuses on specific therapies tailored to each disease.

Seborrheic Dermatitis Treatment

Antifungal shampoos, cleansers, and creams reduce yeast overgrowth and inflammation in seborrheic dermatitis. Top agents include:

• Ketoconazole
• Pyrithione zinc
• Selenium sulfide
• Coal tar

For severe seborrheic dermatitis, topical steroids like hydrocortisone help decrease inflammation and itching. Your dermatologist may also prescribe oral antifungals.

Rosacea Treatment

Treatment for rosacea aims to control symptoms and avoid triggers. Oral and topical antibiotics reduce inflammation along with creams like:

• Metronidazole
• Azelaic acid
• Ivermectin

Laser therapy, photodynamic therapy, and isotretinoin may be used for severe, resistant rosacea. Avoiding personal triggers is key to prevent recurrent flares.

Causes and Risk Factors

The primary drivers behind seborrheic dermatitis vs. rosacea offer helpful clues about which condition is present:

Causes of Seborrheic Dermatitis

Seborrheic dermatitis results from an inflammatory reaction to a common skin yeast, malassezia. An overgrowth of this yeast on oily areas leads to red, flaky, itchy skin.

Causes of Rosacea

Doctors dont know the exact causes of rosacea, but contributing factors may include:

• Blood vessel abnormalities
• Environmental triggers
• Demodex mites
• Neurovascular signaling problems
• Reactive immune system

Genetic predisposition also increases rosacea risk. It often runs in families.

Risk Factors

Seborrheic dermatitis and rosacea share some similar risk factors, like fair skin, while others are unique:

• Oily skin - Predisposes to seborrheic dermatitis
• Middle age - More common for both conditions
• Family history - Risk factor for rosacea
• Emotional stress - Triggers rosacea flares
• Immune disorders - Increase risk of both

Male sex, northern European descent, and a personal or family history of rosacea raise your risk. Seborrheic dermatitis is tied to oily skin, infrequent shampooing, obesity, and Parkinson's disease.

Diagnosis

Distinguishing seborrheic dermatitis from rosacea begins with an evaluation of clinical presentation and medical history by a dermatologist. Diagnostic techniques may include:

• Physical exam of skin
• Review of symptoms
• Looking for mites, yeast, and bacteria
• Assessing reaction to treatment

There are no definitive laboratory tests for rosacea or seborrheic dermatitis. Skin biopsy is not usually required. Paying attention to unique signs and response to therapy confirms the diagnosis.

Seborrheic Dermatitis Diagnosis

Doctors diagnose seborrheic dermatitis by inspecting for characteristic red, greasy, scaly patches on classic areas like the scalp, eyebrows, nose, and chest. Dandruff is sufficient for scalp seborrheic dermatitis.

Rosacea Diagnosis

To diagnose rosacea, dermatologists look for persistent central facial redness, blushing, telangiectasia, ocular symptoms, and intermittent papules or pustules. There are four rosacea subtypes with unique features.

Seborrheic Dermatitis vs. Rosacea Pictures

Visual images of seborrheic dermatitis and rosacea help demonstrate the varied presentation of each condition:

Seborrheic Dermatitis

• Scaly red patches and crusts on scalp, face, chest
• Yellow, waxy scale on eyelids and eyebrows
• Dandruff flakes covering scalp
• Plaque-like lesions on upper back

Rosacea

• Diffuse facial erythema and prominent blood vessels
• Bumpy texture resembling rhinophyma on nose
• Watery, irritated eyes
• Acne-like breakouts on cheeks and chin

Images showing the diversity of presentation help differentiate seborrheic dermatitis vs. rosacea for accurate diagnosis and treatment.

Lifestyle Changes and Home Care

While medical treatment is necessary for seborrheic dermatitis and rosacea, certain lifestyle measures can help control symptoms:

Seborrheic Dermatitis Lifestyle Tips

• Use anti-dandruff shampoo daily
• Avoid oil-based hair and skin products
• Shampoo cleaning pillowcases and hair accessories
• Keep skin clean and dry
• Get sunlight exposure
• Decrease stress

Rosacea Lifestyle Changes

• Use gentle skin cleansers
• Wear sunscreen daily
• Identify and avoid triggers
• Use green-tinted makeup
• Avoid extreme temperatures
• Manage stress

While not definitive treatments, these self-care tips can improve the signs and symptoms of both seborrheic dermatitis and rosacea.

The Takeaway

Seborrheic dermatitis and rosacea cause considerable facial redness and skin lesions that can appear similar at first glance. But important differences in location, triggers, scale, and texture provide clues to distinguishing these conditions.

Seborrheic dermatitis results from fungal overgrowth, while rosacea stems from blood vessel and immune system abnormalities. Each requires specific therapies to reduce symptoms and prevent progression. With proper diagnosis and management, both seborrheic dermatitis and rosacea can be controlled.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.