Lindsey Emery, 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?
College may be good for the mind, but it can be tough on your skin. Maxine Hillman, a 21-year-old junior, can attest to this. She had struggled with acne since the fourth grade, but with the help of a dermatologist, she finally got it under control in her teens. That is, until her first year at the University of California, San Diego. Pizza, breadsticks, and ice cream, a heavy course load as a linguistics and Latin double major, and a shift in sleep patterns ("I was napping more than I did in preschool")...
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 broad-spectrum SPF every day.
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.
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