Eczema vs. Acne: What’s the Difference?

Some of the symptoms of acne and eczema can often look similar, which is why many people confuse the two conditions. That said, these conditions are unrelated, and require very different treatments. Let’s dive into everything you need to know about the similarities and differences of eczema vs. acne, and how to treat and manage both conditions. 

What is Eczema?

Eczema refers to a group of conditions where the skin barrier isn’t able to effectively retain moisture, leading to extreme dryness and inflammation. It can affect the body and the face, although babies and young children are more likely to experience symptoms of eczema on the face. 

Allergens or environmental irritants can trigger eczema flare-ups by activating the immune system, which leads to inflammation. Those with a family history of asthma, allergies, and/or the condition itself are more likely to experience it. 

Eczema symptoms can vary from person to person, but the most common symptoms include itchiness and dry, cracked skin. Those battling eczema may also experience swelling, soreness, rashes, and/or eczema “pimples” (raised bumps that may bleed or ooze when picked at). 

There are seven different types of eczema: 

  • Atopic Dermatitis: The most common form of eczema, which leads to dryness and itchiness. It most frequently occurs in very young children (although anyone can experience atopic dermatitis at any age). 
  • Discoid Eczema/Neurodermatitis: This chronic form of eczema involves scaliness and itchiness in small circular or oval patches of skin. It typically doesn’t affect the face or scalp.
  • Contact Dermatitis: This form specifically refers to eczema triggered by external aggressors, such as jewelry, fragrances, plants, or airborne allergens. Symptoms vary widely, but can include itchiness, dryness, bumps, blisters, swelling, and/or burning.  
  • Seborrheic Dermatitis: Also known as dandruff, this inflammatory form of eczema affects the scalp, leading to red, scaly patches. 
  • Dyshidrotic Eczema: With this type of eczema, the skin is left with rashes and blisters, and may have a burning sensation. Symptoms typically form around the palms of the hands, soles of the feet, and fingers and toes. 
  • Nummular Eczema/Nummular Dermatitis: This form of eczema creates small rounded lesions, particularly on the arms and legs. 
  • Stasis Dermatitis: This form affects people with poor blood flow. It leads to discoloration in the skin, most often on the legs. 

What is Acne?

Unlike forms of eczema like atopic dermatitis, acne is not triggered by an immune system response. Rather, it’s a condition where the hair follicles become clogged with sebum (your skin’s natural oil), dead skin cells, and other debris, which leads to blemishes. Those with oily skin are typically more prone to acne, since there is an excess of oil that can clog the pores. 

Hormonal fluctuations, genetics, certain medications, diet, and stress can all play a role in breakouts. While acne is very common among teenagers, it can affect anyone at any age. It can also happen anywhere on the body, but most often appears on the face, chest, shoulders, and upper back. 

There are multiple forms of acne, including the following:

  • Blackheads: Blackheads (also known as open comedones) are open clogged pores that look black or gray on the surface. 
  • Whiteheads: Whiteheads (also known as closed comedones) are closed clogged pores that have a white bump. 
  • Papules: Papules are characterized by small inflamed bumps that are red or pink and tender. 
  • Pimples/Pustules: Pimples (also known as pustules) are pus-filled papules that are white or yellow at the tip, and red or pink at the base. 
  • Nodules: Nodules are painful large solid bumps that are deep under the skin. 
  • Cystic Acne: Cystic acne refers to painful lumps deep under the skin that are filled with pus. 

How to Tell the Difference Between Acne and Eczema

If you’re unsure whether you’re dealing with eczema or acne (or both), the best thing you can do is meet with a dermatologist who can give you a proper diagnosis. That said, there are a few key signs you can look for to help you narrow down your condition at home. 

Both of these conditions can lead to inflammation, redness, and bumps, which is why it can be difficult to distinguish the two. With eczema, however, these symptoms can often be accompanied with super dry patches of skin, as well as itchiness. Acne, on the other hand, typically emerges in oilier areas of the skin. You also shouldn’t experience any itchiness with acne. 

Perioral Dermatitis vs. Acne

Another condition worth highlighting is perioral dermatitis. Despite the name, perioral dermatitis isn’t a form of eczema. However, it has some similar symptoms, and likewise can often be confused with acne. 

With perioral dermatitis, a rash will occur, most often around the mouth. This rash is typically made up of small red bumps that look like acne, and most often there will be dry and flaky skin. It can also be accompanied by itchiness and/or a burning sensation. 

While the cause of perioral dermatitis isn’t completely clear, it may be caused by an external aggressor, such as toothpaste. Overuse of a corticosteroid treatment can also trigger this condition. 

The biggest difference between acne and perioral dermatitis is that the latter is often joined by dry and flaky skin, as well as itchiness. If you’re unsure which condition you’re dealing with, a dermatologist will be able to help diagnose your situation.  

Eczema vs. Acne Photos

Here are a few examples of real cases of eczema and acne. Keep in mind that both of these conditions can present differently, especially considering there are many different forms of acne and eczema. This is just a sample of how they may visually manifest on the skin. 

Here are some examples of eczema:

Photo 1 Image Credit/Photo 2 Image Credit/Photo 3 Image Credit

Here are some examples of acne:

Photo 1 Image Credit/Photo 2 Image Credit/Photo 3 Image Credit

Can You Have Acne and Eczema at the Same Time?

It is possible to have both acne and eczema at the same time, although it isn’t super common. That said, if you do experience both at once, they usually won’t appear in the same areas – particularly since acne thrives in oilier spots, whereas eczema thrives in drier areas. For example, if you had both acne and eczema on the face, the breakouts would more likely appear on the T-zone (where the skin is oilier), while eczema symptoms would develop on the drier cheeks. 

How To Treat Eczema & Acne

Acne and eczema require very different treatments. Here’s a look into how to treat and manage each condition. 

Eczema Treatments

There currently isn’t a cure for eczema, so treatment revolves around managing symptoms when flare ups occur, and doing what you can to avoid flare ups in the first place. A gentle, unscented moisturizer should help seal in moisture to tackle dryness and minimize symptoms (be sure to regularly moisturize even when not dealing with flare ups, as well).

A non-prescription hydrocortisone cream or a calamine lotion can be used to relieve the itchiness, while natural solutions like aloe vera and colloidal oatmeal may also provide some relief from inflammation. In more severe cases, a doctor may prescribe a prescription topical treatment (corticosteroids or a non-steroid option), and/or an antihistamine. 

Additionally, there are certain ingredients that can be responsible for eczema flare ups, so it’s best to do what you can to avoid skincare and grooming products with these ingredients. This includes fragrances, dyes, and detergents (but specific triggers will differ from person to person). 

For more severe cases of seborrheic dermatitis (dandruff), there are medicated shampoos and ointments that have antifungal or inflammation-controlling properties. There are also antifungal oral medications that may help. However, some may also be able to control symptoms using more natural solutions like MCT oil, aloe vera, or apple cider vinegar. 

Acne Treatments

There are many over-the-counter topical treatments that can be used to help treat and prevent breakouts. Retinoids (like Differin) are effective, as they speed up skin cell turnover and unblock pores. They’re also ideal for those with post-inflammatory hyperpigmentation (dark marks caused by previous blemishes), as they can help improve the appearance of discoloration. 

Salicylic acid (which is a beta hydroxy acid) is also a great option. This chemical exfoliant is oil-soluble, and works to unclog debris in the pores. Another popular ingredient is benzoyl peroxide, which kills acne-causing bacteria and gets rid of dead skin cells and excess oil. Both of these ingredients can be found in topical treatments, as well as face cleansers (although you’ll see the most dramatic results with leave-on treatments).  

When used in combination with a solid foundational skincare routine, all of these treatments can be particularly helpful for those with mild to moderate acne. 

For more persistent cases, a dermatologist may recommend stronger topical treatments, such as prescription-strength retinoids, azelaic acid, or dapsone. In some cases, they may also prescribe an oral antibiotic to stop the growth of acne-causing bacteria and reduce inflammation. Oral isotretinoin (also known as Accutane) is also an effective (although intense) solution for preventing acne. A treatment will typically last around four to five months, although your dermatologist will determine the best treatment length for your specific needs. 

For girls or women dealing with hormonal breakouts, a dermatologist may also recommend oral contraceptives or spironolactone. These treatments help balance hormones to keep hormonal acne at bay. 

Can Eczema and Acne Be Treated Together?

If you do find yourself battling both eczema and acne, you have to take a thoughtful approach to your skincare routine. It’s best to avoid benzoyl peroxide or other harsh treatments with high concentrations of ingredients that may irritate or dry out the skin. While these may help with breakouts, there’s also a risk that they’ll trigger eczema flare ups.  

So can you use acne-fighting ingredients like retinol or salicylic acid for eczema? While these types of ingredients aren’t used to treat eczema, you can still use them in your routine to help control acne – you just need to make sure you’re using the right formulas. 

Pick out products with lower concentrations of salicylic acid or retinol to get the benefits while minimizing the risk of irritation and triggering eczema episodes. Retinol products specifically made for sensitive skin are great options. Work these solutions into your routine gradually to allow your skin to adjust and to monitor how it reacts. 

You’ll also want to ensure you’re using a gentle, non-comedogenic moisturizer morning and night to keep your skin balanced and healthy, and to fortify the skin barrier. This will also help reduce your risk of eczema flare ups.  

With all of this in mind, it’s rare to experience acne and eczema in the same exact spot, since they tend to thrive in different environments. This means you can use targeted treatments and products in different areas of the face and body to control the conditions where needed.  

How To Prevent Eczema & Acne

In order to prevent acne, you will want to stick to a targeted skincare routine that uses proven treatments, such as retinol, benzoyl peroxide, and/or salicylic acid. In addition to your treatment(s), your routine should include a face wash that is ideal for your skin type and a facial moisturizer. You should also use a non-comedogenic sunscreen to protect your skin against the damaging effects of the sun. 

If a skincare routine with over-the-counter treatments isn’t helping you achieve the results you desire, you’ll want to meet with a dermatologist who can suggest prescription topicals and/or oral medications. 

While you may not always be able to prevent eczema, there are some steps you can take to reduce your risk of flare ups. As mentioned, you’ll always want to ensure your skin stays moisturized by using a gentle moisturizer. Some of the best ingredients for soothing the skin, sealing in moisture, and strengthening the skin’s barrier include ceramides, aloe, hyaluronic acid, glycerin, shea butter, and oat. Using a humidifier in your home may also help keep your skin’s moisture levels up. 

You should also identify any triggers that may cause eczema flare ups, and do your best to avoid them. While everyone’s triggers may be different, some common causes used in grooming and household products include fragrances (including those in laundry detergents), essential oils, dyes, urea, and lanolin. Animal dander is also a common trigger, as is a sudden change in temperature and/or humidity. 

When to See a Professional

In both the cases of eczema and acne, if at-home treatments don’t seem to be working, it’s a good idea to meet with a dermatologist. A dermatologist will be able to diagnose the exact condition you’re dealing with, and can help you create a treatment plan to manage symptoms (in the case of eczema) or clear up acne. 

Sudden changes in either your acne or eczema symptoms also warrant a meeting with a dermatologist. Anyone with eczema who notices signs of infection (such as fever, blisters, or pus) should also immediately seek medical attention.

Originally Published: February 24, 2023

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sam wood is GoodGlow's Chief Editor
Analyzed by Sam Wood

Hi, I’m Sam Wood, the chief editor, lead acne expert, and health coach at GoodGlow, as well as a best-selling author for one of the top acne books on Amazon. I struggled with acne for over 10 years, and began studying the effects of diet on skin quality while pursuing a degree in Nutrition Sciences at the University of Missouri. After shifting from mainstream skincare trends to in-depth research in medical journals, I experienced significant personal success in managing my acne. This inspired me to start GoodGlow, where I simplify complex scientific findings into easy-to-understand advice. With over 10 years in the field, I’ve helped more than 2,500 people achieve clearer skin through natural, holistic methods, and I’m dedicated to personally assisting those seeking guidance on their acne journey.

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