Itchy, red blotches on your face been bothering you? Find out if its your run-of-the-mill acne vs eczema, an entirely different skin condition.

You know there’s nothing more frustrating than looking at the mirror, seeing a blemish, and not knowing what the heck it is. Is it acne or something else? If it’s itchy, red, and blotchy, it might not be acne but eczema.

So, let’s get cracking and find out what acne and eczema are and how you can spot which is which is on your face.

Acne VS Eczema

acne vs eczema

Both acne and eczema can cause inflamed skin. They can happen to anyone at any age. Both can come and go—flaring one day, going away the next, and returning some other day. And both skin conditions can be frustrating to deal with.

Apart from those similarities, acne and eczema are actually very different conditions.

You’ll see this as we look at how they form and what they look like, what causes them, and how to treat them.

What’s Acne?

When we say acne, we’re actually talking about the skin condition called acne vulgarisThis is a common skin disease where clogged pores turn into inflamed lesions.

Before, a lot of people thought acne was just for teenagers. But in reality, it can go on much after that—with adults experiencing acne well into their 30s, 40s, and 50s.

How Does Acne Form?

It all begins with the hair follicles—tunnel-shaped structures in the outer layer of the skin. These structures can get clogged with dead skin and oils. 

When follicles become clogged but not inflamed, they are called comedones. That's what we know as blackheads (open comedones) and whiteheads (closed comedones).

Inflammation begins when harmless bacteria naturally living on our skin become triggered and turn nasty.

Cutibacterium acnes is that harmless bacteria­—it’s the acne bacteria to be precise. But because it’s an anaerobic organism—meaning it grows in number in conditions devoid of oxygen—clogged follicles or ‘pores’ become its perfect breeding grounds.

Take away oxygen and the normally chill acne bacteria, Cutibacterium acnes, will multiply and cause inflammation—redness and swelling—on your skin [1].

Inflammatory lesions then begin to form, like papules and pustules. Those are better known to us as pimples and zits, the blemishes of acne. We can find both inflammatory and non-inflammatory acne lesions appear not only on our face but also our neck, shoulders, chest, and back.

acne vs eczema

What Causes Acne?

Acne is a multifaceted problem—meaning it has many aspects and sides. That’s why there is no one known cause for acne.

What we can look at are the known triggers of acne

  • Hormonal changes — Sex hormones can affect acne formation.
  • Skin oil (sebum) build-up — Skin oil contributes to what clogs our pores.
  • Diet ­— Some foods can contribute in forming acne (like milk and sugar).
  • External factors — Products we use on our skin and even the water we use to wash our skin can contribute to acne.
  • Exfoliating — Not exfoliating dead skin cells off our skin allows them to clog our pores. Exfoliate too much and you can irritate your skin.
  • Stress — We tend to produce more sex hormones when we’re stressed—hormones that can affect acne formation.
  • Internal health issues — Our skin could be telling us there’s an underlying issue causing our acne.

How is Acne Treated?

Treatment depends on how severe your acne is. It can range from products you can buy from the drugstore to prescription topical or oral medicine from your derm.

For example, benzoyl peroxide is the gold standard over-the-counter topical treatment for acne. That’s because it’s a powerful bactericide that can eradicate the overgrowth of acne bacteria.

Ranging from OTC to prescription, retinoids are also known for effectively treating various severities of acne. A type of retinoid called isotretinoin, better known as Accutane, is a prescription-only oral medicine that’s known to be like a nuke for acne.

What’s Eczema?

Eczema refers to several different types of skin swelling or inflammation. It’s actually a general term for rash-like skin conditions. 

The most common type of eczema is atopic dermatitis, which is also called as the “the itch that rashes.” This is the type of eczema we’re talking about.

Eczema is most common in babies and children, but adults can have it too. In time, as kids with atopic dermatitis grow older, the skin condition may get better or go away.

Sadly, as it is chronic, skin with eczema may stay dry and get irritated easily.

acne vs eczema

How Does Eczema Form?

People with atopic dermatitis often have asthma or seasonal allergies and can experience hay fever. They often test positive to allergy skin tests.

Though eczema is often linked to allergies, it’s not really caused by allergies. It’s now thought to be because of a “leaky” skin barrier [2].

Our skin barrier handles keeping water in our skin and protecting the skin from external aggressors like pollution and UV rays. For skin that has eczema, the skin barrier “leaks,” allowing water to leak out, making the skin dry.

The main symptom of eczema is itchiness and the skin is also often dry. If you have eczema and you scratch your skin, it will turn red, and swell and itch even more.

If you have eczema, you can find dry, itchy skin, and rashes on the face, inside the elbows and behind the knees, and on the hands and feet.

What Causes Eczema?

The exact cause of eczema is unknown. But it is likely caused by both genetic and environmental factors. So, you are more likely to have atopic dermatitis or eczema if you have a family history of this condition. Some environmental factors like dry, cold weather can also trigger or worsen eczema.

Here are some of the triggers you can watch out for:

  • Allergies to pollen, mold, dust mites, or animals
  • Cold and dry air in the winter
  • Colds or the flu
  • Contact with irritants and chemicals
  • Contact with rough materials, such as wool
  • Dry skin
  • Emotional stress
  • Drying out of the skin from taking frequent baths or showers and swimming very often
  • Getting too hot or too cold, as well as sudden changes of temperature
  • Perfumes or dyes added to skin lotions or soaps

How is Eczema Treated?

Apart from avoiding potential triggers, there are topical treatments that can help with eczema.

Since dryness is common with eczema and tends to worsen the condition, you’ll want to keep your skin happily moisturized.

Ointments are the most common types of moisturizers used for treating eczema. They have more oil that water, making them thicker and greasier compared to other moisturizers.

Creams and lotions can also work, with creams being the thicker formula between the two.

Having eczema will likely make your skin more sensitive. So, it’s best to avoid ingredients that can potentially irritate your skin like:

  • Alcohols (Denatured, ethyl, isopropyl, etc.)
  • Fragrance
  • Strong acids (glycolic and lactic)
  • Menthol
  • Camphor
  • Sodium laureth sulfate

An ingredient you should want to have in your moisturizer is urea. It’s naturally present in healthy skin and is very useful in treating dry skin conditions like eczema and psoriasis [3].

Urea is helpful for these conditions because of its:

  • Hydrating effects — Urea draws and retains water within skin cells, effectively helping with the “leaky” skin barrier problem of eczema.
  • Keratolytic effects — Dry skin conditions often deal with clingy dry patches. Urea softens dead skin cells so we can easily remove them from the skin surface.
  • Regenerative skin protection — A “leaky” skin barrier needs all the help it can get and urea is exactly that. Urea directly protects the skin from drying influences and can even help strengthen the barrier with regular use.
  • Irritation-soothing effects — Urea helps keep the itch at bay as it provides anesthetic effects.
  • Penetration-assisting effects — Urea can help other substances penetrate the skin more effectively, like substances that can increase skin hydration.


When your skin is red and itchy, you better resist the itch and the urge to slap your acne creams on it. Because until you find out exactly what you’re dealing with, your handy creams might do more harm than good. 

Hopefully, knowing more about acne vs eczema can help you differentiate and deal with both when you encounter them.

With that, thanks for reading and I hope we meet again soon!

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