Acne is a very unique condition of the skin wherein dirt, oil and bacteria get trapped in hair follicles or pores and a thin layer of skin or a skin cell forms over it so that it can't get washed away. This then grows into what we call a pimple. Because pimples are usually red and the area around these breakouts is typically also red, itchy, and inflamed, it's easy to see how it can be confused with rosacea and vice versa. But it's important to understand that rosacea is not acne because it is not a collection of dirt, oil and bacteria. Instead, rosacea is a condition wherein the skin becomes red, irritated and inflamed. It can also be somewhat dry and scaly. A person can have small bumps with this condition, but these pustules are not the same as acne. As a matter of fact, using acne medication on rosacea can actually make the condition worse, since most topical treatment options for acne are very drying and contain harsh ingredient such as peroxide and alcohol. Imagine adding any of these to an open wound or scrape you have on your skin - obviously this would just make it feel much worse!
Closed comedones (whiteheads) have small ostia. A combination of both inflammatory and comedonal acne is most commonly seen in younger patients.
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