Rosacea and eczema (atopic dermatitis) are both common, chronic inflammatory skin conditions. Because they have similar symptoms — redness and hypersensitive skin, for example — differentiating between the two can get difficult. As many as 14 million people in America experience rosacea. Eczema affects more than 31 million people in the country.

While they are two different conditions, it is possible to have rosacea and eczema at the same time. As one member of MyEczemaTeam wrote, “I also have rosacea that is basically out of control after staying inside for this past year, and from wearing a mask when I do go out.”

Living with both rosacea and eczema can make someone’s treatment more complicated. Why? Each condition gets treated in different ways, ways that can conflict. And to treat eczema, a person’s rosacea needs to be managed.

To learn more about co-occurring rosacea and eczema and what it’s like to live with both, MyEczemaTeam spoke with Dr. Brian S. Kim. Based at the Center for the Study of Itch and Sensory Disorders at the Washington University School of Medicine in St. Louis, Dr. Kim serves as its co-director and directs a lab there.

“A lot of people have rosacea,” Dr. Kim said, “and I think facial eczema is largely complicated by having underlying rosacea.”

Causes and Risk Factors of Eczema and Rosacea

According to Dr. Kim, while the relationship is not well-studied in research, many people with eczema also have underlying rosacea. What exactly causes rosacea remains unknown, and current medical theories vary greatly.

Some doctors theorize rosacea is linked with:

• A disorder of the blood vessels
• A fungus
• A microscopic skin mite
• Psychological factors

As for eczema, its cause(s) include a combination of genetic and environmental factors, the immune system, and a compromised skin barrier.

It is unclear whether having rosacea increases a person’s risk of developing eczema. What is known is that they share similar risk factors. (Risk factors are things that make a person more likely to develop a disease or condition.) Heredity factors into the risk for both eczema and rosacea. That means when you have a family member with either or both conditions, you are more likely to develop them, too. Emotional stress can also trigger symptoms of both rosacea and eczema.

Risk factors specifically for eczema include a family history of asthma, hay fever, or allergies. And rosacea-specific risk factors include age (over 30), skin tone (light), smoking history (actively smoke), and gender (female).

Certain so-called “environmental factors” can prompt a flare-up of either condition. Rosacea symptoms may get triggered and intensified by spicy foods, sun exposure (or sunburn), alcoholic beverages, and intense exercise. Eczema’s triggers include sweat, obesity, and allergens like dust and pollen.

Living With Eczema and Rosacea

Living with both eczema and rosacea may be more physically and emotionally challenging than living with just one of the conditions. And living with both rosacea and eczema may also make treatment more complicated, as each condition is treated in different ways.

Take treating eczema-related inflammation in someone who also has rosacea. “Rosacea is essentially where your blood vessels are open,” Dr. Kim explained. On the other hand, he said, “One of the key mechanisms to getting rid of all those [eczema-related] inflammatory cells is to then close off those vessels."

“Now, if you can’t close those vessels off … ,” Dr. Kim continued, “how do you get rid of the inflammation? You’re just going to have more inflammatories coming in. So there’s a combination there, and it actually manifests as this refractory, chronic facial dermatitis.”

And while you want to avoid any ill effects the treatment of one condition has on the other, balancing can be tricky.

Take medication, for example. Eczema treatments include topical medications, corticosteroids, antibiotics, or injected biologics. Rosacea treatments commonly include topical medications, oral antibiotics, or laser procedures (to treat visible blood vessels).

The conflict? The topical steroids used to control eczema can actually worsen someone’s rosacea. Yet a person’s rosacea symptoms need to be managed in order to treat their eczema symptoms.

Members of MyEczemaTeam post about the challenge of treating both conditions. “I am feeling really conflicted over the long-term use of [medication] for rosacea,” wrote one member. “I’m not sure what to do. It calms the skin down enough for me to treat eczema, but isn’t really the long-term treatment plan I had in mind.”

Managing Eczema and Rosacea

Rosacea and eczema are managed through different treatments and lifestyle modifications that aim to control your symptoms. Because they are both chronic conditions, and because symptoms may vary from person to person, it may take trial and error to find the treatment regimen that works best for you.

Identifying and avoiding factors that trigger flare-ups and aggravate your symptoms is very important for managing eczema and rosacea. Triggers can vary for each person with eczema and rosacea, so it’s helpful to understand your personal triggers and irritants. Minimizing and managing stress can help to address symptoms of both eczema and rosacea.

Working with a dermatologist or other health care provider can help you to find the most effective treatments for your eczema and any underlying rosacea. Doctors such as allergists can also help you to identify different triggers and allergies that may worsen or cause flares of these conditions.

Talk With Others Who Understand

On MyEczemaTeam, the social network for people with eczema and their loved ones, more than 42,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema. When managing both eczema and rosacea, joining a support group and talking about your experiences may be helpful.

Do you have eczema and rosacea? Share your experience in the comments below, or start a conversation by posting on your Activities page.