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Difference Between a Lupus Rash and Rosacea

A lupus rash is a skin rash that occurs due to a person having systemic lupus erythematosus. Rosacea is a red rash that occurs on the face.

What is a Lupus rash?


A lupus rash is a result of having lupus, which is an autoimmune condition.

Causes and prevalence:

A lupus rash is caused by the cells of the immune system attacking cells in the skin. The rash sometimes happens after the person has been in the sun but this is not always the case, sometimes the rash appears even without sun exposure. A rash occurs in about half of all patients who have systemic lupus erythematosus (SLE). SLE occurs in approximately 5 people out of every 100,000, and mostly affects people between 15 to 44 years of age. 

Symptoms and complications:

A lupus rash often forms on the face where it extends over the nose and onto the cheeks. The rash often has a butterfly shape to it, but pustules are absent. Lupus rashes can also occur elsewhere on the body.


The diagnosis of a lupus rash is made by a skin biopsy and a blood test. The blood tests show the presence of antinuclear antibodies (ANAs). 


The treatment of a lupus rash is often by corticosteroids. A dermatologist can inject the corticosteroid medicine into the skin.

What is Rosacea?


Rosacea is an inflammatory skin problem of the face where the skin appears flushed and pustules sometimes develop. 

Causes and prevalence:

Rosacea is caused by different factors including genetics and environmental factors, and possibly also immune system dysfunction. There do seem to be triggers for the condition including stress, alcohol, and sun exposure. The condition occurs most often in people who are between 30 to 50 years old. Rosacea affects about 5.46% of people.

Symptoms and complications:

Rosacea appears as a rash on the skin of the scalp and face. The rash on the face is red, extends over the nose and cheeks, is found in the creases of the nose, and often develops pustules. The fine veins of the face may also be seen sometimes if you have rosacea.


Diagnosis of rosacea is by a physical exam and exclusion of other potential skin conditions.


Treatment of rosacea includes the use of oxymetazoline cream, metronidazole, and sometimes oral antibiotics if there are pustules.

Difference between a Lupus rash and Rosacea?


A lupus rash is the rash that occurs due to having the autoimmune condition called lupus. Rosacea is a rash on the skin that is due to an inflammatory problem.

Rash color and pustules

In the case of a lupus rash, the rash is red in color without any pustules or pimples. In the case of rosacea, the rash is red and often has pustules and pimples.

Location of rash on the face

On the face, the lupus rash takes the shape of a butterfly and extends over the nose and cheeks and does not affect the creases surrounding the nose. On the face, the rosacea rash occurs on the forehead, cheeks, nose, and chin and also affects the creases surrounding the nose; blood vessels are often visible.

Location of rash other than the face and scalp

In patients with lupus, the rash can occur elsewhere on the body in patches. In patients with rosacea, the rash only occurs on the scalp and face and not anywhere else on the body.


The potential complication of a lupus rash is that it can lead to vasculitis. The possible complications of rosacea include conjunctivitis (inflammation of the conjunctiva) and rhinophyma (a condition of the nose).


Treatment of a lupus rash is usually by corticosteroids. Rosacea treatment includes oxymetazoline cream, metronidazole, and sometimes oral antibiotics if there are pustules.

Table comparing a Lupus rash and Rosacea

Summary of a Lupus rash Vs. Rosacea.

  • Both lupus and rosacea rashes can occur on the face but they are not the same condition.
  • Lupus rashes are due to autoimmune problems.
  • Rosacea is a rash that is a result of inflammation which can be triggered by genetics or environment.


How do I know if I have a lupus rash or rosacea?

A lupus rash usually is in the shape of a butterfly and does not have pustules present. Rosacea produces a rash that does have pustules and blood vessels visible, and creases at the nose.

Can a lupus rash be mistaken for rosacea?

Yes, it is possible to confuse a lupus rash with rosacea until other signs appear like pustules and red skin around the nose.

How do I know if my rash is lupus?

The best way to know the cause of your rash is to see a doctor.

What autoimmune disease causes rosacea?

It is thought that autoimmune conditions like type 1 diabetes and celiac disease can contribute to the development of rosacea.

What does the beginning of a lupus rash look like?

The first sign is a reddening of the skin over the face.

How can I rule out lupus?

You would need to see your doctor and have a complete physical exam including blood tests. This can establish if you have lupus because if so, your blood will show the presence of certain autoantibodies.

When should you suspect lupus?

Some of the signs that may suggest lupus include feeling extremely tired, having sore joints, and developing the facial rash.

Would it be obvious if I had lupus?

No, it is not always obvious that you have lupus which is why a doctor’s visit and further testing is important. 

What are the top 5 signs of lupus?

The top signs of lupus include swollen legs, fever, fatigue, joint pain, and skin rash. 

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References :

[0]Buddenkotte, Joerg, and Martin Steinhoff. "Recent advances in understanding and managing rosacea." F1000Research 7 (2018).

[1]Keri, Jonette E. “Rosacea (Acne Roacea)”. Merckmanuals. Merck & Co., 2022, https://www.msdmanuals.com/professional/dermatologic-disorders/acne-and-related-disorders/rosacea

[2]Nevares, Alana M. “Systemic Lupus Erythematosus (SLE)(Disseminated Lupus Erythematosus)”. Merckmanuals. Merck & Co., 2022, https://www.msdmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/autoimmune-rheumatic-disorders/systemic-lupus-erythematosus-sle

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