Few things can ruin your day more than discovering a new acne breakout. But what if your pimple was something else entirely? There are actually many skin conditions that often get mistaken for acne; after all, acne vulgaris is one of the world’s most common skin conditions.
So how can we distinguish a classic bout of angry pimples from something more severe or challenging to treat?
What causes acne?
To differentiate acne from other skin conditions, it pays to know what causes acne in the first place.
While acne can be influenced by a range of lifestyle and medical factors, the process behind any pimple growth is the same. The American Academy of Dermatology (AAD) explained that acne is caused by a buildup of sebum and dead skin cells clogging the pore. These clogged pores become the paradise for acne-causing bacteria to reproduce, resulting in inflammation and ultimately a pimple.
There are six different types of acne, and each can either be categorised as inflammatory (red and painful) or non-inflammatory (flat and painless). The six types of acne include:
Common skin conditions that are commonly mistaken for acne
Now we know exactly what causes pimples, how can we identify skin conditions that mimic these angry lumps and bumps?
1. Fungal acne
Despite having the word acne in the name, fungal acne isn’t a type of acne at all. Also known as hair follicle infections, pityrosporum folliculitis, or Malassezia, folliculitis is actually just an infection of the hair follicle.
Fungal acne is categorised by inflamed, itchy spots that look like lots of tiny pimples. These infections are caused by a yeast known as Malassezia, which is part of the fungi family. Malassezia naturally exists on everyone’s skin, but overgrowths can sometimes happen in hot and humid weather or even when a person sweats.
Like regular acne, fungal acne can affect the face, but it can most commonly be found in clusters on the chest, back and areas of restrictive clothing.
Millia are pale, raised dots that closely resemble whiteheads. These harmless spots occur when keratin cysts become trapped inside a pore. While most often spotted around the eyes, millia can develop anywhere on the body, and as they are enclosed, they can stay there for months unless removed.
Millia won’t typically affect anyone’s day to day life, but some people choose to have them removed for cosmetic reasons. When this happens, a dermatologist will generally puncture the comedone with a sterilised tool and extract the keratin buildup from the pore.
Another skin condition commonly confused with acne is rosacea. This chronic skin condition is characterised by red patches on the skin, visible veins and even inflamed bumps.
The cause of rosacea is still unknown, but many professionals believe that this skin condition could be due to a combination of both genetic and environmental factors. Rosacea can also be triggered by several factors such as spicy foods, alcohol and even strong winds. Those with rosacea often have extremely sensitive skin, and harsh cleansers and scrubs may only worsen the condition. Instead, rosacea sufferers should opt for hydrating and irritant-free skincare products that focus on repairing the skin barrier.
There is also no known cure for this chronic condition, but dermatologists can prescribe many treatments to reduce redness and inflammation.
4. Keratosis Pilaris
Keratosis pilaris (KP) is yet another chronic skin condition caused by keratin clogging up the hair follicles. KP, also known as chicken skin or strawberry skin, are identified as rough, red and bumpy patches on the skin that mainly occur on the upper arms, thighs, buttocks and cheeks. Luckily, KP doesn’t cause any physical discomfort or itching, although they might make you shy away from that sleeveless dress.
Usually, KP is a stubborn condition that’s resistant to treatments, but luckily, it often disappears with age (with most cases fading by 30). There are also some treatments to reduce the appearance of these keratin filled bumps, including microdermabrasion, chemical peels and prescription retinoids. Over the counter products containing urea and lactic acid are also great to loosen dead cells and soften the skin.
5. Perioral Dermatitis
Perioral dermatitis may look like acne, but this skin condition is actually defined as clusters of small, itchy and red bumps that often form around the mouth. Perioral dermatitis is commonly caused by the overuse of topical steroids or steroids found in nasal sprays. Perioral dermatitis can also be triggered by a sensitivity to toothpaste and heavy moisturisers.
As it’s a reactionary condition, perioral dermatitis will usually disappear once you stop using topical steroids or other irritating products.
6. Ingrown Hairs
Ingrown hairs are easily taken for papules and pustules. But, if you ever attempt to squeeze one of these spots, you’ll most likely find a hair stuck inside. As the name suggests, ingrown hairs can develop when the hair turns around and grows back into the skin, creating an infected and inflamed bump. In women, these spots are most likely to occur around the underarms and bikini line, while men tend to see ingrown hairs in the beard area.
Like acne, you should always avoid the urge to pick at an ingrown hair as this could result in more inflammation and irritation. Usually, ingrown hairs will disappear on their own, but if you have a particularly stubborn hair, book an appointment with a dermatologist for extraction. Alternatively, you can always try using exfoliating products to help encourage skin cell turnover.