What If It’s Not Acne: Skin Conditions That May Be Mistaken For Acne
Just like any organ in the body, your skin is dependent on multiple factors to keep it healthy and functional. Everything from your family history to the weather, from hormonal changes to your diet, from the medications you use to the makeup you put on--all these interact with each other in complex ways that influence your skin.
With so many factors at play, it’s not uncommon for problems to come up. And while acne vulgaris is by far the most widespread among them, there are many other disorders that exist.
Because the skin often reacts to pathogens with inflammation, redness, and swelling, it’s easy for us to mistake acne for something else. But the problem is, even if the symptoms might look the same, the treatment approach is vastly different.
So if you have redness or bumps on your skin that do not improve (or even worsen) with various acne products, consider the possibility that you might be suffering from a different skin condition.
Here we list some disorders that might look like acne, but aren’t.
Rosacea
Rosacea is a condition characterized by facial redness--sort of like if you put on way too much blush. It is often accompanied by small, dome-shaped protrusions that are easily mistaken for pimples, blood vessels are obvious on the skin surface, chronically gritty eyelids, and extreme sensitivity. There may be some parts of the skin that become thickened, particularly the nose.
People suffering from rosacea note that the condition worsens when they are under the sun, when they put on any kind of topical products, or when they drink alcohol or spicy food.
The jury is still out on the definitive cause of rosacea, but it appears to be influenced by the immune system, genes, and exposure to triggers. This often occurs in adults aged 30 to 50 years old, and most commonly among those who are descended from Celtics.
Folliculitis
Folliculitis is caused by infection of the hair follicle. It looks very similar to acne because acne affects the pilosebaceous unit, which is the medical term for a hair follicle paired with a sebaceous gland.
As the name suggests, folliculitis occurs anywhere in the body where you have hair. Acne affects only the face, back, and chest because that’s where hair follicles are associated with oil glands. So if you have what appears to be pimples on your legs, arms, belly, or butt, the chances are high that you are suffering from this skin condition.
There are many types of folliculitis, depending on what caused the infection. Bacterial folliculitis is associated with Staphylococcus aureus, fungal folliculitis is usually attributed to Malassezia folliculitis, viral folliculitis may be caused by herpes viruses.
But it’s not just pathogenic organisms that cause folliculitis, but our habits too. If not handled properly, hair follicles are damaged by removal methods like shaving, plucking, or waxing. When your skin is constantly being rubbed and exposed to heat and moisture, it can get irritated and infection can occur. Soaking in poorly-maintained hot tubs, wearing tight clothing when sweaty, and constant skin-to-skin friction are some common causes of folliculitis.
Keratosis pilaris
Keratosis pilaris are small, dry, scaly bumps that most often appear on the arms, legs, cheeks and back. They may be either red or brown and do not typically have white centerpoints unlike full blown pimples. It usually affects both sides of the body in equal measure.
This is a genetic condition that causes a build-up of keratin in the hair follicle. It’s not irritating nor itchy, but many still seek treatment because it can be considered unsightly. Keratosis pilaris is often most obvious during the teenage years, but may fade away in time especially if managed by chemical exfoliants.
Perioriorificial dermatitis
“Peri” means around and “orifice” means opening, so you can expect that this condition is concentrated around bodily openings. Perioral and periocular dermatitis are the versions of this disorder that are most likely to be mistaken for acne because they occur on the face. If you have a lot of small, angry and painful “pimples” that swarm around a few millimeters around your eyes and mouth, you might just be suffering from this condition.
The mechanism behind this condition is not completely understood, but studies show it may have something to do with a compromised skin barrier, changes in the facial microflora, bacteria, hormonal changes, and substances that trigger the immune system.
Hidradenitis suppurativa
If you’re familiar with Greek terms, you might think that this medical condition has something to do with sweat glands. You would be partly correct because this disorder occurs in parts of the body that tend to sweat. But the understanding of this condition has advanced since the naming of the disease, and studies suggest it has something to do with the body overreacting to irritants and bacteria.
Hidradenitis suppurativa is also called acne inversa because it causes abscesses from deep, painful boil-like lesions in the armpits, groin, inner thighs, and under the breasts. This is a difficult condition to have because healing takes a long time and the boils tend to recur.
We may not fully understand why it happens, but we know it associated with chafing of skin against skin or against cloth, immune responses to changes in skin bacteria, and inflammatory conditions that destroy sweat glands. Management of this condition is difficult, but medical intervention combined with lifestyle changes like quitting smoking and weight loss programs appear to help.
Tuberous sclerosis
Tuberous sclerosis is a rare disorder brought about by either a hereditary or acquired mutation on the genes that produce the proteins hamartin and tuberin. It causes non-cancerous growth in different parts of the body, including the brain, heart, gastrointestinal tract and the skin.
The symptom of this disease that is likely to be mistaken for acne is the angiofibroma. This looks like a red rash made of flat or raised red spots that spread out like a butterfly from cheek to cheek. This can sometimes be seen in the forehead or the scalp. Note that these marks usually appear much earlier than the usual onset of acne--around 3-10 years old.
It is relatively easy to differentiate tuberous sclerosis from acne because it has other very specific symptoms. Growths on the nail beds, the presence of 3 or more light-colored birthmarks, welt-like birthmarks are some that are easily seen. The severity of the disease will depend on where the tumors grow.
Acne agminata
This rare skin disease usually affects the faces of adolescents, so many people think it is just a bad case of acne vulgaris.
There is very little known about the cause of this disorder, but it can be differentiated from your run-of-the-mill type of acne by the absence of comedones and the fact that it can affect the eyelids and the armpits. They can be red or brown raised bumps that are easy to mistake for pimples to the untrained eye. The difference is much more obvious when examined under the microscope by pathologists.
Conclusion
The skin is a part of the body that can be affected by many diseases. Whether you’re suffering from acne vulgaris or something that looks remarkably like it, the most important thing you can do is consult a medical health professional about it. Understanding the skin condition you have allows you to make better decisions on how to treat and manage it.
In skin, as in all things, knowledge is power.
