Acne Look-Alikes: Other Skin Conditions that Cause Pimples

Is It Really Acne? Maybe Not!

Not all pimples are caused by acne. Would it surprise you to know that there are other skin problems that cause pimples, inflamed bumps, and other acne-like symptoms.

Sometimes it can be hard to distinguish between common acne (AKA acne vulgaris) and acne "look-alikes". If you're unsure what's going on with your skin, it's always a good idea to see a doctor to make sure you get the correct diagnosis of your skin condition.

Rosacea

Rosacea
Photo © A.D.A.M.

Also called acne rosacea, this is a chronic inflammatory skin disorder that causes small acne-like pimples across the cheeks, nose, chin, and forehead.  It's often confused with adult onset acne.

How can you tell the difference?  Rosacea causes dilation of the blood vessels, which gives the skin a flushed appearance.  Acne may cause red pimples, but won't cause flushing of the face.

Roseacea typically doesn't develop before the age of 35, and it's more common in women than men.  With rosacea, you'll often have flare-ups interspersed with periods where the skin is relatively clear.

The exact cause of rosacea is unknown, but there are treatments available.

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Keratosis Pilaris

Keratosis Pilaris
Photo © A.D.A.M.

Although it has a long name you've never heard, chances are you've seen keratosis pilaris.  It's an extremely common skin condition that causes small, rough bumps on the skin's surface.

Often, skin with keratosis pilaris is described as feeling "sandpapery." The bumps may be skin-colored or red, and can look like tiny pimples.

Typically, you'll find keratosis pilaris on the backs of your upper arms, thighs and buttocks.  But it can also develop on the face, especially in children, where it is often mistaken for acne.

Keratosis pilaris is caused by a buildup of keratin (a protein in the skin and nails) within the hair follicle. These keratin plugs create a rough, goose-bump or pimple-like appearance.

Keratosis pilaris is most common in children and teens, although it can occur in adulthood. It is not serious.  It usually goes away without treatment, but has a tendency to come back.  A gentle moisturizer can help improve the bumps.

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Folliculitis

Folliculitis
Photo © A.D.A.M.

While the red bumps and pustules of folliculitis may look like acne breakouts, they are actually caused by irritation and inflammation of the hair follicles.

How do you irritate a hair follicle?  Shaving is a big cause.  Friction can irritate those follicles too, like where the straps of a heavy backpack rest on the skin.

Sometimes folliculitis is caused by a bacterial infection.  Folliculitis can occur anywhere on the body.

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Miliaria Rubra

Heat Rash
Heat Rash. Photo © Angela Palmer

Miliaria rubra is the technical term for your common heat rash or prickly heat. 

Miliaria rubra is an acute inflammation of the sweat glands. You'll get small red bumps on the surface of the skin. The rash may also itch or burn.

As you may have guessed, miliaria rubra is caused when the skin is over-heated.  It's most common in babies and young children, but it can happen at any age. 

Typically you'll get heat rash on areas of the skin covered by clothing. In severe cases the rash may spread to the face, especially the cheek area.

Did the rash appear quickly?  Suspect miliaria rubra.  Acne pimples develop over time.

Ingrown Hairs

Is it acne or ingrown hairs?
Photo: CMSP / Getty Images

Ingrown hairs can cause pustules (also known as whiteheads) to develop on your skin.  These can look so similar to acne, it can be really difficult to tell the difference.

Here's a clue, though: if breakouts are occurring only in the beard area, there's a good chance it's ingrown hair.

Ingrown hairs, also called psuedofolliculitis barbae, is super common in the beard area.  African-American men, or anyone who has thick or curly hair, is a prime candidate for developing this skin problem.

Ingrown hairs can also appear in other areas of the body, and are most common in places where we shave or wax (like the legs, bikini area, etc.)

Gentle exfoliants can help in some cases.  But often the best treatment is to let the hair grow out. 

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Boils

A boil looks like a large pimple.
Image: Science Picture Co / Getty Images

Got what looks like a monster zit?  It might not be an acne pimple at all, but rather a boil.

Boils look like an acne  whitehead, only supersized.  They happen when the hair follicle becomes infected. 

Don't try to pop this bad boy, though.  You'll damage your skin and can spread the infection.  Some boils can heal on their own, but if it's very large, painful, or long-lasting, having it treated by a doctor is your best bet. 

If you're not 100% sure what you're dealing with is acne, give your doctor a call.  Once you get the correct diagnosis, you can start appropriately treating your skin problem and get your skin looking and feeling better.

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