Acne Imposters

As if acne weren’t enough on its own, occasionally acne vulgaris is also accompanied by other unpleasant skin conditions. Some are simply unwanted tagalongs, like dandruff; while some conditions can actually be mistaken for acne, but require a different course of treatment. Only your dermatologist can make a conclusive diagnosis but finding out more about some of these conditions can help you prepare to talk to your doctor about any concerns you might have.

Acne Cosmetica

This mild and relatively common form of acne is caused by cosmetics. Since it's triggered by topical products (like ointments and creams) it can happen to anyone — even people who are not otherwise prone to acne.

Acne Cosmetica usually takes the form of small, itchy or rash-like pink bumps on the cheeks, chin and forehead, developing gradually over the course of a few weeks or even months. Acne Cosmetica can linger indefinitely, but rarely causes scarring.

To avoid Acne Cosmetica, look for make-up and skin products that are "non-comedogenic." These products are less likely to cause irritation or clogging of the pores.

Dandruff (or Seborrheic Dermatitis)

For reasons we don't know, dandruff often accompanies acne, especially in adolescents.

The causes of acne and dandruff are similar. For dandruff sufferers, the natural process of scalp-cell renewal is accelerated when fighting off P. ovale, a normal fungus found on every human head. This causes dead cells to shed more quickly, causing the symptoms we know as dandruff — flaking, scaling and itching of the scalp. In some cases, dandruff also involves tiny pimples on the scalp. Climate, heredity, diet, hormones and stress can also impact on dandruff.

Most cases of dandruff can be managed effectively with non-prescription shampoos containing zinc, coal tar or salicylic acid. Stronger shampoos can be prescribed by your doctor if the problem continues. Dandruff isn't caused by overwashing of the hair, so it's okay to shampoo every day. On the other hand, scratching or picking at the scalp can make dandruff worse.

Dermatitis (or Eczema)

Appears on the skin as a rapidly spreading red rash which may be itchy, blistered and swollen. Atopic dermatitis is related to asthma and hay fever-type allergies, and is often seen in early childhood. Contact dermatitis is usually caused by contact with irritants (detergents or harsh chemicals) or allergens (substances which a sufferer is allergic to, like rubber, preservatives or certain fragrances).

People who suffer from chronic dermatitis will have a longstanding history of irritation in the affected area or areas of their skin. The eyelids, neck and hands are most commonly affected in adults. The skin in these areas may be darker than surrounding skin, and thickened from persistent scratching. Chronic dermatitis is thought to be hereditary, but can be influenced by environmental factors as well. Dermatitis may come and go throughout a person's life.

Enlarged Pores

Before the onset of puberty, most people have relatively small pores and smooth skin. Pores tend to become larger in adolescence when the skin produces more sebum. As we continue to age, sun damage decreases the skin's elasticity, making pores appear larger.

As an adult, the size of your pores is determined by genetics; some people retain the small pores of their youth, while others develop larger pores. People with larger pores may experience small grayish blackheads on the nose and cheeks.

Contrary to popular belief, these "blackheads" are simply the sebum doing its job: lining the pore. Since the sebum is meant to be there, squeezing blackheads is not very effective — the oil will simply reappear the next day. What’s more frequent squeezing over time may actually damage the pore, causing it to enlarge permanently.

Epidermal Cysts

Unlike cystic acne, which occurs within an infected follicle itself, an epidermal cyst is a sac-like growth in the deeper layers of the skin. The cyst sac is filled with a soft, whitish material that can remain indefinitely.

Small cysts (less than 5mm in diameter) can be annoying, but are generally harmless. Larger cysts are more likely to become infected. Infected cysts are very painful and can lead to scarring. Epidermal cysts are often permanent; even if the contents are extracted, the sac remains and the cyst may return. In these cases the entire cyst sac must be removed to prevent it from returning. While cysts are typically benign, it's a good idea to consult a physician about any lumps and bumps that you might be concerned about.

Favre-Racouchet Syndrome

This condition is caused by severe, ongoing sun damage over the course of many years and is most prevalent among men and women over 50.

Favre-Racouchet Syndrome is characterised by large clusters of comedones (blackheads) around the eyes and on the upper cheeks. Unlike acne blackheads, Favre comedones do not go away if left untreated; they must be surgically extracted or treated with topical retinoids.

Keratosis Pilaris

Keratosis Pilaris is a condition that is common among teenagers and appears as patches of tiny, red, kernel-hard bumps on the backs of the arms, shoulders, buttocks and the front of the thighs. Occasionally it occurs on the cheeks as well, with a number of bumps in the affected areas.

Unlike acne, Keratosis Pilaris is usually painless and feels spiny to the touch. It tends to be more severe during the winter months when humidity is lower, and is more prevalent in arid climates.

Milia

These tiny, white bumps are found mostly in the area around the eyes. Milia are cystic, occurring deep within the skin and are hard to the touch.

Milia can linger for weeks or even months. If you are bothered by persistent milia, consult your dermatologist for professional, safe removal.

Peri-Oral Dermatitis

Most commonly affecting women in their 20s and 30s, Peri-Oral Dermatitis is characterised by patches of itchy skin or tender red spots around the mouth. The skin bordering the lips may appear pale and dry, while the chin, upper lips and cheeks may be red, dry and flaky. It can also affect the skin around the nose area.

Pseudofolliculitis Barbae

Pseudofolliculitis Barbae is more commonly known as the acne-like breakouts "shaving bumps." As hairs begin to grow back after shaving, waxing or plucking, they get trapped inside the follicle and cause irritation and swelling.

Not everyone gets shaving bumps; people with curly hair are more susceptible. To help prevent shaving bumps use an electric razor or, if you prefer blade shaving, use a new, single-edge blade every time you shave. Prep the shaving area with warm water and use a rich shaving cream and always shave with the grain, not against it. Then, after you’ve finished shaving, apply a mild toner or antibacterial gel.

Rosacea

Frequently mistaken for acne, Rosacea is a skin condition most commonly found in adults between 30 and 60 years of age. Unlike acne vulgaris, Rosacea does not involve comedones, and appears only in areas that are likely to flush when we're embarrassed, excited or hot — such as the face, neck and chest. The skin is bumpy, red and oily in appearance, and may also involve papules and pustules.

Rosacea can begin as a recurring inflammation, or a temporary annoyance. Left untreated, however, it can become a chronic condition, causing facial scarring. If you think you may have Rosacea, it's best to contact a dermatologist right away.

Debunk the myths that surround acne