Acne has got a bad rap. Acne is the most common skin condition spanning across all ages- teenage to even seniors! So much has been said and discussed about the prevention and treatment of acne that it’s easy to mislabel other skin conditions as acne.

Many people in Singapore suffer from the wrong acne treatment in Singapore due to misdiagnosis. A good way to find out if the skin conditions is not acne is if they are still present after acne treatments. Here are some common acne ‘imposters’ which often confuse people;

#1. Acne Rosacea

This condition looks like a blush on the skin in early stages and can develop into swelling of blood vessels in the face, inflammatory Rosacea which resembles acne and even irritating sensation in the eyes called ocular rosacea.

Experts are still unable to pinpoint the cause of rosacea but genes are said to play a part. Doctors have observed some triggers like alcohol, spicy foods or sunlight to cause flare-ups.  The main treatments are used to reduce inflammation and prolong the time between flare-ups. Some patients will need to continue treatment for months or even years.

#2. Steatocystoma Multiplex

A rare disorder characterized by the development of sebum-containing dermal cysts on the skin. In this condition, the skin shows an absence of pores, inflammation and tender cysts. Extraction will cause a gelatinous liquid to ooze. Hormonal imbalances are thought to be the cause of this but it is a very difficult condition to treat.

#3. Folliculitis

Fungal Folliculitis is a common skin condition where the hair follicles become inflamed caused by bacteria or fungi. Anyone from a baby to a senior can be affected by folliculitis. It resembles a white-headed pimples around hair follicles but can get quite itchy and sore. Areas such as the face, scalp, chest, back, buttocks, groin, and thighs are susceptible to folliculitis.

Common causes of this condition are friction, sweating, occlusive clothing, greasy emollient products, and/or antibiotics. But it can be prevented by avoiding tight clothing, proper shaving techniques, using clean hot-tubs and pools and avoiding extreme humidity.

#4. Rosacea Fulminans aka Pyoderma Faciale

An unusual skin condition, Rosacea Fulminans can resemble severe acne. Unlike acne, this condition starts abruptly, is temporary, limited to women and is confined to the face.

Presenting itself as painful, red large red bumps that occur on the forehead, cheeks and chin, these lesions may leave scars. The lesions generally do not have a core when extracted – they just drain. This occurs in young women between 20-30 years of age and is seemed to be triggered by stress.

It affects only women who have a specific enzyme deficiency which suppresses the adrenals’ output of hydrocortisone and prompts excess production of testosterone. Most cases of Rosacea Fulminans can be treated with a combination of antibiotics, Isotrentinoin and systemic steroids.

#5. Staph Infection

Staph Infections do look like acne but is much more severe and dangerous. One way to differentiate between acne and staph infection is that the latter has unsymmetrical borders like a pimple or boil does. Staph infection can show up as pimples, boils, pus filled lesions, swelling, or redness. Since this a serious skin condition that requires antibiotics, self-treatment is not recommended.

#6. Perioral Dermatitis

Dermatitis is a medical term referring to inflammation of the skin and perioral refers to the area around the mouth. Often confused for acne, this condition is characterized by clusters of tiny inflamed papules, sometimes pustules, around the chin, nose and mouth area. Unlike acne which is quite pain free, dermatitis is typically itchy and rash like. Sometimes the rash will look inflamed, with the surrounding skin appearing red or pink.

This condition affects more women than men with 1 in a 100 women being affected. However the more men use skincare products, the higher is the likelihood of perioral dermatitis occurring.

There is no exact cause for the disease but the following factors can act as a trigger:

  • Steroid creams
  • Environmental factors such as strong winds and sunlight
  • Toothpaste containing fluoride as a constituent
  • Hormonal imbalances
  • Oral contraceptives in some cases

To treat this condition, a doctor will firstly recommend that you not apply any steroid cream, ointment or makeup on your face. Generally, they recommend a course of antibiotics which is usually for six to twelve weeks

#7. Keratosis Pilaris

A harmful imposter of acne, this condition affects up to 40% of the population.  In this condition, patients observe small, rough bumps which look similar to goose bumps usually on the upper arms, thighs, cheeks or buttocks. Keratosis pilaris is observed in teenagers and disappears by adulthood.

Overproduction of Keratin, a natural protein found in the body, is the main cause of this condition. Too much of keratin on the skin can form hard plugs on the skin’s surface, causing bumpy and rough skin.

There is no permanent cure but this condition can be managed by effectively moisturizing the skin. Lactic acid can help manage symptoms by exfoliating away rough bumps from keratin overgrowth. For more severe cases, vitamin A and higher concentrations of lactic acid may be beneficial.