Is It Acne or Something Else?

Think that bump or breakout on your chin (or elsewhere on your face) is a typical pimple? Guess again. Not every imperfection that looks like a zit is one. In fact, there’s a whole host of skin conditions that get misdiagnosed and incorrectly treated (usually at home when you self-diagnose, which is why you should always see a dermatologist). So, before you slather on the blemish-busting creams and lotions, make sure you know what you’re really treating so you can get rid of it properly.

Milia
These harmless, small, hard, white bumps are frequently mistaken as whiteheads, but are actually totally different and here’s why. A true whitehead sits above the skin; milia are trapped just underneath the surface. A true whitehead can appear anywhere on the skin; milia are usually found under and around the eyes and on the cheeks. A true whitehead contains bacteria, pus, oil, and dead skin cells; milia, according to New York dermatologist Dendy Engelman, MD, contain keratin (skin protein) and tend to be non-inflammatory, although they are deeper in the skin than acne.

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How to treat it: No amount of anti-acne products will even come close to scratching the surface when it comes to zapping away milia. The best way to get rid of them is to have them professionally extracted—they can linger for months if not. A needle or lancet needs to be used by your dermatologist or aesthetician to open the milia before the keratin is gently pushed out. “Because milia don’t usually go away without extraction, don’t try to remove them yourself,” says Seattle dermatologist Jennifer Reichel, MD. This is one you definitely want to leave to an expert.

Rosacea
One reason why this inflammatory skin condition is often thought to be acne (although there is more redness) is due to the small bumps, papules and pustules that crop up on the skin that resemble pimples. “Bumps and pimples are among the most common symptoms of rosacea, so it’s not surprising that nearly half of sufferers think they have acne before being properly diagnosed by a doctor,” says Dr. Engelman. Rosacea, unlike acne, tends to come along with some different symptoms like flushed skin, redness on the nose and cheeks and broken capillaries—plus, patches of red skin.

How to treat it: Over-the-counter and prescription-strength anti-inflammatory creams and lotions tend to work best. Your doctor may put you on a topical product like Finacea, Metrogel or Soolantra to help control the symptoms of rosacea. “For the facial redness with flushing, Mirvaso is a great topical option,” says Dr. Engelman. Other modes of treatment include oral medication or even a pulsed-dye laser or IPL treatment.

Keratosis Pilarais
If your legs, arms or any other part of the body other than your face are prone to developing itchy red bumps that don’t go away—and don’t come to a head—chances are it’s KP (keratosis pilaris) rather than a breakout. While it’s not impossible to break out in places other than your face, lesions on these parts of the body usually aren’t acne because there aren’t many sweat glands to produce enough oil. KP is the result of abnormal keratinization of the lining of the hair follicle. “It's a condition that so, so, so many people have,” says Dr. Reichel.

How to treat it: Exfoliate, exfoliate, exfoliate! KP requires diligent and regular use of a good exfoliator because the root of the problem is in essence a clogged pore (predominately clogged with just dead skin, not bacteria and oil, which is the case with pimples). Body washes and lotions with lactic acid are key because they unplug the follicle, as are laser treatments to reduce any redness, too. “KP is hard to treat due to the inflammation around the follicles,” says Dr. Reichel. “I put my patients with KP on Hydro40, which helps it get better.”


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1 Comment
  • Kate Clarke
    Posted on

    This article was very helpful, thank you! Although I do not have any of these skin conditions above, I do have bumps on my legs due to shaving. I moisturize my skin daily but the bumps don't seem to go away. I read, in this article: http://www.northdallasderm.com/uncategorized/laser-hair-removal-get-started-now-for-smoother-skin-by-summer/ that laser hair removal can actually help treat razor bumps, on top of removing unwanted hair. Has anyone tried laser hair removal this and seen good results?

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