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Acne Look-Alikes

Other Skin Conditions that May Cause Pimples


Updated June 19, 2014

Not all pimples are caused by acne. You may be surprised to learn 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 and acne "look-alikes". It is always in your best interest to be evaluated by a doctor to ensure the correct diagnosis of your skin condition.


Photo © A.D.A.M.

Formerly called acne rosacea, rosacea is a chronic inflammatory skin disorder affecting the cheeks, nose, chin, and forehead. Rosacea causes dilation of the blood vessels, which gives the skin a flushed appearance. Acne-like bumps, papules, and pustules frequently occur. It is often confused with adult onset acne.

Roseacea typically does not develop before the age of 35, and is more common in women than men. Those with this condition may find they have flare-ups as well as periods of time when the skin is relatively clear. The exact cause of rosacea is unknown, but there are treatments available to help control the progression and severity of this condition.

Keratosis Pilaris

Keratosis Pilaris
Photo © A.D.A.M.

Keratosis pilaris is 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 flesh colored or red. It most often affects the upper arms, thighs and buttocks, but may occur on the face 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 like appearance. Keratosis pilaris is most common in children and teens, although it can occur in adulthood. It is not serious and usually resolves without treatment.


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. Irritation of the hair follicle is often caused by friction, such as where the straps of a heavy backpack rest on the skin, or by shaving. The follicles may become infected. Folliculitis can occur anywhere on the body.

Pseudofolliculitis barbae is a condition in which hair grows back into the follicle (ingrown hair) causing an inflammatory reaction. These lesions commonly fill with pus. Pseudofolliculitus is common in the beard area, especially in African-American men.

Miliaria Rubra

Heat Rash
Photo © Angela Palmer

Also known as prickly heat or heat rash, miliaria rubra is an acute inflammation of the sweat glands. Miliaria rubra is characterized by the eruption of small red bumps on the surface of the skin. The rash may also itch or burn.

Caused by exposure to excessive heat, miliaria rubra tends to be most common in children, however it can occur in adults as well. It is typically is found on areas of the skin covered by clothing. In severe cases the rash may spread to the face, especially the cheek area.

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