3. Other conditions can look like acne, so don't be fooled

Doctor Jacob here, and today we're going to be talking about other conditions that can look like acne. The title is "Other conditions can look like acne, so don't be fooled."

This is really important, because if you think that you're going to get treatment for acne, well it's really important that you have acne. Otherwise, the treatments have no shot at working, for the most part. So let's talk about conditions that can look like acne that can kind of fool you.

The condition perhaps most commonly confused with acne is something called rosacea. The way you tell rosacea apart from acne is by the presence of the clogged pore, also called the comedo, in acne. A patient who has only rosacea will not have clogged pores or comedones. Comedones or clogged pores evolve into the other features of acne, including the pimple and the big cyst, or nodule, whereas in rosacea clogged pores are not a feature at all. The hallmark of rosacea is redness, usually seen as dilation of blood vessels called telangiectasia on the cheek. However, in more severe forms of rosacea, pimples can also occur. They usually occur in the central face area, like the nose, cheeks and sometimes the forehead and chin. Rosacea tends to run in families and tends to be more common in fair-skinned individuals. Of course, some people have both acne and rosacea.

The next condition that I'd like to talk about that can be confused with acne is something called perioral dermatitis. As you can imagine, it's typically seen around the mouth. It's seen mostly in women, and again, unlike in acne, in this condition there are no clogged pores. Instead, there are tiny pimples, little papules or micro-pustules which are seen usually around the mouth, but sometimes can be around the nose or even around the eyes. The condition is also called periorificial dermatitis, meaning not just around the mouth, but around other openings, orifices. So that's a potential thing that could be confused with acne. This condition of perioral dermatitis is seen almost exclusively in women and can be made worse by topical cortisone type products.

The next condition that can sometimes be confused with acne is something called pathologic skin picking, and was previously called acne excorie. It's actually not acne, because the problem isn't really clogged pores. It's that patients may think that they have little blemishes and they pick with either their fingernails or an implement such as a tweezer, typically using a mirror or even a magnifying mirror, and the picked out spots become sometimes infected and raw, and the treatment is to not pick. I'm not talking about the average person with acne who squeezes a pimple here and there; this is a primary problem of skin-picking, although there may be some minor acne of the regular type that can be associated, which is the cause for the picking. But the main problem in this condition is pathologic skin picking, which is the name of that condition.

Finally, there's one more commonly confused condition with acne, and that's something called pseudofolliculitis barbae. Translated, it means false inflammation of the follicles of the beard - pseudofolliculitis barbae. Why does it happen? It's a problem typically seen in people with darker skin, usually of African descent, with curlier hair. It comes about when such individuals decide to shave their facial hair for hair removal. As the hair grows back, the curlier type hair tends to turn around and grow inward into the skin. The shaved hairs have a very sharp point, and they're kind of like very tiny hair spears. As the hairs travel throughout the skin they cause inflammation, which leads to small little bumps, sometimes even scarring. By stopping shaving or using alternate forms of hair removal, the condition tends to improve drastically.

In summary, not all bumps on the face are acne. Other conditions can look like acne, so don't be fooled.

I'm Doctor Jacob, we'll see you next time.