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Acne vulgaris - Management
What else might it be?

  • Acne vulgaris is rarely misdiagnosed. Conditions which may mimic the signs of acne include:
    • Rosacea is the condition most commonly mistaken for acne vulgaris. It usually occurs in older people and its main symptom is flushing and the presence of inflammatory papules, with a central facial distribution. However, there is an absence of comedones, nodules, or scarring. See the CKS topic on Rosacea.
    • Folliculitis and boils may present with pustular lesions similar to those seen in acne. Swabs usually yield Staphylococcus aureus. Sycosis barbae is persistent folliculitis of the beard area. See the CKS topic on Boils and paronychia.
    • Milia are small keratin cysts that may be confused with whiteheads. They tend to be whiter than acne whiteheads, they do not have a central punctum, and they are most commonly found around the eyes.
    • Perioral dermatitis presents as erythema and small papules around the mouth, nasolabial folds, and sometimes the lower eyelids. It can have both eczematous and acneiform features, and when acneiform features predominate it may be mistaken for acne. In these cases, the perioral distribution gives the best clue as to its nature.
    • Demodex folliculitis is caused by mites and usually occurs in older people. It predominantly affects the face.
    • Pityrosporum folliculitis is caused by a yeast-like organism. It tends to affect younger people and predominates on the trunk.

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