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It May Not Be Acne — How to Tell What It Is

July 24, 2019

Who hasn’t had acne? Maybe even a pimple that lasts for months — and seems like it will stick around forever. But if you have what appears to be long-lasting acne, particularly as an adult, it could be something else. There are several rashes and skin infections that look like acne, and this infographic can help you recognize the difference.

Infographic Text


Basal cell carcinoma

A slow-growing type of skin cancer, usually caused by too much UV exposure, including sunlight and tanning lamps.

Understanding Acne

Acne is usually caused by hormone changes that trigger excess oil secretion, mostly in younger people but also adults.

The pimples (whiteheads or blackheads) typically show up on the face and neck, and can extend to the chest, shoulders or upper back. These pesky bumps can become inflamed and painful, but usually don’t itch.

Pimple Imposters and How to Recognize Them


A chronic, inflammatory skin disorder that’s often hereditary and most common in people with fair skin.


  • Persistent bursts of redness, mostly on the nose and cheeks
  • Lots of little thread veins, and/or acne-like bumps that come and go
  • Facial skin may sting, burn or feel super sensitive

Clues it’s not acne:

  • Unlike acne, you’ll see more facial flushing from dilated blood vessels
  • Environmental triggers can make it worse, including extreme temperatures, sun exposure, stress, alcohol and spicy foods

Perioral dermatitis

An inflammatory facial rash that may be caused by topical steroids, heavy face creams, or the chloride and fluoride found in dental products.


  • A rash concentrated around the nose, mouth and chin area
  • The skin will be dry and flaky, with very small acne-like breakouts
  • The affected area tends to be itchy or suffer a burning sensation

Clues it’s not acne:

  • Unlike acne, this itchy, burning rash usually develops only around the mouth
  • It will get worse with typical acne treatments like exfoliators and benzoyl peroxide

Keratosis pilaris

A chronic skin condition caused by excess keratin that blocks hair follicles.


  • Rough red, white or skin colored bumps, often on the upper arms and legs
  • Skin with this condition is described as feeling "sandpapery"
  • Can cause itchiness and dryness in affected area

Clues it’s not acne:

  • Unlike pimples, these bumps feel rough and usually appear on dry skin
  • You’ll find them on your upper arms and the front of your thighs, rather than on your face

See Your Dermatologist for Treatment

If you think you may have any of these conditions, visit a dermatologist. He or she can examine all your symptoms to provide the right diagnosis and treatment plan.