Acne and Acne-Mimicking Conditions

Acne, although a skin condition seen most often during adolescence, can also appear in adulthood or persist for many years. Blackheads and whiteheads, inflamed spots, deep and painful nodules, and the scars and marks that can follow are its most common findings.

Overactivity of the sebaceous glands, blockage of the hair follicles, bacteria, hormonal factors and genetic predisposition all play a part in the development of acne. For this reason the clinical signs, severity and treatment approach can differ from patient to patient.

Acne treatment is planned according to the extent and severity of the condition, the risk of scarring and the patient's age. The most suitable options from among topical treatments, oral medications and scar treatments are determined on an individual basis. Starting the right treatment early is of great importance in preventing permanent scarring.

That said, not every spot-like eruption on the face or trunk is acne. Some skin conditions can mimic acne, and an incorrect diagnosis can lead to unsuitable treatments being used for a long time. One of the most common of these is pityrosporum (Malassezia) folliculitis, an inflammation of the hair follicles caused by a yeast. It is characterised by itchy, spot-like eruptions of similar size, seen especially on the chest, back, shoulders and face. It often does not respond to acne treatments; indeed, prolonged antibiotic use can make it even more pronounced.

Similarly, rosacea, gram-negative folliculitis, an increase in Demodex, drug-induced acneiform eruptions (particularly those caused by corticosteroids, some cancer medications, vitamin B preparations and certain other drugs) and various hair-follicle conditions can also mimic acne. For this reason, making the correct diagnosis is very important in spot-like eruptions that persist, recur frequently or fail to improve despite treatment. With detailed dermatological examination, dermoscopic examination where needed, and supporting diagnostic methods, the conditions that mimic acne are distinguished and the most appropriate treatment plan is created for the individual.