6 Skin Bumps That Aren't Acne
When a pink or flesh-toned bump pops up seemingly out of nowhere on your face or body, it’s easy to assume it’s a pimple and treat it accordingly. But not all bumps and blemishes are caused by acne—and, in some cases, treating them that way may do more harm than good. Linda Stein Gold, M.D., a dermatologist in West Bloomfield, Michigan, and an Acne Store advisory board member sees it all the time. “You see these pimples and go buy some acne medications, and all it does is make your skin look even redder or even worse,” she says.
That’s because acne isn’t the only thing that goes bump on your skin. There are a whole host of other skin conditions that can cause red, raised lesions. Here, Stein Gold helps us spot these other pimple-like conditions, so you can treat them right.
1. Small bumps on the face could be rosacea
You may picture red, flushed cheeks when you think about rosacea, and that’s part of the inflammatory skin condition. But one type of the skin issue (there are a few), called papulopustular rosacea, also causes acne-like breakouts along with the redness. Any skin tone can have rosacea, but it’s more common in fairer complexions. And it tends to peak in women in their upper 40s. “You’ll see some background redness, some visible capillaries, and you may see some pimples and pustules as well,” says Stein Gold.
Unlike your regular bout of blemishes, the pimples associated with rosacea are not caused by a bacterial component. “Rosacea at its core is really an inflammatory process,” says Stein Gold. It’s treated with topical and oral anti-inflammatory medications. Antibiotics are often used for rosacea, but a low dose that’s used for its anti-inflammatory properties, not it’s bacteria-killing benefit.
To help determine if your bumps stem from acne or rosacea, look at the rest of your face. If it’s acne, you also may have some blackheads and whiteheads. “These don’t occur with rosacea,” she says.
"Not all bumps and blemishes are caused by acne and treating them that way may do more harm than good."
2. Tiny bumps all over the body could be keratosis pilaris
This condition has earned the nickname “chicken skin” because it causes rough, bumpy areas that look like bumps on a raw chicken. “Like acne, keratosis pilaris occurs on a hair follicle, but what’s different is that this really isn’t an inflammatory skin condition,” says Stein Gold. “This is a keratotic clog in the hair follicle that creates a little bump.” That means your follicle is clogged with keratin, a type of protein. The treatment may include moisturizers that include keratolytic ingredients, which break down that extra protein and soften and smooth the rough skin. These include ammonium lactate, lactic acid, salicylic acid, and urea.
3. A bump on the skin that won’t go away could be skin cancer
“If you see a pimple that’s been on your face for a while—maybe it even hurts or bleeds occasionally—it may be skin cancer,” says Stein Gold. We tend to think of skin cancer as dark moles that look different than the rest, but it can show up as flesh-toned, pink, or red pimple-like spots, too. In fact, basal cell carcinoma is often mistaken for a pimple. And even a melanoma can be pink or colorless (a type called amelanotic melanoma).
Bottom line: If you have a bump that’s not going away, or a spot that bleeds on its own (not from picking it), then Stein Gold suggests you circle it and take a pic to show your dermatologist. “It should really be investigated as soon as possible,” she says.
4. Bumps where there’s normally hair could be folliculitis
Red, pus-filled bumps that start in a hair follicle, sure sounds like acne, but it’s actually a different skin condition. Called folliculitis, these bumps stem from inflammation of the hair follicle. They can also be triggered by infection. And they can show up anywhere you have hair. It can show up on the face and neck (especially if you’re a man who shaves), but folliculitis can also occur on the thighs, the buttocks, or anywhere you might have some friction, says Stein Gold. It’s typically treated with antibiotics or topical steroids. “If someone is prone to it, I may have them use a benzoyl peroxide wash, which kills all bacteria, not just the type that causes acne,” says Stein Gold.
5. Small fleshy bumps on the face could be milia
Milia are tiny hard skin-toned bumps on the skin’s surface, and are often put into the acne category, but that’s a mistake. These bumps form when keratin gets trapped just beneath skin’s surface. It can happen at almost any age. In fact, it’s very common in newborns. Milia can go away on its own, but topicals that rev up cell turnover (and natural exfoliation) such as topical retinoids can speed up the process. A dermatologist can also extract the skin plug in the office. Don’t try that at home.
6. Bumps on the skin after shaving may be pseudofolliculitis barbae
This condition, also known as razor bumps, is directly related to irritation from shaving. “If you have naturally curly hair, once shaved or cut down, it can curve back into the skin, causing a bump on the hair follicle,” says Stein Gold. Men tend to get it on their necks where they shave, and it’s more common in skin of color. “But it can occur in anyone with curly hair where the hair isn’t growing out completely,” she says.
“The best way to treat it is to prevent it from occurring in the first place, which means not giving yourself those close shaves,” says Stein Gold. When bumps do occur, topical antibiotics, topical retinoids, and benzoyl peroxide can treat them and allow the hair to grow out naturally, she says.
Linda Stein Gold, M.D.
Dr. Linda Stein Gold, Chair of the Acne Store Board of Dermatologists, is the Director of Dermatology Clinical Research and Division Head of Dermatology at the Henry Ford Hospital in Detroit. She received her medical degree from University of Pennsylvania School of Medicine in Philadelphia, completed an internship in the Department of Internal Medicine at the Hospital of the University of Pennsylvania in Philadelphia.
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