Is It Acne or Is it: Folliculitis, Sebaceous Filament, Rosacea, Keratosis Pilaris, or Dermatitis

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When an angry red or white lesion pops up on your face, chances are you’ll immediately assume it’s a form of acne — a cystic pimple, maybe, or perhaps a whitehead. And why wouldn’t you? Google images of acne and you’ll find your screen inundated with photos of just that: a slew of nameless faces scattered with inflamed red and white spots, varying in shape and size. The same goes for #acne on social media, of course.

But here’s the thing: It’s a little more complicated than that. Because there’s actually quite a few different skin conditions that can be confused for acne in one way or another. They may overlap with bumps, redness, or even pustules. The good news is we’re breaking them all down here with the help of a board-certified dermatologist so that you can feel equipped to determine the difference and treat yourself accordingly. Knowledge is power — never forget it. 

Sebaceous filament

What it is: Sebaceous filaments are a good thing: They actually help to moisturize our skin by lining pores to facilitate the flow of sebum to the skin’s surface. Kind of cool, right? While they are completely normal, Dr. Garshick says they can become more visible when there’s an overproduction of sebum because the pore appears larger — and thereby it becomes more visible. 

How to tell it apart from acne: Sebaceous filaments are tiny, typically noticed on the nose, and won’t have a dark center like blackheads do. 

Treatment tips: Dr. Garshick recommends retinoids and exfoliants, such as beta hydroxy acid, which, unlike alpha hydroxy acid, is oil-soluble and is therefore able to dive into and clear clogged pores from within. Strawberry Smooth BHA + AHA Salicylic Serum and Watermelon Glow PHA+BHA Pore-Tight Toner can both aid in regulating oil production via a gentle BHA and, in doing so, prevent pores from becoming clogged. 

Folliculitis

What it is: As the name implies, folliculitis is inflammation of the hair follicle. According to New York City dermatologist Marisa Garshick, M.D., it typically presents as red or pus-filled bumps centered around a hair follicle, and can appear on both the face and body. “For some people, it can be more typical along the hairline or involving the lower face,” she says. 

How to tell it apart from acne: With folliculitis, there are typically no comedones, whiteheads, or blackheads. With that said, lesions can look extremely similar to acne bumps — so it’s always best to see your dermatologist if you’re unsure. 

Treatment tips: Dr. Garshick recommends antibacterial washes and topicals, and when it comes to prevention, she recommends being extra cautious when shaving and avoiding plucking, which can trigger inflammation of the hair follicle. 

Rosacea 

What it is: Rosacea is a common skin condition characterized by facial redness, flushing, and/or red bumps and pustules. It’s most often seen in middle-aged women with fair skin tones, though it can occur at any age. While redness can appear in all skin tones, it’s typically not caused by rosacea among those with deeper skin tones. 

How to tell it apart from acne: With rosacea, you won’t see the whiteheads and blackheads that go along with acne. Moreover, Dr. Garshick notes that people with rosacea typically experience other symptoms, such as flushing and adverse reactions to triggers like spicy food, hot temperatures, and alcohol — which is a key differentiator from acne. 

Treatment tips: When it comes to treating rosacea, Dr. Garshick drives home the importance of using gentle, skin-nourishing products with ingredients designed to calm and soothe the skin. She recommends niacinamide as well as ceramides, both of which you’ll find in the Avocado Ceramide Recovery Serum. Additionally, prescription options are available to reduce bumps and improve redness, as well as certain cosmetic lasers like Intense Pulsed Light (IPL). 

Keratosis pilaris

What it is: Keratosis pilaris — often called KP — is typically thought of as a “chicken skin”-like rash that appears on the back of people’s arms, but as Dr. Garshick explains, it can also occur on the face. KP develops when the skin produces an excess of keratin, which can block hair follicles and cause ingrown hair-like bumps to pop up.

How to tell it apart from acne: “Keratosis pilaris can occur on the face as small pinpoint bumps causing the skin to feel rough and bumpy,” says Dr. Garshick. “When involving the face, it tends to occur on the outer cheeks.” 

Treatment tips:  Retinoids and exfoliating ingredients, like lactic, glycolic, and salicylic acids are great at reducing KP bumps, but Dr. Garshick stresses the importance of nourishing and hydrating the skin as well. Try the Strawberry Smooth BHA + AHA Salicylic Serum to tackle clogged pores while simultaneously hydrating the skin; for handling KP on the skin, the Watermelon Glow Pink Dream Body Cream pairs smoothing AHAs with multiple weights of hyaluronic acid to keep skin smooth and comfortable. 

Dermatitis 

What it is: Dermatitis is an umbrella term for a wide range of skin conditions characterized by inflammation; however, it’s most commonly associated with eczema, which can appear anywhere on the face or body. 

How to tell it apart from acne: Unlike acne, dermatitis appears as red flaky patches of skin (flat or raised), which are often itchy and sore to the touch. With dermatitis, you won’t see pus-filled bumps, papules, or whiteheads and blackheads. 

Treatment tips: Similar to rosacea, you want to aim for soothing products that calm and hydrate inflamed skin. Our Avocado Ceramide Recovery Serum is great for this, as is the Plum Plump Hyaluronic Cream, which features ice willowherb to support a healthy skin barrier. Moisturizing in general is helpful for dermatitis, as it often manifests as an impaired barrier — and therefore leaves skin more prone to dryness and dehydration alike.

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