Acne is a common skin condition but can be very difficult (and annoying) to treat. I have dealt with acne since I was a teenager, and while it has improved over the years (thanks to science-backed medications) I still have to manage it from time to time.
What some people may not realize is that there are other medical conditions that can cause acne-like bumps that may not be true acne. Or maybe it is acne (clogged pores) but it’s on an area not commonly discussed. Like your buttocks for example?
As a dermatology physician assistant, I treat all different types of skin conditions. Based on what I have seen in clinic, and after discussing with my patients, I have come to the conclusion that there are several common skin conditions out there that people are simply not familiar with. After reading this article, you should feel more educated on these less talked about skin conditions that can cause acne-like bumps.
Acne rosacea
I have written about rosacea treatment previously. You can find a more detailed article here. Rosacea is an inflammatory condition that can affect people of all skin types. There are several different subtypes of rosacea and also many different triggers.
One of the subtypes of rosacea is acne rosacea, which typically causes acne-like bumps on the cheeks and nose but people can experience it on other parts of the face as well. There are many great topical and oral treatment options for the acne-component of acne rosacea but the first step is to avoid your triggers.
The most common triggers to be aware of (and to try and avoid) are sun exposure, stress, alcohol, spicy foods, and high intakes of caffeine or sugar. Unfortunately, there is no cure for rosacea but if you figure out what your trigger is and avoid it then you should notice an improvement in your condition. If you know you have rosacea and feel like every sunscreen causes your rosacea to flare, then try Elta MD UV Clear. It is my favorite mineral based sunscreen for acne and rosacea-prone skin.
Acne mechanica
Acne mechanica is a type of acne caused by pressure, friction and/or tight clothing. One of the common places to get this is on the buttocks. I see this commonly in my patients who are athletes especially those who like to ride bikes or go to spin class. The constant pressure and friction can clog the pores and cause acne. Adding in sweat only exacerbates the condition.
Make sure to always shower as soon as possible after working out. I find that antibacterial washes work well for this type of acne. One of my favorites is Panoxyl wash, which you can find over the counter in the acne aisle. Panoxyl is Benzoyl Peroxide and can bleach clothing, sheets, and towels so just be aware of that!
A subtype of acne mechanica is maskne (mask acne), which became a commonly used word when COVID-19 started. If you are still required to wear masks for your job (which I am) you want to make sure that you are washing your masks regularly and are avoiding wearing makeup or heavy moisturizers underneath.
Acne keloidalis nuchae
Acne keloidalis nuchae is actually a type of folliculitis (inflamed hair follicles) typically found on the back of the neck. It more commonly affects men of color. It is caused by shaving too close to the skin. The hair follicles become inflamed and then turn into little keloids or thickened scars which resemble acne-like bumps.
These bumps can become itchy and sometimes painful. The first step in treating this condition is to stop shaving close to the skin. Using clippers at least a quarter of an inch from the skin is safe to do. Topical or oral antibiotics in combination with steroid injections can be used to treat this condition. In severe cases, permanent hair removal can be a solution to the condition.
Steroid-Induced acne
There are many different types of medications that can either cause or worsen acne. One of these medications is steroids. This includes both topical and oral steroids. Typically I never recommend applying topical steroids to the face except in rare circumstances. Topical steroids over time can thin the skin but they can also cause steroid-induced acne.
The treatment of steroid-induced acne is relatively simple. All you have to do is stop the topical steroid. The downside to this is whatever skin condition you have been treating with the steroid will likely flare upon discontinuing. This is when a dermatology medical provider comes in. They will be able to provide you with an alternative medication to help treat your condition, but at the same time not cause acne. NEVER discontinue oral steroids without first discussing with your medical provider.
Perioral dermatitis
Perioral dermatitis is a condition that causes small red bumps around the mouth. People may notice a burning or tingling sensation associated with the rash. It can look like acne but it is only in this distribution. (Although occasionally people can also get something called periocular dermatitis, which is the same thing but around the eyes!)
Perioral dermatitis can be caused by using topical steroids, but it can also be caused by other reasons such as pregnancy, birth control, recent fluoride treatment at the dentist, or skin care products you are using.
Using a very gentle skin care regimen while the rash is active is important to prevent worsening of the rash. Discontinuing the use of any topical steroids is also necessary although it will likely cause it to flare temporarily. Perioral dermatitis is a skin condition that likes to recur in some people, although it’s difficult to know when that will happen.
Conclusion
There are many types of skin conditions out there that can present differently from person to person. These five skin conditions: acne rosacea, acne mechanica, acne keloidalis nuchae, steroid-induced acne, and perioral dermatitis are common enough that people should be made aware of them. When in doubt always seek out a dermatology medical provider to help you distinguish between the different types of acne-like bumps you may be experiencing.
If you found this article helpful, please leave a comment below! I would love to know what skin condition you are struggling with.
*Disclaimer: Opinions expressed are solely my own and do not express the views or opinions of my employer. Information on this website is for education and entertainment purposes only. Content is my opinion. It is not substituted for your own doctor’s medical care or advice. One should not make any health or medical-related decisions based in whole or in part on any content on this site. Content is not intended to replace the services of a licensed, trained health professional. Content may not apply to you as an individual. Although I will update my website with current information, this website is not a definitive guide to dermatology.
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