Last Updated on November 12th, 2019
Nearly everyone gets mild to moderate acne between the ages of 8 and 18, and nearly every case of acne resolves on its own eventually even without medical care. Some people who have acne, however, need the services of a specialized acne clinic. And it’s also possible to have diseases that look like acne but that really aren’t—that may be a sign of something even more serious. Here is a list of the acne and acne-like conditions that require medical attention.
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An astonishing number of diseases cause acne-like or “acneiform” eruptions on the skin that require medical treatment, including:
The most common acne-like infection, however, is impetigo. This skin infection can be caused by staph bacteria, which cause pimple-like eruptions on the skin that ooze a clear yellow fluid, or by strep bacteria, which cause pimple-like eruptions on the skin that ooze a fluid the color and consistency of honey.
Treatments for acne will not usually help these conditions and could make them worse. If you have acne-like outbreaks on the skin that don’t respond to your usual acne care, see a doctor for advice.
Acne conglobata “burrows” between pimples to form large sores on the face, back, chest, and buttocks. It can strike between birth and the age of 30, and it cannot be treated by conventional acne medications. Laser resurfacing may help relieve scars.
Dermatitis herpetiformis is caused by sensitivity to a protein called gliadin, found in gluten in wheat and certain other cereal grains. As much as celiac disease causes severe irritation of the bowel, dermatitis herpetiformis causes severe irritation of the skin. Medications that shut down the inflammation function of the immune system, such as dapsone, are usually required to bring the condition under control.
Many people who don’t have acne as teenagers develop cystic acne in their early 20’s. Usually striking young people with otherwise healthy brown skin, cysts form when rapidly growing skin envelops acne bacteria in pores. The immune system tries to remove bacteria with inflammation, but the bacteria secrete a chemical that redirects the effects of inflammation to nearby skin cells. The cyst grows larger and larger because the acne bacteria are not killed and cannot escape.
Cystic acne used to be treated by lancing. Nowadays it is treated with retinoid drugs like Accutane and Retin-A. Safe use of these medications, however, requires medical supervision. Never try to pop or lance cysts on your own. Permanent scarring and even worse infections can result.
Rosacea is a condition of “pimpling” of the skin on the nose, across the cheeks, and around the eyes. Capillaries leak blood when they are filled with blood, creating tiny red spots on the skin. After a period of years, scar tissue can build up around these capillaries and cause the formation of tiny bumps under the skin, especially under the skin of the nose. You may be able to control rosacea outbreaks on your own, but you will need the assistance of a physician to treat rhinophyma, or “bumpy nose.”
You can probably manage everyday acne on your own without ever seeing a dermatologist, but there are things a doctor can do for you that you cannot do for yourself:
And sometimes your dermatologist can treat “cosmetic emergencies.” Your doctor may be able to give you a steroid injection directly into a pimple to make it less prominent and less noticeable before a special occasion.
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