Copycat Conditions: What Really Lies Beneath the Bumps

Acne is one of the most common concerns clients present with, yet what looks like acne is not always acne. Acne vulgaris is a chronic condition marked by pimples, excess oil, and redness. Genetics are a key factor, as some clients are more prone to clogged follicles filled with oil and dead skin cells. Acne typically appears on oily areas such as the face and back, and in severe cases, it can lead to scarring and emotional distress.

In the treatment room, professionals often meet clients who are frustrated after trying countless products and treatments without results, only to discover they are not dealing with acne at all. Many other conditions mimic acne’s appearance, yet the causes and treatment approaches are entirely different. Recognizing these differences is essential for creating an effective skin care plan and knowing when to refer a client to a dermatologist.

ROSACEA

Rosacea is one of the most common conditions mistaken for acne. It shares several symptoms – redness, bumps, and visible capillaries – most often appearing on the nose, cheeks, and forehead. Many clients seek acne treatments that can actually make their rosacea worse. Although the exact cause of rosacea is still unknown, triggers such as stress, alcohol, sun exposure, and spicy foods often exacerbate symptoms.

Professionals can support these clients by focusing on barrier repair and soothing treatments while recommending that they consult a dermatologist for prescription therapies or laser treatments.

FOLLICULITIS

Folliculitis produces small pimples or pustules that closely resemble acne but usually occurs in small, localized patches anywhere hair grows. Both conditions involve inflamed follicles, yet folliculitis can be bacterial, fungal, or viral in nature.

In a spa setting, the goal is to recognize when the condition is not acne and avoid treatments that could worsen it. Once a physician provides a diagnosis, professionals can support overall skin health with noncomedogenic products and gentle exfoliation as advised.

PERIORAL DERMATITIS

Perioral dermatitis appears as clusters of small bumps or blisters with surrounding redness, typically around the mouth and nostrils and sometimes near the eyes. Many clients mistake it for acne, especially when the bumps resemble whiteheads.

This condition is often triggered by topical steroid use or heavy skin care products. Aestheticians can help by simplifying the client’s routine and recommending fragrance-free, non-irritating products. Clients typically need oral antibiotics or prescription topicals, making referral to a dermatologist essential.

SYRINGOMA

Syringoma presents as small, firm, skin-colored or yellowish bumps, most commonly on the eyelids, cheeks, or forehead. These bumps are not inflamed and contain no pus, but clients often confuse them with acne due to their location.

Syringomas are benign growths that cannot be treated with facials or acne products. Clients who are concerned about their appearance should be referred to a dermatologist, as carbon dioxide laser treatments are the most common removal method.

KERATOSIS PILARIS

Keratosis pilaris is a harmless condition that causes rough, small bumps, most commonly on the arms, thighs, and buttocks, but occasionally on the face. Symptoms often worsen in dry weather and occur when keratin builds up in the hair follicles.

Clients often believe these bumps are chronic breakouts. Professionals can create a plan focused on exfoliation and hydration using lactic acid, urea, and barrier-supportive products to smooth skin’s texture.

MILIA

Milia are tiny white or yellow cysts that develop when keratin becomes trapped under skin. They are most often seen around the eyes, cheeks, and nose, and many clients believe they are stubborn whiteheads.

While milia can resolve on their own, manual removal by a licensed professional can be performed safely in the treatment room. For prevention, gentle exfoliation and noncomedogenic eye creams are recommended.

OTHER CONDITIONS

Several other disorders can mimic acne, including sebaceous hyperplasia, molluscum contagiosum, and rare conditions such as steatocystoma multiplex. Basal cell carcinoma, a form of skin cancer, can also occasionally present as acne-like lesions.

KEY TAKEAWAY

A thorough skin analysis is essential before recommending any acne protocol, as these conditions differ greatly in both cause and treatment. Licensed professionals must understand their scope of practice, supporting skin where appropriate, educating clients, and referring to dermatologists when medical treatment is needed.

Collaborating with dermatologists not only ensures clients receive comprehensive care but also strengthens professional credibility. Building relationships with local dermatologists creates a trusted referral network that benefits both providers and clients. Staying within scope while partnering with medical professionals reinforces the value skin professionals bring as part of a client’s overall skin health team.

Tori Prince is an award-winning international skin of color expert, licensed aesthetician, published makeup artist, and educator with over a decade of experience specializing in melanin-rich skin. She is the founder of Tori Prince Beauty, a results-driven luxury skin care brand devoted to healing hyperpigmentation, restoring confidence, and redefining beauty standards for women of color. Known for her clinical insight and soulful approach, Prince blends corrective science with intentional care. Her mission is simple yet powerful: to help every woman feel radiant in her natural canvas – without apology, without compromise.