That's right: You might not actually be dealing with acne at all. Two dermatologists break down the differences between these skin conditions.

By Lauren Wellbank
February 21, 2020
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sDo you suffer from reoccurring "acne" that seems to mainly pop up on-and-around your chin or rashy spots that appear around the folds of your nose? The blemishes you see may not actually be acne, but instead a condition called perioral dermatitis. Ahead, two board-certified dermatologists break down the difference between the two skin ailments—and they explain exactly what you can do to stop perioral dermatitis in its tracks.

Getty / Ridofranz

Periorial dermatitis presents more like a rash—but masks as acne.

Perioral dermatitis is an inflammatory rash—not an acne subtype—that mainly develops around the mouth and nose, says Dr. Michelle Henry, a New York City-based board-certified dermatologist and Galderma consultant. The rash is often red, scale-like, and bumpy. Although much remains unknown about the condition—Dr. Henry says that the cause of perioral dermatitis is still a widely debated topic—we do know that it is more common in women than men, and it typically crops up anywhere from the late teens to the mid-40s.

These bumps don't usually go away on their own.

One main way perioral dermatitis differs from acne is that these flare ups last longer when they are left untreated. "Even without treatment, acne lesions will usually go away on their own," Dr. Henry explains. She adds that the appearance of each condition's blemishes offers another main difference between the two. "Acne lesions also tend to be more inflamed and less scaly than those of perioral dermatitis." Dr. Julie Russak, of Russak Dermatology Clinic, adds that perioral dermatitis is often itchy and may even burn, whereas acne does not. "Perioral also has a faster onset, while acne typically develops more slowly," she notes.

See a doctor if acne medications aren't working.

If your problem isn't getting better with over-the-counter acne treatments, and it lasts for two weeks or longer, Dr. Henry recommends going to a dermatologist for evaluation—especially since perioral dermatitis probably won't resolve with these types of remedies. Your doctor will most likely prescribe anti-inflammatory creams (but say no to steroids, which only prolong and aggravate the problem!) and topical antibiotics like metronidazole; oral antibiotics such as doxycycline are also prescribed to help eliminate any bacteria that might be contributing to the problem and reduce inflammation. While perioral dermatitis can resolve on its own, Dr. Russak says that chances of that happening are slim—and that it will often come back without medical intervention.

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