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Are the Bumps on My Body Really Acne?

Did you know that bumps on the body may not always be acne? There could be bumps or lesions on the skin for multiple reasons, and the best thing to do is see a dermatologist so you can get properly diagnosed and a customized treatment plan. All bumps are not acne or even cystic acne, and treating them as such could lead to exacerbating the condition or improper healing. Here are some conditions that produce raised bumps on the body but are not acne. 


Hidradenitis suppurativa (HS) 

HS is a non-contagious condition that may start with spots filled with white liquid, or even firm, pea-sized lumps. The lumps may disappear, or they could rupture after some hours or days. However, without medicine, namely antibiotics, new lumps will often develop. HS is also known to create sinus tracts or tunnels under the skin that can resemble cystic acne. 


Without treatment or if one tries to rupture it by themselves, some of the lumps may become infected with bacteria. Hidradenitis suppurativa (HS) can be very painful, and it is a long-term condition that often presents on the armpits, breasts, groin, and glutes 


What causes hidradenitis suppurativa?

Scientists are unsure of hidradenitis suppurative’s exact cause, but inflamed, blocked hair follicles and hormonal factors are known to cause HS. It could also be an immune response to naturally occurring bacteria in the area.


Folliculitis

Caused by a yeast infection, pityrosporum folliculitis presents as a rash of itchy, pus-filled bumps that may resemble pimples or whiteheads. Typically, you’ll see it on the back and chest.


Bacterial folliculitis

This is when the hair follicle gets infected with bacteria instead of yeast. When the hair follicles become infected with bacteria, usually staphylococcus aureus (staph), it also looks like a rash with pustule bumps. Staphylococcus aureus actually lives on the skin naturally, but it can become a problem upon being too numerous or entering the hair follicle. 


When you go to see a dermatologist, the doctor may pluck some of the hairs and look at them under a microscope with potassium hydroxide to see if it is fungal or bacterial. In rare cases, they may also perform a skin biopsy.

This is when skin cells or skin lesions are removed to be tested. Skin biopsies are very rare for diagnosing folliculitis, but there’s a small chance the physician may do one on certain patients to rule out any other potential medical conditions. 


Keratosis pilaris

Keratosis pilaris is caused by compiled keratin, a hard protein that protects the skin. The keratin builds up, covers the top of the hair follicle, and hardens. Keratosis pilaris can resemble little red dots, and on richly melanated skin, keratosis pilaris may resemble blackheads. When you run your fingers over a patch of keratosis pilaris, it may feel raised, rough, and bumpy


Fox-Fordyce  

Mostly affecting women, Fox-Fordyce is a rare skin disorder. Fox-Fordyce is very itchy, and it commonly presents on the underarm area, pubic area, and around the areolas. Fox-Fordyce is thought to be caused by abnormalities that affect the apocrine sweat glands.

In turn, there is inflammation, enlargement of the glands, and intense itching.  “Apocrine glands produce viscous, lipid-rich sweat, which is also comprised of proteins, sugars, and ammonia” (NIH, 2019).

Oftentimes, the skin affected becomes darkened and dry. Small, raised papules are often seen as well. The hair follicles affected by Fox-Fordyce can also become damaged, and this may result in hair loss.