Acne is a skin condition that is so common these days, common term people use for acne is pimples. But people confuse acne with another skin condition known as folliculitis. Let’s dig out the difference between the two conditions of the skin.

Acne vs Folliculitis

Definition:

Acne:

Acne is defined as a skin condition that happens when your hair follicles of skin are blocked with dead skin cells and oil. A hair follicle is a small secretory cavity, covering of connective tissue and cells, which surround the root of a hair.

Folliculitis:

Folliculitis is defined as a skin condition that causes infection or inflammation of the hair follicles of the skin.

Risk factors:

Risk factors are those factors that increase the risk of certain diseases.

Acne:

Following are the factors that may increase the risk of acne in a person:

  • Age (acne is most common in teenagers but it can occur in any age group)
  • Family history (positive family history may play role in developing acne)
  • Oily skin or substances (oily skin is more prone to develop acne and using oily substances like lotion or creams can also increase the risk of developing acne)
  • Stress (stress also plays a key role in developing acne)
  • Polycystic ovary syndrome (PCOs)
  • Cigarette smoking
  • Diabetes
  • Hormonal changes (commonly occur at the time of puberty)
  • Food (carbohydrate rich diet increases risk and also worsens the already existing acne)
  • Medicines (medicines such as corticosteroids increase the risk of developing acne).

Folliculitis:

Following are the factors that may increase the risk of folliculitis in a person:

  • Tight clothing (tight clothing which traps heat and sweat)
  • Swimming pool or hot tub (frequent use of unclean swimming pool or hot tub)
  • Shaving
  • Medications (long term use of antibiotics)
  • Weak immune system
  • Diabetes
  • Frequently rubbing or touching your skin.

Causes:

Acne:

Common causes of acne are the following:

  • Overconsumption of sebum or oil
  • Bacterial products
  • Hair follicles blocked by dead skin cells and oil or sebum
  • Inflammation
  • Steroids injections

Folliculitis:

Common causes of folliculitis are the following:

  • Tight clothing which blocks sweat and heat
  • Bacteria (staphylococcus aureus)
  • Frequent use of unclean hot tubs or swimming pools
  • Frequent shaving
  • Certain medications
  • Damage to hair follicles.

Types:

Acne:

Following are the different types of acne:

  • Mild acne
  • Moderate acne
  • Black heads
  • White heads
  • Comedones
  • Acne vulgaris
  • Nodules
  • Pustules
  • Papules
  • Nodulocystic acne
  • Cysts
  • Acne mechanica
  • Acne conglobata.

Folliculitis:

Following are the different types of folliculitis:

  • Superficial folliculitis
  • Deep folliculitis
  • Bacterial folliculitis
  • Gram negative folliculitis
  • Pseudomonas folliculitis
  • Furuncle (boil)
  • Pseudofolliculitis
  • Pityrosporum folliculitis
  • Eosinophilic folliculitis
  • Carbuncles.

Signs and symptoms or clinical presentation:

Acne:

Signs and symptoms may vary depending on the type of acne. The most common presentation of acne is the following:

  • Hyperpigmentation or hypopigmentation
  • Skin discolouration
  • Swelling
  • Redness
  • Pain
  • Tenderness
  • Dark patches
  • Inflammation.

Folliculitis:

Signs and symptoms may vary depending on the type of folliculitis. Most common presentation of folliculitis is the following:

  • Round small red bumps
  • Itching
  • Pain
  • Tenderness
  • Burning
  • Pus filled bumps.

Investigations or lab tests:

To diagnose and rule out the cause or/ and site or/ and type of the disease your doctor will suggest some lab tests (investigations).

Acne:

Mostly acne is diagnosed clinically but in some rare and severe cases your doctor may advice the following investigations:

  • Tests for microorganisms
  • Hormonal tests
  • X rays
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI) brain
  • Complete blood count (CBC).

Folliculitis:

Alike acne, folliculitis is also diagnosed clinically but in some rare and severe cases your doctor may advice the following investigations:

  • Skin swabs (bacterial or viral)
  • Tissue culture
  • Skin scraping
  • Complete blood count (CBC).

Treatment:

Acne:

Treatment options for acne are the following:

  • Topical retinoid cream or lotion
  • Topical and oral antibiotics
  • Dapsone
  • Topical salicylic acid
  • Combined oral contraceptive pills (COCPs)
  • Anti androgen agents
  • Laser treatment (it includes invasive lasers and non invasive lasers)
  • Chemical peel
  • Light therapy
  • Steroids injections
  • Life style changes (keep the skin clean, apply warm washcloth, use soothing cream, gel, or lotion, avoid frequent shaving, use antibacterial soap).

Folliculitis:

Treatment options for folliculitis are the following:

  • Antibacterial or anti fungal topical lotions, creams, or gel
  • Antibiotics oral
  • Topical steroids
  • Laser treatment
  • Life style changes.

Complications:

Acne:

Complications of acne are as follows:

  • Acne scars
  • Hyperpigmentation
  • Hypopigmentation
  • Keloids.

Folliculitis:

Complications of folliculitis are as follows:

  • Hair follicles destruction
  • Discolouration of the skin (hyperpigmentation or hypopigmentation)
  • Spread of infection
  • Permanent acne scars.

Conclusion:

Prevention is better than cure. Acne or folliculitis if not taken care of or treated properly can lead to lethal skin diseases.