A pimple-like rash on the face can arise with a variety of infectious and noninfectious skin conditions that affect people of all ages. In many cases, the condition resolves without treatment. For chronic conditions, doctors often recommend topical or oral medications. Although pimple-like rashes often resemble acne, the causes and treatments often prove distinctly different.
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Rosacea, also known as acne rosacea, is a chronic skin disorder that most commonly affects fair-complected people between the ages of 30 and 50. The disorder typically begins with redness of the cheeks and nose, known as flushing. In some people, pimple-like eruptions accompany the red rash. People with pimple-like lesions have the rosacea variant known as papulopustular rosacea. Treatment may include topical or oral antibiotics and other medicated lotions, creams or washes.
Folliculitis is a local infection of the hair pores, or follicles. Sycosis barbae refers to folliculitis of the skin area of the male beard. The bacterium Staphylococcus aureus most commonly causes sycosis barbae. Tender, pus-filled, pimple-like lesions occur on the chin, cheeks and the area between the nose and upper lip. In most men, the condition resolves with topical washes and antibiotics. A break from shaving may help speed the resolution of the disorder. Doctors may prescribe oral antibiotics or other treatments for men with severe or repeated episodes of sycosis barbae.
Milia are white, pimple-like bumps representing an accumulation of dead skin cells, commonly occurring on the face. Newborn babies often have milia, which usually clear without treatment. Adults can also develop facial milia, which may resemble acne. Although milia pose no medical threat, they tend to persist in adults. Some people opt for simple removal of milia for cosmetic reasons.
Measles is a systemic viral illness characterized by fever, runny nose, cough and a pimple-like rash. The rash typically begins near the hairline and spreads to the face, neck and chest. The rash continues spreading to the arms and legs before resolving in approximately 5 to 6 days. Measles is a vaccine-preventable disease but unvaccinated children and adults remain susceptible to the illness.
Shingles, or herpes zoster, occurs when the varicella-zoster virus reactivates after a previous case of chickenpox. The varicella-zoster virus, which causes both chickenpox and shingles, remains inactive in the nerves after recovery from chickenpox. Many years later, the virus can reactivate, causing shingles. The face is the second most common site for shingles. A pimple-like rash usually erupts on one side of the face after several days of pain, itching or burning in the affected skin region. The bumps first appear as red blisters, which gradually become pus-filled before crusting and healing. The painful, pimple-like rash of shingles typically resolves in a few weeks.
Next Steps and Precautions
Many adults continue to have periodic outbreaks of acne, which can be difficult to distinguish from other pimple-like rashes on the face. Seeing your doctor is the best course of action if you have an unexplained facial rash. She can accurately diagnose your condition and prescribe appropriate therapy. If you suspect facial shingles, see your doctor right away as there can be serious complications. Antiviral therapy is most effective if started within 72 hours of the appearance of the shingles rash.
- Acne and Rosacea: Epidemiology, Diagnosis and Treatment; David J. Goldberg and Alexander Berlin
- Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Eighth Edition; John E. Bennett, et al.
- Manual of Dermatologic Therapeutics, Eighth Edition; Kenneth A. Arndt, et al.
- Centers for Disease Control and Prevention, Pink Book: Measles
- Merck Manual Professional Version: Herpes Zoster (Shingles; Acute Posterior Ganglionitis)