Professor Nicola Ralph on The Pat Kenny Show - Newstalk: Is it really Acne?

Understanding the Difference Between Acne and Other Skin Conditions

Professor Nicola Ralph, Consultant Dermatologist and Co-Founder of the Institute of Dermatologists, recently joined The Pat Kenny Show on Newstalk to discuss a topic that many patients ask about:

How do you know if your skin condition is actually acne?

Acne is extremely common, affecting around 9.4% of the global population, particularly during the teenage years when hormonal changes stimulate the skin’s oil glands to produce excessive sebum (oil).

However, not every breakout is acne, and treating all facial spots as acne may exacerbate certain skin conditions.

What Causes Acne?

Acne develops when increased oil production combines with dead skin cells to block pores resulting in the formation of a blackhead/comedone.

The earliest visible sign are usually blackheads, which form when these blockages sit within the pore and become oxidised at the surface.

These blockages can then lead to inflammation, red spots and pus-filled lesions.

Because acne begins with blocked pores, the presence of blackheads is often an important clue when diagnosing the condition.

When It Isn’t Acne

Several other common skin conditions can resemble acne at first glance.

Rosacea

Rosacea affects around 10% of Irish adults, particularly those with fair skin.

It commonly presents with:

• Persistent redness on the cheeks and nose
  

• Small red bumps or pustules
  

• Visible broken capillaries
  

• Episodes of flushing
  

Unlike acne, rosacea often worsens when harsh acne treatments are used.

Perioral Dermatitis

Perioral dermatitis causes clusters of small red spots around the mouth, nose or eyes.

It can sometimes feel mildly itchy and may spread gradually across the face from one side of the mouth, nose or eye to the other.

Dermatologists have noticed an increase in this condition in recent years, partly related to overuse of skincare products or harsh active ingredients that disrupt the skin barrier.

Treatment focuses on restoring the skin barrier, often using gentle moisturisers containing ingredients such as ceramides.

Keratosis Pilaris

Keratosis pilaris appears as small red, rough bumps, most commonly on the upper arms.

It is linked to dry skin and genetic factors and is often more noticeable during childhood and adolescence.

Moisturisers containing ingredients such as urea can help improve skin texture and reduce its appearance.

Why Squeezing Spots Can Make Acne Worse

A common instinct is to squeeze blackheads or spots.

However, this can spread bacteria across the skin and increase inflammation and risk of scarring.

Clinical studies have shown that squeezing spots does not make them heal faster, and it can sometimes lead to scarring.

The Importance of Gentle Skincare

Many acne treatments contain ingredients such as salicylic acid designed to clear blocked pores.

While these can be helpful for true acne, they may worsen other skin conditions that require hydration and barrier repair instead.

Choosing appropriate skincare - and ensuring moisturisers are labelled oil-free and non-comedogenic when treating acne - can help protect the skin barrier.

When to Seek Advice

If you are unsure whether your skin condition is acne, rosacea or another inflammatory skin disorder, professional advice can help guide the right treatment.

Consultant dermatologists are trained to recognise subtle differences in skin conditions and tailor treatment accordingly.

Listen to the Interview

You can listen back to Professor Nicola Ralph’s full conversation on The Pat Kenny Show here: https://open.spotify.com/episode/1SC1kD0jq7XlEfvGOv7cGv?si=432b350901f44452