Acne is distinguished by the presence of comedones (blackheads and whiteheads), which are the primary lesion and are absent in simple folliculitis.
This presents as itchy, scaly papules centered on follicles, an eczematous process rather than the primarily pustular inflammation of bacterial folliculitis.
Miliaria rubra (heat rash) consists of tiny, pruritic red papules that are not necessarily centered on follicles and are related to sweat duct obstruction, not bacterial infection.
