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Annoying Never-Ending Folliculitis

folliculitis

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#1 ihatedinosaurs

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Posted 09 June 2014 - 06:09 PM

I am at a loss, and was hoping to get some direction from people that may have already overcome, or gone through more of the battle than I.

 

Last year around March, I got an ear infection and scalp infection at about the same time.  I had to go to the doc for the ear infection though, and the scalp bumps came up in discussion - she said it was folliculitis.  She said that the antibiotics she was giving me would cover both issues, which they did.  I give this story not because of a specific correlation for sure, but interesting coincidence.

 

Ever since then, I really have no issues with ear infections (which I haven't before), but the infection on my head won't go away and stay away.  I have spoke to my doctor about it, and he just kept prescribing more meds and more meds - which work, but 2 weeks after the dose stops its back again. I finally went in one time and asked about doing something more, at which point he referred me to a dermatologist.  The dermatologist was eager to help.  She asked for all the symptoms, which I told her -

 

Large (.25-.75 cm) bumps on head, pain, sometimes hot, pus in the bumps.  Also, my lymph node was swollen (like 1-2 inches) on the back of my neck on the left side.  All of this together results in pain and irritation all around.

 

I told her that I have had staph before (about 2 years before this for the first time ever), and this was exhibiting itself a lot like staph, but not as sharp and red hot pain as staph.  Since it was responsive to antibiotics so well and would go away at least for some time and come back, she was prescribing more antibiotics, but doing a culture to see what bacterium it was so that we could target it.  I was ecstatic that something was being done....

 

Then I got the bad/weird news - the culture was negative/no bacteria.  This confused me a lot since the antibiotics work well (varying on the type used), and the lymph node is swollen.  To me this sounds like infection from everything I know of medicine (though I am not a doctor).  I finished that round of meds, but of course it came back - again.

 

I went back to her office, and she thought that it might be chronic.  I said I find that weird since I NEVER had it before in my life until March of last year, and it responds to antibiotics.  She did another bacterial culture, and a fungal culture to see if it could be either.  Neither came back positive.  She ended up getting me a refillable prescription for the antibiotics that are effective (at the current time at least) but I don't think she thinks theres anything more she can do, and at this point I don't know what either.

 

I have tried (know I didn't spell these correctly):

Doxycycline

Minocycline

Cephalexin

Sulfameth

Fluocinoide (apply to hair/no real difference)

Clobetasol (apply to hari/no real difference)

Mupirocin (apply in nostril/no verifiable difference)

Hibiclens (used every day in shower for shampoo, even when not exhibiting/no difference)

(others I can't remember now but will if you tell me a name)

 

I hate taking all of these since I know they can hurt more than help, but at this point I don't know what to do.  It can hurt to sleep because of the bumps so bad, which definitely encourages yourself to take the meds so they go away, even if for a moment.

 

If there is something Im missing or something I should try, please let me know.  I am just so confused as to how my lymph node can be so swollen, and the folliculitis respond to antibiotics, but a negative on TWO bacterial cultures.


Edited by ihatedinosaurs, 16 June 2014 - 09:19 PM.


#2 Tom Busby

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Posted 10 June 2014 - 01:46 PM

I have the same problem, which I think is where the sweat glands clog up, and then the sweat can't escape, and the salts and other components of the sweat react with one of the deeper dermal layers.  The skin turns into a red bump that heals only very slowly.  By the time the bump forms, no one can determine if it started with a hair follicle or a sweat gland, or if it's fungal or bacterial.

 

If you're like me, the problem is fungal in origin, and is best described as an allergic reaction to malassezia.  Antibiotics only make the problem worse.  There are many OTC anti-fungals to try, and none of the anti-fungal topical treatments will cause any harm, but they will provide an easy at home differential diagnosis.  You'll need to use an OTC anti-fungal every day, and the full-on treatment is fairly complicated, but it works.  For starters, web-order some Nizoral 1% shampoo, and apply some Lotrimin Ultra cream (not the AF kind).  Then read this:  http://www.rosaceagr...-for-Malassezia



#3 ihatedinosaurs

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Posted 13 June 2014 - 07:59 PM

So when you say that antibiotics only make the problem worse, do you mean in the long run, or actually worse?  That's why I've always thought it to be bacterial, is the lymph node gets soo swollen, and antibiotics usually clear it up in 7-10 days.



#4 Tom Busby

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Posted 14 June 2014 - 05:32 PM

If antibiotics haven't done their job in 7 to 10 days, then it seems to prove that they aren't the answer to the red bumps.  (But I guess antibiotics resolved your swollen lymph node?)  Red bumps are not necessarily bacterial.  For example, in my case, I had bumps on my head when I was five, and still get them very rarely but much smaller -- they appear and go away in the course of a day.  Doctors never have figured out what causes the red bumps. 

 

I believe the red bumps occur when malassezia makes a biofilm out of my own skin components, which occasionally causes the sweat glands or the sebum glands to clog, and then the sebum and/or sweat is trapped slightly below the stratum corneum, where it causes irritation, inflammation and swelling of the skin.  The red bump resembles acne, but isn't acne, because there aren't any comedones or pus -- plus, the only fluid inside is much clearer than you would see with acne..

 

Myself and a few other people I have talked to have taken antibiotics for one reason or another, and then their symptoms like mine (seb derm or folliculitis would be a possible diagnosis) have gotten worse.   Google killing-germs-wrong for more info' on fungal problems that worsen after using of antibiotics.



#5 ihatedinosaurs

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Posted 16 June 2014 - 09:17 PM

I think that there may be a misunderstanding.  Antibiotics DO their job very effectively - within 7 to 10 days.  Within the first 1 new bumps stop forming and the lymph node is drastically reduced in size, within 2-3 most of the bumps have scabbed over and are shrinking, and the lymph node is almost completely gone, and within 10-12 days my scalp is perfectly fine.  That's why I keep leaning back towards bacterial.  If I misunderstood something, or need to put more clarification, please let me know.

 

As a side note, since the antibiotics work so well, I've tried using Hibiclens as a shampoo/soap for 2-4 weeks at a time, both during outbreak and in between, and new infections can begin even while using it.  This leads me to believe that it is something more internal/systemic then external on the skin. 



#6 theguynextdoor

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Posted 25 June 2014 - 12:45 AM

I could see where your situation would leave you frustrated and confused.  It's possible that you could have a chronic or persistent infection/inflammatory/autoimmune condition. Chronic conditions can have an onset at any time.  Someone may be healthy one day with no allergies, and tomorrow have medical problems and allergic reactions. Also, just because something is persistent or classified as chronic (usually a condition lasting longer than 6 months to 1 year get classified as chronic), this doesn't mean it can't be effectively managed, treated, or eventually cured.  

 

If antibiotics effectively manage your symptoms, then you should work with your doctor about long term therapy using whatever medicine helps you.  As far as diagnosing, if your primary care physician (PCP) and a dermatology specialist have both evaluated you and processed cultures and you still have no answers....I would suggest seeking another medical opinion, possibly from a second dermatologist or an infectious disease specialist.  Doctors are only people with unique experiences and backgrounds and it's possible you just haven't connected with the right one for your condition.  I work as an RN in healthcare and the reality is sometimes it takes a team of clinicians and multiple specialists to get the right diagnosis and treatment.  If you have reached a point in your medical care where you feel your doctor can't solve your issue, then you might want to seek other opinions and options.  Of course, you should be candid with your doctor and ask all your questions and share your concerns.  

 

Even though it's 2014, healthcare can't solve every human mystery and symptom...although it's amazing at what all it can do for us!  Also, you may need more than a culture, it may take a biopsy of your tissue (scalp) for a pathology evaluation to look at your skin on a cellular level.  It's also possible there's no bacteria at play in your circumstance and this could be an allergy or autoimmune condition, which both can cause skin/scalp dermatitis and swollen lymph nodes. And, it's possible that a culture can have a false negative.  My father once had a chronic infection that worsened and worsened despite antibiotic therapy, and eventually it was discovered that it was fungal, and not bacterial. His treatment changed from antibiotic to antifungals and he healed up.  What you're doing is great.  You're taking action, searching for answers, and critically thinking about your body and symptoms. Keep exploring and scouring the internet and it's possible you'll make the right connection. Good luck. -rm



#7 ihatedinosaurs

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Posted 03 July 2014 - 11:38 PM

@theguynextdoor - Thanks for taking the time to give a long response.  I understand how little is still known in relation to healthcare, yet also how fast we are growing.  Yet that's a story for another day!

 

Anyways, I think I will take your suggestion and try to see a different specialist.  So, given these points:

 

1. Started last year, recurring since

2. Antibiotics clear it up, comes back after being off for about 2-4 weeks

3. Cultures don't show growth

 

What type of specialist would you recommend - another dermatologist, an immunologist, something else?  Is there anything specifically I should ask for that may be helpful?  Like a different type of culture test.

 

Thank you again for your response!





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