ihatedinosaurs

Annoying Never-Ending Folliculitis

11 posts in this topic

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

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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.rosaceagroup.org/The_Rosacea_Forum/showthread.php?28667-Seborrheic-Dermatitis-amp-Folliculitis-Review-of-OTC-Treatments-for-Malassezia

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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.

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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.

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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.

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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

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@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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I have the same thing, including a vicious ear infection, that i had for probably a month maybe two.  Antibiotics clear it as well.  My thought is that it is fungal and here is why.  Sugar and simple sugars make it flare. Fungus thrive on that.  I believe once the fungus gets really inflamed on my scalp the staff that lives everywhere on our body can get in.  Then they battle causing inflamed lymphnodes and large red bumps on my scalp, neck, chest and back.  Antibiotics kill the staff and the fungus has been beat up enough by the bacteria that the bumps go away.  However fungus loves antibiotics, it takes away the enemy of fungus, bacteria so it gets more of a foothold in our bodies.  Also I believe that overgrowth of fungus does not have as much of a visual effect as bacteria, so it lives more silently.  Unless you know what to listen for.  Fatigue, lack of restful sleep, changed body scent, slight changes in skin, sticky slimey sweat and itching.  Also every round of antibiotics kills the weak bacteria and leaves the strong.  This repeated natural selection process is how MRSA is eventually created.  This is also why it keeps flaring over and over and gets progressively worse.  

What I am now doing is using things that attack both. Among many others, im using the following.  Iodine both internal and external.  Apple cider vinegar internal and external.  Also adjusting my diet to boost my thyroid.  I feel this is important because that is your engine.  The faster it runs the faster you clear toxins from your body.  I have also had low thyroid issues in the past, I'd be interested if you have the same issue, because I believe thats a factor.  I'm not a member here came across this on google, I know its an old thread.  Just trying to save the OP from years of antibiotics that will only make it progressivly worse unless the underlying fungal issue is resolved.  

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On June 9, 2014 at 5:09:51 PM, ihatedinosaurs said:

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.

Use benzaclin and clindamycin topical I had this for 12 years and now trying to help everyone . Go ask the doc to prescribe it you'll thank me later

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IT IS THE WATER!!!!

Get a filtered shower head!!!! You will be amazed how your water is damaging your skin and hair. A filter will filter chemicals making your hard water softer. Trust me, I have tried everything before I started washing my body with only filtered water. Wash your face with combinations of honey, lemon, and coconut oil. Thayers Witch Hazel (No Alcohol) as toner. Use aloe Vera gel as moisturizer. Tea tree oil is great too. Best of wishes.

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