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I have had red spots, and itchiness on my shoulders/back for the last few years. It starts every year around oct/nov, and goes away in mar/apr. Spring and summer- no problems at all. Im getting tired of having this- derm took a biopsy and it came back as having high yeast- was given antifungal topical (ciclosporox). It has worked a little bit, but i cant handle the itchiness and am going to request the oral antifungal (itracanazole?)
My questions
I tried the nizoral shampoo on the spots with some success- is this something that you can rub in every day or just a few times a week?
Also, the oral antifungal, for people that have used it....does it work right away, does it take a few weeks, or does it take months?
Finally, would tazorac, a retinal cream, help or hurt this problem?
Thanks
Hi,
You can use the Nizoral shampoo a few times a week, up to once a day if it seems to work for you. I use it about every 3rd night.
The oral antifungal will probably take a couple of weeks to start working.
I don't think that Tazorac or other retinoids are helpful with fungal breakouts, due to the fact that the breakouts are not due to clogged pores (which is what tazorac helps prevent). Unlike acne lesions, fungal folliculitis lesions have no "core" in the center. One topical that has helped me is mandelic acid. It has antifungal and exfoliative properties.
do any of the people in this thread suffer from Seborrhoeic dermatitis and dandruff?
i tried using nizoral, and I think it worked at first, but it doesn't work anymore....furthermore, it makes me breakout on my scalp.
I'm getting sick of all this and it doesn't seem like the derms have any real solutions for this problem. i've been on loprox but that doesn't work either.
Ive just started to eat 3 cloves of RAW garlic each day and take 2 oil or oregano pills, and can already see results after just 4 days. While it may be a while before it is completely gone, I can see it is working.
The only thing with garlic is that is comes out in your sweat, so you'll probly smell like garlic for a while, just cover it with some deodorant though. Garlic is a also a potent anti-bacterial, anti-viral and anti-fungal, because of the chemical compund that is produced when a raw clove is crushed - Allicin. This makes garlic capsules useless, as there would be no allicin in them, because it coverts into other compunds after an hour.
Seriously though try garlic, it should help with folliculitis and will probably clear up some acne while its at it. Its also been shown to kill MRSA.
Google for "garlic MRSA", "garlic fungal", "garlic bacteria" etc, theres some interesting reading.
Well I do it after I get home, on a night, except on weekends if I have nothing planned I can stay in and do it earlier throughout the day.
All I do is peel the skin off the clove, put it in my mouth, cringe a little because it is AMAZINGLY strong tasting, and as quickly as possible crunch it as much as I can (releases more Allicin).
I'll admit that its an acquired taste 
The first time I did it I was so close to being sick I had my head over the toilet waiting!
And definately don't do it with an empty stomach. I was laid on my side in pain the other night for half an hour because I made that mistake!
ANYWAY its been just under a week of taking garlic and I'm seeing a massive improvement. Ive stopped using any products on my neck, and its going quicker than ever before. This really works for me!
But also something which probably plays a significant part for me is taking 2 oil of Oregano capsules a day, been doing this since Friday I think it was, and the results as I said before are amazing. You can pick them up off E-bay for next to nothing aswell!
Oh and make sure you have a big glass of water handy when eating a raw clove! To help it go down and for the aftertaste!
EDIT - And make sure you don't eat 3 raw cloves AT THE SAME TIME. Spread it out over a night if you can.
After 2 courses of antibiotics for an infection that took awhile to go away, my skin got real clear but then later I started getting bumps of my back, chest, neck, and arms. Sometimes they itch but most times they don't. I told my derm I thought it was folliculitis and was concerned it was staph. She said it could be but it could also be acne bacteria. Anyways, she took a sample from my back, chest, and a whitehead from my chin. She put me back on Doxycycline which I used to take over 4 yrs ago. I got the culture results a week later and they were "no growth." I guess this means it's a fungus? I'm kicking myself for already starting the Doxy. I can't tell if it's gotten worse but it def. isn't better. I can't see my derm again for another 2 months. Will treating it while on the antibiotic just be a waste of time?
If its fungal then treating with anti-biotics should make it worse. Try using some over the counter cream containing Ketoconazole and see if that clears it up.
Oh and treating it while on the anti-biotic wont neccessarily be a waste of time, results will just be much slower, and at the very least you can slow its growth down, you don't wanna let this thing get really bad 'cos its a pain in the arse to get rid of.
Came off minocycline other day after a nasty staph infection, and my ketoconazole tablets arrived yesterday. Ill let you know how it turns out, think ketoconazole is the best azole to treat this so shouldnt be long before its gone 
EDIT - For the past couple days since originally posting this I've been using 100% pure tea tree oil to treat both the folliculitis and acne, and so far its working wonders, AND it doesnt leave my skin looking all red (As long as I give it a couple of hours between applying it and going out)
This post is being written to address a member's use of ketoconazole without a prescription. The specifics of this use (how to order it and from where) has been edited out of previous posts on this topic. Please do NOT use this or any other prescription medications without a doctor's prescription. As you can see from the following warning on potential serious side effects, this drug should only be taken under the supervision of a medical doctor:
Warning on this drug:
Ketoconazole is a prescription drug and it has a huge warning on Medline about it causing liver damage. So, let me first state our policy on this board about not documenting the use of prescription medications without a doctors prescription. This is a against board policy, as is providing information or links as to where you obtained the medication. Here is the warning on this drug from MedLine:
IMPORTANT WARNING:
Ketoconazole may cause liver damage. Tell your doctor if you drink or have ever drunk large amounts of alcohol and if you have or have ever had liver disease. Tell your doctor and pharmacist if you are taking acetaminophen (Tylenol, others); cholesterol-lowering medications (statins) such as atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), or simvastatin (Zocor); isoniazid (INH, Nydrazid); methotrexate (Rheumatrex); niacin (nicotinic acid); or rifampin. If you experience any of the following symptoms, call your doctor immediately: extreme tiredness, loss of appetite, upset stomach, vomiting, yellowing of the skin or eyes, dark yellow urine, pale stools, pain in the upper right part of the stomach, or flu-like symptoms. Keep all appointments with your doctor and the laboratory. Your doctor will order certain tests to check your body's response to ketoconazole.
I would highly recommend not continuing to use this medication. Many doctors prescribe this only as a last option when topicals and less risky medications have not worked. It is not something you want to mess with on your own.
I wanted to update my progress with mandelic acid for treatment of stubborn body folliculitis. It works amazingly well!!!! I really think it is the product that has worked the best to clear this up for me. I use a 15% mandelic serum on my chest and back 2 out of 3 nights. On the third night I still use the Nizoral shampoo. I don't think the Nizoral is effective on its own though. I stopped using the mandelic when I was out of town for thanksgiving and the folliculitis came back full blast, even though I continued to use the Nizoral. I also stopped using the ZNP bar, as that just seemed to dry out and irritate my skin. I replaced it with the Vivant Mandelic cleanser, which I LOVE!!!!! I use the cleasner 1-2 times a day, and it is not drying or irritating at all. It actually has a lot of soothing ingredients in it. It can be used as a body cleanser, facial cleanser or dandruff shampoo (since mandelic is antifungal and antibacterial). My chest and back are almost 100% clear of the folliculitis now - its probably been over a year since it has been this clear.
For anyone dealing with body breakouts, I'd really recommend mandelic as the first treatment option. Since it is both antibacterial AND antifungal, it should work on bacterial or fungal folliculitis and should also work on body acne.
Good to hear of your success! I have found good results with tea tree oil too, although it is a spot treatment more than a preventative one. I still wish I had a preventative...
Did you modify your diet at all? avoiding any simple carbs or sugars? or milk even?
I wanted to update my progress with mandelic acid for treatment of stubborn body folliculitis. It works amazingly well!!!! I really think it is the product that has worked the best to clear this up for me. I use a 15% mandelic serum on my chest and back 2 out of 3 nights. On the third night I still use the Nizoral shampoo. I don't think the Nizoral is effective on its own though. I stopped using the mandelic when I was out of town for thanksgiving and the folliculitis came back full blast, even though I continued to use the Nizoral. I also stopped using the ZNP bar, as that just seemed to dry out and irritate my skin. I replaced it with the Vivant Mandelic cleanser, which I LOVE!!!!! I use the cleasner 1-2 times a day, and it is not drying or irritating at all. It actually has a lot of soothing ingredients in it. It can be used as a body cleanser, facial cleanser or dandruff shampoo (since mandelic is antifungal and antibacterial). My chest and back are almost 100% clear of the folliculitis now - its probably been over a year since it has been this clear.
For anyone dealing with body breakouts, I'd really recommend mandelic as the first treatment option. Since it is both antibacterial AND antifungal, it should work on bacterial or fungal folliculitis and should also work on body acne.
Good to hear of your success! I have found good results with tea tree oil too, although it is a spot treatment more than a preventative one. I still wish I had a preventative...Did you modify your diet at all? avoiding any simple carbs or sugars? or milk even?
I didn't do any specific diet modifications. I had already modified my diet for acne prevention purposes (low dairy, low iodine, no peanuts, taking a zinc suppliment). But, I'd been on that diet for over a year, and I was still getting the folliculitis. Nothing topical worked for more than a couple of weeks until I started using the mandelic. Its a great preventative and spot treat. If I start to notice any spots coming back, I just put 15% mandelic on it at night and its pretty much gone the next day.
Good to hear of your success! I have found good results with tea tree oil too, although it is a spot treatment more than a preventative one. I still wish I had a preventative...Did you modify your diet at all? avoiding any simple carbs or sugars? or milk even?
I didn't do any specific diet modifications. I had already modified my diet for acne prevention purposes (low dairy, low iodine, no peanuts, taking a zinc suppliment). But, I'd been on that diet for over a year, and I was still getting the folliculitis. Nothing topical worked for more than a couple of weeks until I started using the mandelic. Its a great preventative and spot treat. If I start to notice any spots coming back, I just put 15% mandelic on it at night and its pretty much gone the next day.
how fast are you going through the mandelic bottles? the one i was using before was so small, i can't imagine how much money i'd spend putting it on my whole back!!!!
Good to hear of your success! I have found good results with tea tree oil too, although it is a spot treatment more than a preventative one. I still wish I had a preventative...Did you modify your diet at all? avoiding any simple carbs or sugars? or milk even?
I didn't do any specific diet modifications. I had already modified my diet for acne prevention purposes (low dairy, low iodine, no peanuts, taking a zinc suppliment). But, I'd been on that diet for over a year, and I was still getting the folliculitis. Nothing topical worked for more than a couple of weeks until I started using the mandelic. Its a great preventative and spot treat. If I start to notice any spots coming back, I just put 15% mandelic on it at night and its pretty much gone the next day.
how fast are you going through the mandelic bottles? the one i was using before was so small, i can't imagine how much money i'd spend putting it on my whole back!!!!
I am going through about one every 4-6 wks. Yeah it is alot. The cleanser is a bit more cost-effective. There is also a 9% toner by Vivant that might be cheaper as well (although not as strong as the 15% serum). It still might be strong enough to help the folliculitis though.
O.K, I originally posted this is a new thread, but am re-posting it here for everyone with pr.fol to see.
Well, went for some blood tests other day, and results came back that I have unusually high levels of 2 enzymes in my liver, and my doc seems to think it could be liver failure. Going to hospital for more tests tommorow, hopefully it will be nothing.
She seems pretty sure its because of the 200mg a day ketoconazole I've been taking that I bought online to treat pr. folliculitis. So looks like I've traded bad skin for potentially fatal liver failure... Just letting people out here know that resorting to things like ketoconazole isn't as good an idea as it seems at the time, and I should have listened to the advice some people were telling me and stopped taking them. With any luck everything will sort itself out, if not I'm on the market for a new liver
If anyone wants to know anything I'm more than happy to tell you everything. Oh and btw, I'm using ZNP now to control the pr. fol, with pretty good success, and gonna try mandelic acid aswell as I hear that works too.
On a different note, it seems that the ketoconazole has become ineffective anway, not seeming to do anything anymore, so after using the cream for over a year and a few courses of the tablets they may become basically useless.
Thanks
Thanks so much for posting this info, TC. I really hope you're okay and that your liver recovers from this setback (the body can do wonderful things when it comes to healing itself).
I had been thinking about asking my derm to prescribe ketoconazole or something similar ...... but now I don't think I want to. The mandelic cleanser and toner are working well for me, and I don't want to push my luck.
No, type pityrosporum folliculitis into google, and click on the dermnetnz link, it has pictures there of what it looks like.
A question of my own though, where in the U.K would sell Mandelic acid? I'm really interested in trying to get some but not sure where to start. If anyone knows please let me know.
I just picked up Nizoral.
Apparently, you can't use it everyday. I guess I'll be alternating with Sulfur and Head & Shoulders.
Really? It says not to use it daily? I don't think my Nizoral shampoo had those instructions. I think they suggested to use in nightly for the first few weeks, then once you start to clear up you can reduce it to every other night or every third night. I use mine every third night now, alternating with mandelic cleanser and serum.
Oh, sorry I was getting this from your old post:
Hi,
You can use the Nizoral shampoo a few times a week, up to once a day if it seems to work for you. I use it about every 3rd night.
The oral antifungal will probably take a couple of weeks to start working.
I don't think that Tazorac or other retinoids are helpful with fungal breakouts, due to the fact that the breakouts are not due to clogged pores (which is what tazorac helps prevent). Unlike acne lesions, fungal folliculitis lesions have no "core" in the center. One topical that has helped me is mandelic acid. It has antifungal and exfoliative properties.
So, you can use it everyday? Do you think I can use it 2x a day? I thought what you meant by your post was that it was too harsh or something to use regularly.