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Hey everyone, I've been dealing with this kind of inflamed, pustular acne for at least a decade. Just like many here it shows up under my nose and my chin. Over the past few months I read this thread front-to-back three times. I want to say thanks to everyone in here for all the work and information put in to figure this out.
I'm not in the clear yet, but here are some things that I have noticed for me. The diet-acne connection is undeniable in my case. The culprit being carbohydrates-- specifically sugar -- like so many of you have mentioned. I've changed up my diet a few times this year to figure it out and noticed big differences. One period of time I was eating 6-8 pieces of fruit a day and experiencing huge pustules. I cut fruit and it got better, but not good enough. Now I am sticking to a keto diet with <50g net carbs. Specifically, low sugar. I'm talking 20g or less of natural sugars a day.
My biggest tip to readers would be to download a food log app on your phone and enter in what you eat. There are a good, free ones there that will calculte your macro and micro nutrients. It's much easier than writing everything out by hand. The main benefit of logging your food is looking back on days of a flare up to see where your nutrition may have gone wrong. Find the pattern in the numbers. For me it is high sugar/high carbs.
In addition I've taken up intermittent fasting to help monitor blood sugar spikes, another strategy I learned from this forum. I feel better during the day by skipping breakfast and just eating breakfast and lunch at the same time. My hunger doesn't activate until I eat that first meal, so another benefit is I'm not craving lunch a few hours beforehand.
Ultimately though I believe this strategy of dieting is a treatment and not a cure. I'm still not sure what the permanent solution would be, where I can enjoy carbs and sugars without reprisal. Maybe its just genetic. Truth be told I did this to myself. I messed up my hormones from a decade of Marijuana use. Yeah I know Marijuana is perfect and harmless -- most people have no problems with it. I do. I developed adverse reactions and still used it anyway. Specifically, I couldn't hold any food in my gut when using it. I'd have to head to the bathroom everytime, and it wouldn't be solid waste. Apologies for being graphic, but everyone that's read this far knows the gut-acne connection.
Again, thank you to everyone in this thread for pouring your heart and soul into this. Every time I read this I have hope. It takes time, but time heals.
Do you have permanent scars from 10 years of pustules? Or do they heal completely?
Do you have permanent scars from 10 years of pustules? Or do they heal completely?
Thank you for asking @Eevs, I've always found your posts helpful.
For me, these pustules pop and leave red marks behind that eventually fade over time. I was scared straight early on from reading this forum years ago not to pop them prematurely. Maybe because of that I am free of indentions or scaring. I still can remember the biggest pustules I've gotten a long time ago and you could never tell anything was there now. I am fortunate too that my body will form one or two pustules at the most at a time, as far as I remember.
About a week ago, I started using topical Retinol on the most recent hyperpigmentation and it seems help the healing. I've just started using this because I feel certain that I pinned down my trigger to sugar. I'm alternating nightly between 10% BP and retinol on my problem areas. Maybe after another week of no new pustules I'll drop the BP and only use Retinol.
What's always intrigued me was how my pustules would appear in the same areas. It was always in the crevices beside my nose, on my chin under the lips, and near the cleft of the chin. They appear where my facial hair doesn't grow, which annoying when all you want to do is hide it with facial hair.
Writing about this here has been therapeutic. There have been so many mornings when I head straight to the mirror to asses my face for the day. So much dread in my mind about how I'm perceived from others. What really matters is how you feel about yourself. It is hard to feel good about yourself though with this a lot of the time.
One thing I wanted to add in my other post for others: Remember to think of this as a positive thing. Our bodies are tell us, hey, something is not right. Something is out of balance in us. Many, many people have no idea they are out of balance as their skin has nothing to say about it. At least we are aware. At least we can restore health and balance and live better because of it.
Do you have permanent scars from 10 years of pustules? Or do they heal completely?
Thank you for asking @Eevs, I've always found your posts helpful.
For me, these pustules pop and leave red marks behind that eventually fade over time. I was scared straight early on from reading this forum years ago not to pop them prematurely. Maybe because of that I am free of indentions or scaring. I still can remember the biggest pustules I've gotten a long time ago and you could never tell anything was there now. I am fortunate too that my body will form one or two pustules at the most at a time, as far as I remember.
About a week ago, I started using topical Retinol on the most recent hyperpigmentation and it seems help the healing. I've just started using this because I feel certain that I pinned down my trigger to sugar. I'm alternating nightly between 10% BP and retinol on my problem areas. Maybe after another week of no new pustules I'll drop the BP and only use Retinol.
What's always intrigued me was how my pustules would appear in the same areas. It was always in the crevices beside my nose, on my chin under the lips, and near the cleft of the chin. They appear where my facial hair doesn't grow, which annoying when all you want to do is hide it with facial hair.
Writing about this here has been therapeutic. There have been so many mornings when I head straight to the mirror to asses my face for the day. So much dread in my mind about how I'm perceived from others. What really matters is how you feel about yourself. It is hard to feel good about yourself though with this a lot of the time.
One thing I wanted to add in my other post for others: Remember to think of this as a positive thing. Our bodies are tell us, hey, something is not right. Something is out of balance in us. Many, many people have no idea they are out of balance as their skin has nothing to say about it. At least we are aware. At least we can restore health and balance and live better because of it.
Thank you for the detailed answer.
It is really calming to know that the pustules at least don't cause any scarring! Otherwise it would be truly horrible!
I totally agree that the trigger is SUGAR. In my experience, carbs without sugar content don't cause pustules. One has to choose the carb sources wisely! Some bread types have <1g sugar per 100g.
The pustules caused mental issues for me too. A lot of distress and my confidence dropped. The difference of clear skin and pustule ridden skin is truly huge. 1-2 pustules can be ignored but it you got your whole mouth area full with white zits... And then with red marks... It is tough.
Interesting that you developed them through marihuana consumption. I developed the condition by drinking over 3 litres of raw milk every day and avoiding all fibre sources (listening to the advice of stupid people) which likely caused a microbiome shift.
I focus on eating sugar free but high carb high fibre and eating a lot of probiotics to reverse everything. It is sad that one cannot eat fruit though... I wonder if there are sugar free Vitamin C sources!
I take a Vitamin C supplement just because I know I'm not getting it from other sources like fruit. What kinds of supplements do people take here? Here's what I use:
- Fish oil
- Vitamin C
- Calcium
- Probiotic
- Vitamin A
It seems like most of us start with a hormonal imbalance that disrupts the gut bacteria, like you mentioned. The imbalance can come from different things, ending with the same result.
I once heard a quote to the effect of however long you spent messing yourself up is how long it will take to restore your health back. In that case it will take me a long time to sort myself out! But I will continue down the right path.
So it is been a while since I have written here. So will give some interesting update. I took a pustule from my nose and did microbiological test. And it came out as Enterobacter aerogenes or Klebsiella aerogenes (it is actually same bacteria but sometimes called differently). This is actually in line with microbiological analysis I did from lession on my face 2 years ago when I had the worse breakout in my life. I can't take pustule material for these test from face now as I am constantly using BP as treatment and you need to have your face without any treatment for around 5 days (which is too much for me:D).
If you read on wikipedia about this bacteria you can find this statement: "It is an anaerobic facultative and mesophilic bacterium that is able to consume different sugars".So maybe why we can't tolerate sugars at all... Anyway what I also did.. I asked chatgpt to make diagnosis based on my symptoms and propose treatment (you need to know some prompts to be able get medical responses:)). So below is what I got. I am visiting dermatologist in 1 week and will try probably go antibiotic route both systemicly and inside of nose. This is the only hope.
---------------------------------------------------------------------------------------------------------------------------
Given the microbiological test result, the patient's condition becomes clearer.
Enterobacter aerogenes is a gram-negative bacterium that's part of the Enterobacteriaceae family. While it primarily resides in the human intestinal tract, it can be opportunistic and cause infections in other parts of the body, especially if there is a break in the skin or mucosal barriers.
Updated Summary of Patient Encounter
- The patient is a 33-year-old male with a history of severe acne, now presenting with yellow pustules around his nose and mouth.
- These pustules sometimes spread to other areas of the face and body.
- Pustules also appear inside the nose and after blowing the nose.
- Consumption of sugary foods and saturated fats triggers the pustules.
- The patient uses Benzoyl peroxide daily.
- Pustules spread if popped prematurely.
- Microbiological test from a pustule in the nose identified a high population of Enterobacter aerogenes.
- Significance: This provides a direct cause of the infection. E. aerogenes is not the typical bacteria associated with skin infections, but it can be opportunistic.
Updated Possible Causes of Issue
- Enterobacter aerogenes infection
- Required documentation: Microbiological test.
- Requirements met: Yes.
- Probability: High, given the positive identification of this bacterium from the pustule.
Given this new information, the other differential diagnoses (like Acne Vulgaris, Folliculitis, Impetigo, Rosacea, and STI) move down in probability, with the Enterobacter infection being the most probable.
Updated Treatment Plan
Antibiotic Therapy:
- Since Enterobacter aerogenes is sensitive to Ceftriaxone, Ciprofloxacin, Gentamicin, Neomycin, and Tobramycin, any of these can be chosen as the primary antibiotic therapy.
- Ceftriaxone is a third-generation cephalosporin and can be administered intramuscularly or intravenously. It's a good choice for systemic treatment.
- Ciprofloxacin is a fluoroquinolone antibiotic and can be taken orally. It's suitable for patients who prefer oral treatment and can effectively treat a variety of bacterial infections.
- Gentamicin, Neomycin, and Tobramycin are aminoglycosides. They can be used topically, especially for skin infections, or systemically for more severe infections. However, due to potential side effects like ototoxicity and nephrotoxicity, they are often reserved for situations where other antibiotics are ineffective or not feasible.
- Given the location of the infection (around the nose and mouth), an oral antibiotic like Ciprofloxacin or an intramuscular antibiotic like Ceftriaxone would be most appropriate for systemic treatment.
- Since Enterobacter aerogenes is sensitive to Ceftriaxone, Ciprofloxacin, Gentamicin, Neomycin, and Tobramycin, any of these can be chosen as the primary antibiotic therapy.
Topical Care:
- Continue using Benzoyl peroxide.
- Given the resistance to Fusidic acid and the sensitivity to Neomycin, consider a topical antibiotic ointment containing Neomycin to help combat the bacterial infection on the skin surface.
Hygiene:
- Regularly clean the affected areas using a mild antibacterial soap.
- Avoid touching or popping the pustules to prevent further spreading.
- Consider saline nasal rinses to reduce bacterial load in the nasal passages.
Diet and Lifestyle:
- Continue to limit sugary foods and saturated fats, as the patient has noticed a correlation between these and the pustules.
Follow-up:
- A follow-up appointment in 2-3 weeks is essential to assess the effectiveness of the chosen antibiotic treatment. If the patient doesn't show significant improvement or if side effects emerge, the antibiotic regimen might need adjustments.
If the condition persists despite treatment, consider consulting with an infectious disease specialist or dermatologist for a more in-depth evaluation and treatment recommendations.
To summarize, given the antibiotic sensitivity test, the best course of action would be to start the patient on either Ciprofloxacin (oral) or Ceftriaxone (intramuscular or intravenous) and use a topical antibiotic ointment containing Neomycin for local treatment of the pustules.
So it is been a while since I have written here. So will give some interesting update. I took a pustule from my nose and did microbiological test. And it came out as Enterobacter aerogenes or Klebsiella aerogenes (it is actually same bacteria but sometimes called differently). This is actually in line with microbiological analysis I did from lession on my face 2 years ago when I had the worse breakout in my life. I can't take pustule material for these test from face now as I am constantly using BP as treatment and you need to have your face without any treatment for around 5 days (which is too much for me:D).
If you read on wikipedia about this bacteria you can find this statement: "It is an anaerobic facultative and mesophilic bacterium that is able to consume different sugars".So maybe why we can't tolerate sugars at all... Anyway what I also did.. I asked chatgpt to make diagnosis based on my symptoms and propose treatment (you need to know some prompts to be able get medical responses:)). So below is what I got. I am visiting dermatologist in 1 week and will try probably go antibiotic route both systemicly and inside of nose. This is the only hope.
---------------------------------------------------------------------------------------------------------------------------
Given the microbiological test result, the patient's condition becomes clearer.
Enterobacter aerogenes is a gram-negative bacterium that's part of the Enterobacteriaceae family. While it primarily resides in the human intestinal tract, it can be opportunistic and cause infections in other parts of the body, especially if there is a break in the skin or mucosal barriers.
Updated Summary of Patient Encounter
- The patient is a 33-year-old male with a history of severe acne, now presenting with yellow pustules around his nose and mouth.
- These pustules sometimes spread to other areas of the face and body.
- Pustules also appear inside the nose and after blowing the nose.
- Consumption of sugary foods and saturated fats triggers the pustules.
- The patient uses Benzoyl peroxide daily.
- Pustules spread if popped prematurely.
- Microbiological test from a pustule in the nose identified a high population of Enterobacter aerogenes.
- Significance: This provides a direct cause of the infection. E. aerogenes is not the typical bacteria associated with skin infections, but it can be opportunistic.
Updated Possible Causes of Issue
- Enterobacter aerogenes infection
- Required documentation: Microbiological test.
- Requirements met: Yes.
- Probability: High, given the positive identification of this bacterium from the pustule.
Given this new information, the other differential diagnoses (like Acne Vulgaris, Folliculitis, Impetigo, Rosacea, and STI) move down in probability, with the Enterobacter infection being the most probable.
Updated Treatment Plan
Antibiotic Therapy:
- Since Enterobacter aerogenes is sensitive to Ceftriaxone, Ciprofloxacin, Gentamicin, Neomycin, and Tobramycin, any of these can be chosen as the primary antibiotic therapy.
- Ceftriaxone is a third-generation cephalosporin and can be administered intramuscularly or intravenously. It's a good choice for systemic treatment.
- Ciprofloxacin is a fluoroquinolone antibiotic and can be taken orally. It's suitable for patients who prefer oral treatment and can effectively treat a variety of bacterial infections.
- Gentamicin, Neomycin, and Tobramycin are aminoglycosides. They can be used topically, especially for skin infections, or systemically for more severe infections. However, due to potential side effects like ototoxicity and nephrotoxicity, they are often reserved for situations where other antibiotics are ineffective or not feasible.
- Given the location of the infection (around the nose and mouth), an oral antibiotic like Ciprofloxacin or an intramuscular antibiotic like Ceftriaxone would be most appropriate for systemic treatment.
Topical Care:
- Continue using Benzoyl peroxide.
- Given the resistance to Fusidic acid and the sensitivity to Neomycin, consider a topical antibiotic ointment containing Neomycin to help combat the bacterial infection on the skin surface.
Hygiene:
- Regularly clean the affected areas using a mild antibacterial soap.
- Avoid touching or popping the pustules to prevent further spreading.
- Consider saline nasal rinses to reduce bacterial load in the nasal passages.
Diet and Lifestyle:
- Continue to limit sugary foods and saturated fats, as the patient has noticed a correlation between these and the pustules.
Follow-up:
- A follow-up appointment in 2-3 weeks is essential to assess the effectiveness of the chosen antibiotic treatment. If the patient doesn't show significant improvement or if side effects emerge, the antibiotic regimen might need adjustments.
If the condition persists despite treatment, consider consulting with an infectious disease specialist or dermatologist for a more in-depth evaluation and treatment recommendations.
To summarize, given the antibiotic sensitivity test, the best course of action would be to start the patient on either Ciprofloxacin (oral) or Ceftriaxone (intramuscular or intravenous) and use a topical antibiotic ointment containing Neomycin for local treatment of the pustules.
Thank you so much for this detailed post. Keep us updated!!!!
Your report is very interesting to me, thank you for sharing! I had never heard of Klebsiella aerogenes before. I am glad to have a new avenue of research to look into.
Looking forward to hearing what the dermatologist thinks from your upcoming visit.
Also, I was wondering why your ChatGPT report also mentions limiting saturated fats in addition to sugar. What is the connection with saturated fat? I haven't heard that discussed before.
Hi all,
coming back after some time as the condition got a little worse the past days. Super thankful for all your trial and error stories that help when assessing what to do next. I am especially very interested in how the Klebsiella story turns out. Seems like you are onto something there.
I would agree that this conditions has to be somewhat related to sugar intake. Lately I am doing pretty fine with only having one to two pustules the one or the other day even sometimes having no new pustules at all and sort of feeling like a normal person not worrying about my skin. Last Saturday I had a cup of ice cream and woke up with a pustule the next day accompanied by some sort of bloating whereas digestion is not really a problem to me, and if it does, I can almost be sure pustules are coming the next day. Right now I feel digestion is fine again and can definitely feel that my skin starts calming down as well.
Further, I noted that my chin/mouth area is actually dry and flakey which may be an open door for bacteria to enter the hair follicle and thereafter create an inflammatory response, i.e. a new pustule. Beforehand I only showered without plain water (which indeed is considered hard and thus may dry out my skin) and did not moisturize my face afterwards as I was afraid the moist could lead to new pustules. Against this background I just now started incorporating a refatting soap called savon d'alep with 30% laurel berry oil which moisturizes the skin while cleansing and not applying any moisturizer afterwards. What I noticed after a two day use is that no new pustules have formed and already an inflamed pimple near the corner of my mouth seems less irritated, but will update on whether this actual dryness and impaired skin barrier turned out to be a cause for this.
Weirdly what I also discovered is that when I drink alcohol, the next day I am basically free of pustules and my skin feels normal and only starts to get a little greasier the day after my hangover day. Generally my skin is not as oily as it was when I was in my early 20s (29 now) which seems explanatory to me that this condition is less severe than it was earlier.
Generally, I am convinced that there will be a solution to this and we are just all doing something harmful to it we are unaware of. Otherwise I have no explanation for me at some days literally going out with normal skin. This may be diet related for sure, but still I think it is an interaction of multiple factors like environment, bacterial load on the skin, allergies etc. etc.
Just recently, there was a study published that botox injection on the scalp could bring scalp folliculitis in remission for 2 years ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10123058/) which makes me curious whether that would work for facial folliculitis as well. I can only guess the math behind it is that botox decreases sebum production in the hair follicles leaving the bacteria therein with less food so no major outbreaks/inflammation of the hair follicles follow. There is a medical provider nearby and I tend to go through a treatment should my condition worsen or not clear up now. Will definitely keep you updated on this or maybe someone even has experience with having botox on the face.
i think horomonal changes are the main cause for the pustules to develop and balancing hormones will clear them
i cant speak for everyone else here but ive realised the only time i get the pustules is when i ramp up my hormones. this is when i have unintentionally lost weight and in the process of regaining the weight back. I was 100% clear for many months last summer, i caught covid and could barely eat, i could feel my hormones change. everyone knows puberty = acne for most young men
everything is else just fluff, there are a number of others things (like seb derm) that make you more susceptible but isnt really a factor if your hormones are stable. very oily skin is also a sign of hormonal imbalance
number 1 to stay pustule free for me is maintaining natural weight, doesnt have to be exact, the main thing is that you have enough body fat and not too much, that should give you almost 10kg leeway depending on how tall and big your frame is. too low bodyfat will tank your hormones, i am natually lean and can easily slip into being underweight, it worse than being overweight for this condition becasue you need fat storage for hormone production
balance blood sugar - that means smaller regular meals throughout the day when you need to, i am very against IF and had the worst breakout of my life when i was doing omad.
i do not avoid sugar at all, unless you mean added sugar, i eat lots of fruit and never noticed any connection.
the only topical i do is salt rinses now, if you have oily / flaky skin it will help alot. No side effects except it burns and can leave face red for 20-30 mins after depending on how much salt you use. you cannot replicate being by the sea as the air is also salty...never got a single pustule when on holiday at the beach
+2 i also use blue light therapy, cant say if it helps or not but it is also good for calming down your skin
ps. i lost all faith in the westurn medicine, all of the treatments set you up for a massive rebound. they dont do BP2.5% here but that seems like the best option - you are still damaging your skin barrier and killing all bacteria on the skin which leads to even more bad bacteria coming once you stop, plus you cant go in the sun which is one of the best treatments imo
Finally the day has come - Today I started FMT therapy in the hope to address the root of this issue. It will last for 12 days and I assume in order to see any potential progress it will take around 2-3 weeks, I'll let you guys know how it went and perhaps post an update if there's anything worth mentioning in the meantime.
i think horomonal changes are the main cause for the pustules to develop and balancing hormones will clear them
Have to agree with that, I'm sure a hormonal imbalance started this for me. I'm just not sure how to fix it other than time. The sugar connection is just a treatment and not a fix.
i think horomonal changes are the main cause for the pustules to develop and balancing hormones will clear them
Have to agree with that, I'm sure a hormonal imbalance started this for me. I'm just not sure how to fix it other than time. The sugar connection is just a treatment and not a fix.
mine started when i decided to "bulk" aka eat junk food all day like a idiot. It got a lot worse when under the supervision of a derm who eventually prescribed accutane - all this time they drilled into to me to use sunscreen every 2 hours which i believe led to getting seb derm.
being in the sun is the only thing that has helped seb derm, except steroids which you really dont wanna be using.
i think everyone with this pustule issue has hormonal sensitivity, weak adrenals and probably a compounding affect of poor lifestyle choices/ medication which doesnt necessarily have to show up right away. You can pay for your lifestyle choice years later.
If you are hormonally sensitive you can yo-yo your hormones very easily; thats probably where the sugar link comes, also sat fat = more sex hormones but i would not avoid sat fat
High intensity exercise should be avoided
Excessive sex/ masturbation - definately no pron
Practice sleep hygeine
take evening primrose oil
avoid stress, which is a catch 22 becasue if you are hormonally unstable you become emotional
@23220 so saturated fats are related with hormone production. As I am sensitive to hormone fluctuations it is a real trigger for me. So I just gave this input to chatgpt so this is why it mentioning it.
So update.
I went to dermatologist. Very expensive as she is PhD in Dermatology.
She said that accutane would be ideal treatment for folliculitis but as I can't tolerate it anymore so this is not an option.
As alternative she proposed to try Doxycicline for 30 days. As I read that some folks recently reported having success with low dose doxy I decided to try. So it will be 2*100mg first 5 days and 100 mg for 25 days. If it will not work she adviced to use gentamicin ointment (as per bacteria sensitivity test) into nose 2x per day for 2 weeks.
She also said that it would be best to repeat microbilogical test when a pustule in nose occurs just to confirm if it really that bacteria as GNF is quiet rare.
So will start Doxy sometimes this week and will see how it goes.
Wish me luck.
Glad you were able to see a dermatologist to get a diagnosis. I am interested if your next bacteria test returns the same result as before. It is something I definitely want to have done for myself, however the earliest dermatology appointment I could get is in October.
I'm trying a different method of treatment after a bad breakout over the weekend. I don't have anyone to blame but myself, of course. In a moment of weakness, and that's all it takes for me, I drank a couple of sugary sodas for the quick releasing energy. Well, two days later, I wake up to about 10 pustules over my mid chin after a couple clear weeks of strict dieting. Very demoralizing. My body can't even handle a relatively small amount of sugar.
So in a depressed state I began scouring through searches and forum threads for any more leads. I found some post of similar looking pustules on Reddit which lead me to look into Staph acne and it's treatments. Basically, I'm trying nasal and ear decolonization with Hibiclens as outlined by @healthyalmonds and @silverlight22 on page 5 of this thread. I don't know if I have gram-negative or gram-positive bacteria but I do like that Hibiclens will kill both, and I'm willing to try it. I do wake up everyday with stuffed nose and congested eyes for years. Maybe there is some related info there. I will update everyone here with any results. All the best to everyone.
Just wondering, has anyone had bloodwork done before, and was anything out of normal reference range?
I've gone that route a few times just to know what is going on internally. I thought for sure the answer would be in there for me (it doesn't appear that way)
The only things out of reference range for me was my kidney numbers. I have a high volume of protein in my urine and a low eGFR, indicating poor kidney health. I wonder if there is a correlation between these factors and my body creating these pustules. I really don't know if there is any connection. We have linked it to sugar, but maybe too much protein could be a detriment(?)
Also, I'm curious to know the grams of carbs and sugars people are taking in. Sugar is hard to avoid. For example I eat hard boiled eggs and there is sugar in it. I eat vegetables and there is sugar + carbs.
I've tracked my nutrients for a few weeks now. Most days I'm getting 80 - 100g carbs, 50 - 70g fiber (so net carbs ,<50g) and 10g - 20g sugar. Everyone is welcome share their statistics.
All the best to everyone.
Double post. I wanted to write a bit about my Hibiclens use so far. (In reference to nose decolonization on page 5 of this thread). For the past 5 days I've been thorough about applying Hibiclens in my nose twice a day and some on my chin once a night with cotton swabs. I end up leaving it in my nose throughout the day as it doesn't irritate me. I do wash it off my face after a few minutes.
So far I haven't had any pustules in the creases of my nose. The 10 or so pustules I had from sugar on my chin cleared up after one day with the Hibiclens + applying a hydrocolloid patch overnight. Peeled the bandage off the next day, washed my face and the white stuff was gone. Some red spots there, but to be expected and better than pustules!
It hasn't been perfect though. I've gotten a couple of pustules on the corners of my chin below the lower lip. I'm beginning to think I have two kinds of acne. Maybe bacteria and fungal. It's just that these ones I get under the lip behave differently than the others near my nose. There is always a spot on the skin where you can tell somethings coming. The nose ones and mid chin ones will pop up overnight. The pustules don't respond to BP like the nose ones, and they don't dry out easily or last a short amount of time. They bother me the most too, of course.
Maybe I'm going crazy, but I just want my dermatologist appointment to get here as quickly as possible so I can get some kind of swab test and figure out what this is. Then I can fight it the right way.
I'll continue to use Hibiclens in the nose though. I've woken up a couple times with two clear-breathing nostrils and that is worth it to me.
thats the same routine ive found my best results too, clean well in the evening and remove any buildup then genlte wash in the morning to get rid of any oil - salt rinse during the day when i can do it.
my actual skin is improving a lot doing this, pores are becoming clear and less visible, also the tone more even. the only pustules i seem to be getting are from clearing the clogged pores on my forehead, but they are more like "purge" pustules - very small and not raised, they only last around 6 hours
im also trying no gluten and no straight sugar (on an empty stomach) - i dont know about gluten but the sugar connection is real, i havnt got 1 pustule around my mouth since i stopped having a glass a fruit juice in the morning.
everyone here should look into the Demodex mitestheroy
seb derm/ dead skin buildup could easily be mistaken for the 'crusting' that an infestation causes
they feed on oil, if you have oily skin + immunocompromised very high chance its caused by the mites
+1 if you get pustules on hairline
+1 if you have rosacea type appearance
+1 if you get flaking on the ear corners/ eyelashes
doctors rarely assume mites, it would explain why some users here had a lot of success with ivermectin.
looking at some photos i think i definately had this badly when i was at my worst, though currently i look much improved but it could still explain the buildup and pustules i get.
I hope everyone is doing well. It has been 2 weeks since I've started using Hibiclens in my nose twice a day and once on my face (followed by washing). Lately, I have been having clear skin! It's been a few days since I've used BP as well. My skin is finally getting some relief from the 10% BP every night.
It's still too soon to come to conclusions. I am very happy with this progress though. I suppose for me the pustules were a bacteria infection. Fingers crossed.
All the best to everyone.
I'm still clear since my last post, just doing the same routine with benzaclin PM, 10% azelaic acid AM. I haven't had a pustule in months, and I can also eat whatever I want (sugar, etc...) without any impact on my skin.
I think I'm going to try to transitioning to just BP from the benzaclin when I run out... hoping maybe now that my skin has had a chance to heal (months without pustules) it can be enough to keep it from recurring
Guys!!!
news from my end - I insisted the derm to take a culture and it came out as enterobacter aerogenes as in Exquisite Hunts case. Ive just gotten the news a couple minutes ago over the phone and expect to see the derm. soon so will keep you guys updated. Separately, lately Ive just taken magnesiumcitrate and a little bit of erythromycin lotion in the morning keeping it manageable and pretty much pustule free, but it seems not to be the treatment of option I guess.
exquisite hunt, do you have an update on how your derm appointment went?
All the best
I'm glad you were able to pinpoint exact bacteria strain! That is a relief when you know exactly what you're fighting against.
I'm checking in to say that the best response I've had with these pustules has come from two sources: diet manipulation and Hibiclens face wash. Both I picked up from this thread.
The diet portion prevents more from forming and the Hibiclens wash helps speed up the recovery process. I'm not perfect with the diet piece, sometimes I slip up and eat stuff I shouldn't (like at restaurants). But I am much better than I used to be. Specifically, I eat low carb, low sodium, no dairy, high protein and fats. Basically meat and one salad a day. It isn't any sort of variety - the same foods nearly everyday for months now - but I would trade tasty foods for clear skin everytime. I would guess most people in this thread would too. It would be nice to eat pizza sometimes, or a dessert, but the temporary satisfaction is not worth the week long mental toll of a pustule forming and the eventual fading red mark.
Then the addition of the hand pump Hibiclens (I use a generic pharmacy brand one) as a face cleanser really helps pustules that have already formed on my face. It must be gram-negative bacteria for me. The soap does not eliminate them overnight, but it does reduce their appearance overnight. The body still has to go through its cycle to clear it. Just apply the foam and wash off a few minutes later. Then most nights I apply BP and moisturize after a few minutes.
Can't wait for a dermatology appointment of my own at the end of next week. A long time coming. Maybe some kind of solution will be found there. Truthfully though, this is a gut issue for me. I've experimented for months for this condition and ultimately its because my gut can't handle certain foods well. I think a prescription from the derm will just be a temporary solution. But I'll go and report back in the chance I can help someone.
All the best to everyone.
Hi Guys,
So my update. I took Doxycicline for 3 weeks out of 4-5 planned. Had to stop as antibiotics related diarhea was no longer manageable :D. I am sensitive to antibiotics and always get diarhea, unfortunately probiotics are not big help for me.
So my face stayed pretty clean through this period but not 100%. I suspect that doxycicline is not very effective agains my bacterial strain.
But what positive happened is my chronically stuffy nose cleared itself after 2 weeks and now feels great. As I just today stopped taking antibiotics will need to observe if it is temporary relief or permanent.
Anyway will observe further situation and will inform you.
@Benbenzer will be interesting to see what derm says and what prescription you get. I will keep trying new things, will visit derm again in 2 weeks.