55 minutes ago, Aussie Scientist said:

Can you remind me - do you have dandruff or a white tongue ?

I didn't think I had a dandruff problem but maybe I did! I mean I know what it is to have really bad dandruff and my scalp isn't constantly flaking, but I do sometimes get dandruff (it always went away after a good wash - I just used ordinary shampoo until today).

I didn't think I had a white tongue, but now I really don't know. I've looked at some pictures of tongues online and am still uncertain..! Maybe I do have candida... I've looked online at the other symptoms and I honestly don't know if they apply to me... I've never had a urinary tract infection as far as as I know?! And the other symptoms are just too vague for me to feel I definitively have candida... Tireness/fatigue... this is just too general and doesn't everybody suffer from this to a degree? Joint pain... I mean I haven't noticed anything severe... As we get older don't we all start to creak a little at the joints? Haha.... This is why I'm not a doctor.......!!

Is it possible to have BOTH candida fungal acne and malassezia fungal acne?

59 minutes ago, Aussie Scientist said:

I suggest you also buy some azaleic acid cream/lotion (which is not acidic) and apply that together with the antifungal creams. Azaleic acid cream/lotion is anti inflammatory and it will help break down the cysts.

Thank you so much for your replies and suggestions. I don't know if it will work but it can't hurt to try something I haven't tried yet!! I will ask at the drugstore for nystatin (in case it's candida) and azaleic acid (for the inflammation)...!

By the way, will I be dependent long term on the creams? Will it be anotherbenzoyl peroxide situation? Or eventually will I be able to stop using the creams (if so how long after healing)? I guess it's too soon to ask that because I don't know if this is really working... Oh well. If I do get clear I will ask again haha! Thanks so much for your suggestions. Fingers crossed...!

Podo

Yes, one can have both malasezzia and candida fungal acne. You may need to apply the antifungal creams for a long time, but you can possibly drop back the frequency of applying them after a while.

I am happy to hear how things go.

6 hours ago, Aussie Scientist said:

Podo

Yes, one can have both malasezzia and candida fungal acne. You may need to apply the antifungal creams for a long time, but you can possibly drop back the frequency of applying them after a while.

I am happy to hear how things go.

Thanks! I went to the drugstore today and got a product with Nystatin in it (picture below), it's not technically for acne but it has Nystatin in it so I'll give it a go! I I wasn't able to find anything with Alazeic acid though... Maybe it's banned in Japan (like BP). I'm really not sure. I do know that Benzoyl Peroxide cream is not available in Japan (previously I ordered it online)... 

Acne is relatively calm today, notwithstanding the little uninflamed comedones... I hope this can continue and hopefully even heal fully... fingers crossed.

Podo,

As AussieScientist has said, the problem could be fungal acne. But there is another possible cause, demodex skin mites.

Have you been tested for demodex skin mites?Demodex can also cause acne like lesions on a cyclical basis.Everybody has microscopic demodex skin mites.They can get overpopulated when your immune system is down due to illness or stress. The mites live in the pores and/or oil glands. They eat oil and possible skin cells inside the pores.The mites live and die on a 14-24 day cycle.The cyclical behavior can be a big clue.It can seem to wane for a bit then suddenly flare up.When the mitesdie off their dead bodiescan create pustules sometimes quite large or painful, other times smaller.

Demodex can cause lesions anywhere on your body except the 2 places that there are no oil glands: the palms of your hands and the soles of your feet. Body acne, scalp acne and red dry eyes may occur. Their nickname is eyelash mites and they like to live in the oily meibomian glands in the eyelids as well as in the eyebrows. Demodex can cause dry eyes, occular rosacea/blepharitis demodex. They can also make your skin itch.

Because Accutane dries up the oil glands it starves off a lot of the mites and could starve any fungus as well. But it may not kill enough of them, they can come back.

As AussieScientist said demodex may cause rosacea like symptoms with redness. But for some of us it just looks like ordinary acne, no redness.

If it is demodex, there is a 2 week prescription treatment that has been shown to be highly successful at killing off the mites and clearing the skin up. If you do not have demodex then this treatment will not help.

The combined Oral Ivermectin + Oral Metronidazole treatment has worked for me. The report on this treatment was published in the International Journal of Infectious disease in 2013. Treatment takes 2 weeks using Oral Ivermectin and Oral Metronidazole. Insurance copay was just $13.03 (Uninsured retail about $52 USD.

Article: "Evaluation of the efficacy of oral ivermectin in comparison with ivermectinmetronidazole combined therapy in the treatment of ocular and skin lesions of Demodex folliculorum"
https://www.sciencedirect.com/scienc...0197121201315X

Over the counter options include using a tea tree oil face wash and possible a tea tree oil moisturizer or ointment. Tea tree oil is anti-microbial and will kill bacteria, fungus and demodex. Topical tea tree oil may take some time to work. The Body Shop, Dessert Essence and eye eco all make good tea tree oil face washes. Derma e makes a 5% tea tree oil moisturizer and Dessert Essence makes a 5% tea tree oil ointment. Borax soaks can soothe itchy skin. DIY Borax shampoo followed by an Apple Cider Vinegar rinsecan soothe itchy scalp and help rid the scalp of the mites.

If the cause is fungus in addition to Aussie Scientist excellent skin care recommendations there is an oral prescription treatment with oral Fluconazole (Brand name Diflucan) that can also help. Doctors recommend that 24 hours after taking the drug, the patient works out and gets sweaty. It forces the drug into the pores through the sweat glands. Sweating the drug out through the pores aids in killing the fungal infection. Improvements may be noticed within 24 hours of taking the drug.

There is a case study from the NIH with pictures on a patient that had a type of fungal acne that was helped by this drug.

Malassezia (Pityrosporum) folliculitis case study from the NIH is here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970831/

Podo

Elaine makes good points.

My comment is to always use topical treatments BEFORE using oral treatments and ONLY use oral treatments if the topical treatment does not work. Topical treatments are safe and oral treatments are dangerous.

Also, note that the the fungi that cause fungal acne are often resistant to fluconazole.

See how you go with the nystatin., And note that The Ordinary make a product with azaleic acid in it which you should be able to buy online.

I'll sign off now as I have to return to full time work. Best wishes.

15 hours ago, ElaineA said:

Have you been tested for demodex skin mites? 

Hi Elaine, thanks so much for your reply! I have never been tested for demodex skin mites and I'm not sure where I should even go to get such testing. The dermatologist that I last went to in my town didn't seem to offer any sort of testing (he diagnosed and prescribed treatment just by looking... and by looking I really mean just like a glance...).

Hearing how many different kinds of acne and recalling all of the times I've been "diagnosed" by dermatologists over the years without them ever taking a sample of my skin microbiome is really... I don't know I feel like the dermatologists I've consulted over the years (more like decades now!!) have not been helpful at all. And when I ask questions I am made to feel like I'm a problematic client, instead of a patient genuinely seeking answers....

I have Apple Cider Vinegar in my pantry, do you think that using it without the Borax shampoo (I have some antidandruff shampoo I'm using at the moment which I've only just started using) will be helpful?

14 hours ago, Aussie Scientist said:

See how you go with the nystatin., And note that The Ordinary make a product with azaleic acid in it which you should be able to buy online.

I'll sign off now as I have to return to full time work. Best wishes.

Thank you so much for your help!

Unfortunately I seem to have gotten some painful cysts on my chin overnight... They don't itch though, so that's something! They hurt but at least they don't itch. I'm going to keep trying this current approach (antifungal cream and antidandruff shampoo) for a while just so I know I've given it a good run. I'd never even considered fungal acne until now. I'm wondering if I'm breaking out because the anti fungal cream I'm using is killing off fungus and making room for something ELSE that's wreaking havoc on my skin?! Oh well it's only been about a week so I'll keep on going for a while to see how things go. Maybe it's only because it's a week after my period that my skin seemed calmer... I wish I knew how to diagnose myself properly.... sigh

What I like about the current creams I'm using is that unlike BP, I can wash it off after letting it sit on my face for a while. I don't like having stuff on my face if I can help it... Also like that I don't need to use moisturiser... I really hate that stuff haha! Typing this with a face full of Lamisil and nystatin cream haha!

The skin on my hands are so smooth and soft. Saying so is rather pointless I guess. Just can't help noticing the huge difference from when I look in the mirror though... lol! 

5 hours ago, podo said:

I have never been tested for demodex skin mites and I'm not sure where I should even go to get such testing. The dermatologist that I last went to in my town didn't seem to offer any sort of testing (he diagnosed and prescribed treatmentjust by looking... and by looking I really mean just like a glance...).

I have Apple Cider Vinegar in my pantry, do you think that using it without the Boraxshampoo (I have some antidandruff shampoo I'm using at the moment which I've only just started using) will be helpful?

 

The diluted Apple Cider Vinegar rinse (3 parts water to one part vinegar, aka 3/4 cup water to 1/4 cup ACV) is used after the homemade Borax Shampoo to re-balance the Ph of the hair. Borax shampoo can be a little alkaline. Some people use the diluted vinegar rinse after washing for treating dandruff in the hair. By itself, the ACVisn't as likely to help if demodex is the issue.

I totally understand what you mean about the "visual aka glance" exams. Over the years I went to 4 board certified dermatologists who did exactly that type of exam. And then wrote yet another prescription for lots of different antibiotics, expensive prescription retinoids, etc. that never worked. They never did one actual skin test to find out what kind of horrible infection I had that all those antibiotics couldn't cure. The 4th dermatologistwas puzzled by why nothing ever seemed to work and then said gee maybe its hormonal.

There are some knowledgeable people out there. When you call for a dermatologistappointment ask for a demodex and fungus skin test. If they don't know what you are talking about, keep trying doctors until you find one who does know how to do the tests.

A knowledgeable dermatologist should know how to test for demodex and fungus for that matter. It could be either one or both. There are 2 basic methods of testing for demodex both involve getting a sample to put under a microscope to try and count the number of demodex present. They either do a light skin scraping of the very upper dead layer of skin and put the sample on the microscope slide. OR they put some sticky glue directly on the microscope slide, stick it to a section of the face, say the forehead or chin, leave it one minute to let the glue dry and pull it off - just like usinga pore strip. Counting the demodex is a little tricky since they do not like light and tend to scuttle to the edge of the slide. But it can be done. I think the fungus test is similar to the very light skin scraping. Collect a small sample and look at it under the microscope.

As Aussie Scientist says if the topicals work, then oral treatment would likely not be necessary. I finally had to do the oral treatment since the mites got in my eye oil glands causing a severe case of ocular rosacea. The topical treatments with tea tree oil andCliradex eye wipes helped but could only control the infestation, they couldn't eradicate it.

Another topical treatment possibility is Intense Pulsed Light (IPL) treatment. IPL will help people with bacterial acne or demodex without the use of drugs. I'm not sure if it would be useful for all types of fungal acne but they do use IPLon a specific type of finger/toe nail fungus. Demodex skin mites do not like light and the light from the IPL treatment kills them.

IPLis more expensive since the treatments can run in the range of $250-$350 per treatment. It can be helpful for forcing out cysts contents - just let the cysts drain themselves in the weeks following treatment . The cysts get naturally forced out through the skin's pores.. Best to get IPL from a proper medical doctor or medically supervised spa rather than an unsupervised beauty spa. You want to make sure the technicians are properly trained in the procedures and the doctor sponsored treatment tends to give their people better training. They have to shield your eyes properly to avoid damage from the light.

Podo

Sometimes people with demodex mites do need oral treatments but best to try topical treatments first.

Having said that, I think you have fungal acne not demodex mites acne (from your other symptoms) so persist with applying the topical antifungal creams and antidandruff shampoo.

I'm signing off now. I wish you (and Elaine) well.

On 7/23/2019 at 4:54 AM, ElaineA said:

The diluted Apple Cider Vinegar rinse (3 parts water to one part vinegar, aka 3/4 cup water to 1/4 cup ACV) is used after the homemade Borax Shampoo to re-balance the Ph of the hair. Borax shampoo can be a little alkaline. Some people use the diluted vinegar rinse after washing for treating dandruff in the hair. By itself, the ACVisn't as likely to help if demodex is the issue.

Thanks again for your reply and for the information! I had to google borax as I'd never heard of it before...! I didn't realise it was a homemade shampoo...

On 7/23/2019 at 4:54 AM, ElaineA said:

There are some knowledgeable people out there. When you call for a dermatologistappointment ask for a demodex and fungus skin test. If they don't know what you are talking about, keep trying doctors until you find one who does know how to do the tests.

Thanks so much! I'm not keen on looking for another dermatologist as I've just not had a good experience over the past 2 decades... but I'll keep this in mind in case I finally cave yet again and decide to look for one (which I think will be a feat in itself because people in my area just aren't even familiar with Accutane even! Which I think is relevant as it is a part of my treatment history.... YetI get blank looks when I mention it... becauseit's not something that's available here in Japan...)

On 7/23/2019 at 4:54 AM, ElaineA said:

Another topical treatment possibility is Intense Pulsed Light (IPL) treatment. IPL will help people with bacterial acne or demodex without the use of drugs. I'm not sure if it would be useful for all types of fungal acne but they do use IPLon a specific type of finger/toe nail fungus. Demodex skin mites do not like light and the light from the IPL treatment kills them.

One of the dermatologists (who also didn't know what Accutane was....) here mentioned Isolaz, which I think is IPL... I made an appointment but chickened out and backed out at the last minute because I wasn't confident it would help - I couldn't find many success stories online and for those that are successful their acne looked pretty mild compared to what I have...(and,the price is really intimidating too... the nurse told me it could take up to 20 treatments to clear... that would basically break my bank account...!) Maybe I have a combination of triggers (bacteria, fungus and mites?!). I occasionally think maybe I shouldn't have cancelled and maybe I should book again to give Isolaz a go... I'll think about it some more... thanks for the info!!!!

22 hours ago, Aussie Scientist said:

Sometimes people with demodex mites do need oral treatments but best to try topical treatments first.

Having said that, I think you have fungal acne not demodex mites acne (from your other symptoms) so persist with applying the topical antifungal creams and antidandruff shampoo.

Thanks so much for all of the information!! I'm also keen to avoid oral medications as far as possible...

I'm still getting new pimples unfortunately... along my jaw I'm breaking out again.... but I'm going to keep trying the antifungals and antidandruff shampoofor a while.

Hey @podohow ur doing?

I identify so much with your first post, it's crazy. I actually stopped going to the gym cause I couldn't see anyone with skin problems, not a single zit, I just felt horrible how I could be so unlucky in my life. I read a research that said 1 in around 1500 has reasonable severe acne scars and 1 in 100 has some scars. Well, I actually can't find anyone, not sure if we're just hiding inside our homes making it even harder for everyone else.

Luckily I don't have acne anymore but my face is full of severe scars so I still suffer a lot emotionally. I hate giving advice on how to deal with it because I know it's so hard and I couldn't deal with it myself, it just stopped by itself someday. Also I bet you've tried everything too.

Said that I really believe we were meant to eat meat only and I'm trying to do it for some gut problems I have, it is really hard to doas you can imagine, but from what I've seen there's a lot of benefits (including acne) and with time people get used to it because of so many benefits and stop the cravings (I'm not there yet :P)

I encourage you to research more for "zero carb", I think you said you were vegan? Some people are for health concerns so please take a look at eating only meat but if you are vegan for moral/ethics purpose just ignore what I said.

Some resources:

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There's a blog I've seen a long time ago that was such a great read (I've read it all in a day or two) about a guy that lost his bowels due to a colonoscopy medical error and changed from vegan to meat and was doing great. Unfortunately I couldn't find it anymore but if you have interest I'll try to search it for you.

Again, I didn't cured my active acne with it, I just discovered it long after my acne has gone. And I'm not a expert in the diet yet, I failed at it long ago and I'm just trying again because I believe there's a lot of benefits.

7 hours ago, UnusedNylon said:

I identify so much with your first post, it's crazy. I actually stopped going to the gym cause I couldn't see anyone with skin problems, not a single zit, I just felt horrible how I could be so unlucky in my life. I read a research that said 1 in around 1500 has reasonable severe acne scars and 1 in 100 has some scars. Well, I actually can't find anyone, not sure if we're just hiding inside our homes making it even harder for everyone else.

Hi,

Yes I think a lot of us feel the same way - helpless haha. I think acne is just as poorly understood as cancer to be perfectly honest... But unlike cancer acne really "marks" you and as superficial as that sounds it really affects self esteem. Just... I dunno. I totally get the feeling having been an acne sufferer myself... Sometimes I just get sick of my own thoughts and wonder what it must be like to just have no concept of acne.... Which is why I'm fascinated by people who have been blind from birth. Not saying that I wish I was blind from birth, but it's fascinating to learn their perspective. People who have been blind from birth would never judge people for a condition they can't help.

I know it's not always the case that people are being judgmental, but I'm willing to bet that every acne sufferer has had that ONE (or maybe even thoseFEW)comment(s), that was/were hurtful. And that can be enough to really make you feel crap, as if the acne is your fault... Cue the self-hatred lol.

7 hours ago, UnusedNylon said:

Luckily I don't have acne anymore but my face is full of severe scars so I still suffer a lot emotionally. I hate giving advice on how to deal with it because I know it's so hard and I couldn't deal with it myself, it just stopped by itself someday. Also I bet you've tried everything too.

Yeah I hate giving advice too.

I also have a feeling that even if my face clears one day I'll have no clue what did the trick! That said, I don't think I've tried EVERYTHING. I haven't tried laser treatment, for instance. I'm undecided as to whether I will. For one thing it's just way too pricey and I just can't afford it without knowing for certain it will work. Too often I've shelled out the cash and not had results, or, in the case of Accutane, I had results only while the treatment lasted.

7 hours ago, UnusedNylon said:

I encourage you to research more for "zero carb", I think you said you were vegan? Some people are for health concerns so please take a look at eating only meat but if you are vegan for moral/ethics purpose just ignore what I said.

Thanks for the suggestion... I never believed (and still don't believe) that being vegan would cure my acne, although a small part of me hoped it would. However, a large part of why I became vegan IS because of my acne - but indirectly and not in the way that most people assume when I mention my diet (which is usually only because people ask!! When I reply thatI don't eat animal productsthey assume it's because of my bad skin). The long and short of it is that as an acne sufferer I know what it is to "suffer", and I really don't want to contribute to unnecessary (emphasis on "unnecessary")suffering if I can help it. I'm not dead yet so I don't doubt that I can sustain myself on a plant-based diet. Furthermore,I have seen no evidence that consuming meat or animal products helps to treat acne in any way. I myself ate meat (and lots of it) for most of my life. My acne was at its worst before I went vegan - back in 2014. Also, I've seen many other benefits from eating vegan (uterine fibroids basically went away - and with it, my terrible menstrual pains... also I never realised how constipated I was before I went vegan!! Now I'm extremely regular...!) so... I'm fairly certain I will not go back to eating meat or consuming animal products. I would have gone vegan earlier if I had even known about veganism - I was raised eating meat and fish etc and I never knew about veganism until my late 20s.

Anyway.. YesI am vegan for ethical reasons - but I wouldn't be vegan if eating a balancedvegan diet wasn't sustainable and beneficial for long-term health as well, if that makes sense...

I'm glad your acne is gone... Seriously it is such a horrible condition. Not that there aren't other horrible conditions but acne is extremely persistently chronically annoying lol!

1 hour ago, podo said:

Yes I think a lot of us feel the same way - helpless haha. I think acne is just as poorly understood as cancer to be perfectly honest... But unlike cancer acne really "marks" you and as superficial as that sounds it really affects self esteem. Just... I dunno. I totally get the feeling having been an acne sufferer myself... Sometimes I just get sick of my own thoughts and wonder what it must be like to just have no concept of acne.... Which is why I'm fascinated by people who have been blind from birth. Not saying that I wish I was blind from birth, but it's fascinating to learn their perspective. People who have been blind from birth would never judge people for a condition they can't help.

I know it's not always the case that people are being judgmental, but I'm willing to bet that every acne sufferer has had that ONE (or maybe even thoseFEW)comment(s), that was/were hurtful. And that can be enough to really make you feel crap, as if the acne is your fault... Cue the self-hatred lol.

It's crazy how acneaffect us. I've seen a show on TV that shows 3 girls: one with a big purple spot in her face from birth, another with vitiligo also in her faceand the other one with some acne. In my opinion the first two girls has it way worse and probably would had more difficult in accepting their conditions. No. Both said they are happy now and accept their condition fully while the girl with acne was pretty much crying and was devastated. Why is that?

I have a theory that "acne" is treated by the general population as something "normal" and expected. That 90% of people will have it in their lifes. But this is just ridiculous, acne itself should be treated as a life-changing disease and be differentiate from 1 or 2 zits that someone randomly gets and never see it again. Because it's treated so lightly (like commercials showing 1 zit in a crystal clear skin) the general population doesn't think it hurts so much to make those "comments", they don't view it as a disease/condition, they view it as something thatgo away and you'll be fine later. And us, suffering from it, can't accept something so "easy" and "temporary" (for others) being so resistant in us.

The mental anguish in acnesufferers is extreme. And you'll see all the time people serious complaining from just some persistent zits orsome scars that shouldn't change their lifes that much. Just imagine what's living with a face full of acne and/or scars. I'd like to say my scars are from a real disease (just like other diseases)Ifighted in the past and I should be respected for that, not humiliated.

1 hour ago, podo said:

Also, I've seen many other benefits from eating vegan (uterine fibroids basically went away - and with it, my terrible menstrual pains... also I never realised how constipated I was before I went vegan!! Now I'm extremely regular...!) so... I'm fairly certain I will not go back to eating meat or consuming animal products. I would have gone vegan earlier if I had even known about veganism - I was raised eating meat and fish etc and I never knew about veganism until my late 20s.

Anyway.. YesI am vegan for ethical reasons - but I wouldn't be vegan if eating a balancedvegan diet wasn't sustainable and beneficial for long-term health as well, if that makes sense...

I'm happy that it works for you. We are all different and I respect that, for example I had always being the opposite of constipated so plants make it even worse for me, probably the fiber. In a all meat diet we eat 0 fiber and go every 3~4 days with works for me, but maybe not for you and that's fine.

1 hour ago, podo said:

I'm glad your acne is gone... Seriously it is such a horrible condition. Not that there aren't other horrible conditions but acne is extremely persistently chronically annoying lol!

Yes me too, at least I can try to treat my scars now. I had more hope when I had active acne because it could go away someday, with scars is way worse, there's no way to remove it 100%. We work with small improvements in extreme expensive treaments that takes a long time to show any/if any improvement at all. I really hope you don't have to deal with it too.

Female and 37 years old still suffering from cystic (red, inflamed) acne is most likely caused by an hormonal disorder.

''Speakingof weight loss though... this is the other reason why I'm uncertain about the diet/acne connection. Obese people eat terribly, yet I have never seen an obese person on these shows with severe (and I mean SEVERE) acne... Yes they might have minor skin problems but I've never seen an obese personwith severe (like, distractingly severe)acne.''

That's not a valid point. Some people have a predisposition to have acne and some others hair loss, obesity, diabetes, hirsutism, etc.

If I were you, I would get a full hormone panel done, including testosterone, ADRENAL androgens, thyroid, progesterone, etc.

Get referred to and endocrinologist NOT a gynecologist.

Hi Podo,

Did what Aussie suggest work for you? The antifungal treatment