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I have been struggling with these since I was 13 14 ish for over 30 years. I have been to multiple dermatologists and have tried hundreds of products with thousands of dollars invested, including many prescription drugs. I have read this post since early December of 2025. I think I, and AI have finally figured it out. I told Chat GPT about it after trying a few things on this site. According to chat GPT the problem is my skin biodome. Specifically keratin plugs, fungal folliculitis, and excess sebum. The AI told me to use De La Cruz 10% sulfur every other night to break down the keratin plugs protein, and pryithione zinc for fungal folliculitis on different rotating nights followed by a non oil moisturizer. I was skeptical but I was desperate to try almost anything. It's working, I've been doing it since the 28th of December when I finally got the De La Cruz sulfur ointment. The AI said it would take about 6 weeks and then I would need maintenance for the rest of my life for my skin type. The AI advice was better than any doctor or dermatologist that I ever went to for the past 30 years. I still have plugs under my chin but the AI said those would take the longest because they're the deepest. The AI even told me why the things I tried before didn't work the biggest reason is nothing prescribed or taken before would break down the keratin plugs. Hopefully this helps someone else. 🙂
I have been struggling with these since I was 13 14 ish for over 30 years. I have been to multiple dermatologists and have tried hundreds of products with thousands of dollars invested, including many prescription drugs. I have read this post since early December of 2025. I think I, and AI have finally figured it out. I told Chat GPT about it after trying a few things on this site. According to chat GPT the problem is my skin biodome. Specifically keratin plugs, fungal folliculitis, and excess sebum. The AI told me to use De La Cruz 10% sulfur every other night to break down the keratin plugs protein, and pryithione zinc for fungal folliculitis on different rotating nights followed by a non oil moisturizer. I was skeptical but I was desperate to try almost anything. It's working, I've been doing it since the 28th of December when I finally got the De La Cruz sulfur ointment. The AI said it would take about 6 weeks and then I would need maintenance for the rest of my life for my skin type. The AI advice was better than any doctor or dermatologist that I ever went to for the past 30 years. I still have plugs under my chin but the AI said those would take the longest because they're the deepest. The AI even told me why the things I tried before didn't work the biggest reason is nothing prescribed or taken before would break down the keratin plugs. Hopefully this helps someone else. 🙂
Recently I been talking to chat gbt. Trying to put the puzzle pieces together. This is so interesting to me! Thank you for sharing this
I'm not a doctor and this isn't medical advice, everything below is my own experiences and information I found on the internet.
I've tried nearly everything over a decade and have recently come back to the idea that for myself this issue is most likely related to skin mites, probably demodex. Maybe a subspecies that's crossed from animals to us. For the first few years using tea tree oil when showering was the only thing that helped though it became less effective over time and the painful red bumps that ulcerate with white plugs spread and changed their form, ultimately getting worse. It was like they were being driven deeper into the skin and the stretchy plugs were replaced with hard spike follicle things with black dots inside and broken black hairs in the plug. They still wouldn't heal until removed as before, when the red bump came to the surface I found getting a small sharp sewing needle deep underneath the spike things to pry them up would pop them out with less damage than tweezers and speed healing. But more would come in other areas and without daily tea tree oil I'd start to get itchy.
Things were getting worse until I came across benzyl benzoate as a scabies treatment a month or so ago. I ordered a bottle off ebay and mixed up a 25% strength BB lotion recipe similar to what I found in a research paper.
1 part 100% benzyl benzoate
1.5 part liquid paraffin
1.5 part coconut oil
Mixed in a metal bowl and avoid touching plastic items once applied as it is a plasticiser. It has very strong chemical smell, though not nearly as offensive as sulphur creams which lingered on me for days.
I've applied BB a few times in the last couple of weeks and things are improving, fingers crossed this may be a solution and they don't become resistant. Please do your own research and get medical advice if going this route as this stuff is not supposed to be applied for multiple days at a time or to open wounds as it increases systemic absorption and side affects. I'm also controlling the bacterial element by hitting the bad infected spots with chlorohexidine wash in the shower and sometimes betadine or hydrogen peroxide once dry. Azelic acid cream also seems to dry things up and enhance healing too. When I first used this I noticed black dots coming to the surface of my arms which is the main area I suffer lesions. Vacuming, change of bedding and pillowcases are also done regularly.
Reason I think this is mites is that sulphur and tea tree oil have been somewhat effective in the past, plus all the symptoms of itchiness, red burrows and dandruff like keratin plugs coming off if I wipe my face with a synthetic type shirt. BB is also an antifungal so there could be some symbiosis between fungus and mites, I'm not sure.
I'll report back with how I go in the next month. Stay strong
Okay so
As I mentioned in my last post, my virtual dermatologist appointment was today. Or at least it was supposed to be.
I had logged into the site early as instructed and was waiting for the doctor to join the session, and about 3 minutes past the appointment time I suddenly received a text message and an email informing me that the appointment had been cancelled, with no explanation.
I immediately wrote an email to the patient coordinator who set up the appointment for me asking why it had been cancelled, and just as I sent it off, another email came in which offered this explanation:
"Following your recent appointment with Dr. Galas, based on the images provided, your concerns are consistent with excoriation disorder. At this time, an in-person evaluation by a dermatologist is recommended, as it will allow for a more thorough assessment and a tailored management plan.
Dr. Galas noted that medications for mental health may be part of treatment, but he understands these have not been options you were receptive to previously. The dermatologist will be able to guide the next steps in care."
I could honestly just cry. I want to give up. I don't know what I can do if no doctor believes me. I feel like being upfront and honest about the dermatillomania has only hurt me in the long run; I should have kept that to myself from the start, and now there isn't a single doctor who will believe me or help me.
@dar-wins - I have read all of your posts wherein you recommend the Continuous Glucose Monitor, and I have looked into it, but they are quite expensive; I simply cannot afford one. I don't have any health coverage right now, but even if I did, I doubt they would be covered for me because it's considered equipment for diabetics and I don't have diabetes. However, I did look into the two amino acids you mentioned, and I will probably try to get my hands on some Leucine to add to my supplement regimen. I think I will give the Arginine a pass though, because there are some medications and supplements it can react with which I take.
@bjham - I looked up the DMSO you mentioned, and I might decide to give this a try as well, but I want to look into it a little further first.
Anyway, that's my update.
I hope you're all doing well.
Oh God. I am so sorry to hear what you are going through, and I relate 100%. It sends me back to the past, which was absolutely traumatizing. It's like being erased, it's like suddenly you hold no value or validity - and nothing you can do or say makes a difference. How do you fight, "you're insane, you are causing this"? You don't - you move on, seek help elsewhere. Somehow I was able to find the will to keep fighting it, and I hope you do as well. I hear that local resources are limited, but I would suggest getting out of your local doctor system and going somewhere completely new, and don't share your medical records with them. There is a finesse to seeing doctors - you don't have to tell them everything, you can be vague, you can skip details. The less you say about your skin, the better (which I know how messed up that is, but unfortunately true). Getting out of the system that gave me the Scarlett Letter, was my break, when I finally found some doctors that started listening. Also, Derms are some of the worst.
You actually could have a rare form of Diabetes. That's what I've been trying to tell people. My A1C and fasting glucose are normal. This is why, for me, the answers were so hard to find. I have low insulin, low C-Peptide, low pro-insulin, high pro-insulin/insulin ratio, high Free Fatty Acids, high Beta Hydroxybutyrate (ketones), low Leptin. Doctors typically look at A1C and Fasting Glucose, for "Diabetes", and if they are fine, they don't look further. I am saying you need doctors to look further.
Try a primary care Physician (at least that's what they are called in the US). The first thing docs found in me was my immune deficiency. Ask for Immune testing from your general doc - just tell them you clearly suspect it as you are obviously presenting atypically. Tell them if anything comes up off, then you get the referral (in the US that's how it works, not sure for your country) to Immunology. These are the tests you want: Complement Proteins, Natural Killer Cells (numbers and function), Cytokins. Or you could go the Endocrinology route. This subset of doctors can be hit or miss - some are just as bad as Derm's. You want 5 tests for your Thyroid (not 3, never let docs only do 3): TSH, Free T3, Free T4, T3, and T4. Also, Leptin, fasting glucose with insulin, and C-Peptide. There are others as well, such as sex hormones, Adrenals (cortisol and epinephrine), but potentially not as important (or maybe they are important to your body).
I know it is hard to get these tests, especially when you feel as though no one is listening. This is why you stop going to Derms, and start going to other types of doctors. You can get these tests, and you will - when you find the right doctor. Don't give up.
I would be happy to send you a Continuous Glucose Monitor. I'm not sure how, as you are in a different country from me. I don't even know if I can privately message you, but if it's possible to have a private conversation, maybe we could figure out a way. I'm guessing you have Amazon, and that is maybe the best way? I'm offering to help as I know how bleak the space you are in can feel. Hang in there.
Edit: I was able to PM you.
Hi! Apologies for the delayed reply. I'm sorry to hear about your dermatologist appointment. That was totally unprofessional. I'm going to be honest, disclosing the dermatillomania works against you immensely. They judge you based on that before they even see you which is not right, but it is reality. Even more concerning is that they don't say "okay, this patient has dermatillomania...but that doesn't explain these white plugs we're seeing" 🙄 Talk about flawed logic. I'm not sure how it works where you live (Canada?), but in the US, there are various medical centers and private practices. Some of the most well known [academic] medical centers include places like Mayo Clinic, Cleveland Clinic, Johns Hopkins, NYU Langone, Mount Sinai Health, etc. depending on which state you live in. I can go see a family doctor/internal medicine doctor at, for example "123 Apple Drive - Mayo Clinic", and he can document that I have dermatillomania in my file. Then, if I go see a dermatologist who works at a different location, "456 Blueberry Drive" BUT it's also a Mayo Clinic facility, that doctor can see that dermatillomania diagnosis. The reason is because they use the same electronic record system. If I were to go to a Mayo Clinic, and then a Cleveland Clinic location those files wouldn't automatically be shared (unless I specified for records to be sent) since they're using different systems.
I looked up the way it works in Canada and apparently they share way more records between doctors/practices in the US, but it's also based on provinces. The new derm could see your records if you were referred by another doctor because they attach your file/history. If you're ever getting referred you have to ask them not to do this. Apparently you guys also have something called "CareConnect" and/or "Health Gateway". You need to check on Google, but there is a way to mask these records (prevent a new derm from seeing the prior derm's notes) by contacting Health Gateway and restricting access via CareConnect. If you ever want to see another derm regarding this problem, which is very clearly NOT dermatillomania induced, I highly suggest you do this. Judgement is medicine is very prominent, and it's up to us to advocate for ourselves.
Here's the good news: they saved you some money (assuming you have a copay/other fees). How many doctors do you think we've all seen between all of us on this thread? My bet is this doctor wouldn't have been very helpful anyway.
Addressing other points:
In a previous post you brought up a proliferation of hair. I have also noticed a proliferation of facial hair. The reason that it gets brushed off is because dermatologists likely attribute it to increased age and fluctuation of hormones (decreased estrogen levels), and therefore it's seen as "normal". I'm constantly thinking about what other changes/events were going on in my life when my first "lesion" appeared. My first "lesion" was during a very stressful time in my life. I always had super thick, healthy hair. During this time I experienced significant hair loss despite not changing any hair products or dying/styling my hair. I assumed the bad skin & hair loss was all related to stress. However, something other than just hair loss occurred. I noticed that the structure and texture of my hair changed in a span of about 6 months. My hair felt very dry. Not only dry, but the structure of individual strands felt literally like wire. I'm 99% certain it's "pili torti" and "trichonodosis" (single knots at the end of some strands due to how brittle the hair is). Although it's somewhat better, I still deal with this today. Here's what's interesting: pili torti is caused by abnormal keratin structure/abnormal keratinization. This got me thinking because I was diagnosed with keratosis pilaris (excess keratin plugs), colloquially known as "chicken skin" when I was ~ 10 years old. I essentially forgot about it because it was only on the back of my arms when I was younger, and it was well managed simply using a acid based exfoliating scrub until I was a teenager. After that it simply went away - I never even used a scrub in my 20's, and I forgot I ever had it. According to what I've read, having keratosis pilaris go into a state of "remission" is typical after your teenage years. Have you ever experienced something similar? Any issues with your hair/nails? I wonder if this isn't all related & if we're dealing with a keratinization disorder.
My skin has been so bad after the holidays (holiday diet) - new spots. I was applying anti-fungals, zinc based diaper cream, etc. Nothing was helping and I kept getting new spots. I was really upset and that's when I went down the keratin disease rabbit hole. I decided to try to treat this as keratosis pilaris or some sort of other keratin disorder. I've been applying prescription tretinoin cream on the spots and they're significantly better after just 3 days. When I say "significantly better" I'm talking about it went from those weeping open lesions to fully closed, almost totally gone spots. I'm going to try to implement some sort of routine where I alternate topical tretinoin, urea and/or other keratolytics (acids) with "rest days during" the week. If this really is a keratin disorder then consistency is going to be imperative (which I'm not great at). At the moment, this makes a lot of sense to me because my skin DID clear up when I was on oral tretinoin and only flared up again when I took very low doses or skipped days. I'm also going to research more about copper deficiency. Copper deficiency is related to increased keratin plugging, brittle hair, dull hair/skin, AND poor wound healing. However, you have to be careful with how much copper you supplement because too much copper can cause zinc deficiency (alternatively, too much zinc can cause copper deficiency).
I don't know if any of this will work long term, but that's my current plan (topical tretinoin, keratolytics on alternate days with breaks + copper supplementation research).
Other points:
I really don't see the point of investing in a glucose monitor. Your glucose drops, and increases throughout the day after you eat something. Even if you discover that your glucose increases at various times even when you didn't eat, so what? What are you supposed to do with that information to treat this condition? It tells you nothing, especially because glucose can spike simply due to stress. Can you be pre-diabetic and have a normal fasting blood glucose test? Sure, but again, how does that help us treat this? It doesn't. You know what you're supposed to do if a continuous glucose monitor shows you may be insulin resistant? Change your diet (avoid sugar), exercise, and lose weight. If that worked I wouldn't be dealing with this condition anymore.
I also purchased DMSO when I first discovered this thread (it was mentioned on one of the oldest posts). I spent like $20-$30 on it & it's just sitting in my cupboard 🥴 The point of DMSO is to help any product penetrate your skin better. It's essentially pointless when the products we're using aren't the correct treatment because we don't even have the correct diagnosis.
Anyway, apologies for my novel. Let me know your thoughts. Wish you well!
A glucose monitor detects and documents over time abnormal responses to food, data you can share with a doctor. Of course one's glucose fluctuates, the purpose is to see how much variation, how high, how low, how often, after eating what. In my case, a limited diet did slightly help, but it wasn't enough. I didn't actually start feeling like I was living again/completely clear skin until I got on medications to help insulin release from my Pancreas. It's not insulin resistance, so it's not pre-diabetes. It's an insulin deficiency. Very different conditions. This is why diet alone doesn't work. No matter what your diet is, it will never increase your insulin.
I don't care if you don't see the purpose in a Glucose Monitor, my only care is to try to help other on this site. Take what you will, throw out the rest. I truly hope you find your answers. I'm just sharing how I found mine.
Never met anyone that has had to have plastic surgery because of this besides me. This site really makes me feel less alone, I had to make an account to let you all know this.
Never met anyone that has had to have plastic surgery because of this besides me. This site really makes me feel less alone, I had to make an account to let you all know this.
I am sure I will also require plastic surgery for the one spot that I have left on my face. Can you all provide your plastic surgery experiences? Was it just scar revision and did you have to wait until all plugs were gone or how did it go? What did the healing look like? How are they now?
I have been struggling with these since I was 13 14 ish for over 30 years. I have been to multiple dermatologists and have tried hundreds of products with thousands of dollars invested, including many prescription drugs. I have read this post since early December of 2025. I think I, and AI have finally figured it out. I told Chat GPT about it after trying a few things on this site. According to chat GPT the problem is my skin biodome. Specifically keratin plugs, fungal folliculitis, and excess sebum. The AI told me to use De La Cruz 10% sulfur every other night to break down the keratin plugs protein, and pryithione zinc for fungal folliculitis on different rotating nights followed by a non oil moisturizer. I was skeptical but I was desperate to try almost anything. It's working, I've been doing it since the 28th of December when I finally got the De La Cruz sulfur ointment. The AI said it would take about 6 weeks and then I would need maintenance for the rest of my life for my skin type. The AI advice was better than any doctor or dermatologist that I ever went to for the past 30 years. I still have plugs under my chin but the AI said those would take the longest because they're the deepest. The AI even told me why the things I tried before didn't work the biggest reason is nothing prescribed or taken before would break down the keratin plugs. Hopefully this helps someone else. 🙂
Recently I been talking to chat gbt. Trying to put the puzzle pieces together. This is so interesting to me! Thank you for sharing this
This is directly from the AI notes for my condition
Why this plan is optimal for your condition
@dar-winsHey there! Are you still in remission? Do you think the treatments you have been given for your MODY is what has helped your skin? What exactly are those treatments? I believe last I heard, you were not taking vacyclovir anymore and were not eating sugar. Were you or are you taking or doing anything else? It seems that conditions like diabetes could contribute to the lack of healing here, but I wonder if it is the root cause. For example, I know people who have leishmaniasis (this is not that, but just for an example) who also have diabetes will have a more difficult time ridding their body of the parasite. So its a contributing factor but not the root cause overall. What are you currently thinking and how have you been doing?
I am still in remission. I do think it's the meds, which are low dose Ozempic (and I am thin, and have not lost weight on it) and microdose Glipizide (smallest dose prescription wise is 2.5 mg -intense hypo's at that dose - so I've had it compounded to a lower dose). My skin is healed after an 11 year battle. I've had 2 plastic surgeries on my face for scar revision, and had my arms tattooed to help hide the scars. I went from having "Delusional Parasitosis" put on my medical record by a Dermatologist (who never afforded me a Psych eval, and that Dx falls under Psychosis. It was extremely harmful to me on so many levels), to having top docs validating me, and testing my, and my families, genetics. It's still in process, and if the docs find the gene, technically my meds could change.
I haven't taken Valacyclovir in a long time, but I did state prior that it helped me. It seemed to calm my skin down, but skin wasn't my only issue and my energy did not improve. I do have an immune deficiency (Natural Killer Cells) that was found a few years into this - and really that's what gave me credibility when doctors just wanted to strip me of it. Right now, that appears to be a secondary implication (along with my Thyroid issues) from not getting fuel into my cells - but until the gene is found, I don't know.
I rarely eat sugar, and certain carbs are included in that - but I'm not on a Keto diet. Diet alone was not enough for me to get better. When I did the Oral Glucose Tolerance Test, where you drink the equivalent of two sodas in 2 minutes - it sent me scarily high. I actually broke out in hives after it. If you ever get to the place where this test has been ordered for you, I have some important pointers for you. My C-Peptide and Pro-Insulin being low, with a high Pro-Insulin/Insulin ratio indicates that my beta cells are struggling to make/release insulin. I can also go Hypoglycemic.
I don't know about the root cause. I don't have genetic answers yet, but I do have doctors searching for them. No infection has ever been found in me, but absolutely blood sugar issues cause a lack of skin healing. I did once have a skin biopsy that came back positive for Herpes, henceforth the antivirals, but they retested later and it came back negative. I don't have answers for you. Technically, the insulin deficiency issues could also be a byproduct of a metabolic genetic mutation whose mechanism of action just also includes Beta Cells. It might not be the core issue, but the meds have significantly increased my quality of life. That's all I know.
Hope you're hanging in there.
Edit: If you struggle with energy, you could try MCT oil. But be careful - very low dose to start, 1/4 TBSP (US measurement) max and can build up - otherwise you'll be in the bathroom.
@coldclimate The surgery and healing went better than expected. You're awake for it, so there is that aspect. The scars were covered in skin by the time I had the surgeries, but they were still active at the edges. By removing, it removed the activity. In my case, it was helpful on multiple levels. I found the plastic surgeons to be empathic, and they also sent my skin sample in for testing (but I had to pay for it). First time it was just general testing, the second time I requested testing for Herpes viruses. Just letting you know that you can direct what kind of testing based on what you specifically want checked out, but you need a sound basis. I just told them I had an immune deficiency that doctors had been struggling to figure out. That was true.
Regardless of whether you think this condition is fungal, bacterial, parasitic, autoimmune, etc., I think there is one thing we can almost all agree on: moisture makes it worse. That said, I would like to discuss something that is rather concerning. I've been following this thread for years now, and I've noticed a pattern. Every so often, someone will come on here and say "XYZ product works!". It's always someone with a brand new account, no post history, directing you to some product found on Amazon. A few things here:
1. Is it possible there are people struggling with this condition, reading this thread semi-regularly, but simply haven't made an account/haven't posted? Yes, absolutely. I, myself, read through this thread for months, buying practically ALL the recommended products that were supposed to be the "cure", before I finally made an account. Anyone who has been dealing with this knows just how impactful and devastating it can be. The idea that someone has been reading on here silently and decided to make an account when, all of a sudden, the most basic product fixed it all for them should give you pause.
2. To be more direct: there is a tactic used by some Amazon sellers in order to promote a product they're selling. They go on forums like this site, Reddit, and others looking for people struggling with certain conditions, and then they post fake testimonials claiming the product worked (obviously not revealing they're the sellers).
I'm not pointing any fingers here. I'm simply letting you all know this is absolutely something that DOES goes on, and you should all be aware before you throw more money away on something that will do absolutely nothing.
3. Lastly, as I've mentioned, I read through this entire thread for months before I ever made an account. I ended up buying the majority of the products discussed on here that were supposed to be the "cure". I was desperate and willing to try anything. Anyone who has been dealing with this knows the feeling. When I was younger, I used sulfur products for the regular occasional acne spot. I forgot about these products - I would use either the "Mario Badescu Drying Lotion" or the "Kate Somerville EradiKate (later on I also tried the Sunday Riley sulfur which I think has since been discontinued). Both of these come in little bottles, you dip a Q-tip in, apply, and they dry out the spot. They cost around $20-$30. Naturally, when I read someone on here claiming the "De La Cruz 10% Sulfur Ointment Acne Treatment for $6.99 worked, I immediately clicked add to cart.
As you can expect, this product did not work at all. It also does not dry like the other sulfur products. It remains wet and has the consistency of glue/hair gel. Again, moisture totally unhelpful for this condition. I left a review on Amazon so other people were aware because anyone who has used sulfur would be surprised to hear of a sulfur product not drying. This company, De La Cruz, refunded me the $6.99 in order to have the negative review removed. I am posting a watermarked screenshot of my order with the date, and removed review.
This product went straight into the trash, however I still thought itd be worth trying a sulfur that actually dries, so I did repurchase the Mario Badescu Drying Lotion I forgot I used years prior. Obviously, despite drying, it also did not work for this condition.
Im sure there are people out there who love the De La Cruz product because it works for their acne. Thats great. However, this is not acne. Please be aware that there are deceptive practices going on to promote certain products.
Please be careful out there & use some discernment.
I think it's interesting that you also deal with keratosis pilaris & have seen hair issues. I havent had any new lesions appear for about 3-4 weeks (no new lesions since my last post on January 7th). I also dont have any more open sores - everything has cleared up.
I altered my plan and started a new prophylactic regimen since my last post, treating this as a keratinization disorder.Im going to hold off on mentioning any specifics because ultimately I dont know if what Im doing will work to prevent new lesions long-term. Ive been at this point, where I think I finally found a way to keep this at bay, only to be disappointed way too many times now.
From chat gpt on this condition ...
There arent exact U.S. statistics on how many people have the exact condition like yours (deep keratin-plug folliculitis), largely because its often misdiagnosed and falls into overlapping categories that arent tracked in big public health surveys. But we can estimate based on related conditions that your type of problem isnt rare although its often not formally captured in prevalence studies.
Heres a realistic picture based on what we do know:
NCBI +2
📊 General folliculitis and related conditions
🧑⚕️ Folliculitis (all types)
Folliculitis inflammation of hair follicles is very common in dermatology clinics.
It happens in people of all ages and races, but exact national prevalence isnt well defined.
NCBI
So while we cant say X% of Americans have folliculitis, we do know its a frequent presentation.
🍄 Malassezia (fungal) folliculitis specifically
📍 Worldwide
General estimates of Malassezia folliculitis prevalence in the general population range from **about 1% to 17%.
Region Hovedstadens forskningsportal
📍 In people with acne-like skin issues
In people clinically diagnosed with acne, studies have found Malassezia folliculitis co-occurring in around 2829% of cases.
PMC
This suggests that in certain subsets of people with stubborn follicular skin problems, fungal involvement is common possibly underrecognized.
🧬 Why exact numbers arent well known
Your condition a deep follicular keratinization disorder with possible fungal/bacterial overlap intersects several categories:
folliculitis
keratin plug disorders
Malassezia-related folliculitis
acneiform disorders
seborrheic conditions
Because it doesnt always fit one diagnosis, its not tracked as a single national statistic.
However:
Malassezia organisms are found on the skin of 7598% of healthy people in the U.S., since theyre part of normal skin flora but not everyone develops disease from them.
eMedicine
Follicular inflammatory conditions are common reasons people seek dermatology care.
Patient
So many more people experience variants of these problems than official numbers capture.
🧠 What this means for YOU
Your deep keratin-plug disease is not an isolated, extreme rarity its part of a family of follicular conditions that affect millions of people, just under differing diagnoses like:
folliculitis
fungal folliculitis
acneiform inflammation
hyperkeratinization disorder
Even if exact prevalence isnt pinned to a number like 5% of Americans, the fact that:
Malassezia folliculitis may be present in ~117% of people generally, and
As many as ~2530% of people thought to have acne actually have fungal involvement,
suggests that a significant portion of the population has overlapping follicular/keratin issues similar to yours.
PMC
🧒 Teen vs adult pattern
Keratin plug tendencies are extremely common in teenagers (up to ~80% in some plugged pore presentations), though those are usually milder than what youre experiencing.
Cleveland Clinic
But the combination of fungal + keratin + inflammation deep in hair follicles isnt rare its just not always separately measured.
📍 Bottom line (practical truth)
Millions of people worldwide struggle with deep follicular conditions, including fungal and keratin-plug components.
Your pattern chronic, itchy, keratin-laden, recurrent fits within a reasonably common group of follicular disorders.
Its not extremely rare, just often underrecognized or misdiagnosed.
Everyones body behaves differently, but structurally similar conditions show up in a noticeable minority of people, especially those with oily skin and repeated follicular symptoms.
Regardless of whether you think this condition is fungal, bacterial, parasitic, autoimmune, etc., I think there is one thing we can almost all agree on: moisture makes it worse. That said, I would like to discuss something that is rather concerning. I've been following this thread for years now, and I've noticed a pattern. Every so often, someone will come on here and say "XYZ product works!". It's always someone with a brand new account, no post history, directing you to some product found on Amazon. A few things here:
1. Is it possible there are people struggling with this condition, reading this thread semi-regularly, but simply haven't made an account/haven't posted? Yes, absolutely. I, myself, read through this thread for months, buying practically ALL the recommended products that were supposed to be the "cure", before I finally made an account. Anyone who has been dealing with this knows just how impactful and devastating it can be. The idea that someone has been reading on here silently and decided to make an account when, all of a sudden, the most basic product fixed it all for them should give you pause.
2. To be more direct: there is a tactic used by some Amazon sellers in order to promote a product they're selling. They go on forums like this site, Reddit, and others looking for people struggling with certain conditions, and then they post fake testimonials claiming the product worked (obviously not revealing they're the sellers).
I'm not pointing any fingers here. I'm simply letting you all know this is absolutely something that DOES goes on, and you should all be aware before you throw more money away on something that will do absolutely nothing.
3. Lastly, as I've mentioned, I read through this entire thread for months before I ever made an account. I ended up buying the majority of the products discussed on here that were supposed to be the "cure". I was desperate and willing to try anything. Anyone who has been dealing with this knows the feeling. When I was younger, I used sulfur products for the regular occasional acne spot. I forgot about these products - I would use either the "Mario Badescu Drying Lotion" or the "Kate Somerville EradiKate (later on I also tried the Sunday Riley sulfur which I think has since been discontinued). Both of these come in little bottles, you dip a Q-tip in, apply, and they dry out the spot. They cost around $20-$30. Naturally, when I read someone on here claiming the "De La Cruz 10% Sulfur Ointment Acne Treatment for $6.99 worked, I immediately clicked add to cart.
As you can expect, this product did not work at all. It also does not dry like the other sulfur products. It remains wet and has the consistency of glue/hair gel. Again, moisture totally unhelpful for this condition. I left a review on Amazon so other people were aware because anyone who has used sulfur would be surprised to hear of a sulfur product not drying. This company, De La Cruz, refunded me the $6.99 in order to have the negative review removed. I am posting a watermarked screenshot of my order with the date, and removed review.
This product went straight into the trash, however I still thought itd be worth trying a sulfur that actually dries, so I did repurchase the Mario Badescu Drying Lotion I forgot I used years prior. Obviously, despite drying, it also did not work for this condition.
Im sure there are people out there who love the De La Cruz product because it works for their acne. Thats great. However, this is not acne. Please be aware that there are deceptive practices going on to promote certain products.
Please be careful out there & use some discernment.
The De la Cruz sulfur ointment product is honestly working for me, but I don't only use it I use other products (sulfer sodium a by prescription cleanser, and an oil free moisturizer by Neutrogena Pink grapefruit, just like the AI and my post said. I am not paid by De La Cruz or any product. I have used and still have prescription products like doxycycline ,tretinoin, isoface, desonide, Nystatin trimcinolon, adapalene gel called Differin. Throughout the many years of struggling with this I was honestly desperate to use anything so I didn't even know about De La Cruz 10% sulfur ointment until 12/23/2025 ish. I had tried one sofa before that didn't work for me called nicoderm. I was highly skeptical of De La Cruz from the AI advice. But I tried the more expensive like $15 one because it's bigger and it's working slowly with the other sulfer products I mentioned. I did ask the AI many questions especially when I told I had used sulfur and it was nicoderm. The AI told me it was Old sulfur technology that wouldn't work for my condition. Also the De La Cruz doesn't stay wet unless you use way too much of it the instructions say rub it in (a thin small layer) and when you rub it in it actually dries, it dries so much that you will need a wet cloth to remove it. We are all just trying to beat the war against acne. If you would have told me what to do and products I would have tried them. The far worse thing I see on this forum is many of us like myself have been to dermatologist for years and they mock us belittle us and misdiagnosis that's why we are here talking about it looking for solutions. If you have a product that's better than De La Cruz or so for that will work for me I would be willing to try it. So far my results are good but a little bit of common Sense from myself with the keratin plugs that I have so deep and so big I would definitely be happy to find a product that would dissolve them or get rid of them faster. 🙂
Never met anyone that has had to have plastic surgery because of this besides me. This site really makes me feel less alone, I had to make an account to let you all know this.
I am sure I will also require plastic surgery for the one spot that I have left on my face. Can you all provide your plastic surgery experiences? Was it just scar revision and did you have to wait until all plugs were gone or how did it go? What did the healing look like? How are they now?
Mine was not scar revision I had to get unhealed skin fixed. Luckily they were able to work with what they had and I didnt need a graph. I was under anesthesia and needed over 100 sutures. I was awake for all the sutures to be removed and that sucked. Recently I had a scar fixed near my lip and was awake for that and that was pure hell.
Surgery didnt help my problem and I was left with little brown spots that I didnt have before. The spot I had fixed still has issues and Im really going through it bad in that area right now. At this point Im convinced its some kind of skin ulcer. I wish I could say surgery fixed my issue but since yours is a scar it will most likely go away lot better.
I had a breakthrough appointment yesterday and ran to the computer this AM to post it for everyone. Believe it or not it was with my OBGYN not a derm or skin related. I was being gaslit and disregarded by every dermatologist and even my favorite PCP. Atrium would not accept my "generic referral" to the derm I wanted to see from my PCP and it was denied 4x... I have always had a good relationship with my OB so I booked with her and also talked about a few other things. I am 33 yo female living in the US. I have been clinically diagnosed with hypothyroidism for 5 years as well as HPV for 10+ years. My OB says that HPV can create excess Keratin. My OB scanned this forum with me and said that she thinks it is highly possible they are connected. She did some labs and PCOS tests of her own but ultimately sat down and went to searching and ended at the Hyperkeratinization at first with a possible filaggrin issue. She did some Androgen and progesterone labs but I have not gotten them back yet. When we pick the plugs it damages the barrier which just signals our body to produce more keratin as a shield 🙁 Of course she did say I should start a food journal and start using milder detergents just as a safety thing... but then we got to talking about the chin hairs and peach fuzz that come in the plugs and ended in a bit of a different place... When I told her retinoids never worked and that there were thin hairs in my plugs sometimes the doctor search engine she was using ended up at Trichostasis Spinulosa. Trichostasis Spinulosa is where my hair follicles in my face fail to shed the old hair and the old hair stays trapped so my body pushes the excess keratin to the trapped hair to protect my skin from the random splinter of hair that wont release. She said most likely the plugs that I do not see a hair in, the hair is so fine or deep that I cant see it and just see the white plug instead. The whiter the plug the more pure keratin it contains without other oils which is why oil fighting acne products like Benzoyl Peroxide or Retinoids have never worked for me. They are also just drying out my skin barrier which makes the plugs worse too. The plugs that have hair are probably the harder ones and the plugs that have no hair or very thin are the ones that seem soft and waxy. Because my plugs are seemingly so much keratin, they are sharp inside of my skin and eventually pierce the side of the pore as I go through my daily facial movements I feel the pain or pings in my face, and my body sends the anti-inflammatory attack that creates the cyst underneath or around the plug. From what we read today I need to STOP all acne treatments that are topical. Benzoyl and Ret. They are making the keratin harder and brittle. Urea needs to be daily, which I had but stopped using because I was not getting anywhere with it but its because I was using other drying stuff and should not have been. Once I try these, I did get a referral to Duke University derm but I will be asking them about all of this and waiting on some labs. Seemingly laser hair removal may be a good option for my face. I do have terribly long and thing peach fuzz though it is fine pieces of hair. I do have some thicker hairs on my chin and neck but we are thinking that is hormonal and will see what the labs say. Where I get the coarser hairs, they require a massive amount of keratin to push through my skin since they are so coarse so that is why I am seeing plugs in those areas. The pale thin hairs are vellus hairs. As I stated above the vellus hairs are not shedding from the follicle before a new one grows so I end up with bundle of 10-50 hairs trapped in a single pore, I just cant see them all. My body tries to seal the hairs away and pushes more keratin to it. Last night I did a Oil soak with Neutrogena Ultra Light cleansing oil. I massaged it into my face for 5-7 minutes in a circular motion. Normally I put it on my face, do some gua shau, add water to emulsify and rinse all in 2-3 minutes. This time I let it sit and massaged it in for 5-7 minutes. I could actually feel some of them releasing as I did it.... I could see some on my fingers... I then took a very warm, not hot towel and put it over my chin and neck to steam the oil. Once the towel cooled i did the emulsify and rinse. I then washed with a hydrating cleanser, no acne products and rinsed the immediately put a thick layer of 10% urea by Prequel on my face. I did not dry my face first, I left the water on and put the Prequel on. I then put another basic moisturizing cream over top of my whole face, I believe cereva night cream or something. I woke up this morning and my face already feels different. I can literally just tell because I have been battling this in the clusters for about 2 years now. The medical search with my OB in the room DID bring up the sulfur mentioned above and I have it on hand but it had not worked in the past because I was also using drying acne cleansers and creams as well.... so going to add that now that I am doing the urea and oil soak etc.... I can tell I am on the right track and I hope it stays that way. I will continue to move forward with my Duke Dermatology referral as well as the hormonal issues and try to see if I can pinpoint where this is coming from but something hunches me towards the HPV theory.... I have always had very thick body hair and have paid for laser hair removal in a few spots due to recommendation of my waxer. One day she said, Girl, you have 5-8 hairs coming out of one follicle... I love taking your money but you would definitely benefit from laser. Those spots that I lasered are so clear and smooth... so seemingly I have always had thick hair and congested follicles.... I feel better already. I know everyone on this forum might not be having the hair follicle issue like I seemingly am but the keratin is coming from somewhere! The whiter the plug the more pure keratin protein it is and the less oil fighting topicals will work.... maybe this will help someone. Thanks for reading if you did and stay strong everyone!!! Maybe I will tag a few people that responded to me in the past (I made a new login )
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