What Worked 100% For Me: Its not what you think
Ive never posted here before, but promised myself long ago to do so if I ever solved my acne problem. That time has finally come. I very much hope this information can help some people free themselves of continuous acne.
Im a 44 year old male who has suffered from acne for 31 years; one month ago it stopped. 100%. No joke. I started doing one thing differently during this past monthand one thing only. Like everyone else Ive tried everything to rid myself of acne. Ok, admittedly, I havent used honey on my zits. Something about putting food on my face instead of in it just bothered me. Go figure.
Im not here to say that what worked for me will work for you. Though I have a reasonable explanation as to why my acne probably stopped, I dont have a medical background. But like many of you, Ive become quite an expert at simple trial-and-error scenarios. 31 years of them.
Ill first cut to the chase and tell you what I did differently, and then follow this up with more detail if you wish to further understand why. I started using an anti-fungal medication all over my face in a thin layer each night before going to sleep. Thats it. Nothing else. No other changes. Sounds gross, right? Fight fungus? Not bacteria? Put a medication that typically goes on body parts I dont wish to nameon my face? I kid you not.
Ive had dandruff since a very young boy, and starting around age 23 I developed seborrheic dermatitis (a more severe form of dandruffGoogle it) around my facespecifically in my hair, ears, eyebrows, and on both sides of my lower nose area. It was a typical by the book case of seborrheic dermatitis. Millions of people actually have it to some degree, but dont always notice it or are bothered by it.
Dermatologists currently believe that dandruff is caused, or at least is exacerbated, by a common skin yeast infection. My dermatologist recommended I use a prescription anti-fungal called Nizoral 2% cream on my facial problem areas. (I use Nizoral 2% shampoo on my hair.) The active ingredient of Nizoral is called ketoconazole. Whenever I got seborrheic dermatitis (seborrhea), I put Nizoral on itbut just on problematic areas: my ears, eyebrows, and noseand within a day or so it completely disappeared.
Over the years my zits appeared randomly anywhere on my face and neckcheeks, forehead, chin, lip area, etc. I always thought of myself as having two completely separate problems: 1) acne, and 2) seborrhea. I knew that both problems were made worse by my extremely oily skin, but I never thought that these two problems could be possibly related. Zits only on my cheeks, forehead, chin, lip area, and neckseborrhea on/in my hair, ears, eyebrows, and nose. Pretty different conditions, no?
What I have discovered is that the anti-fungal Nizoral PREVENTS me from getting acne. Once a zit begins its life on planet Face, I totally understand that its bacteria you then must fight and not fungus. Seborrhea causes greasy scaling skinskin that can then easily get trapped in your pores leading to acne. Though not romantically involved, the fungus that can cause dandruff/seborrhea really loves sebum. The areas of your body which collect the most sebum is often where dandruff/seborrhea will form and be most noticeable. Just because you dont see seborrhea on facial skin areas other than your eyebrows and nosedoesnt mean its not there in small amounts.
So heres where you have to take a leap of faith with me. Whether you think I right or wrongone thing is for surethe Nizoral 2% anti-fungal cream when applied all over my face and neck completely prevented any acne from forming on my face after one month. Heres my non-medically based hypothesis as to why the anti-fungal cream method worked for my acne. Like many acne suffers I have very very oily skinday and night, 24/7. Seborrhea loves sebum. I believe that the greasy scaling skin caused by seborrhea is actually forming ALL OVER MY FACE AND NECK to some degreeand not just in the noticeable areas like my ears, eyebrows, and nose. Nizoral kills the fungus which causes seborrhea, which then prevents my pores from getting clogged by greasy scaling skin. END OF STORY.
Please keep in mind the following things: 1) I have found that only the active ingredient found in prescription strength Nizoral 2% cream, called ketoconazole, worksover-the-counter anti-fungal cream medication (with other active ingredients) does not work for me; 2) Nizoral at a 1% strength is not strong enough (I point this out because theres a Nizoral over-the-counter shampoo which is only 1% ketoconazole strength which doesnt work for meand besides, its way too harsh for facial skin anyway); 3) Nizoral (or generic brand) 2% ketoconazole can be prescribed by your regular primary care physiciana dermatologist isnt always required; just ask your regular doctor for this medication with a brief explanation as to why, and he/she will probably prescribe it without even having you come in for an office visit; ketoconazole is a pretty safe medicationespecially when applied topicallyand its also not too expensive; 4) If you Google Nizoral you'll find various articles saying ketoconazole blocks some DHT, which in turn reduces sebum production; this is not provenand I know thats not why ketoconazole works for me: I only use ketoconazole 2% cream at night, and when I wake up and throughout the dayI still have the same HUGE amount of oil/sebum (and sweat) that Ive always had. Im 120% convinced that its because the anti-fungal ketoconazole at the 2% strength kills the fungus on my face which causes greasy scaling skinand therefore prevents my pores from clogging, and prevents acne from forming.
Im thinking its possible that even if you just have dandruff in your hair, and not seborrhea, that you may still be getting acne due to low levels of fungus living on your face in your sebum. Im not trying to give anyone false hopes, but I do hope that if everything else has failed for youand you have dandruff and/or seborrheathat you try my method out.
This sounds very interesting, and maybe something I need to explore. Ive had dandruff forever and have a very oily face/scalp. I started to develop seborrhea in my ears the last several years, but have noticed recently that the flakes are now appearing under my chin and in my eyebrows to some extent. I fear it getting worse and getting on my entire face.
Thank you for your post and Im glad you found something that worked for you.
Hey, don't go knocking honey on zits...it totally worked for me a while back. But then, yes, I got kind of weirded out putting food on my face. Manuka honey (which is what I used) is antifungal, though. 
I think you have a great post here. My boyfriend had seborrheic dermatitis. Same as you, textbook affected areas-- It was in his scalp, nose, eyebrows and chin (he called it beard dandruff). Super flaky and uncomfortable for him and all the moisturizer in the world wasn't helping. So, he started using shampoo to treat it as well as something called Dermarest on his face. Dermarest has salicylic acid, zinc, and other ingredients in it that treat the symptoms of seborreic dermatitis (they're not necessarily anti-fungal). His entire face and scalp are much better now. Funny enough, the first time he thought it was due to a fungus, he put jock itch cream on his face and it worked, but then he got grossed out/embarrassed about putting that on his face -_- lol
Well, I decided to give it a go just for fun about two weeks back, and my skin is improving every day. I'm not sure if my acne is due to fungus, but this stuff, which is supposed to calm and moisturize and treat all at the same time might be making my skin less prone to breakouts. This could be-- like how you explained it-- because my skin has fewer flakes and therefore fewer places where bacteria can go and feast and therefore create zits.
Great post and I think a lot of people could benefit from considering the possibility of excess fungus on their face! If you've got "dandruff" in your eyebrows or beard (if you're a dude, or if you're a bearded lady), a red, flaky nose, or hardcore dandruff in your hair, I'd look into this. 
Interesting. What creams specifically would you recommend? I have a flaky nose around the creases and on the sides and I get flakes in my ears too, so this could be what causes my acne, who knows.
I used to get dandruff pretty severely, but that's gone away now, but it could be linked! I wonder if anti-fungal oral medication would work similarly...I hate applying topicals.
Great post and could possibly be something I should look into.
Interesting. What creams specifically would you recommend? I have a flaky nose around the creases and on the sides and I get flakes in my ears too, so this could be what causes my acne, who knows.
I used to get dandruff pretty severely, but that's gone away now, but it could be linked! I wonder if anti-fungal oral medication would work similarly...I hate applying topicals.
Great post and could possibly be something I should look into.
I recommend using Nizoral 2% cream--it's active ingredient is ketoconazole. There is a generic ketoconazole 2% cream available too which works exactly the same as the Nizoral name brand does. Ketoconazole 2% is available by prescription only. A posting down below from Tom Busby, however, said there's an over-the-counter cream called "Lotrimin Ultra" which has worked for him.
Hey, don't go knocking honey on zits...it totally worked for me a while back. But then, yes, I got kind of weirded out putting food on my face. Manuka honey (which is what I used) is antifungal, though.
I think you have a great post here. My boyfriend had seborrheic dermatitis. Same as you, textbook affected areas-- It was in his scalp, nose, eyebrows and chin (he called it beard dandruff). Super flaky and uncomfortable for him and all the moisturizer in the world wasn't helping. So, he started using shampoo to treat it as well as something called Dermarest on his face. Dermarest has salicylic acid, zinc, and other ingredients in it that treat the symptoms of seborreic dermatitis (they're not necessarily anti-fungal). His entire face and scalp are much better now. Funny enough, the first time he thought it was due to a fungus, he put jock itch cream on his face and it worked, but then he got grossed out/embarrassed about putting that on his face -_- lol
Well, I decided to give it a go just for fun about two weeks back, and my skin is improving every day. I'm not sure if my acne is due to fungus, but this stuff, which is supposed to calm and moisturize and treat all at the same time might be making my skin less prone to breakouts. This could be-- like how you explained it-- because my skin has fewer flakes and therefore fewer places where bacteria can go and feast and therefore create zits.
Great post and I think a lot of people could benefit from considering the possibility of excess fungus on their face! If you've got "dandruff" in your eyebrows or beard (if you're a dude, or if you're a bearded lady), a red, flaky nose, or hardcore dandruff in your hair, I'd look into this.
Hmmm... Maybe if I ever temporarily run out of Nizoral cream, I'll try slathering Manuka honey all over my face! 
Hi steigerhome 123, I agree that it's an all over skin condition. Nice write-up too, especially this line, "Though not romantically involved, the fungus that can cause dandruff/seborrhea really loves sebum."
Malassezia is lipid dependent, which means it has to have oil to have any metobolic activity
Lotrimin Ultra also works on malassezia, and its OTC. Last year the FDA issued a Guidance for clinical trials involving this drug and malassezia, and I've tried it with good results.
Hi steigerhome 123, I agree that it's an all over skin condition. Nice write-up too, especially this line, "Though not romantically involved, the fungus that can cause dandruff/seborrhea really loves sebum."
Malassezia is lipid dependent, which means it has to have oil to have any metobolic activity
Lotrimin Ultra also works on malassezia, and its OTC. Last year the FDA issued a Guidance for clinical trials involving this drug and malassezia, and I've tried it with good results.
Thanks for the positive feedback. I'll definitely have to check out Lotrimin Ultra. I can't remember if that's one of the over-the-counter meds I've tried before. Heck, I should have kept a running thousand page list. I'm darn sure I never tried honey though. 
Ah! I signed up here just to say that YES! I recently discovered & had this work for me too! I have had the most horrible "acne" for about the past 3.5 years. And likely the seborrheic dermatitis. But this acne - omg... I had never, ever had skin problems & this $hit wrecked havoc on my face I had tried everything under the sun - spent a fortune on OTC acne Txs, various topical & antibiotic prescriptions, tried all the home remedies. The last thing my doc tried was steroid cream - which, as it turns out, actually allows the fungus to proliferate, as do antibacterials since they kill even the good bacteria that tries to fight the fungus... I was getting these huge, painful zits that would last for freaking ever & then leave a super hyper-pigmented spot that lasts another freaking forever. (so I've also spent a fortune on dark spot correctors)
The thing with these terrible zits is that they had these little onion shaped cores in them & these things just would NOT heal until that core came out. they would just swell & peel & sometimes get so full of pus that... well - without being too graphic - they would have to pop. Anyway - another bonus is that those little cores leave a permanent hole. grrrr. Effected my face, neck, chest & shoulders - and seriously - I always felt like I was chasing it... clear up in one place, pop up in another.
Forever, all I could find when searching for others experiencing this, imo, not really normal acne, was info on Morgellons - and that is certainly not what I was experiencing. (google it for info - draw your own conclusions about validity of that skin plight)
Finally, I happened to read through a thread where a guy who claimed to be a doctor (who knows...) explained that this is essentially a presentation of ringworm that a lot of drs are not familiar with. And his explanations really made sense & I figured, what the hell, I've put every damn thing else on my face short of Clorox (and don't think I wasn't tempted). As I thought about it - all this started when I - A) started keeping pet rats (don't knock um - they are awesome pets & I'm not even sure you could get something like that from them! but dogs & cats even get ringworm... so, who knows) And I - B) Took several hot yoga classes & used the studio mats. It turns out, there was a girl who ended up w/ foot fungus on her face I guess - from people not properly cleaning the mats.
Anyway - I went out & got some Lotrimin AF - I got the athletes foot kind because it was cheaper than the one specifically for ringworm, even though they have the same active ingredient, in the same amount (clotrimazole 1%). I'm not kidding you, things started to improve within A DAY. (not totally cured by any means, but I could definitely see & feel improvement & that alone was worth a hallelujah after so long with nothing really working.) I have been slathering it on my face, neck, chest & shoulders (and my hairline - no more stupid 'dandruff')... so thankfully, I discovered you can get an even bigger tube of generic for like 88 cents at Walmart.... cause a small tube of the lotrimin is like 8 bucks! But almost everything is healed up and I haven't gotten another whopper, volcanic, painful zit since & it seems like the hyperpigmentation is fading faster than with any of the expensive dark spot correctors. If I feel a zit trying to come on, I hit it specifically with the cream & it calms right down - maybe turns into a small normal pimple - but usually nothing.
I am going to talk to my doc about a script for an oral antifungal med just for good measure... I also have a suspicion that an oral med probably would have worked a little quicker & it may alleviate the 'chasing' I feel like I'm doing.
Anyway - just wanted to share my similar experience. I assume of all the stuff we all think to try - antifungal usually isn't one of them... worth a shot if you are experiencing this...
(36 year old female)
Honey actually works but it's too sticky, so it's impractical -- I can't tolerate standing around slathered with honey and doing nothing for 3 hours. ANy raw honey works -- you don't need Manuka honey.
Clorox baths are effective on acne but have no effect on malassezia.
In terms of appearance, malassezia causes red bumps without a comedone in the center, and in this way differ from acne. The red bumps heal from the bottom up, slowly, and it doesn't help to scratch them, but malassezia also makes white skin flakes like heavy dandruff that heal from the top down and can be scratched or exfoliated in various ways. I'm pretty sure the red bumps and white flakes are a biofilm formed by the fungus interacting with your dermis, and are mostly composed of your own keratin.
I know what you mean about a "thousand page list." I started writing things down simply to keep track of what I was doing, and I found a lot of medical research articles. My write-up may is located here: The executive summary -- About 8 months ago, I learned that Climbazole at a low pH was more effective than Ketoconazole.
Hey guys...I've had dry skin around the corner of my nose, outer ear and a tiny spot near my chin for about a year-and-a-half now. I thought it was just dry skin so I basically just used moisturizers on it. Then about a month ago it started getting worse. From my research online, I figured it was eczema, so I tried some of the things people were recommending. On a youtube video, a dermatologist said to try olive oil, which I did, but my condition got much worse. I decided to go to a dermatologist. He said it was Seborrheic Dermatitis, and prescribed 2% Ketoconazole cream. I've been using this cream for the past 12 days, two times daily, but my condition has not improved at all. As a matter of fact, it has gotten worse. When I visited the dermatologist, I hadn't yet seen the dandruff in my eyebrows or the scaly skin on my eyelids. Now I have a number of patches of this condition all over my face. It is depressing to say the least, and I have taken a whole month off from work because of it. Since I now know what my condition is, I've been doing more and more research, but it seems like everyone has a different remedy to manage it. I don't know what else to do. I've used H&S shampoo on my face and after shower applying the Ketoconazole. I'm afraid if I go to the dermatologist again he will just give me something else that isn't going to work. Has anyone had any luck with Ketoconazole and can tell me how long do I have to use it to see some results? Thanks.