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My Self-Esteem Is Pretty Much Ruined. Could This Be Folliculitis Instead Of Acne?

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If i'm posting this, it means the situation is desperate and i acknowledge that i have a bad skin condition. I feel some sort of relief now that i share this on a public forum.

I could write a whole essay about how my skin problem affected every aspect of my life in so many ways and how i feel like i'm all alone fighting this demon called "acne".

Here are some facts about my skin problem:

- I started getting moderate acne on my face and neck in 2007 (i was 14 at that time) which cleared up almost completely in 2012 (at age 19) without any topical or oral antibiotic and without leaving any marks even though i used to pick at it a lot. Since then i never had a breakout and i rarely get any zits on my face.

- In 2010 i started getting pimples on my upper arms, which spread to my lower arms also and chest and back. In the same year i waxed my arms only in an attempt to get rid of the pimples, but when hair started growing back it only made it worse and i developed a lot of ingrown hairs on arms. Since 2010 and to this day i have never worn a T-shirt and only once went to the beach but I was self-conscious all the time and the pimples flared up again after i came home from the beach vacation.

- since 2012 i went to 4 different dermatologists and they all diagnosed me with acne vulgaris (i must mention they only took a look at my back, arms and chest for a few seconds before they started prescribing creams and i was never examined thoroughly) I was first prescribed topical creams: Skinoren, Brevoxyl, Zynerit, Isotrexin and last year i followed a 1 month course with oral Erithromicin, but none helped.

- On the 1st of July this year i went to a 4th derm and he prescribed topical Eryfluid (a liquid containing erithromicin) and 100mg of Doxycycline daily for 3 months.

Currently its been almost a month since i follow this treatment and at best my skin is the same as before if not worse. After spending countless hours of reading on acne.org i learned about Folliculitis and i wanted to share with you some pictures i took and i want to know if what i have, might be Folliculitis instead of Acne and maybe that's why none of the treatments worked so far?

Please take in consideration that i have these pimples even on my forearms (weird place to have acne) and most of them feel hard at touch with pus and an ingrown hair inside, as well as those on my upper arms. I even had some fine hairs trapped on my chest also. I can't say if there are any ingrown hairs on my back because i can't see them in the mirror.

Edited by BonTon
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All acne is dead skin and hair and oil around a hair so in essence all acne is folliculitis (irritation of the follicle.)

Folliculitis is typically seem in African Americans as their hair is more coarse. You look very hairless and European (Irish?) If the hair on your chest and back isn't as coarse as your pubic (armpit and groin) hair, it's not the Folliculitis that black people get.

Know that shaving is good for removing dead skin, generally, but it slices off the tapered tip of the hair shaft and creates a blunt shaft that dead skin can occlude and trap.

If you are breaking out over where you shave, stop shaving. You're irritating the hormonal breakout even more and introducing bacteria. This is a condition called Folliculitis Barbae.

Proactiv Deep body wash is a tremendous product. Topical antibiotics are too drying and skin on the body is too thick for anything to really penetrate. Proactiv's sulfur mask overnight is going to be better. Shower and exfoliate 2x a day, but don't unroof the lesions before they're ready (ie don't shave them, or scrub them raw, pick or squeeze them.)

You have Grade 3 Acne and should be taking oral antibiotics like Doxycline in a high enough dose to address inflammation and infection both. (When the infection clears, your doc can cut back your dosage.) Grade 3+ is generally hormonal.

It looks like you're working out, which is great, if you're not using whey protein supplements or "juicing" (and I don't mean with a juicer but you'd know if you were juicing where your acne was coming from,) and if you're showering immediately after exercise. Rancid sweat on the skin = breakouts. If you were a fat guy, I'd say cut beef and milk out of your diet for the estrogen. But cutting beef and reducing chicken in your diet for a month and seeing if it makes a difference might help. Cutting out sugar and caffeine is a must.

Edited by is0late
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It looks like seb derm induced by malassezia, and the follicular variety. This is very hard to treat but not impossible. The best method for a differential diagnosis is to use an effective antifungal for two weeks and see if there's any change. Try Nozoral 1% shampoo (OTC but web-order only) and Lotrimin Ultra cream (not the AF kind). These are not the best treatments in the world but they are easy to buy in the US. If you have some positive results, Hegor 150 shampoo is 1.5% climbazole and more effective, but it contains SLS so it's irritating and not ideal -- that's sold only on eBay.

I think the wax got into your pores and incited an allergic reaction. It's possible that the wax is stuck there and still feeding the malassezia. I know another guy who had exactly the same problem after waxing -- red bumps everywhere.

It's easiest to understand the problem as a skin allergy and a fungal overload. Use an antifungal product to control the fungal overload and use an oil that cannot be metabolized by malassezia. All commercial lotions have oils that malassezia can metabolize, so about all that you can use is MCT oil, which is carbon lengths 8 and 10, which malassezia cannot metabolize. It's too oily to use on your face but it might soften up the residual wax on your arms and chest -- that will be a long shot though. You can buy MCT oil at Hi-Health and Whole Foods, or on the web. The "NOW" brand is sold all over the web.

Doctors in the US are apparently ignorant of this fungal allergy/problem but it's better understood in other parts of the world. All antibiotics will make the fungal overload worse, and good lord how many months have you taken them with no positive results? Time to stop, IMO. Vitamin D3 and magnesium supplements will help a little too. All treatments take a very long time, and probably need to be used every day forever, because the problem is actually an immune system deficiency.

Look back at everything I've ever written here or at rosacea.org and send me a PM when you have enough posts to do that. I've had all the same problems you are experiencing, but my similar condition was bigger than a single follicle, and consisted of itchy red plaques, that slowly flaked off. Both forms of malassezia-induced problems have the same causative agents. I've researched this as much as I can because health care professionals were no help at all.

FYI "Tinea" means fungal and the next word describes where it's located on the body. The word is a useless misnomer, chosen by ancient Romans because it means "worms," which is what the non-scientific medical world thought the causative agent was, 2,000 years ago. Why it persists is a mystery to me. You can't get very far researching tinea because it doesn't describe the cause, but merely where it is and what it looks like.

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Thanks for your replies is0late and Tom Busby.

I have a few clarifications to make:

- I haven't shaved or waxed my arms for over a year.

- Indeed I am European, but not British and indeed I don't have curly hair and i don't have large amounts of body hair, but even so, the little hairs that i have, they manage to curl back into my skin and form an ingrown.

- I don't work out and i merely get out of the house for almost 4 years now since i have this problem on my arms especially, hence i don't use any protein supplements. Luckily for me, i'm some sort of Mesomorph and i'm not fat, but i do retain some bodyfat since all i do is watch movies or study. (one of the things I've always wanted to do is go to the gym, i read articles daily about workout routines, but i'm so embarassed with my arms that i would never go like this to the gym!)

- I have 2 months left of my Doxycycline treatment and when I'm done, if I don't see any major improvements I will ask my derm about antifungal meds! I never tried anything antifungal.

I am still looking for someone who has at the moment something exactly like me!

The skin on my arms and chest has inside almost each follicle a small "bag" filled with liquid or solid white pus and sometimes an ingrown hair. The ingrown hair is not the problem because EVEN the already full grown hairs have a small bag with pus at their root and if i squeeze them i can get the liquid or solid pus out! I don't have any whiteheads or cysts, i only feel the small bags with my fingernails and when i squeeze them the pus comes out, the problem is it takes a lot of trial and error because the "pus bag" is really small and i must squeeze several times to "catch" it, that's why i have so many scars!

On my back I'm pretty sure it's just acne because mostly i get whiteheads. unlike my arms where I don't get whiteheads at all.

These symptoms are very strange, that's why I want to know if anyone else has this?

Edited by Fris
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Hi Fris, looking at your pictures, I am positive that I experience the EXACT same thing that it seems you have! I am 18, and have been dealing with it since i was in the second grade. It has gotten worse as I've gotten older, and i have it all over my body, so needless to say i feel your frustration with self confidence issues. I never wear shorts, and i always make sure that i have a cover over my arms because otherwise people will stare and ask what it is! I have it on my forearms as well, but i can't wear long sleeves all the time so i have to suck it up with those ones! I have been to different dermatologists countless times and I've tried what seems like every medication, cream, or scrub that they prescribed me and sadly nothing has worked or even made a slight difference. I have been researching it for a while, and i am still not 100% sure what it is but you you should know that other people have the same thing as you, you aren't alone in your frustration! Hopefully we'll eventually be able to find something that cures this annoying condition!

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I have something similar, but not exactly the same. Sometimes I think it's folliculitis because it doesn't respond to acne meds and covers large area on my body.

Anyway, this has been affecting me emotionally a lot recently. I can relate to how it makes you feel. Even though we have so many great things in life, it's easy to forget them when you start thinking about your skin. My tactic is to keep busy and try to focus on other good things. Please keep your head up! Everyone is here to support you. It also makes me feel happy to support others on this forum when feeling down.

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This is the end of the 2nd month of treatment with Doxycycline. I don't have any whiteheads, any cysts, or any inflamed acne, although i rarely had those before. But i still have the white liquid in my pores and i also have some ingrown hairs, even if i don't wax or shave!

After viewing hundreds of pictures with acne I can't seem to find something similar to mine and that's why I posted my pics here so others can relate to them and post here! I'm starting to think it's not acne or folliculitis after I recently found a skin picking site and I saw those blemishes look like mine. Perhaps I get the ingrown hairs because I picked at the skin and the hair can't get out because it's trapped under the scabs, but this still doesn't explain the white liquid inside the pores.

Anyway, since I found out about the Skin Picking Disorder I decided not to touch my skin ever again. I find it very difficult, because when I see the slightest bump on my skin I can't stop until I don't squeeze it. But I'm picking my skin less and less and I will eventually stop it. If it's not acne, then my skin will look better. So far my skin hasn't changed much since I took those pictures.

I will update each month and I'm still waiting for people who have the same acne/folliculitis/disorder as mine and each can contribute with their story, pictures, treatments, maybe it's something we eat, or maybe the fabric of our clothes(cotton, polyester), or maybe the water we drink, or maybe because we pick, or something we do that affects us!

@msheary88: I'm happy you replied to my topic! Could you attach some pictures of your skin so I may check if we have the same thing? Or at least could you give me some more details in private message and some pics? Do you apply any gel now, or do you take any medication? Do you have ingrown hairs? I am still trying to figure out what exactly this disease is, what did you doctors say it is, acne vulgaris or smth else? I can't seem to find any pictures on the internet with this condition.

@ElegantSurf: Thank you a lot a for your kind words and your support! I read your thread and you should post some pictures. Also, if you are sure it's acne you should ask your doctor for Accutane, if I knew I had acne, I wouldn't wait a second and get those damn pills. But you say sometimes you think it's folliculitis because it doesn't respond to acne meds, so you must first be sure of what it is. I will keep reading your thread and see what else your dermatologist says after your next visit.

Edited by Fris
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