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Tiny bumps on forehead and face that don't go away? It may be PF!

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I am so grateful for this website! Without it, I may still be dealing with one of the worst skin conditions I've ever had. I wanted to write this in the hopes that someone else can benefit from my situation.


Starting in the summertime, I suddenly got hundreds of tiny little bumps all over my forehead. Assuming it was because of my bike helmet (I am an avid mountain biker), I washed my helmet and made sure to keep my skin clean. It did nothing to help my skin. Then, the bumps made their way down my temples. By the end of May, my face was covered with hundreds, if not thousands of tiny, flesh-colored bumps. No amount of makeup would cover it and my skin looked like I had a disease of some sort.


I've had acne since I was 16 (I'm 30 now), but this was something totally different. None of the bumps came to a head, they didn't hurt at all (like my cystic acne) and there was never any cycling through it getting better, then worse. It was always really bad. I assumed they were clogged pores, because if I squeezed them hard, eventually something would come out.


Of course I went to a dermatologist after 6 weeks of no results. I live in a small town, so our doctors aren't quite as good as other areas. She didn't even ask me to take off my makeup to have a closer look. I was diagnosed with demodex dermatitis (a type of mite that can irritate skin) and was given a prescription. As soon as I got home from the doctor, I looked up demodex dermatitis. I saw red, rosacea-like skin. Mine looked NOTHING at all like that! So, I started to do some research on my own. I kept a log of what I was finding online and products I was trying. It turned out to be over 30 different items, ranging from switching makeup, to hypoallergenic pillows, to all natural acne products, to proactiv, and prescription acne medication.


For over 3 months, I was trying anything and everything. When my baby nephew was born, I refused to hold him because I didn't know if my skin condition was contagious. On my 30th birthday, I wore my hair covering as much of my face as possible so my friends wouldn't see my skin. I spent much of my summer isolated from friends and other people. When anyone looked at me, I knew they were wondering about my skin.


Finally, one day I was looking at photos of skin allergies (I looked up so many skin photos in 3 months, it would amaze you), and I came across a photo of someone's forehead that looked EXACTLY like mine! I followed the link to find that the condition was called Pityrosporum Folliculitis. The more research I did about PF, the more I realized, "OMG, this is what I have!" PF is a fungus overgrowth caused by an imbalance of the natural bacteria and fungus found on your skin. Gross, right? When the natural fungus on your skin isn't kept in line by bacteria, it can cause a major skin reaction. Well that's cool, especially because I've been using an antibiotic on my skin for a year (clyndamyacin). Here's what else I learned:


-PF feeds on oil so you need to use oil-free moisturizers during the outbreak

- antibacterial items remove bacteria, so they should also be avoided. That means no hand sanitizer, antibacterial soap, or Clyndamyacin

- there is a test for PF that is a simple swipe of the skin (though there was no way I was going back to my derm. They already proved themselves worthless twice)

- the treatment is a topical cream called ketoconazole


Fortunately for me, ketoconazole is also the active ingredient in a dandruff shampoo called Nizoral. Based on my research, the shampoo is often used to treat PF. I immediately went to the store and bought it. I did a test on the back of my jawline for 2 days to make sure I didn't have a reaction. I just left it on for a minute then washed it off. No reaction occurred, so I used it on my face. Here was the process:


Every morning and at night- do not skip a cleanse! Wet your face with warm water. Massage a quarter-sized amount of Nizoral on the affected area. Leave for as long as you can (sometimes I'd go 10-15 minutes, and yes, it tingles). Wash off with warm water and moisturize with oil-free moisturizer.


Ladies and gentlemen, I noticed a change in about 3 days. The bumps were smaller and my face no longer felt like braille. After over 3 months of dealing with this horrible, self-esteem crushing problem, 3 days made a huge difference. I've attached photos of what I saw. No, I wasn't clear in 3 days, but maybe you don't understand that I saw ZERO results after 3 months, and actual progress in 3 days. I continued to use Nizoral twice a day for 3 weeks before it completely went away. I also waited about a week before I incorporated any other acne medication into my routine. I figured, I'd rather have 4-5 zits then thousands of bumps. I still use Nizoral periodically to make sure this stuff NEVER comes back.


My biggest hope is that someone here can benefit from my experience. I wasted a lot of time and a LOT of money trying to make my skin condition go away, and all it took was a $8 bottle of shampoo from Target. Good luck to you!





UPDATE:  It has been a year since I went through this ordeal, and I just want to communicate that I still see small flair ups sometimes (though they are MUCH less than before) so every time that I go biking, or spend time in heat, I make sure to use my Nizoral for 5-10 minutes and it goes away, often overnight. That stuff is the only thing that works! Edited by progressnotperfection
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I believe I have this as well and it all started after having co2 laser done way back in may and have tried everything to help my poor face. My skin has gotten so dry and bumpy like braille, with serveral cysts and have gotten fine lines on my forehead :(
I just bought Nizoral shampoo last night and tried it for a few minutes. I do have to ask did you peel and get flakey? Did it make any difference on fine lines? Did you go to your GP too? I have an appointment next week and will ask about getting an anti fungal cream too 

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Hi friend,
I was never actually diagnosed with PF by a doctor since I had such a bad experience with the only derm within 100 miles of me. I didn't go to my general doc (I'm assuming that's what GP is?) because honestly I didn't consider it.

It sounds like you have a few different things going on, which may not be able to be taken care of by a single product. The cystic acne will need something different than the dry skin, which will need something different than the PF. The Nizoral did have a bit of a drying effect (more of feeling tight and the bumps did slough off after they dried up), so I always followed it with a moisturizer. However, I also didn't use any other acne products at the time. While I have no evidence of this, I truly believe that the best treatment of fine lines is a good moisturizer. I spent 2 weeks in Central America this summer and my fine lines that I've had for years magically went away while I was there- I have to believe it was the moisture! Maybe decide which aspect you want to take care of first and put your efforts towards that area. It can become a cycle when you are treating multiple skin issues: using products for acne, which dries out your skin, so then you moisturize and stop the acne treatment, but then you break out again...

On a personal note, I am so sorry to hear about your experience with the laser. It must be incredibly frustrating to have gone through an expensive procedure, hoping that you'd see a difference in your skin, and instead it became more difficult to deal with and painful. However, I can tell you right now that you are not Terribly Flawed. You put your trust in a doctor who clearly messed something up and I while understand how your skin affects your emotions and self-esteem (see my story), there is definitely hope out there. Whether it is a test for PF, or a more experienced derm, or a product that eases your pain- there is hope and it WILL get better. It's not a reflection of who you are as a person or how you treat others, or even what others see when they look at you (YOU are your own worst critic). Hold your head up, because things will get better.
Cheers and best of luck! Keep me updated!

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