Have you taken antibiotics recently ? Do you have a white tongue ? Do you have dandruff ? A white tongue and dandruff are indicative of fungal outbreaks (candida and malasezia respectively) caused by taking antibiotics (and sometimes exacerbated by hormones).

If the answer to one or more of these questions is yes, then what looks like acne is probably fungal outbreaks caused by the antibiotics. Get back to me if you would like further information about how to control the "acne", if you have the indicators of fungal outbreaks (ie, white tongue and/or dandruff).

Organic oils such as jojoba oil feed malasezzia, so do not use organic oils (or moisturiser at all), if you have dandruff (because dandruff indicates that you have skin malasezzia).

On 4/26/2019 at 4:51 AM, Aussie Scientist said:

Have you taken antibiotics recently ? Do you have a white tongue ? Do you have dandruff ? A white tongue and dandruff are indicative of fungal outbreaks (candida and malasezia respectively) caused by taking antibiotics (and sometimes exacerbated by hormones).

If the answer to one or more of these questions is yes, then what looks like acne is probably fungal outbreaks caused by the antibiotics. Get back to me if you would like further information about how to control the "acne", if you have the indicators of fungal outbreaks (ie, white tongue and/or dandruff).

Organic oils such as jojoba oil feed malasezzia, so do not use organic oils (or moisturiser at all), if you have dandruff (because dandruff indicates that you have skin malasezzia).

Nope, Im not takingany antibiotics. And my tongue is sometimes a bit white but not so much, it depends from what I eat. I have some dandruff but it depends, some months I have it a lot and other months I dont have it at all. Im not sure if it has anything to do with my acne.

If you have dandruff, then the skin problems are probably caused by malasezzia, which is a fungus that causes dandruff and skin outbreaks (cysts, nodules, pimples and other acne like symptoms)and seborhheic dermatitis/flaking skin generally.

Your body "fights" malasezzia (and candida), which is why the dandruff comes and goes as your body "wins" and then the fungus/fungi wins. Plus, using jojoba oil would have "fed" the fungus.

I suggest you buy some clotrimazole anti-fungal cream (sold as canesten in some countries) and apply it to the affected areas of your skin. If that does not work, then I can provide advice on more targeted antifungals.

Keep your skin VERY dry and do NOT use moisturisers or any organic oils such as jojoba oil (organic oils and moisturisers feed the fungus - malasezzia LIVES on oils such as jojoba oil and on sebum in skin). And use an antidandruff shampoo.

Don't eat gluten, sugar, dairy, yeast products (check any supplements for yeast), fermented products, or preservatives.

Do you also have unexplained tiredness or unexplained headaches ?

Which country are you in ?

On 4/28/2019 at 3:34 AM, Aussie Scientist said:

If you have dandruff, then the skin problems are probably caused by malasezzia, which is a fungus that causes dandruff and skin outbreaks (cysts, nodules, pimples and other acne like symptoms)and seborhheic dermatitis/flaking skin generally.

Your body "fights" malasezzia (and candida), which is why the dandruff comes and goes as your body "wins" and then the fungus/fungi wins. Plus, using jojoba oil would have "fed" the fungus.

I suggest you buy some clotrimazole anti-fungal cream (sold as canesten in some countries) and apply it to the affected areas of your skin. If that does not work, then I can provide advice on more targeted antifungals.

Keep your skin VERY dry and do NOT use moisturisers or any organic oils such as jojoba oil (organic oils and moisturisers feed the fungus - malasezzia LIVES on oils such as jojoba oil and on sebum in skin). And use an antidandruff shampoo.

Don't eat gluten, sugar, dairy, yeast products (check any supplements for yeast), fermented products, or preservatives.

Do you also have unexplained tiredness or unexplained headaches ?

Which country are you in ?

Sorry to ask(no intent to offend you, Im just curious), areyou a doctor?What if I apply an anti fungal cream and I dont have a fung? Would it be harmful?

And yes sometimes Im tired but I never have headaches

Im from Italy, thanks for the help btw

I am not a medical doctor, as I have advised in previous posts. I don't mind you asking.

However, I have spent more than 2,500 hours reading scientific literature about skin conditions, including skin fungal conditions. Thus, I can provide information from the scientific literature and my own experience (not formal medical advice).

Applying a topical antifungal cream such as clotrimazole will not do any harm, whether you have a skin fungal condition or not. Topical clotrimazole cream (and othe topical anti-fungal creams) are very safe.

Candida and malasezzia skin conditions (which are usually caused by taking antibiotics, but can be caused by taking birth control pills, or possibly by taking accutane, and are indicated by a white tongue (candida) or dandruff (malasezzia)plus acne like symptoms) are usually missed or under-diagnosd by doctors, so people have to do their own research, as I have done.

Anyone who has weird or unusual "acne" should consider that their "acne" might be caused by candida or malasezzia. Have you taken antibiotics in the past, or been on an antibiotic drip (in hospital) ?

6 hours ago, Aussie Scientist said:

I am not a medical doctor, as I have advised in previous posts. I don't mind you asking.

However, I have spent more than 2,500 hours reading scientific literature about skin conditions, including skin fungal conditions. Thus, I can provide information from the scientific literature and my own experience (not formal medical advice).

Applying a topical antifungal cream such as clotrimazole will not do any harm, whether you have a skin fungal condition or not. Topical clotrimazole cream (and othe topical anti-fungal creams) are very safe.

Candida and malasezzia skin conditions (which are usually caused by taking antibiotics, but can be caused by taking birth control pills, or possibly by taking accutane, and are indicated by a white tongue (candida) or dandruff (malasezzia)plus acne like symptoms) are usually missed or under-diagnosd by doctors, so people have to do their own research, as I have done.

Anyone who has weird or unusual "acne" should consider that their "acne" might be caused by candida or malasezzia. Have you taken antibiotics in the past, or been on an antibiotic drip (in hospital) ?

Oh ok that™s interesting! You™re right about doctors I don™t really trust dermatologists anymore, I™ve seen so many of them. 

Yes I™ve taken antibiotics sometimes, during my lifetime (I™m 19), but very few times. For acne, I took minocycline about 3/4 years ago for 1 month, as recommended by my dermatologist but I didn™t work at all. So after that my dermatologist prescribed me isotretinoin cause my acne was persisting and becoming more and more severe. I did accutane for 6 months and it went great, I had zero problems with it (I just had really really dry lips but it was manageable). I had wonderful skin for nearly 2 years then, last year, my acne came back. So my dermatologist, after trying some laser that didn™t work, prescribed me to take minocycline for a month. That didn™t work again so (as the acne was a bit less severe then the past time) he gave me Differin cream to use. I used it for about a month ans I wasn™t really seeing any results so I asked him to switch and he gave me Duac gel. Duac gel worked a lot faster and helped my skin condition a bit, but then, after nearly 4 weeks usage I lost the cream tube (I know I™m that stupid) so I restarted using Differin again. My skin after 3 months of this routine, started to clear up and by July 2018 I was completely clear. But then the cream sort of lost its power and my pimples slowly started to come back. In November my acne was back, even if not in a severe way . With months going on it got better sometimes and then worse others (I thought it was hormonal acne and so did my dermatologist that prescribed me hormonal and blood tests to do). I read about oil cleansing regimen and tried it, as I have written previously, and that made my skin amazing for about 3 weeks (I used just jojoba oil and sometimes castor oil to clean my face). My pimples and marks faded but then, after 3 weeks of this, my skin literally exploded. I got tons of tiny small bumps under my skin surface, on my cheeks and a lot under my mouth and next to my earlobes. It was so unusual for me cause I usually had big cysts just on my cheeks  and that didn™t look like my normal acne. It was also extremely itchy. I came back to my regimen then but since February this bumps just got worse and worse, like they were spreading around my whole face and now they™re next to the neck. And my whole cheek is red from scars and active pimples. I have some sort of œred patches of skin that never fully heal and go away. And under my mouth I have lots of tiny tiny white pumps under my skin surface and if you squeeze them (sorry if it™s gross) I™ll get out a small long white filament, but they don™t go away. I™ll post a picture. My hormonal and blood test are all good (I have just low vitamin d so I™m taking a supplement )

At the end of March I restarted to use Differin for a month but I didn™t see any improvement as I did last year, so I switched to Duac gel since about a week(but that as well doesn™t seem to help my skin).

Sorry for such a long response but I really appreciate your help as I™m pretty miserable right now!

This is my skin and skin texture (in the last 2 pictures I have mineral foundation cause I was out but you can see really well the texture of my skin) what do you think? And have you got specific advices if that is Malassezia? It™s still quite itchy sometimes. Thank you so so much!

I understand your problem, I think. Thanks for the detailed post.

The long white filaments are keratin filaments. They are caused by the fungus affecting the keratin production process in the skin follicles.

Your skin exploded after using the oil because malasezzia feeds on organic oils. You were feeding the fungus !!

What has probably happened is you possibly had some ordinary (non-fungal) acne at 19. The minocycline then triggered outbreaks of malasezzia (and possibly candida) with symptoms of acne (but is not acne). The accutane temporarily controlled the malasezzia because accutane dries up sebum, and malasezzia feeds on the oils in sebum. Differin worked for a while for the same reason, and Differen will also help control overproduction of keratin, which malasezzia and candida make one's skin overproduce.

The Duac (which contains an antibiotic) probably worked temporarily, because by then you possibly had a secondary bacterial infection as well as the malasezzia and/or candida.

From your description, I suspect you have both malasezzia and candida. Buy some clotrimazole antifungal cream, which you should be able to obtain without prescription, and apply that to your skin. If you can, also buy some nystatin antifungal cream (which controls candida) and terbenafine antifungal cream (which contrls malasezzia) - (you might need a prescription for both of these, if so, just buy the clotrimazole cream to start with).

Also buy some chlorhexadine wash, without alcohol. You should be able to get that without a prescription. Also buy some Mustela Foam Shampoo for Newborns (which is anti-fungal and very gentle). Wash your face once a day in the chlorhexadine wash, followed by the Mustela Foam Shampoo. You can leave some of the Mustela Foam Shampoo on your skin, including overnight, if you wish (ie, you could use the Foam Shampoo twice a day). The Mustela Foam Shampoo contains climbazole (not to be confused with clotrimazole) - climbazole is anti-maasezzia, but it does not control candida.

Wash your hands twice in antibacterial handwash before touching or washing your face. This is really important to avoid secondary staph infections. Dry your skin on a clean towel, or on disposable paper towels. Never touch your nose and then touch your face. Wipe your hands with alcohol hand sanitise afte blowing your nose. People car staph in their nose and the last thing you want is a secondary staph infection on top of the fungal outbreaks.

Do NOT use moisturisers - they feed the fungus. Keep your skin dry, apart from applying the antifungal cream. You can dust the covered, affected areas of your skin with corn (ie, maize) flour, if you wish.

After washing the affected areas of your skin, apply the clotrimazole cream. Apply the clotrimazole cream to affected areas 3-4 times a day.

If you can get terbenafine cream without a prescription, apply that together with the clotrimazole cream. Hold off applying the nystatin cream (if you can get it) until we see whether the clotrimazole cream with, or without, the terbenafine cream, controls your problem.

You can apply some 0.5% hydrocortisone cream, if you wish, and aply the hydrocortisone cream with the clotrimazole cream (and the terbenafine cream, if you can get it) to control the inflammation, but only apply the hydrocortisone cream for a few days as it dampens one's immune response. 0.5% is very weak, so no problem for a few days.

Let me know how you go with the above protocol after a week or so. If clotrimazole cream does not work and you cannot get terbenafine cream or nystatin cream without a prescription, then we will go to Plan B.

On 5/1/2019 at 9:00 AM, Aussie Scientist said:

I understand your problem, I think. Thanks for the detailed post.

The long white filaments are keratin filaments. They are caused by the fungus affecting the keratin production process in the skin follicles.

Your skin exploded after using the oil because malasezzia feeds on organic oils. You were feeding the fungus !!

What has probably happened is you possibly had some ordinary (non-fungal) acne at 19. The minocycline then triggered outbreaks of malasezzia (and possibly candida) with symptoms of acne (but is not acne). The accutane temporarily controlled the malasezzia because accutane dries up sebum, and malasezzia feeds on the oils in sebum. Differin worked for a while for the same reason, and Differen will also help control overproduction of keratin, which malasezzia and candida make one's skin overproduce.

The Duac (which contains an antibiotic) probably worked temporarily, because by then you possibly had a secondary bacterial infection as well as the malasezzia and/or candida.

From your description, I suspect you have both malasezzia and candida. Buy some clotrimazole antifungal cream, which you should be able to obtain without prescription, and apply that to your skin. If you can, also buy some nystatin antifungal cream (which controls candida) and terbenafine antifungal cream (which contrls malasezzia) - (you might need a prescription for both of these, if so, just buy the clotrimazole cream to start with).

Also buy some chlorhexadine wash, without alcohol. You should be able to get that without a prescription. Also buy some Mustela Foam Shampoo for Newborns (which is anti-fungal and very gentle). Wash your face once a day in the chlorhexadine wash, followed by the Mustela Foam Shampoo. You can leave some of the Mustela Foam Shampoo on your skin, including overnight, if you wish (ie, you could use the Foam Shampoo twice a day). The Mustela Foam Shampoo contains climbazole (not to be confused with clotrimazole) - climbazole is anti-maasezzia, but it does not control candida.

Wash your hands twice in antibacterial handwash before touching or washing your face. This is really important to avoid secondary staph infections. Dry your skin on a clean towel, or on disposable paper towels. Never touch your nose and then touch your face. Wipe your hands with alcohol hand sanitise afte blowing your nose. People car staph in their nose and the last thing you want is a secondary staph infection on top of the fungal outbreaks.

Do NOT use moisturisers - they feed the fungus. Keep your skin dry, apart from applying the antifungal cream. You can dust the covered, affected areas of your skin with corn (ie, maize) flour, if you wish.

After washing the affected areas of your skin, apply the clotrimazole cream. Apply the clotrimazole cream to affected areas 3-4 times a day.

If you can get terbenafine cream without a prescription, apply that together with the clotrimazole cream. Hold off applying the nystatin cream (if you can get it) until we see whether the clotrimazole cream with, or without, the terbenafine cream, controls your problem.

You can apply some 0.5% hydrocortisone cream, if you wish, and aply the hydrocortisone cream with the clotrimazole cream (and the terbenafine cream, if you can get it) to control the inflammation, but only apply the hydrocortisone cream for a few days as it dampens one's immune response. 0.5% is very weak, so no problem for a few days.

Let me know how you go with the above protocol after a week or so. If clotrimazole cream does not work and you cannot get terbenafine cream or nystatin cream without a prescription, then we will go to Plan B.

Thank you so so much, Ill let you know in a week then!

Ive got some questions and if you could answer it would be really nice of you.

1 How do I know that this might be a fungus like Malassezia or Candida and not a Staph infection? (Im saying this cause I googled both of them and theyre so similar)

2 Can I use Nizoral shampoo to wash my face? Because its the easier to find in my country

3 I read on the Internet that its important to keep the skin dry but hydrated, should I use Squalane oil? (I read that doesnt feed Malassezia) If yes, should I applyit before or afterthe clotrimazole?

4 Is it more effective terbenafine or butenafinecream? And how should I apply one of themtogether with clotrimazole?

I know those are a bunch of questions but Im really curious about this cause I think you could be a lot right!

Thank you again!

1. Staph infections are hot and painful. Fungal infections are not hot, and are usually more itchy than painful, although they can be painful. Staph infections have a characteristic yellow exudate which forms a yellow crust. Fungal infections can have exudates but not usually yellow. You can have both fungal and staph infections.

Staph infections are very dangerous. One must practise EXTREME hygeine (see below) to avoid getting staph infections on top of fungal infections.

To avoid getting staph infections - buy some chlorhexadine wash, without alcohol. You should be able to get that without a prescription. Wash the affected areas in chlorhexadine or other antibacterial wash. Then wash in anti-fungal wash. You can use Nizoral, but it is harsh on skin (because it contains sodium laurel sulphate), Mustela Foam Shampooo for Newborn is better than Nizoral.

Antifungal wash will NOT control staph. You MUST use chlorhexadine wash to avoid getting staph.

Chlorhexadine wash will NOT control areas that are already infected with staph. You need to apply an antibiotic cream or iodine to the areas with staph (before or after the antifungal cream) if you have staph infections.

ALWAYS - Wash your hands twice in antibacterial handwash before touching or washing your face. This is really important to avoid secondary staph infections. Dry your skin on a clean towel, or on disposable paper towels. Never touch your nose and then touch your face. Wipe your hands with alcohol hand sanitiser after blowing your nose. People carry staph in their nose and the last thing you want is a secondary staph infection on top of the fungal outbreak.

If you already have a staph infection on top of the fungal outbreak, you MUST apply antibiotic cream (or iodine) to the areas with the staph infection as well as the antifungal cream. You have got the staph infection because of touching the affected areas (with broken skin) without washing your hands first. Never do that.

If the staph infection starts to get red or yellow lines running from it, or you develop a temperature higher than normal (take your temperature every few hours, if you have a staph infection) then go and see a doctor IMMEDIATELY.

2. See above. You can use Nizoral, after using chlorhexadine wash, but Nizoral will probably irritate your skin.

3. I would NOT use any moisturiser or oil. There is conflicting evidence about whether squalene feeds malasezzia or not. Oxidised squalene causes ordinary acne, so I would not use squalene. Keep your skin dry (fungus LOVES moisture) apart from applying the antifungal (and the antibiotic cream, if you have staph) and see how you go.

4. Mix the terbenafine cream on your finger with the clotrimazole cream, and apply the mixture to you skin, or you can apply one cream after the other. It does not matter. I would apply the clotrimazole cream first, because clotrimazole is mildly antibacterial, as well as being antifungal. Some people find terbenafine better, and some find butenafine better, for controlling fungal "acne". I would use terbenafine cream, at least to start with, because it boosts the anti-fungal effects of clotrimazole.

I am happy to hear back from you.

PS> I read a bit more about squalene. Some people have found it helps control malasezzia (because it not actually an oil, which I did not know), but the evidence is mixed. I would just apply the antifungal creams to start with (with the antibiotic cream, if needed to stop staph). You might wish to try using squalene after a while.

Buy some Ring Guard cream (details below, ignore Australian info). You can probably buy Ring Guard cream at shops that sell Indian goods in Malaysia. If you cannot buy Ring Guard cream in Malaysia, then import some.

Ring Guard cream is anti-fungal and it will also control mild staph infections.

https://www.ebay.com.au/itm/4-PACK-Ring-Guard-Jock-Itch-Double-Action-Anti-Fungal-Cream-Ringworm-20-GRAMS-EA-/283191946922

Staph and malasezzia (and candida) often co-infect skin, so it is important to apply antibiotic cream AND antifungal cream (or Ring Guard which combines an antifungal and an antibiotic, if you have malasezzia (or candida) AND staph.

If you staph infection serious (hot, ooozing skin) or just low-grade (skin not hot, not very red, no exudate.) Is the skin with the staph infection hot ? Low grade staph infections do not necessarily cause hot skin, but they can turn dangerous. Staph infections which cause hot skin and which ooze are potentially very dangerous, and they must be treated with topical antibiotics (and with oral antibiotics, if really serious).

Oral antibiotics cause the fungal problem, so you can see why is it SO VERY IMPORTANT to apply strict hygiene protocols (see above) with your skin. The last thing you want is a (secondary) staph infection on top of a fungal outbreak.

1 hour ago, Aussie Scientist said:

Buy some Ring Guard cream (details below, ignore Australian info). You can probably buy Ring Guard cream at shops that sell Indian goods in Malaysia. If you cannot buy Ring Guard cream in Malaysia, then import some.

Ring Guard cream is anti-fungal and it will also control mild staph infections.

https://www.ebay.com.au/itm/4-PACK-Ring-Guard-Jock-Itch-Double-Action-Anti-Fungal-Cream-Ringworm-20-GRAMS-EA-/283191946922

Staph and malasezzia (and candida) often co-infect skin, so it is important to apply antibiotic cream AND antifungal cream (or Ring Guard which combines an antifungal and an antibiotic, if you have malasezzia (or candida) AND staph.

If you staph infection serious (hot, ooozing skin) or just low-grade (skin not hot, not very red, no exudate.) Is the skin with the staph infection hot ? Low grade staph infections do not necessarily cause hot skin, but they can turn dangerous. Staph infections which cause hot skin and which ooze are potentially very dangerous, and they must be treated with topical antibiotics (and with oral antibiotics, if really serious).

Oral antibiotics cause the fungal problem, so you can see why is it SO VERY IMPORTANT to apply strict hygiene protocols (see above) with your skin. The last thing you want is a (secondary) staph infection on top of a fungal outbreak.

But I cant apply together 3 creams right? So which one should I choose? The clotrimazole and the antibiotic cream or the terbenafine and clotrimazole or the antibiotic cream and the terbenafine?

And what about candida? Should I wait applying that cream that controls it?

last question, how come the antibiotic cream doesnt worsen the fungal like the oral antibiotics?

Chiabrb

My apologies. I have confused you. I'll be clear -

1. Staph infections and antibiotics.

I misread your email. I thought you said that you had a staph infection. Re-reading your email, you did not say that you have a staph infection. Apologies. However, staph infections do sometimes occur on top of fungal outbreaks, so use the hygeine protocol (chlorhexadine wash etc.) to make sure you do not get a staph infection. If you do NOT have a staph infection, then do not apply the antibiotic cream.

Staph infections are usually hot, and painful (mild staph infections can also be itchy), and they ooze yellow exudate. Staph infections are dangerous.

Fungal outbreaks of malasezzia or candida are not hot, and they are usually itchy, rather than painful (although they can be painful from inflammation). Fungal outbreaks can produce exudate, but it is usually clear, and it does not form a yellow crust like staph exudate does.

Even though you do not appear to have a staph infection (although from the photos, it is possible that you might have a mild staph infection on top of the fungal condition?), I would still buy some Ring Guard, if you can get it from an "Indian shop" in Malaysia, because it is good to have some antibiotic cream, just in case you get a bacterial infection (staph or other bacteria) on top of the fungal outbreaks.

It is common to get a mild bacterial infection on top of fungal outbreaks (not necessarily staph) because we carry bacteria on our skin. You might be able to buy other antibiotic cream in Malaysia at pharmacists ? but Ring Guard is good, because it contains an antibiotic (neomycin) and an antifungal (miconazole).

You will know if you have a bacterial infection on top of the fungal outbreak because the affected areas will be painful and wet, and the pain will go away when you put antibiotic cream on the affected area.

In a perfect world, one would not use any antibacterial or antibiotic on areas affected by malasezzia or candida, because doing so kills good bacteria as well as bad bacteria. In the real world, though, one has to use antibacterial wash (and sometimes antibacterial or antibiotic cream) on areas affected by fungus, to avoid getting secondary bacterial infections.

In answer to your question about topical antibiotic creams worsening the fungal condition. Oral antibiotics cause fungal outbreaks because they destroy good bacteria in one's gut, and this lowers the ability of one's immune system to control fungal in the body, on the skin etc. Topical antibiotics do not affect the bacteria in one's gut or the body's overall immune system, although they can have a local effect (on the skin) of encouraging fungus.

Therefore, ONLY use topical antibiotics if one has a staph or other bacterial infection on top of the fungal outbreak (ie, only if one has a bacterial infection), only use the topical antibiotic for the time needed to kill the bacteria, and always apply a topical antifungal cream along with the antibiotic cream

2. Topical antifungal creams.

Apply the clotrimazole cream mixed with the terbenafine cream to the affected areas of your skin 3-4 times a day for several days. If that does not control the problem, then buy some nystatin cream (if you can get it) and mix the nystatin cream with the terbenafine cream and apply that to your skin. Get back to me if that does not star tocontro your problem

You can mix ,ost, including the above antifungal (and antibiotic) creams together, although I would not mix the clotrimazole cream with the nystatin cream because that would be diluting the concentration of the antifungals in each cream for no benefit. Terbenafine boosts the antifungal power of both clotrimazole and nystatin, so it is good to mix terbenafine cream with those other two antifungal creams.

Terbenafine, on its own, controls malasezzia, and does not control candida (or not very well). Nystatin cream (on its own) controls candida, and does not control malasezzia, Clotrimazole cream controls both, but usually not as effectively as terbenafine cream for malasezzia or nystatin for candida. Since you appear to have both candida and malasezia, start with clotrimazole cream mixed with terbenafine cream.

Yo could also apply some Savlon cream (or Burnol, which is similar to Savlon) if you wish. Savlon is antibacterial (not an antibiotic) and it has some mild antifungal activity also.

Clotrimazole also has some antibacterial activity (as well as being antifungal), but terbenafine and nystatin do not.

Pls get back to me if the above information does not make sense, or if you require further information or if the above treatments do not start to control your problem after a few days. And my apologies, again, for confusing you, inadvertently.

8 hours ago, Aussie Scientist said:

Chiabrb

My apologies. I have confused you. I'll be clear -

1. Staph infections and antibiotics.

I misread your email. I thought you said that you had a staph infection. Re-reading your email, you did not say that you have a staph infection. Apologies. However, staph infections do sometimes occur on top of fungal outbreaks, so use the hygeine protocol (chlorhexadine wash etc.) to make sure you do not get a staph infection. If you do NOT have a staph infection, then do notapply the antibiotic cream.

Staph infections are usually hot, and painful (mild staph infections can also be itchy), and they ooze yellow exudate. Staph infections are dangerous.

Fungal outbreaks of malasezzia or candida are not hot, and they are usually itchy, rather than painful (although they can be painful from inflammation). Fungal outbreaks can produce exudate, but it is usually clear, and it does not form a yellow crust like staph exudate does. 

Even though you do not appear to have a staph infection (although from the photos, it is possible that you might have a mild staph infection on top of the fungal condition?), I would still buy some Ring Guard, if you can get it from an "Indian shop" in Malaysia, because it is good to have some antibiotic cream, just in case you get a bacterial infection (staph or other bacteria) on top of the fungal outbreaks.

It is common to get a mild bacterial infection on top of fungal outbreaks (not necessarily staph) because we carry bacteria on our skin. You might be able to buy other antibiotic cream in Malaysia at pharmacists ? but Ring Guard is good, because it contains an antibiotic (neomycin) and an antifungal (miconazole).

You will know if you have a bacterial infection on top of the fungal outbreak because the affected areas will be painful and wet, and the pain will go away when you put antibiotic cream on the affected area.  

In a perfect world, one would not use any antibacterial or antibiotic on areas affected by malasezzia or candida, because doing so kills good bacteria as well as bad bacteria. In the real world, though, one has to use antibacterial wash (and sometimes antibacterial or antibiotic cream) on areas affected by fungus, to avoid getting secondary bacterial infections.

In answer to your question about topical antibiotic creams worsening the fungal condition. Oral antibiotics cause fungal outbreaks because they destroy good bacteria in one's gut, and this lowers the ability of one's immune system to control fungal in the body, on the skin etc. Topical antibiotics do not affect the bacteria in one's gut or the body's overall immune system, although they can have a local effect (on the skin) of encouraging fungus.

Therefore, ONLY use topical antibiotics if one has a staph or other bacterial infection on top of the fungal outbreak (ie, only if one has a bacterial infection), only use the topical antibiotic for the time needed to kill the bacteria, and always apply a topical antifungal cream along with the antibiotic cream

2. Topical antifungal creams.

Apply the clotrimazole cream mixed with the terbenafine cream to the affected areas of your skin 3-4 times a day for several days. If that does not control the problem, then buy some nystatin cream (if you can get it) and mix the nystatin cream with the terbenafine cream and apply that to your skin. Get back to me if that does not star tocontro your problem

You can mix ,ost, including the above antifungal (and antibiotic) creams together, although I would not mix the clotrimazole cream with the nystatin cream because that would be diluting the concentration of the antifungals in each cream for no benefit. Terbenafine boosts the antifungal power of both clotrimazole and nystatin, so it is good to mix terbenafine cream with those other two antifungal creams.

Terbenafine, on its own, controls malasezzia, and does not control candida (or not very well). Nystatin cream (on its own) controls candida, and does not control malasezzia, Clotrimazole cream controls both, but usually not as effectively as terbenafine cream for malasezzia or nystatin for candida. Since you appear to have both candida and malasezia, start with clotrimazole cream mixed with terbenafine cream.

Yo could also apply some Savlon cream (or Burnol, which is similar to Savlon) if you wish. Savlon is antibacterial (not an antibiotic) and it has some mild antifungal activity also.

Clotrimazole also has some antibacterial activity (as well as being antifungal), but terbenafine and nystatin do not.

Pls get back to me if the above information does not make sense, or if you require further information or if the above treatments do not start to control your problem after a few days. And my apologies, again, for confusing you, inadvertently.

For now I™ve been using since Wednesday Clotrimazole 3 times a day  and since Thursday Nizoral shampoo morning and night .

The only benefit I™ve seen so far is that my itching has been a lot better, nearly disappeared. The problem is that my acne is the same. One cheek got a little bit better, cause when I touch it is a bit softer, while the other cheek looks like it got even a bit worse, I have a bit more bumps when I touch it. I don™t know if this is normal with fungal acne. I think I could have hormonal and fungal acne mixed up, but I seriously have no idea. My whole face is really inflamed.

this ones are the small white bumps that I was telling you about

Chiabrb

Is the acne condition painful ?

From the photos and the only partial response to clotrimazole, I suspect that you have a mild (don't worry) staph infection combined with the fungal outbreak.

I suggest that you buy some antibacterial cream with cetrimide and/or chlorhexadine (Savlon cream is as good as any - see below) and apply that to your skin with the clotrimazole cream. Since the itching has reduced with the clotrimazole cream (which implies that the fungus is being controlled by clotrimazole), use the clotrimazole cream combined with the antibacterial cream (eg, Savlon) for the present.

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If applying the Savlon (or other cream with cetromide/chlorhexidine in it) combined with clotrimazole cream does not reduce the problem substantially in a few days, then try combining the clotrimazole cream with an antibiotic cream (such as Ring Guard or other antibiotic cream which you should be able to buy without a prescription in Malaysia), and see how you go with that.

Also wash the affected areas of your skin (just once or maybe twice,a day) in an antibacterial wash such as chlorhexadine wash.

; . Make sure that the antibacterial wash has no, or only low concentration of, alcohol in it, as you don't want to irritate your skin with alcohol. Make sure you twice wash your hands in antibacterial wash, BEFORE you wash, or otherwise touch, your face.

Let me know how you go with applying the clotrimazole and Savlon (or other antibacterial cream) mix.

On 5/5/2019 at 11:58 AM, chiabrb said:

In just something like 2 weeks all my pimples were gone and my marks faded a lot.

I believe that you already found the answer in your original post. Message me if you like.

Not so, because the "acne" erupted again.

There was a change made that temporarily cleared her acne. She was using jojoba oil, so from your perspective, the fungus would feed off the oil. Which wouldn't make sense why she got clear.

She had the acne explosion while using the jojoba oil. Jojoba oil can temporarily help control fungal acne because it helps with the skin barrier.

But IF the fungal acne is caused by malasezzia, then the fungal acne will explode (as hers did) after using the jojoba oil for a while, because the malasezzia has been "fed".

IF the fungal acne is caused by candida (which does not feed on oil) then jojoba oil will not exacerbate the fungal acne, and may help control it by helping the skin barrier.

From her other symptoms, chiabrb has both malasezzia and candida fungal acne, so using any organic oil is VERY unwise.

In any case, applying clotriomazole antifungal cream is perfectly safe. So, why not see if it helps. It cannot do any harm. Chiabrb did get a positive response to applying the antifungal cream, albeit not a huge response. BUT I suspect she has a secondary staph infection, which I have given her advice about how to control.

Using both clotrimazole cream (possibly combined with another antifungal cream) and an antibacterial cream such as Savlon (or a antibiotic cream if necessary) will likely control her symptoms.

On 5/9/2019 at 1:57 AM, Aussie Scientist said:

She had the acne explosion while using the jojoba oil. Jojoba oil can temporarily help control fungal acne because it helps with the skin barrier.

But IF the fungal acne is caused by malasezzia, then the fungal acne will explode (as hers did) after using the jojoba oil for a while, because the malasezzia has been "fed".

IF the fungal acne is caused by candida (which does not feed on oil) then jojoba oil will not exacerbate the fungal acne, and may help control it by helping the skin barrier.

From her other symptoms, chiabrb has both malasezzia and candida fungal acne, so using any organic oil is VERY unwise.

In any case, applying clotriomazole antifungal cream is perfectly safe. So, why not see if it helps. It cannot do any harm. Chiabrb did get a positive response to applying the antifungal cream, albeit not a huge response. BUT I suspect she has a secondary staph infection, which I have given her advice about how to control.

Using both clotrimazole cream (possibly combined with another antifungal cream) and an antibacterial cream such as Savlon (or a antibiotic cream if necessary) will likely control her symptoms.

 

Hi there! This is an update.

My face right now is a lot better, I cant believe it, I hope it wont aggravate too much again.I still have problems on one side, next to the eyebrow and on the upper cheek but I wont complain too much cause two weeks ago my face wasa lot worse.

But I dont know how to get rid of those small white bumps next to my chin, the ones that I showed you in the picture. Pimples near that area are pretty much gone but all those white bumps are still there. And I really think those are causing some of my breakouts in that area. In fact, some of those, after a couple of days, usually developin pimples. But when the pimple goes away, the white bump doesnt go away, and comes back to its original form. I dont know what they are and what to do about them.

Morning routine:

I wash my face with a So bio Etic face wash, I disinfect my pimples and problematic areas with some Chlorhexidine disinfectant, then I apply some Squalane oil or an acne gelthat is fungal acne safe.

When I get home and I dont have to go out I try to remove makeup as quick as possible and do all that process again.

night routine:

same as morning routine but before putting Squalane oil on my face I apply some Lasimil on my problematic areas (its a terbenafine cream as you suggested).

In the last couple of days I restarted to use Nizoral at night:instead of using my normal So bio etic face wash, I wash my face with Nizoral.

Have you got any ideas about the white bumps and how to make them disappear? I thought about buying some Niacinamide 10% + Zinc% The ordinary or some AHA 30%+BHA 2% by The ordinary.

Could that help?

thank you so so so much, Im so grateful to you, cause my skin has seriously improved right now (I hope it doesnt get so bad again)

Chiabrb

I am so pleased that things are improving.

Do the bumps have pus or other fluid in them ?

You could apply tea tree oil or eucalyptus oil (will sting a bit) on a q tip/cotton bud to the white bumps . The other thing worth trying is to crush an aspirin tablet and dissolve it as much as you can in rubbing alcohol (propanol) or methylated spirits (ethanol) and apply that to the white bumps on a cotton bud/q tip. It will sting a bit... You can do both of these things.

The white bumps are probably keratin, which is caused by the fungus making one's skin do "strange" things. There might be a tiny hair in the white bumps ?? See how you go with applying the tea tree /eucalyptus oil and/or the aspirin in alcohol.

I look forward to hearing back from you.

1

On 5/19/2019 at 12:28 PM, chiabrb said:

Have you got any ideas about the white bumps and how to make them disappear? I thought about buying some Niacinamide 10% + Zinc% The ordinary or some AHA 30%+BHA 2% by The ordinary.

Could that help?

The Niacinamide by the Ordinary is great! It should have an anti-inflammatory effect on your skin, which is quite red. The AHA 30%will likely be too strong on top of active acne as an exfoliant; would try Lactic Acid every other night instead and see how your skin tolerates it!

Chiabrb

Do NOT exfoliate your skin. Exfoliating skin destroys the skin barrier and allows fungus (and bacteria) to invade the pores.

Azaleic acid cream/lotion should get rid of the bumps and will calm your skin.

On 7/10/2019 at 7:16 AM, Aussie Scientist said:

Chiabrb

Do NOT exfoliate your skin. Exfoliating skin destroys the skin barrier and allows fungus (and bacteria) to invade the pores.

Azaleic acid cream/lotion should get rid of the bumps and will calm your skin.

 

I agree with AS about Azelaic Acid; used twice a day studies have shown it to be as effective as retinoidsfor regular acne and is a great, mild all-rounder. It is a mild exfoliant and may itch slightly when you apply it. Skinoren is 20%, but out of stock until October, but you can get hold of Finacea gel at the moment.