Dermatology Expert Forum
Acn Rosacea, Folliculitis, or something else? IS accutane the answer?
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This forum is for questions regarding Dermatology issues, such as: rashes, acne, birthmarks, skin infections, rosacea, and general skin care. All questions will be answered by a medical professional.

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Acn Rosacea, Folliculitis, or something else? IS accutane the answer?

I never have had a bad acne problem.I have occasionally had some clogged pores and cysts, but it was not an every day or even monthly occurance.When I was 34 years old an area on my left cheek began to have small pustules which i could clearly see a hair in. It wasnt the classic ingrown hair, rather a hair that almost broke the skin surface, but never did.Sometimes the hair would just stay there below the surface.  The area has continued to grow over the past 2 years and I have seen 6 different dermatologists looking for answers.They all say acne and maybe rosacea or follicultis.The treatments I have been given include Evoclin, Tazorac, Ziana, Duac, and many antib. 9months ago, a PA suggested that I try laser hair removal in the area. I had 4 treatments and two of them produced some bad follicilitis.Teh first went away within 2 weeks.The second January has yet to heal.This area of my face is still red and inflamed.The PA suggested that I see the MD.He said that I should try cutivate to help the inflammation and to help the skin push the ashy particles out.  the hairs are coming out gradually in 4 months.It is producing bumps similar to acne and scarring is taking place from the lesions it is leaving.The skin in that area of my cheek is more wrinkled and sort of lumpy underneath.  Also, the skin is really red in places and I can see a lot of blood vessels.Some of the hairs are really deep nd do not surface.Others are right at the surface yet grow underneath the skin without breaking through. I have asked about fungus, mites, and just about everything. I tried some over the counter antifungal. After a month straight of Cutivate then two weeks a month, he thinks we should try Accutane (20mg). The skin on the rest of my face is clear with an ingrown hair or deep ingrown hair causing a pimple every once in a while.  My skin isnt overly oily, however and dries out while using many topicals.  What does this sound like and should I suggest a test.  If so, what test?
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If 6 dermatologists in person haven't been able to offer a clear answer, I'm afraid I can't either.  I will say that in my experience some patients who are convinced they have ingrown hairs attempt to squeeze them out, which never works and always makes the skin look worse.  If this applies to you, then I advise you to discontinue this practice for a minimum of 3 months.  Only then should oral treatment be considered, because otherwise it is certain to fail.

Dr. Rockoff
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