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Chronic Scalp Folliculitis
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Chronic Scalp Folliculitis

Hello,

I am a 25 year old female that has been battling with scalp folliculitis for the past 2.5 years. I have been on Bactrim DS for several years now for acne, I would say since 2005, but I developed scalp folliculitis in approximately Feb. 2008.  I have tried every shampoo imaginable, prescription & non prescription (tar-based, salicylic acid, sulfur, sodium sulfacetamide, zinc, ketoconazole, salicyclic acid AND sulfur combined, hypoallergenic, selenium sulfide).  I currently go to a dermatologist every 3 months for follow-ups (mostly for acne, but my scalp as well), but have received at least 3 other opinions.  First doctor switched me to minocycline & Re-10 Wash (containing sodium sulfacetamide) which did no good.  Second doctor took a biopsy of one of my lesions revealing folliculitis.  He placed me back on Bactrim and Clindagel for topical use.  He instructed me to use regular Head and Shoulders as well as Pantene Pro V. The Clindagel does help clear up all the active lesions, but it does not help prevent any new lesions.  Of course, I don't use the Clindagel on ALL of my scalp, so I understand there is no way to prevent new lesions with just this medication.  Third doctor, whom which I saw earlier this month, suspects I have scalp acne & has switched me to doxycycline.  So far, no results.  I still use the Clindagel on all my lesions, but I am so frustrated with this disease.  I also recently used a steroid shampoo called Clobex 2x a week for 2 weeks - no results.  I have had my nose cultured-normal, and 2 lesions cultured as well.  First culture came back as normal scalp, second one was done recently so I do not have results yet.  Everyday I seem to have 1 or more new lesions on my scalp.  They are itchy,painful, and range from small to moderately large.  I am at my wit's end with this condition.  My routine dermatologist has recommended possibly ketoconazole for 5 days only to help flush out any fungus, yeast that may be causing this.  I am willing to try anything at this point.  Any thoughts?
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16 Comments Post a Comment
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563773 tn?1374250139
Hello,
I agree with the dermatologists that the standard treatment of folliculitis is topical and oral antibiotics. You can also use antifungals for any superimposed fungal infection. Folliculitis is the inflammation of one or more hair follicles. The condition may occur anywhere on the skin.

If you are getting repeated folliculitis, please get your blood sugar checked.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing



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Avatar m tn
I am 40 years old and had exactly the same problem of dancer 4j since 1993. I tried all kind of antibiotics, but the best success I had so far was 3 years ago after my dermatologist put me on Isotretinoin (Roaccutane) same like Accutane for 1 year. I took the Isotretinoin on 4 different occasions in the last 17 years but never for 1 year no stop. The course was 20mg B.I.D. with accumulated dose of 83mg/kg (I am 100 kg). After 8 months the dose was reduced to 10mg per day until the end of the cure to reach 100mg/kg. After the course finished I didn't have an episode of fulliculatis for 14 months, the longest time ever. Then they came back, slowly.
I was prescribed antibiotics again for 4 months (doxy) but they don't work anymore. I am still using and tried all possible kind of shampoos.
Tomorrow  I am starting  again Isotretinoin 20mg per day for 1 year and see if this time it works. I am in Asia for work at the moment, I have been to dermatologist and specialist in Europe and Asia and no one really know what is going on. My fulliculatis is only happening on my scalp, I don't have it on my beard or anywhere on my body. I don't even have acne.
So far all swabs have came back sterile, so there is no staph infection that is causing this. I had some alopecia problems on my beard, so I m guessing this is an immune problem. Beside that I am very fit 6,3 ft and healthy, no HIV , Herpes or Diabities. If anyone else have ideas on this condition or like to share your experiences I would be happy to know.
cheers
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Avatar n tn
I think your problem may be yeast related (fungal). Most doctors/derms ignore this and prescribe anti-bios, which make it worse. Try cutting out all sugars (incl fruit), gluten/grains/bread, dairy and junk food. Drink plenty of water daily. Take vit C (1000mg), B complex and cod liver oil (Vit D and A). Be careful with Vit A - its easy to overdose on it, and can be toxic, so check re:safe levels.
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Avatar f tn
Any pics to share? I believe I have folliculitis as well, but not sure since one doc told me it was acne and other one just had no idea and didnt even try to get a culture to determine what it is. Fed up with docs, I know not all are created equal, but I feel that some are just drug pushers.
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Avatar m tn
Hi I have the same problem, seen 4 Dermatologist in the last 3 year, was on different Antibiotics, Steroids and every shampoo you have mentioned and nothing help with my foliculitis (folliculitis). Last week I stopped everything and tried EMU oil, applied 2-3 times a day and alovera shampoo to clean my hair. In a matter of 4 days I already seeing a lot of improvement.
Good Luck.
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Avatar m tn
Hi I have the same problem, seen 4 Dermatologist in the last 3 year, was on different Antibiotics, Steroids and every shampoo you have mentioned and nothing help with my foliculitis (folliculitis). Last week I stopped everything and tried EMU oil, applied 2-3 times a day and alovera shampoo to clean my hair. In a matter of 4 days I already seeing a lot of improvement.
Good Luck.
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Avatar m tn
I have battling scalp folliculitis for 4 years, doxycycline, Bactrim (works but after 10 days it come back again), acutane etc.....
I have found that when I stop eating sugar I get better and I control the disease.  So NO CARBS, NO PROCESSED FOOD, NO DAIRY, NO BREAD NO PASTA.   Only eat salad and meat and fish and poultry.
Must probably it is candida (fungus) in your guts and you must get rid of it by mainly cutting on ALL carbs.  
Also run a lot, by losing weight you ll be cutting the sugar levels in you body and this will help.

Trust me it works  good luck
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Avatar f tn
I too have it used isotretinoin want q cure
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Avatar f tn
I have had scalp fulliculitis for 4 years.  My history is pretty much similar to the other you'll find here.  I have done every possible antibiotic there is including bactrim. This one works and after exactly 10 days My folliculitis was back.  I did accurane and after 6 months it was back.  Also my sugar blood levels came elevated so I decided to stop eating all kind of sugar ( bread, fruits, pasta, artificial sweeteners, starches) ( except stevia which is healthier) and I have been able to control it this way. I found out through the saliva test I have an over production of candida yeast.  Now I am trying to get rid of it. Not easy but is possible.  NOTE. MOST DOCTOR WILL NOT AGREE WITH YOU ON THIS. THEY WILL NOT EVEN AKNOWLEDGE THIS IS THE PROBLEM, SO YOU HAVE TO DO IT BY YOUR SELF. GO ONLINE AND DO YOUR RESEARCH.
IMPORTANT TAKE LOTS OF PROBIOTICS.  GOOD LUCK
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Avatar m tn
I have recurrent chronic folliculitis for 30 years. My follicultis return in the same places. I have tried every thing, ani-fungal, antibacterial, different shampoos. I tried to shave my hair, different moisturizing
No thing work
One of the dermatologist culture my nose and find staff and gave me antibiotic for one month. The follicultis disappeared for one week during which I felt I'm different person then recur
They are painful, itchy and I feel carrying block on my head.
Sometime I can not sleep, I have to wahs my head 3-4 times each day to feel relive
Any advice
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Avatar m tn
I have recurrent chronic folliculitis for 30 years. My follicultis return in the same places. I have tried every thing, ani-fungal, antibacterial, different shampoos. I tried to shave my hair, different moisturizing
No thing work
One of the dermatologist culture my nose and find staff and gave me antibiotic for one month. The follicultis disappeared for one week during which I felt I'm different person then recur
They are painful, itchy and I feel carrying block on my head.
Sometime I can not sleep, I have to wahs my head 3-4 times each day to feel relive
Any advice
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Avatar f tn
CLEAR SCALP FOR SEVEN YEARS NOW

http://www.curezone.org/forums/am.asp?i=1025720
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Avatar f tn
Greetings,

I was suffering from recurring scalp folliculitis for almost 15 years.  I’m 39, female, Asian w/natural hair, over weight, pre diabetic, have Hashimoto’s disease (hypothyroid).  Like everyone else I’ve tried acne meds, antibiotics, anti fungals, steroids, diet changes, spices, colloidal silver, etc... also tested for staph, biopsies, A1C (blood sugar) - and nothing special happened or was found.  One thing I have never tried are the stronger medications like Accutane.  My recurring folliculitis was mainly small puss filled spots; however, I had a few boils(?) that were so large and painful, it hurt to move my eyebrows and left small bald spots; mercifully, my hair grew back. My scalp felt like a crusty decorative autumn squash. Due to embarrassment, I’d get my hair cut only once a year.

About 2 months ago I found my solution, oddly, back at square one: 3% benzoyl peroxide.

Take it for what it’s worth, but this is how my solution came about.

At 39, I started getting adult acne fairly badly on my face and started using Retin-A and salicylic acid; however, neither were helping.  I read online that while SA & Retin A can help keep pores clear and skin rejuvenated, it’s benzoyl peroxide that actually kills the acne bacteria.  I was reticent about using benzoyl peroxide because in the way back, I used the 10% max strength bp and it bleached my hairline, pillow cases, clothes - everything it came in contact with - so I stopped using it.

One day at Walmart I started looking for a lower concentrate bp, and decided to try the AcneFree for Sensitive Skin kit (blue/white kit).  After about a week, my face started clearing up but more interestingly, my hairline was not bleaching.  Since I work from home, I took that as a cue to throw caution to the wind and slap it all over my scalp. After a week or so there was significant improvement on my head (and face).

Flash forward 2 months, and my scalp is clear.  About every other day or so I part my hair in sections and try to cover my entire scalp with the lotion.  Every now and again the 3% bp will make my head itch, but i’ll take the itch over the lesions any day.  I’m hoping as time progresses I can eventually stop using the goo, but we’ll see.

Anywho, I imagine many of you scour the internet looking for remedies, and you’re probably aware that folliculitis has many many modalities and what works for some may not work for others… I sincerely hope this post helps someone out there.

Take care!
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Avatar m tn
I have had the same issue for about 3 years now..It started with acne on my face for which I tried all possible medications (Clindamycin, minocycline, doxy...you name it..) . Nothing helped and then my derm switched me to acutance for 6 months which got rid of my facial acne but a few months after I developed chronic scalp folliculitis. Over the last three years I have tried everything from shampoos to different medications. The only thing that keeps my scalp clear is 100mg capsules of minocycline (mind you that I have been on it for the last 2 years. Everyday at night time right before bed). The only problem is if I stop the Minocycline, the folliculitis appears back within 2-3 days. I have also tried pus samples, cultures, biopsies etc. and everything was normal.
I live in Canada and this problem may be climatic (as far as I believe). Every few years I travel to India for a month or so and for the entire duration I am there (~1 month) my scalp heals and remains free of folliculitis even when I am on NO Medication whatsoever!.
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Avatar m tn
Hi all...

I have the same issue... but not always. I have outbursts that are normally related to the consumption of bread and pasta. But not all types.

If I avoid it, I have no issues.
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Avatar m tn
Probably you eat different type of food. I notice the same when I travel to South America.
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