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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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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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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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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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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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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. 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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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. 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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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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I too have it used isotretinoin want q cure
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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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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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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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CLEAR SCALP FOR SEVEN YEARS NOW

http://www.curezone.org/forums/am.asp?i=1025720
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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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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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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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Probably you eat different type of food. I notice the same when I travel to South America.
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I have experience having scalp foliculitis too. I have read plenty of forum but found nothing that can help it at bay. I did visited dermatologist but could not provide permanent solution. one day, I met a person and told me at it could be because of my blood sugar so I decided to have FBS and found out I am prediabetic. now I eat less sugary food and less sweets and that cures my foliculitis. it only comes back whenever I eat too much sweets. you guys better check your blood sugar too, you might be prediabetic too and that causes your foliculitis.
let me hear if it helps.thanks.

-Ark
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I have had folliculities on my scalp for over 20 year seen over 20 Dr and specialist, the infection are getting worse to a point where it is attacking my immune system. I am trying to eat no sugar whether refined or non refined or substitute I have lost over 40 lb trying to kill the bacteria by cutting over it is main source of sugar supply and trying to eat only what naturally exist in nature, it is my last hope.
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Hello! Well, same as dancer4j. I too have seen several doctors, biopsy with same outcome, several wigs, and I watch my blood sugar levels carefully. I've poured anything from bleach to facial peel acid. This is the first time in a long time I've researched my scalp condition on the internet in a long time. I scare the crap out of me with diagnosis like pemphigus vulgaris, schlerderma, and that list is a mile long. The reason today....stuff coming off my scalp and researching the products which caused some fantastic results. Undecylenic acid (fungicare) and salicylic acid 20%. I still don't know anything yet but I dint care if I melt what little hair is left, I love my wigs! I just want the itch, burn, and sores to stop. Wishing all suffering good luck during this battle! Hope to update with phenomenal results soon.
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Hi OppPenelope.  I have a strong hunch that many of us are battling demodex mites on scalp (could involve face, neck, upper body as well).  I could write several pages on what has led me to this thinking. We live in Nashville but have had limited success finding a knowledgeable dermatologist.  The music/showbiz industry here promotes fairly extreme cosmetic dermatology.  It's easy to find ophthalmologists and dermatologist to do IPL (intense pulsed light) which kills demodex.  Our insurance doesn't cover cosmetic IPL.  In my husband's case, because his "infestation" has gone for so long unattended (we married 5 years ago), he has open lesions and carcinomas.  So for him insurance will cover some of a procedure called PDT (a form of light treatment).  However, I'm 7 years younger, not diabetic or overweight and try not to eat sugar.  My scalp is to yet ulcerate but weird hard lumps are beginning to form (and I can actually feel the demodex bump into hair follicles--which makes me feel like I'm losing my mind). We are currently using permethrin 5% every night.  Last night I used clove leaf extract essential oil with grapeseed oil to dilute (though I did not know what ratio to mix).  I read in a medical research article that clove leaf oil kills demodex.  I really don't know how successful we will be.  HOWEVER, I feel certain that getting rid of any existing fungal infection is critical.  I believe the next step is treating the bacteria that live on the mites.  I've read that oral metronidazole works.  Unfortunately, that requires a prescription.  But maybe with a diagnosis of folliculitis, a doctor would prescribe some antifungal medication.  I'm betting the longer a person has been battling this, an oral medication may be the only thing to work against the fungus that feeds the mite and the bacteria that keeps the mite healthy.  I hope someone out there with sincere motives (not selling a product) can shed light for us all.  In the meantime, fight the good fight. Stay strong.  Best wishes.
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Hi OppPenelope.  I have a strong hunch that many of us are battling demodex mites on scalp (could involve face, neck, upper body as well).  I could write several pages on what has led me to this thinking. We live in Nashville but have had limited success finding a knowledgeable dermatologist.  The music/showbiz industry here promotes fairly extreme cosmetic dermatology.  It's easy to find ophthalmologists and dermatologist to do IPL (intense pulsed light) which kills demodex.  Our insurance doesn't cover cosmetic IPL.  In my husband's case, because his "infestation" has gone for so long unattended (we married 5 years ago), he has open lesions and carcinomas.  So for him insurance will cover some of a procedure called PDT (a form of light treatment).  However, I'm 7 years younger, not diabetic or overweight and try not to eat sugar.  My scalp is to yet ulcerate but weird hard lumps are beginning to form (and I can actually feel the demodex bump into hair follicles--which makes me feel like I'm losing my mind). We are currently using permethrin 5% every night.  Last night I used clove leaf extract essential oil with grapeseed oil to dilute (though I did not know what ratio to mix).  I read in a medical research article that clove leaf oil kills demodex.  I really don't know how successful we will be.  HOWEVER, I feel certain that getting rid of any existing fungal infection is critical.  I believe the next step is treating the bacteria that live on the mites.  I've read that oral metronidazole works.  Unfortunately, that requires a prescription.  But maybe with a diagnosis of folliculitis, a doctor would prescribe some antifungal medication.  I'm betting the longer a person has been battling this, an oral medication may be the only thing to work against the fungus that feeds the mite and the bacteria that keeps the mite healthy.  I hope someone out there with sincere motives (not selling a product) can shed light for us all.  In the meantime, fight the good fight. Stay strong.  Best wishes.
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Hello, just wanted to share what has worked for me in hopes it might help some of you guys as well, it's a terrible affliction and no one deserves to suffer with it... My folliculitis started about 2+ years ago, it started as small bumps and eventually spread to large cystic sores all over the back of my head, crown of my head, hairline and was moving onto the sides. They would burst and ooze puss, it was so painful I couldn't even lay my head on my pillow at night. I tried the dermatologist and various anti fungal shampoos and the standard rounds of antibiotics which, like everyone else, helped until I stopped taking them at which point it would come back with a vengenance. Similar to all of you I turned to the internet and found that I was not alone. Through pure luck one day on a forum site (so far buried in the depths of google search that I could probably never find it again) I found a recommendation from someone who completely saved me. He was doing the same thing I am doing now just spreading the word about something that worked for him. He said to use OXIDERM + PS it is a veterinary shampoo manufactured by the Ceva Corporation (I get mine on amazon). The results came fast, within a couple days I could feel all the bumps and sores completely drying up and flaking off! It was one of the best moments of my life for sure! I get the occasional bump every once in a while but for the most part I don't even consider myself having folliculitis anyomore I never even think about it! I used it everyday for 6+ months and I still use it every other day now. I looked up all the ingredients and they are all normal ingredients in shampoos plus a whole bunch of strong acne medications so as far as I can tell it is completely safe to use. The only thing is that after quite a while of use it will start to turn your skin a bit pink, not like hot pink or anything lol but just pink skin tone, which I have anyways cus I'm Irish so it's a easy trade off! Anyways I hope this helps someone looking for relief because I know firsthand how painful, embarrassing, and life consuming this disease can be!
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Wow!! It is nice to know that I am not alone in this battle against this weird thing I also have had since the last 8-10 years. Symptoms - little itchy boils on my head, that would build up with pus, and then burst. And any place the pus would touch, in the head, I would start getting more boils.

My approach has been
1) whenever the boils develop, use cotton soaked in dettol to burst them and clean up the pus and blood.
2) wash hair morning and night with J&J baby oil; finish the hair wash with a mug of water with 4-5 drops of dettol
3) blow dry my hair after the wash
4) Come snow or rain, I gotta do the above every single day
5) every time I go for a hair cut, immediately shampoo and wash with dettol.

Some things which aggravate or has been likely to cause the situation
1. too much food rich in cholesterol, very high probability I will get it. Eggs, prawns etc
2. frequent heavy drinking - read like every day for a few days together
3. Hot, humid weather - especially if head gets sweaty
4. Some type of pickles - especially those that could have fennel, mustard, chillies, etc.

Every 6-7 months, I am prone to thinking that I got rid of the problem - you can't blame me cos it will completely disappear - and miss the routine, and bang the buggers will be back. I missed it this time, and have a really bad case. So went and saw a doc this time, and started searching online and landed to this page. So now I realise that this could be a life long condition :(

So no option to continue the battle till my grave I guess.
You might want to try my approach too.
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