Folliculitis on chest.

Hey,

For more than a year I have been battling acne like lesions on my chest.

Originally I visited a Doctor about a few annoying spots on my face. He prescribed long term antibiotics which, rather than resolving the problem, seem to bring on the acne on my chest and upper legs.

I visited a dermatologist who put me on low dose accutane. This worked and the problem went away, although I did experience odd visual side effects from the drug and would be reluctant to use it again.

The spots on my chest are just now progressively returning. My derm. performed a culture and found the causal bacteria to be p.acnes, rather than a staph infection or similar. She still termed the condition Folliculitis though as it's always the follicles inflamed. They are tender to the touch, filled with pus and quite large (some half pea sized).

Since my own derm is not particularly helpful and seems to always wish to rush me from her office I'm asking you for advice as I'm getting rather down as a result.

Should I try stronger antibiotics (even though past experience seems to have had a negative effect) or is there anything else which will work? I have tried Fucidic Acid which worked amazingly well until I developed resistance.

Thanks,
Alex.

[Alan Rockoff, MD]

Chest acne is difficult to treat.  I tend to doubt that antibiotics made you worse--I think what may have happened is that the acne got worse while you were on them, but not because of them.

In any case, the options include other oral antibiotics and a repeat course of Accutane at a regular dose.  Another suggestion might be a culture for Pityrosporum yeast or a biopsy to look for Grover's Disease.  These are acne-like conditions which need different kinds of treatment.  You might ask you dermatologist (or a different one) about these.

Take care.

Dr. Rockoff