Protracted Acne

[Solution Driven]

I am 50+ and started with normal premenstrual acne as a teen. In my 20's I started having bumps on my bottom. In my 30's I started having bumps on different parts of my body. In my 40's I had severe facial acne and took two rounds of accutane. I currently experience acne (cuniform, folliculitis?) everywhere. My skin will itch with the formation...I scratch the area and then the area becomes infected. I know...don't pick, but this has been a 30yr. process and it is almost impossibe to keep my hands off. I have tried every abx and tricyclic known. This doesn't seem like your normal garden variety of acne to me. Could I have some type of immune disturbance? I also have these weird episodes where my skin begins to itch uncontrollably. I have learned not to scratch when this occurs because the result is an almost full thickness skin breakdown. These areas seem to be in strategic areas on my hands and feel only. I have been to many (12+) dermatologists and they try to give me a tube/jar of whatever, most of the time not even enough for 1/2 of my body. If it makes a difference, I have a 30 yr. hx of herpes which has moved from my labia to the inside of my anus resulting in a stabbing pain down either leg. My acne seems to exacerbate with my herpes attacks. I do plan to begin palliative Valtrex as soon as I can get to my MD. This acne has created a disabling in my ADL. I do not go outside and participate in physical activities and this has negatively affected me. I would greatly appreciate some guidance. I am in the medical field and know that it is sometimes beyond a physician's comfort level to refer a patient when they cannot diagnose and treat leaving me to suffer the consequences of ineffective treatment. Thanks so much!

[Alan Rockoff, MD]

It sounds pretty clear to me that you don't have acne.  You most likely have folliculitis that you either aggravate or cause by picking.  I understand that, "this has been a 30yr. process and it is almost impossible to keep my hands off," but unless you do keep your hands off, you're just never going to clear up.  I doubt that herpes has anything to do with it.  You'll need to continue looking into therapy to help you stop picking.  After all these years, it's going to be hard, but you really don't have much choice, it seems to me.

Best.

Dr. Rockoff

[Solution Driven]

One other thing I forgot to tell you...
I have a recurring formation of something akin to an inflammed follicle? on my lower lip. It is like a tiny pearl. It comes out of the same area every time. What could that be? It is similar to the discharge from my follicle irritations. I also have the same thing coming from the tip of my right ring finger.

[jerseyman]

Washing the skin regularly, not excessively, but on a regular basis twice a day. Many of the over-the-counter benzoyl peroxide products are really very effective if they are used regularly and the patient understands that what they are supposed to do is open up the pores and dry the skin a little bit. As they use them, they will notice a little tightness and dryness in the skin. And that's good; that's the effect of the medication. Washing the face twice a day with an ordinary mild soap and a wash cloth- there is no need to use a complexion brush or anything like that - and then using the over-the-counter benzoyl peroxide products will control a lot of the milder acnes. If they can't be controlled, then we encourage them to see a dermatologist because if some of that inflammation gets deep enough and extensive enough it can lead to scarring, and that's what we want to prevent.


The biggest problem we see is oftentimes girls will use heavier, greasier make-up to try to cover it up, but heavy, greasy make-up will often aggravate the plugging up of the pores and make the condition worse.


Check out other dermatology info here:
http://beauty.expertvillage.com/interviews/dermatology-skin-care-2.htm