Severe Acne

[serenewalker]

I am experiencing a severe breakout. I have larger nodules under the skin around my chin, jaw bone, and neck. They last for two weeks before they become painful and eventually come to a head. An esthetician  recommended taking probiotics with a digestive enzyme, but that seemed to make it worse. I have tried medication, facials, microderms, etc... They only seem to make it better temporarily. What could be causing this and how do I fix it?  

[serenewalker]

Thank you and I will keep you posted.

Also, I woke up with a swollen lip that was caused by a small pimple. Now it seems like my lip is bruising but the swelling has gone down.  

[Bhupinder Kaur, MD]

Hello,
From the symptoms it can be folliculitis or boils. Folliculitis starts when hair follicles are damaged by friction from clothing or blockage of the follicle. In most cases of folliculitis, the damaged follicles are then infected with the bacteria Staphylococcus (staph).

Please keep the area clean and apply some topical antiseptics. Also wear loose-fitting cotton clothing and use an antibacterial soap or mild soap like dove. Avoid any kind of cosmetics and do not pop the pimples. Topical antibiotics such as mupirocin or neomycin containing ointment are also useful. In case the symptoms persist then oral antibiotics or incision and drainage may be needed. Please consult a dermatologist in that case. Also then the possibility of cystic acne has to be ruled out.

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 dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.