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Avatar universal

Severe folliculitis in my scalp

I have had this painful problem for years (9 years and 6 month to be exact). I am 40 years old, male, from Canada. Here's how the problem started. Tiny red bumps and they endup with the white thing on it  on top of the scalp back in around 1999, they got very itchy and they blood and white things will be discharge from the pinples. After a few months, I went to a dermatologist, he prescribed me with antiboitic and shampoo and cream and lotion . i used them for 3 month and after i stoppped few one month after I had them back on my scalp and face.I called my dermotologist booked an apt and i saw him and said i should take accutane 40mg daily and antibiotic for 6 month and keep on using the stieprox shampoo for fungus , so i did that and i my scalp and face they got better , so after 6 month i was done my medication course went back for finale visit and he said that i am done .
after  5  to 6 month after the treatment  same issue is back i went and i saw my family Dr and he said to go back and see my dermotologist so i called book an apt , i went for my apt and same thing he want me to be back on accutane for 4 month this time and the stieprox shampoo and other shampoo brand i can't recall . so i did that and after 3 weeks my scalp face look better and after 4 month everything was cleared  saw my dermotologist and he was satisfied with the result again , so he said to stop treatment and i did.
after 4 to 5 month same issue i endup with than made me think more , went to my family Dr we talked and he recommend to see a another dermotologist than the one  i was seeing so i agree and we went through  that
same treatment for 6 month  and i did it   and after 5 to 6 month same issue i changed over 10 dermotologist  and on off on antibiotic and accutane and shamppo and lotions dalacin ....and till today's day no luck  same issue and all this dermotologist did culture and was negative result and they did alergy test negative tooo, few weeks ago as per oct 24 2009  a saw a new dermotologist she did a culture and the result endup with Citrobacter koseri  in my scalp and she said that the cause was from the antibiotic however i am still taken till now antibiotics , and she want to reffere me to another specialist who deal with the bacteria issue's so now i am waiting for my apt . honestly after all those yrs i had the worse time in my life , and i can't beleive that some dermotologist didnt care less for my situtation , i am loosing sleep and is effecting my daily life  and i am looking for a solution please helppppppp.
PS i did tryed all kind of prescription shampoo ,lotion,cream,antibiotic,accutane ,cureacne , i spend over 12000 dollars and no luck  , and i endup a one  year ago with a damaged lazy  liver i had to stop accutane and take other medication to get my liver back to normal situtation  please helpppppppppppppppppppppp

now i am under antibiotic but however not doing the job at all  and all it's doing is controlling the bumps a little. Like 1 week of the month, I will have 70% clear scalp. The other 3 weeks, I'll have 30-40 spots .
These spots are extremely painful, sometimes I can't sleep right since the scalp pushes against the pillow. I have to wait upto 3 weeks before scalp is somewhat clear so I can get a haircut, even the past few month i don't go to a barber anymore i cut mine with number one hair  cliper  

From all my research, this seems like extreme stubborn case of folliculitis, but I don't even know anymore what to do. Please, anyone out there, help me. I'm willing to pay you if you can help solve this problem


This discussion is related to Severe Scalp Folliculitis (Seen 4 Dermatologist already).
80 Responses
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Avatar universal
In my case, the only thing that can effectively control this miserable disease (99% or even 100% of the scalp is clear) is benzoyl peroxide 2.5% & 1% salicylic acid & 1% sulphur shampoo (2-3 times per week, leave it for 30 min and don't let it get into your eyes! - very important).

I won't write the name of the shampoo because I don't want to advertise anything here. You know the ingredients (benzoyl peroxide 2.5% &1% salicylic acid & 1% sulphur) so I'm sure you will be able to find it.
Helpful - 2
Avatar universal
It's eye-opening when sufferers of a condition have more knowledge and non-antibiotic advice than a trained doctor has about it. My heart goes out to all of you, and I'm thankful for everyone's advice. It's frustrating and sad to see the ineffective treatment people are still being given for this condition when other solutions must be sought.
Helpful - 1
Avatar universal
Dermatology is one of the highest paid specialties, but all they have is antibiotics or Accutane at their disposal. Come on, do more research. Veterinary medicine seems more advanced in their knowledge of skin issues than dermatology. It's quite pathetic.
Helpful - 1
1 Comments
I so agree with you, you can't even imagine.
Avatar universal
Having the exact same problem! i have tried everything . after trying so many things I wondered if there could be something internally wrong however, I can find no evidence of anything going on other than this reoccurring itchy horror.  I am willing to pay for any help with this as well. Going to try oral antibiotics if the doctor approves. I just don't know what else to do......
Helpful - 0
Avatar universal
I do recommend Kitikiti myself. I too, have issues with recurring PFB (psuedofolliculitis barbae) on the back of my head. The issue is that's where sweat/oils collect, so it needs to be kept clean or else pores will clog and cause ingrown hairs.

I had stopped using KitiKiti after I (thought) was cured, and forgot all about the product for years until I began searching again for solutions and stumbled across it again.

Shortly after I get my haircut (maybe a day or two) is when I tend to notice an increase of bumps/pustules A.K.A PFB on the back of my head. I've had it so long that I'm suffering from achne keloidalis nuchae (AKN).
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Avatar universal
So comforting to see all of you beautiful people sharing the same problems as me. All your courage perseverance and gathered knowledge.. wow! We know better than the so-called ''professionals'' dermatologists.

Excuse my basic english since i'm a french speaker of Québec.

My story began as a teenager, I used to shave my head with always the same razor blade just for the look. I remember often Id cut my scalp badly and bleed while doing this. Late teenage years I stopped with that shaved head look. At 17 years old I started to have thousands of pimples all over my head, especially around the hair line. I first thought of.. acne? What an odd place for acne. Some family members recommended me my first Dermatologist, an old grumpy man. He diagnosed me Scalp Folliculitis and insisted on the fact that It was my fault by spending my teenage years shaving my head with a dirty razor. It hurt my feelings and I wasn't sure about his theory.  Was it linked? I will probably never know. He got me on some Minocycline for about 3 months with a topical antibiotic cream. By magic it all disappeared leaving only scars around the hair shafts. But I had lots of digestive side effects. Once off the Minocycline, it came back few weeks after, that's when I understood that I had a freakin chronic disease and that I was entering hell.

Saw another Derm, she said that NO it was not my shaving that caused the Folliculitis and that I should'nt feel guilty at all. She tested for gram-negative bacteria and came back negative. She gave me Minocycline again, for about 7 months. Was mostly free of flare-ups during that period, It was great but I had a hard time dealing with the side effects. Then while on it, it seemed like if the whatever bacterias causing this had developed resistance to the antibiotic. I had a severe comeback, the worst of worst all over my head bleeding and full of pus. Suffered a lot. Lost trust in dermatology and decided to stay away from conventional medicine because they don't treat the cause, they just give you random crappy synthetic chemicals like a lab rat and see what it does. It aggravated my case. As I read all of your comments, it seems like they are all the same.

From 21 to 24 years old I managed it myself. Better lifestyle and tried natural organic mild shampoos with Tea tree oil. By 23 years old it disappeared completely! I thought I was CURED!

.....

At age 24 started noticing a random small scab on top of my head (Usually where guys bald) but I'm not balding. I pulled it off for weeks, and it kept coming back larger and larger. few months later another small scab appeared left of the initial one in a symmetrical way. Tea tree oil had no effect on those strange scabs, and even if I stopped touching it, It grew bigger weeks after weeks. It was so itchy and painful. I must say I was experiencing lots of stressful events during those years and a crazy breakup. I'm sure its all related. It grew the size of two birds wings all of the top of my head. Took me some time to go back to see a dermatologist because I hate em. I was now stuck with a new condition, an even worst disease than just simple Folliculitis. I was diagnosed ''Folliculitis Decalvans with Tuft hairs'' What the heck? Had crazy inflammation and scar tissue forming on top of my hair so that plenty of hairs in that area merged to single giant follicles. It looked like doll hair. Also I started to lose patches of hair. The nightmare.

From 24 years old to 30 years old I stayed away from doctors. I tried so many natural and organic treatments by myself with no substantial results. The only thing that was keeping the condition stable a bit was applying a 5% salicylic acid lotion twice a week and then wash it out after 4 hours. It was good for melting the scabs under the hot shower and to diminish the inflammation. Also again good life habits, change pillow case every day and try not to stress or drink to much alcohol.

But now i'm almost 31 years old.. and desperate.  All my hairs in the infected area are starting to fall, leaving a giant patch of scar tissue. It is soooo hard on self-esteem. I have to walk around with a hat all the time, and I feel ugly and unattractive. Its also messy when you wanna do some sport or lay your head on someones couch.. you always have to make sure you don't stain with the blood or pus. This is a hell condition.

I went to see a new dermatologist lately and she prescribed me low dose Accutane (10mg per day for a month and then 20mg the following.). I've read a lot about Isotretinoin over the years and knew all the dangers of it, but now I had nothing to lose...

At the last minute I changed my mind after reading all the side effects and risk of long-term permanent damage of Isotretinoin. I also deal with anxiety and depression and its known that Accutane mess with the brain. I don't want to put my remaining health in jeopardy for a ''maybe'' it will cure. Isotretinoin is a form of Vitamin A poisoning, so basically it messes up with every cells of your body, no wonder there are so many things that can go bad permanently. Also 99% of the stories of people that tried Accutane for my condition turned out that the disease came back after. Would you jeopardize your precious health for a ''maybe''? If it was 100% guaranteed that it would cure people, it would be an whole other story.

So now i'm left with no hopes because I don't trust those pills and synthetic creams and all that crap.

Be strong people, you are beautiful and i'm sending you strenght!
Helpful - 0
Avatar universal
You very likely have a Demodex infestation...classic symptoms - 10% Sodium Sulfacetamide/5% Sulfur wash twice a day, plus Bactrim DS 1-2x per day, and oral Ivermectin (based on weight) for three days (4days off, then Ivermectin for three days, repeating cycle for 60 days). Most doctors believe incorrectly that two doses of Ivermectin two weeks apart will kill all Demodex and newly hatced eggs. This would be true ONLY if the patient just contracted Demodex. This rarely occurs as most are misdiagnosed as having dermatitus or other catch-all diagnosis, and months later make the correct call-by then, the egg hatching cycle is daily new hatchlings.
The above would be my starting treatment - it is imperative to treat before long term infestation. You can beat this, but get a doc who will be aggressive in treatment.
Also, if you can afford it, get advanced Lyme testing done - IGeneX is widely considered the best at it - forget base two tests - they miss late stage Lyme more often than not. Good luck!
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3 Comments
Reason for Lyme test is to eliminate of confirm more complex co-infections from Lyme - If positive, seek out and use only a Lyme specialist for treatment lest you get more frustrated with non/wrong responses. I'm being blunt here, but there are 2 schools of thinking on Lyme - classically, treated as recent infection and if not responsive, cast off as an immune system problem. Had a conversation today with microbiologist about this very subject... The Lyme specialty docs represent small percentage of ID docs our there. It's not cheap, but worth every penny if they are good
Also, with no disrepect intended, but home remedies will not beat Demodex...some may help (Borax skin washes for example. Containing boran, it is helpful and should also be liberally used in laundry). Borax washes on skin (dilute in warm water obviously) won't solve the problem, but helps. It IS essentialy in washing linens and clothes (hot water and extra rinse) - change out sheets every night - seal pillows in bed bug resistant cover and then clean pillow case outside that. Vacuum floors and wipe down computer keyboards and mouses, car steering wheel, phone, etc. Throw away brushes if in hair - get cheap ones and keep immaculately clean - then still toss periodically (if in scalp, buy dollar store brushes and toss daily til symptoms go away - worth it)
one more thing - this one is simple to do, but seldom followed - try NOT to touch your face - studies vary, but people touch their faces regularly without thinking about it - it only adds to potential spread of demodex - try to minimize and wash hands as much as needed to reduce potential spread of demodex -
Avatar universal
This condition is baffling. Is there any research being done on it? From my own searching, researchers are just now looking into ways to populate "good" bacteria on those with chronic skin issues. Odd to me that they are just now attempting to do this. Maybe bacteriophage therapy and quarantining yourself as not to be reinfected holds the best promise? I don't know. Mind boggling that this condition is given the, "we aren't sure why" response. I cant help but believe dermatology is more about botox and easy money than trying to make a true difference in chronic suffers' lives. Quite sad.
Helpful - 0
1 Comments
So true about dermatologists, they're all about money...
Avatar universal
overnight guys: 1/2 cup conditioner, add in: tsp household bleach, mint oil (for itch) half dropper tea tree oil,
neem powder -- go carefully with the household bleach, obviously. I do this. It makes a huge difference. A bleach bath overnight for your head. And spray in the day with some cedar oil drops in alcohol. Best medication for me: Clindamycin rifampin.
Helpful - 0
4 Comments
Is this still working for you?
It is better than without, for sure. Not completely cured. Also, look into pure gum spirits of turpentine
Thank you for replying. Is your boyfriend still cured?
Do you also suffer from atopic dermatitis/Eczema? I've learned that people with atopic dermatitis are more prone to folliculitis.
Avatar universal
Don't use any antibiotics..Use garlic for best results.

1. Crush/Mixer raw garlic (don't add water)
2. Put the crushed garlic in a cloth and press it for liquid.
3. Apply the garlic liquid extract on scalp and leave it overnight for best results.

I also take Turmeric Circumin extract capsules daily.
Helpful - 0
1 Comments
Mayb try Using Apple Cider Vinegar on ur scalp. Here they bathe in it deluted..They use it full strength. U cud try deluteing it if necessary.
Avatar universal
Hello,

I also have this horrible condition for two years and feel for you all. I do NOT have a cure but some thoughts for you that may help alleviate symptoms. However, my boyfriend got it from me and IS CURED. What did he do? 4 weeks of minocycline and he buzzed his head. I also made an overnight cover for him, and the ingredients of a smililar cover are below. My biopsy confirmed staph, so -- I don't know exactly what you have. Definitely ask for cultures if you have not done so already. They can do a punch biopsy on your head.

Also, there are reports of people shaving their head bald and using a spray of rubbing alcohol with clindamycin capsules emptied into the alcohol.  

isopropyl alcohol bottle is a 60 ml
Dalacin 150mg
I remember that it was two 150mg capsules per 60 ml bottle of alcohol.

In the meantime, the following may help you to live with this:

Shampoo with Chlorhexidine shampoo 4%. You can get it online as Hibiclens. Shampoo, rinse off, shampoo and leave on for 5 minutes, and not more than 5 minutes, as it can be toxic after 5 mins.

Overnight, I get relief from covering my head with a mixture -- and I have tried several. This is mostly natural antibiotic oils -- such as tea tree. I have done the research on the oils that work best as antibiotics/anti-virals, and anti-fungals. I use all three in the cover. Here are some suggestions: This makes about 6 cups:

Base: pure aloe vera (go to a health food store) 5 cups
sulphur USP (Amazon) 3-4 tsp or
Nustock (Amazon) same amount, this is a strong sulphur product for animals
3 tbsp Neem flakes (Little India or order on Amazon, where it is much more expensive)
Zinc oxide powder (Amazon)
Mint oil A LOT it stops itching and brings down pain, at least for me -- start slow I guess
black drawing salve (Amazon) 2 tbsp
2 tsp lemon juice
5 droppers tea tree oil
2 cap fuls orange oil -- that's the CAP, not a cup!
20 drops of each:
clove oil
eucalyptus oil
10 drops:
geranium oil
tsp powdered vitamin c
4 capsules niacinamide, emptied into the mixture
3 tbsp turmeric
add about 30 - 40 drops of cedar oil at the end, add the orange oil at the end too. What you last add most impacts the smell. DON"T get neem oil, it is truly awful. Get the flakes.

If your doctor or dermatologist will agree to this, ask for extra capsules of minocycline or clindamycin -- I think there are the best -- perhaps flagyl -- and put these in the mixture. Put about 15 to this mixture.

Also, I suggest you check into the demodex angle, especially if you have rosacea. It was verboten in the medical community until about two years ago, however Galderma did a study using ivermectin topical (ivermectin is a broad-spectrum antiparasitic drug -- you can google it) and had over 90% success rate in curing papulo-pustular rosacea. (You can google that study also.) The drug the released is called Soolantra in the U.S. and Rosiver in Canada. You will need a prescription. I put that in this mixture also, and this has been helpful for me. You could ask for 2 doses of ivermectin oral, however it seems the doctors don't love doing this. I think it is worth a shot to check into scalp demodicosis. Yes, that exists. Here is a warning re: oral ivermectin -- if you DO have demodicosis, the ivermectin may cause a very dramatic die-off, and that may cause MORE bacteria, because they decompose in the skin. So make sure you have medical support if you do this.

I will be praying for us all. This affliction takes quality of life man -- it's so MEAN. And the doctors seem really quite at sea. If anyone actually reads this, best of luck.

Sincerely,

Elizabeth



Helpful - 0
Avatar universal
sounds like you may have to talk to your dr about doing an IV antibiotic treatment. my problem started over a year ago when I went to a new hair dresser and I noticed that she was scrubbing my scalp with her fingernails while shampooing my hair and a couple of weeks later I had crusty sores popping up on my scalp and my hair started falling out, well being a woman this had really effected me badly, have lost half of my thick hair now, and went to dr 2x and got on doxycycline for a month and it helped to cut down on my sores on my scalp to about 2 sores in the last 3 months but I have small pimple like ones that come up on my body in other places on my back, shoulders, arms, sides, buttocks but they are also very small and not very many after being on the doxy. I have used all kinds of natural treatments, garlic, Epsom salts and bleach bath soakes, and even sprayed listerine all over my body and on my scalp a couple times a week, and ACV with water and some peroxide, coconut oil and vit e oil and caster oil on scalp, and tee tree oil and oregano oil on the scalp and collidal silver dropped on the scalp and internally, and clyndamician drops on the scalp and antifungal shampoos to no avail but the doxycycline did help take the occurances of the scalp sores down to 1 sore that came up a month ago but my scalp is very sore feeling around the crown area and my hair is still falling out but very little now compared to a brush full everyday, so I am sure this thing has not gone away as my scalp is very sore and I still get some itchy bumps come up on my body hear and there, but a dermatologist told me to wash and shampoo with liquid chlorhexidine antiseptic skin cleanser which I bought at the drug store over the counter and I have very few sores appear on my scalp and body as of this last month of using it but I also used listerine on my body and let it set on there for 10 min before rinsing it off so maybe these two products are helping to keep the sores down, don't know for sure but I do know that when I started using the listerine on my scalp for the sores that's when the sores started healing overnight and was a big help with that but the doxycycline was the last thing I got on that really made a difference but it had side effects and made me feel not so good feeling and my abdomen would start to hurt after being on it for 2 weeks but I took a 2 week break and got back on for another 2 weeks of this medication. I am going to my derm next week and beg him to do an antibiotic sensitivity test to see what antibiotic will kill my infection out. I will also get the neem soap that someone on here said they were using and see if that will help my soreness to go away on my scalp and get rid of the infection, but if it doesn't work I will see if my dr will do the IV antibiotic treatment on me to see if that will do the trick. its probably I'm my blood stream as it may be in yours also.  
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Avatar universal
Your story is my story.  I started out with one cut that got infected.   I was treated with Augmenten sp?    There is still a red spot there but soon thereafter I started getting what I thought was acne but I have never had acne issues so I would just pop it.   Soon it was around my hairline, neck, shoulders, and the back of my legs.  Went to Dr and I had a staph infection and it was colonizing in my nose.   Doxycycline and topical ointment.   Did very little . Went to a dermatologist and he did like a 3 foot circle around me and took a nose culture . Nose was clean and he said red spots would dissapear within a few weeks .  Now about a year later I have been on doxycycline, cephlex and the latest was clindamycin which helped a lot for about 5 days and then seemed to have no effect anymore .  I have two young kids and every day I live in fear I will give this to them.  It is now confined to my scalp exactly as u describe .  I was in the Cayman islands 6 months ago and the salt water had a tremendous effect on it but of course it came back .  I have a great deal of respect now for people with skin disorders . I take bleach baths and use Epson salt.   Antibiotics don't seem to do a thing and Drs won't come close enough to see the issue .
Helpful - 0
3 Comments
What are you using now to help control it?
Hello Sadie -- Sorry for delayed response. For some reason this forum will not direct me to the question you asked. Yes, my boyfriend is still cured. We don't know if he had the same infection or something different. It seems probable it was the same, given our proximity. His was treated very quickly with minoccyline, he cut his hair short (brush cut) and used  some of the topical solutions. For him it was sulphur/tea tree oil and a couple of other things. He beat it in a matter of a couple of months. We have no idea why he was cured and not me. We think it might have been the brush cut. Good luck to you :)
Thank you so much for replying. Glad to hear. Thank you for the tips. Much appreciated.
Avatar universal
Hi I have had this problem since I was 15 I'm 60 now never had acne. But on my scalp early treatment was salicylic acid ointment messy and useless my mother used to apply it with cotton buds. After a time I was put on oxytetracycline tablets been taking them for 44 years also use a lotion betamethasone 0.1% scalp application after a hair cut or if I forget to take the tablets. I'm fine it is well controlled if I stop taking the tablets it flares up, start the tablets it goes after about a week had liver test as on medication for so long it was fine
I'm certain diet effects my scalp but never been able to pin it down
Apart from this I am a very fit 60 year old
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Avatar universal
Update: I have stopped washing my hair with shampoo, every three days i will rinse with vinegar, it has improved immensely! Down to about 10 percent of what i use to get and i know if i keep it up it will totally go away. First two days are tough, your scalp gets greasy and you break out even more but by the fourth day you will see great results.
Helpful - 0
13361073 tn?1431873940
Thanks for the info. It looks like that is how it started. For now the 40 mg of Accutane is working well. My pores have tightened, less outbreaks and I am starting to heal. No complaints thus far. Thanks to all for discussing this in a attempt to find a cure.
Helpful - 0
4 Comments
It has come back. Now I am trying to control it with Epidou Forte, doxycycline and clindamycin gel. May have to consider a low dose of Accutane.
Tried 150 mg of doxycycline, cleared up quite a bit. I am back to using medicated shampoo and clindamycin has well. The doctors want me to take Accutane for a third time, possibly low dose. Wish me luck since this stuff came back with a vengeance.
I have been under a great amount of stress and that seems to cause the fare ups, but life is full of stress!
Hi Tigerclaw. Have you found anything to help control it?
Avatar universal
Does anyone have a large bump on the back of their heads thats not painful? It seems to grow only when i have an outbreak.
Helpful - 0
Avatar universal
hello to you and all of you i think it may be solution?my name is daniel from poland,i have this problem too about 10 yrs now.there r 2 places in world ,one i Georgia one in Poland(wroclaw)where are producing Bakteriofags -please read about them and tell my what u think?u can watch it on youtube .
Helpful - 0
Avatar universal
hello to you and all of you i think it may be solution?my name is daniel from poland,i have this problem too about 10 yrs now.there r 2 places in world ,one i Georgia one in Poland(wroclaw)where are producing Bakteriofags -please read about them and tell my what u think?u can watch it on youtube .
Helpful - 0
13361073 tn?1431873940
Hang in there. I do not think there is a clear solution for the common problem we all share but I wish us all the best. Find the positives in you life, it is not ruined. Eventually we will all emerge successful.
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Avatar universal
I have been on the dosage you have been prescribed exactly last year.  It caused a lot of dryness and I developed folliculitis decalvans on my scalp after one month of 40mg.  I persisted for 6 months and kept me clear for another 6 months afterwards.  Then the acne / folliculitis came back with a vengeance.

I am giving the low-dose maintenance plan a try because on both high-dose occasions, it only cleared me up temporarily.  In the meantime I still struggle with my folliculitis decalvans which has also ruined my life.
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13361073 tn?1431873940
40 mg. once a day for a month then 80 mg.. With the humidity out here I broke out really bad. They are going to do 6 to 7 months with the drug. They gave me one that absorbs better into my system, Absorica. When I took it in the mid 80's it cleared me up almost all the way. Then I worked in real hot attics for almost 15 years. I wore a hat has well. This is what I think brought it back. Hoping that it is the solution.
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Avatar universal
What dosage are you on?  I am on a low dose of 20mg every 3 days at the moment.  So far it's controlled although I still do have fragile sensitive skin and a few white heads at the back of my scalp.  The only side effects so far is dry lips.  I mean to do a blood test soon to see if there are any "real" side effects.  

Not to sound discouraging, but I doubt you will "cure" it after 6 months of accutane.  I've done the full 6-month treatment twice, and it always came back.  I'm hoping a low-dose maintenance regimen is the way to go.
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Avatar universal
It was great to find this forum for some new ideas, though I totally feel everyone's frustration and disappointment after suffering from deep scalp folliculitis for several years.

I have found two things that clearly work for me, providing cures for years with eventual relapses, or as an ongoing method of controlling the outbreaks.

The best for me was accutane (though it's not a long term solution due to toxicity). I took roaccutane as a teenager for 6 months and then again at a lower dose in my mid 20s, both times mainly for face acne. I am considering asking my doctor if I should take it again for my scalp follicle infection/inflammation because it prevents me from getting any type of pustular skin inflammation. I'm 31 now.

Or alternatively (and I suggest people try this if they haven't!!), as a topical treatment, that controls, rather than cures scalp folliculitis... benzoyl peroxide wash solution (Benzac 5%, from Galderma, 200ml bottle). I gently lather it into the follicles like a shampoo and leave it on the back of my head for a couple of minutes during my shower. then rinse thoroughly (make sure to rinse your hands after lathering and avoid getting it on your ears and neck that will be exposed to sunlight during the day or you will dry out/bleach/sensitise your healthy skin!). Frequency of application; once per day during flare ups and every second day if I'm clear or I notice the inflamed areas have started to recede. It sometimes takes 5 - 8 days of treatment to make the bad flare ups recede. When I moved to France they didn't have the 200 ml wash version, so I had to use smaller tubes of cream (also 5% but this doesn't form a lather, I just massage it into my scalp) from the same company. Also, it's a prescription medicine here which is inconvenient. In Australia and many other countries it's an over the counter pharmacy medication, for about 20 AUD per bottle (which should last for 2 - 3 months), though I find it's less effective the longer the bottle has been in the bathroom (the product could possibly be inactivated by light or heat or air exposure? ?). I have found that this topical treatment also drastically reduces the frequency of large acne/folliculitis on my (hairy) bottom!

I also went through a period of about 2 years where I had some large inflammed chin hair follicles. This is controlled now... and it may sound strange but I think what drastically reduced the number of outbreaks (to about one or two inflammed chin follicles in 2 years) is the complete reduction of simple sugars in my diet (both processed and 'natural' sugars such as fruit and honey but especially liquid sugars such as juice and soda) and moving out of Australia to France where the UV index is much lower. I got an inflammed chin follicle about a week ago while on holiday (completely stress free) in a sunny location in Europe, and it was during a time where I decided to eat very sweet desserts with dinner for two nights in a row. It could be just one or the other (sugar or UV light), but I have a hunch that it's probably a combination of simple sugars and UV exposure...a double whammy of inflammation, inside and out. Also I notice that the hair follicles in the areas where I get beard folliculitis are always white, compared to the healthy hair which is dark brown on my chin. most of my hair is dark brown, except those in the position on my chin where I used to get folliculitis.

...though on the other hand, maybe sunlight and air drying of shaved scalps is the mechanism by which a haircut has improved many peoples condition on this forum? it's known that UV light is a bactericide and fungicide. or maybe having longer hair means that it can be moved mechanically, with your hands, clothes, pillow case, hats...which may start an inflammatory process in the base of the follicle? ? or allow surface bacteria to enter into the hair follicle?

I'm also curious about the ethnicity and hair type of people on this forum? I'm from a Mediterranean background and I have very thick hair.

Some of the other things I do to minimise folliculitis;
changing pillow cases and bedding very frequently, and washing them in very hot water, with antibacterial and fungal agents, and drying it in direct sunlight reduces the number of my scalp outbreaks, as does sleeping for more than 8 hours per night, doing vigorous exercise which promotes good blood flow to the skin surface and flushes pores with sweat, avoiding picking the scabs, or only squeezing pus out before the benzoyl peroxide shower treatment, not wearing helmets or hats that cause mechanical movement at the shaft of hair
i recommend non-comedogenic skin products (I don't use a shampoo, only a non-comedogenic face cleanser on the back of my scalp), and sleeping on your side (alternate sides each night to reduce eye wrinkle formation on just one side of your face.)

Good luck everyone, and remember to give new treatments at least 3 weeks before giving up on them. Everyone is different, and folliculitis is probably a large group of diseases, sometimes caused by completely different things in different patients, so I don't expect a reduction in sugar and UV light to clear everyones beard folliculitis, nor do I expect benzoyl peroxide to improve everyones scalp acne/inflammation...but I'll be happy if it at least works for a few people on this forum!

I wish everyone the best of luck in finding a cure!
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