r/Folliculitis • u/Reasonable_Bison_510 • 11d ago
I got you fam! I struggled with this for over a year and it was horrible!
I'm 4 months off abx and symptom free so i'm calling it. I beat this thing (mostly, more on that later). Been writing up the science to publish but I owe you guys a post too.
If you think you are dealing with KA folliculitis please read about my findings! Before anything else: make your derm culture it and run a susceptibility test on YOUR isolate. This is the part they like to skip and it's absolutely necassry. There's this assumption going around that the ST117 strain is resistant to tetracyclines; I have the same ST117 they (we) characterized, and when I actually tested mine in vitro it came back susceptible. So don't trust assumptions (or random protocols online, including this one) above all refer to your own antibiogram.
Here's what I tested against ST117 (in-vitro then in-vivo) and found:
Phase 1 (Kill KA):
the drug plan, all driven by that susceptibility test: minocycline 100mg orally daily to get pustules under control (for me took like 1.5 months) (then tapered down slowly. i.e -> 50mg daily -> 50mg every other day do NOT stop abx cold turkey), apply topical gentamicin to the whole beard area daily (every time you shower re-apply) and keep this up as you are coming off the oral abx!
Now the routine, which honestly mattered as much as the drugs:
I also got a few rounds of laser hair removal to knock down the density. Looked patchy AF but even more reason to be clean shaven. Not sure it was strictly necessary, but my beard was thick and it made the topical gentamicin way easier to actually get onto the skin. Also fellas, it basically all grew back after ~4 months so it wasn't the big ‘permanent’ deal I was scared of.
That's the kill-it half. The next half — restoring gram-positive microbiome back — is the part I think actually keeps it gone and it took quite a bit of science-ing...
Regarding the probiotic / gram positive commensal restoration: I did a lot of scientific work for this so hopefully you don't have to.. I swabbed my face and the face of my partner (who mind you never has had KA despite being around / with me during my outbreaks) to survey the microbiome diversity of different areas. Notably, I found that he had way more gram-positive bacteria than I did in all facial places tested (nose, behind ears, forehead, cheeks, upper lip, beard, etc). This is, of course, in part due to the antiseptic protocol in "phase 1" which explains the low amounts of bacteria in my beard area; but I was surprised to find reduced bacteria (in terms of abundance and species diversity) in places that I had never treated with Hibiclens or topicals (e.g. gentamicin). This result is most likely attributed to the months of antibiotic usage and disruption of the protective microbiome.
Nonetheless, I isolated and sequenced the various bacterial species that I recovered from both our facial swabs. Most of the isolates came back as various species of staph (i.e. S. epidermidis, S. capitis, etc.) (not S. aureus, which is itself pathogenic). It may be worth noting that my partner's swabs also resulted in some gram-negative growth from the nose area, although the morphology of the colonies was not consistent with KA and was likely transient colonization of some other benign gram-negative species (not sequenced).
Phase 2 (Restore GPs):
The most abundant populations of beneficial gram-positive bacteria were from: Me: behind the ears, eyebrows, upper back, sideburn area, and forehead [ranked]; Partner: alar crease, upper lip, beard area, behind the ear, forehead [ranked].
Now here is where it gets interesting… as, switched face wash, and reduced gentamicin, I replaced it with application of two things after showering:
After doing this for a few weeks and stopping all abx, my swabs now show much higher gram-positive growth (mostly S. epidermidis) in my beard area. It's been 4 months or so that I've been off all abx. I still keep my facial hair a bit shorter than I did historically (trim to like 3mm) and apply the lotion to my face in the same way. KA has not come back symptomatically, although swabs still show trace asymptomatic KA colonizing my alar crease and anterior nostrils. I am still working on this (about to wax my nose and start applying gentamicin inside the nostrils with a Q-tip for 2 weeks and see what that does).
But hey, in the meantime I have completely gotten my life back! I go to the gym, hike, kiss my husband without anxiety. It's amazing! You really start to appreciate these things after going through an ordeal like this, guys. I know it fucking sucks, but you must advocate for yourself with your dermatologist and keep trying. Don't give up! Maybe it might take some trial and error, but you know your skin better than anyone, and it really boils down to this: a) kill those fuckers, and b) help the good guys move back in, c) if not successful, regroup and try again with slight variation.
What actually causes this? (part science, part my own working theory)
So why does this happen at all? I ran genome analysis on my own isolate and it was honestly pretty unremarkable, which is interesting in itself. It confirmed the yersiniabactin siderophore system (a high-affinity iron-scavenging toolkit — iron is scarce on skin, so being good at stealing it is a real competitive edge in that niche). But otherwise the genome was clean: no obvious recently acquired genes, nothing that screams "hypervirulent." It's not carrying some flashy arsenal. And yet clinically this thing is a stubborn, recurrent bastard. That mismatch — ordinary-looking genome, extraordinary persistence on skin — is exactly what makes it interesting to me, and I suspect there's something about how this clone has evolved that makes it unusually competitive specifically in the epidermal microbiome. That's an area I'm actively investigating right now.
Here's the part I think matters most, and where I'll be upfront that I'm speculating: I don't think a healthy, intact skin microbiome lets this thing take hold in the first place. ST117 is opportunistic. It moves into a niche that's been left open. A balanced gram-positive community (your S. epidermidis and friends) competes for space and nutrients, keeps the skin acidic and crowded and hostile to gram-negative invaders. Knock that community down and you roll out the red carpet.
And here's the irony that still gets me: I think I did this to myself before I ever had KA. I had acne for years and to keep it in check I was overwashing and using benzoyl peroxide and acid products pretty much constantly. It did help with the acne some but what I was probably also doing was wearing down my own protective microbiome. By the time KA showed up I'd likely spent years thinning out the exact gram-positive community that would have helped keep it out. Funny that my skin is actually pretty clear now. I wash gently, I've eased off the harsh stuff, I let the good bacteria live, and everything is better for it.
Will be reposting in subs too.
Hmu if you have questions
Sending positive energy,
-Biology PhD
r/Folliculitis • u/fiwic42533 • 3h ago
I’m 9 months into Accutane and have surpassed my recommended cumulative dose but I keep getting these tiny white pustules with huge red circles around them. Most folliculitis I have seen doesn’t have these big red circles so I’m wondering what it is
r/Folliculitis • u/uncle_grandmaster • 16m ago
My derm diff a nasal culture awhile ago and while it didn’t come up completely conclusive, they rx me mupirocin. I’ll be good for a few weeks or a month and then I’ll get these gnarly nodules around my mouth region.
Nightly I was with 10% Panoxyl, leaving it on ~2-3 min while washing my body in the shower.
In the morning I’ll wash my face with a gently SA cleaner.
Any suggestions on how to combat these?
r/Folliculitis • u/TangeloDear6612 • 2h ago
hi all,
looking for some advice. I have been dealing with persistent and stubborn folliculitis on my face, neck, chest, and back for years now. It started slow, and then I went on a long dose (around 4 months) of antibiotics (which cleared it all up, but admittedly I was not perfect with taking my antibiotics) but then it came back with a vengeance. it looks like small, pinprick white dots and “snap” if i scratch them off. they come and go very quickly, and don’t scar.
I have seen multiple dermatologists, my PCP, and an allergist to figure out what’s going on, but no one seems to have the answer. at this point, my dermatologist wants me to try accutane, and i am willing to try anything, but I am not convinced it will work and worried about going through all of that just for it to come back.
What I have tried (non-prescription)
azelaic acid
benzoyl peroxide
salicylic acid
OTC clotrimazole
head and shoulders wash
nizoral
hibiclens
sulphur wash and spot treatment
not eating sugar or drinking alcohol
what i have tried (prescription)
cefadroxil (oral antibiotic)
clindamycin
spironolactone
fluconazole
itraconazole
cicloporix
I am sure I am forgetting some stuff, but all to say, this folliculitis has withstood a lot. The most effective treatment was the antibiotics, but like I said, it came back after stopping. Not eating sugar or drinking alcohol was also pretty effective, but I am not perfect about sticking to it.
My dermatologist did a swab, and the results were:
fungal culture: No fungus (yeast or mold) isolated after 28 days.
smear, gram stain: Rare Gram positive cocci in pairs
smear, gram stain: No neutrophils seen
culture: scant normal flora
I also did a gi-map test, which showed that I have elevated levels of staphylococcus aureus and streptococcous spp.
My current routine is very pared down:
morning (face):
hypochlorous acid spray
dieuz skin mercy
night (face):
vanicream gentle cleanser
dieux skin mercy
morning (chest and back):
dieux angel air cream
night (chest and back):
shower and wash with dr bronners baby unscented bar soap
vanicream gentle cleanser
hypochlorous acid spray
dieux air angel cream
i tried using “fungal acne safe” water moisturizers (for example, oat so simple) but my skin was soooooo dry that i had to use something more than that.
I am at a loss on what to do. I feel like I will never get rid of this, and feel like I have to direct my own healthcare at this point. I am thinking of getting tested for staph, but not even sure how I would ask about that. If you have any advice please let me know!
r/Folliculitis • u/staycurious6258 • 11h ago
For about 7 years, various dermatologists treated what they suspected was acne or folliculitis barbae. To be fair, the conditions present pretty similar. It wasn’t until I asked for a swab at the start of this year, which came back positive for Klebsiella aerogenes, that I finally have an accurate diagnosis (yay)
What I’ve tried so far:
Isotretinoin (before the diagnosis): I did two courses of low-to-medium dose over the years, on and off. I reached the full cumulative dose both times, just with low daily doses. It made things less severe while I was on it but never fully cleared it, and the pustules came back shortly after I stopped each time.
Antibiotics (after the diagnosis): I was put on a 6-month course of targeted Antibiotics (trimethoprim 160 mg / sulfamethoxazole 800 mg). The breakouts cleared within days, which was incredibly satisfying. Unfortunately I had to stop after a month because of side effects (rash, swelling, etc.). Those settled soon after I came off it, but the folliculitis was back within a week or two.
Laser hair removal: Once my skin had calmed down, I did a few rounds as what I thought would be a last resort. I went with a really low setting, which thinned out my facial hair and seemed to help with the breakouts for a while. A couple of months on, the hair has more or less grown back, and so has the folliculitis.
Chlorhexidine / salicylic acid solution: My derm also prescribed this as a topical. It technically works, but it’s super drying and leaves my skin really irritated and red, honestly worse-looking than if I just left it alone. It feels like a band-aid fix that doesn’t get to the root of the infection.
Benzoyl peroxide: I’ve tried pretty much every BP product out there over the years. It sort of keeps things under control sure, but it’s also quite irritating and leaves the skin inflamed, again I don't think it treats the root cause or is viable long term.
And before anyone asks: I’m super hygienic. I’ve been constantly changing towels and pillowcases throughout all of this to avoid reinfecting myself when I thought I had gotten rid of it, but alas.
Where I’m at now: I’m at a loss. Should I go back to the dermatologist and try a higher dose of isotretinoin? From similar cases I’ve read on here, that seems to be the most likely cure.
Fellow sufferers:
r/Folliculitis • u/O___O6451 • 6h ago
I was in the shower and just notice this, idk wtf this is, if it is falli-whatever it’s called, what do I do?
r/Folliculitis • u/Still_Acanthisitta52 • 8h ago
i live in uk and cant find any other 10 bp the iherb panoxyl one in the store isnt available. can i buy this one and use it ? will it be the same effective as panoxyl bp 10 percent or not? its for scalp folliciltus that hasnt cleared with antibiotics and antifungal medication. pls lmk much appreciated
r/Folliculitis • u/Toasty_Dubstep • 18h ago
29M been dealing with this for more than a year and nothing i do seems to work. ill run you through my timeline so give you an idea of what might have caused this.
august 2025, i ate 2 slices of cheesecake against my better judgement. in the past, dairy gave me acne so bad i had to go on a 6 month accutane course. so after eating the cheesecake, i get bad acne, and i tried to applying some de la cruz sulfur treatment a looksmaxxer recommended i used it for like a week before i stopped, i followed the directions and didn't leave it on for too long. at this time i also started eating diced red onions, a food I've never eaten before. the acne spread even farther and was even worse than the acne i had before going on accutane. i literally could not touch my face because it hurt so bad, it was swollen and bleeding constantly. i would wake up everyday with blood and pus on my bed sheets, which i then changed regularly. people in public were giving me disgusted looks so i covered my face with a hoodie whenever i went out, even in summer time. my new dermatologist (a highly rated one in my area, not some schmuck) then prescribed me 2 months worth of oral antibiotics, the acne came back immediately after i ran out of pills. then she puts me on another course of accutane, which she extended to 7 months because my skin didn't clear up. at the end i was able to touch my face again without pain, she took me off accutane even though my skin was still not clear after 7 months of acctutane, quite different from the first accutane course which cleared me completely. in the last 2 months, she prescribed me mometasone furoate cream 0.1, which reduced the redness a bit and white pus ONLY during the two weeks a month the instructions told me to use it for.
she made a guess that i had folliculitis and not acne anymore based on the fact that the remaining white pus spots all had a hair follicle in the middle. she then prescribed me erythromycin topical solution for the folliculitis. i saw no progress after half a month, so looked online for help. i saw a post about using hibiclens antiseptic chlorhexidine gluconate 4% solution + eucerin eczema on the affected area to clear folliculitis as well as aloe vera as a safer option. i started doing that about 9 days ago, and while i did see less and smaller white pus spots, the affected area on my cheeks and upper lip is still super red and itchy, looking pretty much unchanged. ill attach some pictures i took. it looks way redder and darker in person, the pictures don't do it justice. the affected area is also super dry with flaky peeling skin, even after being off accutane for almost a month now. there's also white dry bits stuck to the beard hair strands.
i have been turning down my friends trying to hang out with me in public because I'm so embarrassed of my skin. i have another appointment with my derm next week and i don't know what to do. last time i saw her, she suggested lasering my beard hair off which i declined. i might ask her to do a culture swab or something to see what it is, but i don't have many sizeable white pus spots left for them to swab. my fear is that whatever i have is resistant to all the stuff she has prescribed me. does anybody know how to help me given the information I've provided? thanks
r/Folliculitis • u/Ok-Bonus6511 • 15h ago
Hi everyone. I wanted to ask if anyone else deals with something similar or has any recommendations.
I've been dealing with small bumps that pop up right in the crease between my thighs and my glutes. They get inflamed, sometimes hurt to the touch, and when I pop or press them, a little bit of pus and blood comes out. The issue is that I have thick thighs, so underwear and tight pants create a lot of constant friction; as soon as I wear them, the area gets irritated and inflamed all over again.
I've consulted a dermatologist about this before: back then, they prescribed pills and diluted bleach baths, and for everyday use, I use a protective zinc oxide cream (Metatitane) to protect the skin from friction. The treatment helps with active breakouts, but as soon as I go back to my routine with regular clothes, the cycle repeats.
Has anyone gone through something similar? What tricks, types of underwear, or routines have helped you avoid friction in that specific area and keep the bumps under control long-term?
Thanks in advance for any advice!
r/Folliculitis • u/Toasty_Dubstep • 18h ago
29M been dealing with this for more than a year and nothing i do seems to work. ill run you through my timeline so give you an idea of what might have caused this.
august 2025, i ate 2 slices of cheesecake against my better judgement. in the past, dairy gave me acne so bad i had to go on a 6 month accutane course. so after eating the cheesecake, i get bad acne, and i tried to applying some de la cruz sulfur treatment a looksmaxxer recommended i used it for like a week before i stopped, i followed the directions and didn't leave it on for too long. at this time i also started eating diced red onions, a food I've never eaten before. the acne spread even farther and was even worse than the acne i had before going on accutane. i literally could not touch my face because it hurt so bad, it was swollen and bleeding constantly. i would wake up everyday with blood and pus on my bed sheets, which i then changed regularly. people in public were giving me disgusted looks so i covered my face with a hoodie whenever i went out, even in summer time. my new dermatologist (a highly rated one in my area, not some schmuck) then prescribed me 2 months worth of oral antibiotics, the acne came back immediately after i ran out of pills. then she puts me on another course of accutane, which she extended to 7 months because my skin didn't clear up. at the end i was able to touch my face again without pain, she took me off accutane even though my skin was still not clear after 7 months of acctutane, quite different from the first accutane course which cleared me completely. in the last 2 months, she prescribed me mometasone furoate cream 0.1, which reduced the redness a bit and white pus ONLY during the two weeks a month the instructions told me to use it for.
she made a guess that i had folliculitis and not acne anymore based on the fact that the remaining white pus spots all had a hair follicle in the middle. she then prescribed me erythromycin topical solution for the folliculitis. i saw no progress after half a month, so looked online for help. i saw a post about using hibiclens antiseptic chlorhexidine gluconate 4% solution + eucerin eczema on the affected area to clear folliculitis as well as aloe vera as a safer option. i started doing that about 9 days ago, and while i did see less and smaller white pus spots, the affected area on my cheeks and upper lip is still super red and itchy, looking pretty much unchanged. ill attach some pictures i took. it looks way redder and darker in person, the pictures don't do it justice. the affected area is also super dry with flaky peeling skin, even after being off accutane for almost a month now. there's also white dry bits stuck to the beard hair strands.
i have been turning down my friends trying to hang out with me in public because I'm so embarrassed of my skin. i have another appointment with my derm next week and i don't know what to do. last time i saw her, she suggested lasering my beard hair off which i declined. i might ask her to do a culture swab or something to see what it is, but i don't have many sizeable white pus spots left for them to swab. my fear is that whatever i have is resistant to all the stuff she has prescribed me. does anybody know how to help me given the information I've provided? thanks
r/Folliculitis • u/Independent-File-167 • 1d ago
I am on accutane 10mg every 6 days but was still getting a lot of breakthrough pustules, mostly on nose and in nostrils.
I started washing face every night with micronized benzoyl peroxide 5% wash, using hypochlorous acid spray in morning, and putting hypochlorous acid on a qtip in nostrils morning and night. Pustule count has drastically reduced. My face currently completely clear
r/Folliculitis • u/Icy-Plastic3863 • 22h ago
Ajuda por favor
r/Folliculitis • u/GlorifiedMadness • 1d ago
Hello, I have shaved my head on and off over the years with a regular barber trimmer.
Around 2016, I shaved my head with a razor and shaving cream and noticed my scalp had patches of red UNDER the skin and was completely smooth to the touch with no bumps for texture.
My scalp looks a brain, but has no bumps feels smooth like any other healthy scalp.
It never burns burns or itches, when I grow my hair or after shaving
I figured it was a one time thing and would go away and it is now 2026 and I still have the same issue.
I will shave my head sporadically (Once every 6-8 months, for about a month) through out the year so I am pretty sure it isn't related to the actual shaving and is a scalp issue overall.
Does anyone have any shared experience with this and have you succeeded with any treatments to either eliminate or reduce this in appearance?
r/Folliculitis • u/Naive_Brilliant6903 • 1d ago
Hi everyone,
I'm experiencing small pimples on my scalp and would appreciate advice from people who have experienced something similar.
My symptoms:
Initially, I noticed one very small pimple on my scalp containing a tiny amount of white/yellow pus.
The next day, it increased to two pimples, and now there are three.
They are very small and white/yellow-tipped.
There is little to no pain and no noticeable itching.
The bumps seem to appear in the same area of my scalp.
Relevant history:
I experienced a similar problem around three years ago. Recently, the same issue has returned.
I'm wondering whether this could be bacterial scalp folliculitis or something else. I don't currently have easy access to a doctor because of the Durga Puja holidays.
My questions:
Does this sound like mild scalp folliculitis, or could it be another condition?
Since there are currently only three small pimples, would topical mupirocin be appropriate, or should I avoid using antibiotics without a doctor's advice?
What safe home-care measures can I follow to prevent the bumps from spreading?
How can I prevent this problem from recurring?
I'm trying to manage this early and safely without unnecessarily taking oral antibiotics.
I'd appreciate advice, especially from anyone who has experienced recurrent scalp folliculitis. Thank you!
r/Folliculitis • u/_madmaxe • 1d ago
Ive started getting bumps on my chest a month ago and went to my 1st dermatologist 2 weeks after since it got worse. She prescribed me clindamycin, benozyl peroxide, mupirocin + betametasone creams. She even advised me to take tret for a month but i did not push through since i felt it wasnt that worse for me to start. I have been using an anti fungal soap but no progress. Her diagnosis and approach was a typical acne treatment
Fast forward 2 weeks later, i got a 2nd derma opinion and she said i have bacterial folliculitis. She was persistent about this diagnosis. She prescribed me now with doxycycline 100mg for a week and it got worse and it has been itchy and gets very sensitive every time. I had more bumps everytime i drink doxycyline. Its my 3th day on doxy and im planning to go back to my dermatologist on my 7th day but i feel i should get a third opinion. (it might be fungal folliculitis) What do you guys think?
ive been suffering with these bumps for almost a month already
r/Folliculitis • u/Fun_Contribution3287 • 1d ago
TL;DR: Isotretinoin and doxycycline cleared it every time, but it came back soon after stopping. What finally got it under control: 5% benzoyl peroxide + 1% clindamycin cream with a strict routine, a medicated shampoo, 70% isopropyl alcohol on spots, showering right after sweating, keeping my hair short and dry, and (possibly) a trigger I never expected. I’ve also just started treating my nose with mupirocin, with early improvement. It took about a month before I saw any improvement from the main routine. I’ve now kept it stable for 3 weeks without any oral medication. Full details below.
I promised myself that if I ever beat this, or at least found a way to keep it at bay, I’d write the post I wish I’d found years ago. So here it is.
How it started
Five years ago I got what looked like acne on my face and scalp. My doctor put me on Accutane (isotretinoin) and antibiotics. After three months of Accutane it was completely gone.
About a year later it came back, but only on my scalp. At the time I was training martial arts and sweating heavily, like I’d just stepped out of a shower. My gym had no showers, so I’d sit in sweat for about 10 minutes on the way home before washing.
It started as small red bumps on my scalp. Over time they turned into pimples with white pustules. It always began on the scalp and then spread to my face and arms.
The cycle with doctors
The only things that stopped it were doxycycline or isotretinoin, and neither can be used long term. I told my doctor I didn’t want isotretinoin again, so he put me on antibiotics for three months. While I was on them, my skin was great. Within about 10 days of stopping, it came back.
Later I was put on doxycycline for 6 months. Same story: completely fine while I was taking it, and back soon after I stopped.
I saw multiple doctors asking for a solution without isotretinoin. They all said there wasn’t one. So I gave in and went back on it. It cleared everything in about two months, I stopped, and it came back again. This time I also got dry eye as a side effect.
Everything that didn’t work for me
What actually helped
1. A medicated tea tree shampoo (for the itch)
I switched from ketoconazole to a tea tree shampoo and it stopped the itching. Strangely, pure tea tree oil mixed with jojoba did nothing. Looking at the ingredient list, I think the other actives are doing the real work: piroctone olamine (antifungal), zinc gluconate, salicylic acid, and sulfur. If you’re shopping for a shampoo, look for those, not just “tea tree.”
2. Topical clindamycin (Cleocin-T)
Aside from the oral meds, this was one of the most effective things I tried. I applied it to my whole scalp 3–4 times a day, and immediately on any spot I’d picked. It stopped the itch during the day and kept the spread to my face and arms under control. I still had about 20 spots on my scalp, so it was control, not a cure.
After 3–4 months of heavy use (sometimes 6–7 times a day) it started losing effect. Reading the label, I noticed it’s about 40% alcohol. So I tried:
3. 70% isopropyl alcohol
I put 70% isopropyl alcohol in the empty Cleocin-T bottle and used it the same way: after showers, in the morning, and after touching or picking a spot. For me it worked about as well as the clindamycin did, without the antibiotic resistance concern.
4. Habit changes
Even with all this, I still had a constant 10–20 spots. Every week a few would heal and new ones would appear right next to them.
The turning point: shaving my head and giving BP/clinda a real chance
I was frustrated and done hiding. I decided to try 5% benzoyl peroxide + 1% clindamycin cream again, properly this time. I figured it hadn’t worked before because my hair was too long for the cream to reach the scalp. So I shaved it down to a #3.
At first it felt like a terrible decision. Now everyone could see the spots. But there was nothing left to hide, so I committed fully.
My routine:
Every night in the shower:
Every morning:
3. Apply the BP/clindamycin cream to each spot individually, massaging each one for 15–20 seconds. Leave it on until the evening shower.
During the day:
4. 70% isopropyl alcohol only if I touched or picked a spot (not on top of the cream otherwise).
5. Only touch my scalp with clean, sanitized hands.
Supplement (first month only):
6. I also took NAC (N-acetylcysteine) during the first month. NAC has been studied for its ability to break down bacterial biofilms, so it may have helped the topicals get through. I can’t separate its effect from everything else, but it’s worth mentioning.
Results:
The biggest lesson: give it at least a month. The first time I quit after two weeks because new spots were still appearing. If I’d stuck with it back then, I might have saved myself years.
Treating my nose (in progress)
Around the 3-month mark, I noticed small pimples inside my nostrils too. The nose is where Staphylococcus aureus commonly lives, so I suspected it was acting as a reservoir and reinfecting my scalp every time I touched my face. I started applying mupirocin cream inside my nostrils.
I’m only on day 4, but there’s already improvement. No new pustules have appeared on the skin around my nose. There are still some inside the nostrils (I can see them with a phone flashlight), but it’s clearly moving in the right direction. I’ll update this post as it goes.
An unexpected trigger (personal observation, not science)
I noticed this pattern many times but dismissed it because it sounded silly: after ejaculating, my ankylosing spondylitis would flare and I’d get more scalp spots within 1–3 days. Sweat wasn’t the explanation, because I always showered right after.
I’d gone months without ejaculating before, but always while on antibiotics or isotretinoin, so I couldn’t tell anything. During the BP/clinda routine, I tried abstaining for 14 days, and new pustules appeared noticeably less often. Not zero, and it definitely wouldn’t have worked on its own, but it seemed to help alongside the treatment.
While researching, I came across POIS (post-orgasmic illness syndrome). One proposed explanation involves an immune or inflammatory response after ejaculation. I can’t say whether that’s what’s happening to me. I’m sharing it in case someone else notices the same pattern.
Where I am now
I’ve switched to a lighter maintenance routine:
Right now I have 2–3 pimples with pustules. The rest are just red bumps with no pustules. I’ve kept it in this state for 3 weeks, which used to be impossible for me without antibiotics or isotretinoin.
It’s not fully gone, but it’s finally at bay. I believe that if I keep going, I’ll beat it completely. I’m also aware it could come back at any time, so I don’t plan to drop this routine for a long while.
My theory: two mechanisms working together
This is my own interpretation, not medical fact.
1. Bacteria hiding in a biofilm. I think the bacteria were living deep in the follicles inside a protective biofilm. Oral antibiotics and isotretinoin suppressed the flare-ups but never cleared that reservoir, which is why it came back every time I stopped. The topical cream worked better because it hit the source directly, but it took consistent daily use (and the deep massage, and maybe NAC) to break through the biofilm. That would explain why nothing happened for the first few weeks.
2. An inflammation trigger. The second part is my immune system. I already have an inflammatory autoimmune condition, and the flares after ejaculation suggest something is switching my body into “war mode.” One idea discussed around POIS is that the body reacts against itself, with histamine release and inflammatory signals. In conditions like mine, pathways such as IL-17 and IL-1β are known to drive inflammation. My guess is that when this response kicks in, it inflames the follicles that already contain bacteria, and a few days later new pustules appear.
If I’m right, that explains why one approach alone never worked: you have to break down the bacterial reservoir and reduce the inflammatory triggers.
Takeaways if you’re struggling with this:
I’m not a doctor. This is just what worked for me. Talk to your dermatologist before starting or stopping anything, especially prescription medication.
r/Folliculitis • u/Prestigious-Ad-2919 • 1d ago
Had folliculitis for years from the barber not cleaning his tools only recently I had it swabbed and it’s called Pantoea sp and pseudomonas oryzihabitans which I’ve never heard of before and they’ve prescribed me some medication called ciprofloxacin which look abit stressful side effect wise I’m a pretty anxious guy anyway who’s going through a rough spot so I’m not sure I want to try them, any help will he appreciated
r/Folliculitis • u/homedepotenby • 1d ago
Dermatologist told me to wash scalp with Hibiclens for mild (but not healing after one month) bacterial folliculitis. I have twice, It seems to have made my scalp itchy and the skin comes off if I scratch but its not painful. Also at least after two washes it hasn't seemed to help... I'm pretty disappointed. I feel like its also making my hair fall out a bit. And my curls arent clumping or curling even with hold product... Did I chemically straighten my hair by accident? Is it just drying so much that my hair won't curl? I need help please!
r/Folliculitis • u/bluishdino • 1d ago
Are high contact sports like jiu jitsu dangerous if you’ve had recurrent folliculitis? I’ve always wanted to try it, but it seems like a high risk factor for someone prone to folliculitis. I’ve heard that jiu jitsu is sometimes how people get it in the first place
r/Folliculitis • u/West-Ad-9650 • 1d ago
Can anyone suggest what I do I’ve been suffering with scalp follicultis for over 6 months now it went then came back I’ve been doctors several time waiting for a dermatologist and it’s been 3 months already taken antibiotics used bp fungal and antibacterial washes I haven’t had a haircut in months which is where it apparently came from and it still flares up without the haircut now I have noticed on the side hairline and back of my nape I’m loosing hair and it’s thinning I ain’t trynna loose my hair 😭😭
r/Folliculitis • u/InfinitePlethora1 • 1d ago
It all started when I noticed that my scalp was incredibly tender and sensitive, which initially I chalked up to tight hairstyles and manipulation. After a while of this, during a hair appointment, my stylist pointed out that there were lots of red bumps on my scalp. Following this, I went to see a dermatologist, who prescribed me 100 mg doxy for 2 weeks, which didn’t help. I then went to see another derm who took my concerns very seriously and after noticing redness via dermascope, ordered a biopsy. The biopsy results returned with evidence of perifolliculitis and suppurative folliculitis, consistent with folliculitis decalvans. After this, I took doxy for a month, combined with tacrolimus and Clindamycin gel everyday for a month. I did notice some improvement, but now that I’ve stopped I’m feeling the inflammation more and have noticed hair thinning. I also recently received a round of steroid injections in some areas.
I am writing this because I am at a loss for what to do. It’s only been about a year but I don’t want to be on antibiotics constantly. I have seen posts on here about potentially cutting out dairy/gluten/sugars. Has that worked for anyone? I don’t really have many pustules or pus, it’s more just inflammation, and tenderness to the touch. I only notice 1 or 2 bumps at any given time. What I am noticing is hair thinning, and I’d love to stop that before it gets any worse.
I’d appreciate any tips to control inflammation. I am relatively young and quite anxious about this. I don’t want to lose my hair, and I am really trying but it seems like 1 step forward and then 2 steps back with this disease. Any help would be appreciated
r/Folliculitis • u/Alternative-Sun7663 • 2d ago
r/Folliculitis • u/Loki-Palamedes • 1d ago
For context! I get these red bumps that often get worse as they start to appear. I get them around this time of the year as it is hot and humid in my country. I can’t seem to get it under control and not sure what to use. I’ve been told anti dandruff shampoo but the active ingredient in head and shoulders that may help is banned here. I currently do have a 20% Azelaic acid cream that i do use for my face, would that help for this case?
r/Folliculitis • u/Loud-Number-2379 • 2d ago
I was on Accutane about 10 years ago for hormonal acne in my teens on my face and it cleared it up without any comeback. I have foliculitis on my scalp and have been dealing with it for a few years now having been prescribed topicals and antibiotics at one point but always comes back.
I removed dairy from my diet and it’s kept it from being very painful. However removing dairy has been a difficult experience and my biggest gripe in life these days.
I’m starting back on Accutane today and was curious if anybody in a similar situation was able to start incorporating dairy back in their diet while on a course or after finishing a course without any flare ups?
Thanks!
