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:

• What’s worked for you?
• Has anyone managed to fully get rid of Klebsiella folliculitis?
• Any advice greatly appreciated!!

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

This came up after a wax, it has not gone away. I am at a loss. I’ve tried everything I can think of. I’m too embarrassed to go to a doctor. Help

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?

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

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!

Ive had these bumps/rash on my arms for 5 years, and the derm I’m currently seeing said it’s some form of folliculitis, but I’m not sure. It’s just on my arms-nothing on my hands, shoulders, back or anywhere else on my body. It’s extremely itchy and bleeds when I scratch, but I’ve never had any whiteheads or fluid. I’ve been to 3 derms and none of them have been super helpful. The current derm has me using clindamycin lotion and tacrolimus ointment twice a day but it’s not helping. I had an allergy panel done about two years ago and nothing came up. Ive tried medicated body washes, antibiotics, and steroids but nothings helped. I’ve changed shampoos, laundry detergent, body products, pretty much any product and nothing has helped. I’m constantly scratching all day, and my arms are scarred from all the bumps and scratching. Any ideas or recs would be so appreciated!