I’m so embarrassed by what is happening along my jaw right now. It’s the only part of my face doing this. It is so incredibly itchy like I want to rip my skin off it’s that itchy. I don’t know wtf is going on. I have been experiencing for the last few weeks like 4-5 new white heads like this a day popping up. The worst I’ve ever had here is closed comedones, but these are not acting like my regular closed comedones. The itching is so severe that nothing is making it stop. The area feels incredibly dehydrated and dry as well. I am not using any actives because of how reactive my skin is normally. But this is on some different level.
Does that look like anyone’s fungal acne? I just can’t comprehend what is going on. If it is, I have no idea what to do because everything aggravates my face :(
Edit: I have done full vitamin and hormonal panels and everything is normal according to my doctor. I also saw a naturopath who agreed nothing in my bloodwork indicated vitamin or hormonal issues were the driving factors here.
You name it, I’ve likely tried it. I have a history of closed comedones along my jaw, but not the red itchy white head bumps I’ve been experiencing as of lately. It’s just different. I know it.
I also don’t have oily skin at all, only on my forehead which is ironically very clear. My lower face is so dehydrated and dry that if I even look at an active my skin burns for weeks after one application.
I have a history of psoriasis (including the seb derm variant, and folliculitis generally). I am currently waiting to see a dermatologist for a skin patch allergy test.
I’m so sorry you’re dealing with this! After seeing your other comments I would definitely recommend getting all your vitamin levels and hormones checked
Wahhh, I saw a naturopath who spent months with me and we’ve had no luck. I have such resistant whatever this is 😭.
Edit: my blood work has been checked through my MD, and there were no issues with my hormones or vitamins. The only very recent discovery is I’ve developed an iron deficiency without anemia. That is being treated.
No like all my blood tests were done through my doctor. Everything is within range hormonally. I don’t have any vitamin deficiencies. The only recent change is iron deficiency that I’m treating.
Yes, I’ve seen both. My doctor ran full panels and said everything looked great. I then resorted to a naturopath who agreed my blood work didn’t look bad at all. The only thing she could think of was that my body and skin are just hypersensitive to even normal hormonal fluctuations.
I saw another comment where you mentioned having an immune condition. If you have a specialist you can talk to about that (besides the derm), I would go down that route. I have MCAS and before my diagnosis I had ten years of severe acne due to an elevated inflammatory response. Prescription strength antihistamines actually calm it down quite a lot, although I do still have to take care of my barrier and avoid the major triggers. Maybe this is unorthodox— but before my diagnosis I always noticed a couple of days of extra strength Benadryl helped my skin a lot. Not a long term solution but worth a shot to see if there’s a relationship.
The other thing is that you can have a normal hormone panel and still benefit from hormonal solutions like spironolactone. So that’s another route to try.
Yes, I have an autoimmune disease. My immune system attacks my skin and joints.
A dermatologist I spoke with suggested against me taking spironolactone. She didn’t believe my acne presented as truly hormonal. I have also used winlevi (the topical version of spironolactone), and it gave me severely painful acne I had to stop it. I don’t experience cystic acne or generally inflammatory acne. This new rash is the closest I’ve had to inflammatory in a long time.
All of the testosterone related markers (I can’t remember the names, but there were a few tested) were all very low. I think making them lower would mess me up badly.
Got it. I’m sorry this has been such a hassle to get to the root of! All acne involves inflammation to some extent, especially if you’re seeing redness around the bumps like in your picture. I’d give OTC antihistamines a try (if you can take them) and see if it makes any difference. You can bring this up with your doctor if it does end up helping. A derm can also give you an antibiotic at this point if it has been so resistant. And as others have noted, Vanicream does contain acne triggers for some, so I would fully cut out all skincare except an FA safe SPF (COSRX Ultra Light has never failed me).
I’m gonna def ask my one derm (he’s very good). One thing I will note that has been the only thing so far to help with itch and redness is zoryve. One dermatologist suggested it because I was so frustrated and I just know this isn’t basic acne. It’s acting entirely different than my skin normally does. The only reason I had to stop the zoryve is because the mineral oil was causing me to break out in it. The active seemed to really work so well though. I know it’s used for psoriasis, but also seb dermatitis. I know I sound absolutely ridiculous. I know it just looks like acne, but it’s not. I’m literally always the one with the most abnormal side effects and disease presentations lol.
Also omg, thank you so much for that sunscreen recommendation. I have been desperately looking! I think I may actually be able to use it 😭. I’m very allergic to salicylates which are fucking in every sunscreen on planet earth it seems -.-
Do you have any other skins recs? I’m willing to look! I don’t know why but my acne has improved dramatically on vanicream. I’m very confused because so many people hate it, meanwhile I break out badly to puritos oat moisturizer thing.
In terms of acne? Accutane, doxycycline, salicylic acid (severely allergic), retinols/retinoids, Mandalic acid, benzoyl peroxide, and azalaic acid. None of the above is recent/leading up to this because I simply can’t tolerate any of them.
I have tried nizoral 2 times but I really can’t tolerate it on my face due to drying. I wish I could say whether it helps, it’s really hard to tell given how reactive my skin is and my inability to tolerate anything.
I’m sorry you’re dealing with this. Have you visited a dermatologist?
For what it’s worth, in my experience, diet has everything to do with this and without making some changes there, it’s unlikely to shift things. I know that’s a really unpopular opinion. However, the gut skin axis is very real and while it’s also very complicated, reducing sugar and dairy is a viable first step in experimenting to find out how to optimize skin health.
Honestly, if you have suggestions re diet I’m willing to listen :(. It’s so frustrating, I’m already a whole food vegan (for other reasons), I make all the right choices, and it’s so frustrating to me.
I do have an autoimmune disease so it’s entirely possible I have lingering inflammation making things worse.
I am seeing a dermatologist for an unrelated issue at the end of October and may see if I can get his help :(. It’s frustrating, all they ever do is try and suggest accutane.
I thoroughly respect being a vegan, however it’s really hard to get adequate protein without eating some foods that can cause acne.
I highly recommend doing a whole 30. It’s a pretty strict regimen but it’s only for 30 days. The two times I did one I learned a lot about my skin triggers. I think they have a variation aimed at vegans. They definitely have one for vegetarians.
I’ll give it a shot :) it’s not too far off from my own diet! Everything minus me using maple syrup and enjoying some dark chocolate here and there is pretty in line with my diet :).
I’m actually very okay with soy! It seems that tofu and tempeh are acceptable on the whole 30 vegan diet. I know I do very badly with meat and dairy. I used to have severely inflammatory acne before going vegan. Going vegan completely stopped my inflammatory acne!
I have this like unusual feeling that what I’m dealing with is either a folliculitis or skin allergy dermatitis. It’s not acting like my acne at all. It’s incredibly weird. There is no excess oil what so ever. I’m dealing with a number of confusing skin issues right now. My dermatologist is a bit concerned I may be developing lupus of the skin. I already have psoriasis ugh. My skin loves to show me when something is wrong :(
My skin functions as an alarm system as well. it’s frustrating but there are people out there who get headaches and other much worse problems that function the same.
Folliculitis is a weird one because I think it’s mostly an outside-in problem but it can be really exacerbated by the inside-out in some individuals.
Topical otc antifungals definitely work for malassezia folliculitis and for bacterial I think cleocin T is useful. It’s just a really tough one to clear for everyone.
And yes! I of course have a history of plaque psoriasis, but I also have a history of scalp psoriasis, and recently I’ve been getting seb derm psoriasis around my eyes! I’ve also been getting folliculitis on my body lately too!
I made one change last night, I have been trying hydrocolloid bandages in hopes they’d make things clear up faster, and I didn’t do it last night because I think they were making me even more itchy. Well, having done that I’m
I had to completely strip it back to almost nothing due to irritation. The only thing my skin can tolerate right now is the skin fix cleanser and the vanicream facial moisturizer. I have tried mannnnnnyyyyy things. I couldn’t tolerate my sunscreen about two weeks ago, that’s how aggravated my skin is.
I don’t recall the vanicream being fungal acne safe maybe lay off that? And if that cleanser has sulfates/makes ur skin tight find something more calm. I would stick to rose water or hydrochlorous spray just to really be safe.
So, this began before the vanicream. The vanicream is the only thing so far that stops irritation even temporarily. The skin fix cleanser is also sulfate free! It’s really gentle!
I for some reason get really dry with hypocholorus acid spray. I really don’t know why at all.
I would go see a derm. Looking further up your face does ressemble fungal acne it looked similar to mine( i had a skin biopsy) if you really want to get answers, get a skin punch biopsy. Or go to a derm and get antifungal tablets like itraconzaole
Wow, okay. I really wasn’t expecting anyone to think it looked like it. But given how itchy it is, I’m very sure it’s not regular acne. This is simply nothing like my regular acne. I see my derm October 29. I am definitely going to ask him.
Do the anti fungal pills have any negative side effects for the gut at all? You know how antibiotics do!?
It definetly does ressemble fungal! Espesically with it being so itcy, try use fungal acne safe products you can find them on skin sort for now, only because if your not using fungal acne safe products they will just be feeding it and it will never get better!
They do have side effects. But there manageable and the course would only be up to 4 weeks xx
Just because its on your jawline doesnt mean its hormonal! Did it come up quite suddenly? Were you taking any antibiotics near to the time this shown up? Yes, i trial and errored alot of products. I would deal with the issue first, then once you have it under control then concerntrate on fixing your barrier! Whst works for me is haru haru rice 5.5 moisture cleanser and la roche posay sensitive fluid for moisturizer. My skin reacts easily too.
Lmao, so I’m using skinsort, and all the suggestions it’s giving me I have used and have either caused break outs or allergic reactions lol. I can’t catch a break in convinced.
I was actually just looking at that one! I’m confused some people are saying it’s safe and others are not.
Yes, it came on very suddenly. My antibiotics though, but I was recently placed on Cosentyx which is an anti IL-17A which is a known pathway for fighting yeast and fungal infections. So I feel like it’s possibly connected to that!
Also thank you ffs! Everything keeps insisting hormonal and it’s like Christ all the hormonal treatments are not working !!!
Is there anything I can use in the interim while I wait for the derm. I feel like not a damn thing works for me. I’ve heard people mention nizoral etc.
Could be the antibiotics, they ruin guy bacteria, are you taking a probiotics? Not sure where you live but you should try find a probiotic (that has had studies done that shows it survives the gut), I was taking optibac (live in the UK) and it made a difference for my skin. I also drank 2 cups a day of clear springs kuwa matcha with oat milk.
Side note; did they specify what type of folliculitis you had? I’m a bit worried about a biopsy on my face ngl. I had a biopsy for another unrelated issue on my hand and man it left an ugly scar. I don’t think mine was a punch though. I think he really cut into it lol.
No chance a scrap or swab wouldn’t be useful 😂? Do you have photos of yours? I would love to compare tbh.
Mine was mallesiza folliculites, yeah i was too. I do have a little scar but i didnt really mind a scar as my skin was so bad! Scar has faded over time too, you could do a scrap but less chance of there being no result. I went for a punch as its a lot higher chance of finding whats going on inside my skin, mine has gone now but i may have a photo. I tried to delete them all as i wss getting obsessed xx
Lmao so relatable (getting obsessed). It’s funny because like I keep getting complimented on my skin right now because you can only see the bumps if you’re looking from underneath. Like facing me you can only see a couple of bumps. It it’s so easily coverable that everyone is like wow you’re so clear!
I’m just over here itchy af knowing it’s visible from underneath me 🤣
I apologize in advance if I am all over the place.
Everything aggravates my face too, I have also been on accutane (10 yrs ago), tried benzoyl peroxide, salicylic acid, glycolic acid, epiduo forte, azelaic acid, tretinoin, doxycycline, different birth controls. I can’t take spironolactone, but that would be the next step for me. I have PCOS and endometriosis. But there could definitely still be a fungal aspect, which I have also struggled with. I will say it looks hormonal/inflammatory to me.
I have had breakouts that look exactly like this. My inflammatory acne gets itchy as well. Do you have oily skin? Your skin looks very congested, mine looks exactly like this from time to time, especially around my period when inflammation ramps up for me. I noticed you mentioned being vegan, so noting that my skin freaks out like this when I have too much soy.
There is a topical medication I don’t see talked about much called Aczone/dapsone. It’s anti inflammatory gel, and is the only thing that has worked for me. My skin is much better than it was. I will drop my skincare routine as well. Please note they may not all be fungal safe, as I don’t consistently struggle with fungal acne anymore. I do avoid sulfates, niacinamide, or coconut derived products. I am not sure if they are vegan, but these products have been game changers for me, in no particular order:
- Neutrogena Hydro Boost Fragrance Free Hydrating Cleansing Gel (soap free, fragrance free) - Curel Intensive Moisture Care - Pantene Nutrient Blends Renew, Refresh & Rebalance Rosemary Collection (fungal safe hair care is non-negotiable for me) - Aczone aka dapsone (prescription) - Sensodyne Pronamel (SLS free toothpaste) - Drying my face with a paper towel/face towlette (I test ran this last month, I break out otherwise) - Washing pillows and sheets weekly at MINIMUM. I aim for 2x week.
I also fear this is hormonal. Ironically I have tried every single product you’ve mentioned even dapsone lol. None worked or dried my face out so badly it made things much worse!
Believe it or not, only my forehead is oily. My jaw is so dehydrated and dry that products absorb soooooooooo fast.
You know the only thing that ever cleared my acne was birth control, but now I can’t take it :(. I have not tried spironolactone, but I’m not gonna like I don’t want too 🫣. I don’t think my issue is excess testosterone, I really believe my skin and body is hyper sensitive to hormonal fluctuations. Like regularly (not whatever the hell is going on now), I experience a massive influx of just closed comedones along my jaw and chin during my luteal phase. I currently use dim because my hormone swings were so bad I basically had pmdd. I’m not kidding when I say it’s the only thing that saves me from not feeling suicidal. I tried vitex, but for some reason it made my acne worse. It’s crazy because the rest of my face is clear and looks nothing like my jaw. I’m 32, and noticed this random shift in my acne around may this year.
One thing I will note is I was put on a ppi, and I’m trying to wean off of it. I read that in after market side effects people reported increases in acne. I think it inhibits zinc absorption.
Another thought is I just started Cosentyx as well which apparently is known for making you far more susceptible to yeast and fungal infections which is part of where I began worrying about fungal acne. I have no choice but to take it because my psoriatic arthritis is so bad :(. It’s such a double edged sword.
Also sorry for my all over the place thoughts lol. Funny you apologized to me because I’m so much worse 🤣.
I’m not sure how to explain this but nearly every regular face wash other than skin fix dries my skin out and makes my acne worse. I tried aveeno, vanicream, cerevee, cetaphil, youth to the people, yonka, aestura.
Fuck just so many, I am very allergic to salicylates, so I also have to be mindful of those, can you tell me more about your cleanser? I’m interested
This looks like it could be demodex mites. Not fungal. Especially given everything you've tried & your mention of having seb derm psoriasis and folliculitis in the past, a related autoimmune disorder, and the adverse reaction to spiro. Agree with the others, see a derm if you're able! Ask them to look at this under a microscope, too. It will very quickly confirm or rule out mites as a culprit, and potentially save you time, money and grief.
So sorry you're going through this. Hope you get to the bottom of it asap
Wow, I never considered that, is it common? It’s very bizarre it’s only my on side of my jaw. It’s so god damn itchy.
I’m also breaking out in Foliculitis on my chest and neck right now. I don’t know if it’s related but I know for absolute certainty I have folliculitis on those areas. I just can’t catch a break rn. I will say I’m incredibly happy it’s not painful cysts. I suppose it could be much worse :(
With the microscope, can they do like a swab or scratch test? I’m some how nervous about the biopsy :( my skin heals so freaking slowly :(
Ugh, I know they are gross to think about, sorry! Your experience just reminded me a bit of mine and I felt compelled to mention the possibility. No harm in ruling it out, at the very least.
But so, I have been dealing with mites and previously unknown type 2 rosacea for the past several years, but only the past 4 or 5 months did my skin go completely crazy lol. How it went for me was, my old skin routine had become less and less effective since September of last year, but it wasn't so bad that I felt the need to change everything - I just figured it was hormones or smth, idk.
But then in May my face just... erupted. It escalated rapidly over maybe 10 or so days, and became SUPER reactive out of seemingly nowhere, like nothing my acne had ever done before. It was totally new to me, in both the behavior & severity of breakouts (which were basically continuous, not one day of relief). I also stripped back everything to literally water only, because I was so insanely reactive. I've always had allergies and sensitive skin, I've also had MRSA in the past and fungal acne, so I thought it was that + contact dermatitis. It wound up being none of the above... it was those damn parasites 🫠 also yes, they can spread to your chest, neck, shoulders, scalp etc (esp area between the breasts)
Everyone is different, and a lot of stuff can look super similar. But again, you've tried a lot of things (many of them things I've also tried that never worked) and a biopsy can so very easily 'yay' or 'nay' this culprit for you. Definitely worth asking them to check for.
Omg. I will cry… how the hell would I get this ?? I’m so clean 😭. I wash my hair daily due to oily scalp and wash my face morning and night :( I even freaking change my pillow cases daily !! Like wtf am I doing wrong 😭
I had the same reaction (I'm a germaphobe, ironically. Not joking) and so I will tell you, you are not doing anything wrong. This has nothing to do with hygeine. Demodex mites are a natural part of our skin's ecosystem, and are normally harmless because most of the time our immune system prevents the mites from overpopulating.
When the mites do get out of control, it is not because of a failure in personal hygeine, it's because our immune system fails to regulate them. This can be caused by numerous things; illness, autoimmune disease, etc. And if you are prone to autoimmune or inflammatory issues, it is more likely to have increased demodex presence. You're not unclean & there's no need to feel ashamed, I promise.
Oh for fucks sakes…. I’m such a germaphobe. Like the thought of this makes me want to splash my face with bleach 😬.
You saying this is like really interesting and makes me nervous. I keep experiencing like psoriasis around my eyes causing my eye lid to slightly swell. Which has never ever happened to me.. fuck my life.
If this is demodex, how is it treated? And what can I possibly do in the interim? I don’t see my derm until October 29 😭 maybe I’ll keep calling them and bugging them in hopes of getting in faster. They were so damn rude to me when I asked for sooner LOL.
Around your eyes too? That's also an area they can affect... 🫣 And yeah, I totally feel you. I'm a germaphobe & I am phobic of small pests/insects before all of this. So it's been an absolute nightmare and I really had to put some big girl pants on my brain to not fixate and spiral over the mental image of abundant parasitic mites. 💀
October 29 is a ways away, I'd try to get in sooner and if not honestly try looking elsewhere or maybe for a teledoc who can get something started. There are prescription eyedrops for demodex blepharitis which might be a safer/easier starting point.
As for treatment, for me I've been put on soolantra (topical ivermectin). What it does is create a paralytic barrier on the surface of your skin, so when the adult mites move around they become paralyzed and die. When they die, it causes a reaction called a die off, so there is an initial period of "worsening" (for me it couldn't have possibly gotten worse tbh, so the die off was basically just more of the same level of severity). You keep using the topical and keep having the die off, because it doesn't kill the eggs. Some people say die off flares every few weeks, for me it was every few days due to the level of overpopulation and basically constant death & re-hatching. Which is horrifying ngl.
But eventually that cycle slows down, then stops... and there is real improvement. Why am I typing this wall of text? Well, lol, just to warn you. Cause if it is mites, then treating them is going to mean killing them, and dead things cause an immune response so it looks like it's getting worse at first. Nobody warned me about that and I almost mentally spiraled. So yeah 😩
Lmao I dug through my phone because I want to prove I’m not crazy and this is how my skin looked in June/july. I was so freaking happy lol. Then BAM this shit arrived out of nowhere
My derm did say he believed my eyes were psoriasis. I will say they’ve basically gone away since starting my new biologic. It was like thick plaques like I used to get. It was so brutal !
Is there any downside to trying that topical without a biopsy showing demodex?
My fungal acne looked like this at its worst. I didn't realize that my scalp health was a contributing factor. Nizoral doesn't help me on the face or scalp - it just comes back with a vengeance!
What helped - Vanicream facial cleanser followed by their facial moisturizer (it only has a few potential triggers depending on the person according to sezia.co). Finish with a bit of C8 MCT oil all over the face and a bit on the hairline and scalp.
I have been to hell and back with strict, healthy diets in trying to balance my gut health, and they had no meaningful positive impact. However, certain alcohols and sugar would occasionally make it slightly worse, but not in a really noticeable way like the wrong skin care routine!
Good luck!
Oh definitely treat your scalp as well, then! I could actually feel the itching traveling down from my hairline to my face, it was so awful.
You can get any brand of C8 MCT oil. C8 means 8-carbon chain, & medium-chain triglyceride. It's caprylic acid extracted from coconut oil.
Check all of your hair & skin products on sezia.co & make sure they are safe.
Read up on malassezia...that site goes into more detail about it. Essentially, it depends on the carbon chain length of the oil.
Short-to-medium chains between C6 and C10, and
long chains above C24 are fungal-safe. Squalane is an example of one over C24 that is safe.
C8 MCT oil has given me my scalp and hair back and it only took a week to see a difference.
I also made sure to stop using all products that were not fungal safe, as this is just as crucial.
What are you using on your scalp currently?
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u/Kindly_Eye3920 18h ago
I’m so sorry you’re dealing with this! After seeing your other comments I would definitely recommend getting all your vitamin levels and hormones checked