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I am diagnosed with folliculitis decalvans few years ago. During this time, my doctor was prescribing me many different drugs and treatments to cure it. However, I realized this must be a chronic condition, since I cannot get rid of it. Can you tell me is it normal that I have experienced ineffective folliculitis treatment. Could it be that just I cannot find appropriate therapy?

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It is true that folliculitis declavans is chronic condition that can last many years to decades. Once the hair has been lost due to scarring, regrowth is not possible and you should not blame your doctor. The goal of treatment is to prevent further scarring. Treatment also has to diminish the pain and drainage associated with active lesions. I have found that a combination of Rifampin 300 mg with Cephalexin 500 mg is very beneficial in achieving these goals. Some doctors initially treat patients with the antibiotic combination for one month. I have heard most of their patients experience a marked decrease in disease activity with this treatment. Some of these patients continued treatment for one month after the disease has become inactive. Eventually the patient is able to keep the disease under control by intermittent courses of the antibiotic combination, so you cannot say this folliculitis treatment was completely ineffective. A typical regimen might be one or two months on the treatment alternating with 3 months off therapy, so you have to be patient. However, you have to know that topical therapy, including steroids and antibiotics, and intralesional steroids have all been ineffective in treating my patients with folliculitis decalvans, so you could ask your doctor about it.
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I was diagnosed with  folliculitis decalvans a couple of years ago as well. nightmare! I don't even remember that I had signs and symptoms of folliculitis because I would react for sure. Doctor recommended some treatments for me, so we have tried some. At the beginning, he told me that this type of treatment can be difficult and is aimed at controlling rather than “curing” the condition.  At the beginning, he recommended classical antibiotics, and it was1% clindamycin. As far as I know, this can be tried in the first instance in mild cases. Now, once you are diagnosed with other issues or disease, my doctor told me that this will require oral antibiotics such as doxycycline, minocycline, etc.

It is hard to tell which one is the best. It is hard to deal with this issue. 

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As a dentist, I wore a mask everyday to treat patients. I noticed red and soreness on the area under the mask. Vessicles and lesion would appear and not go away. My skin grew thicker. Dermatologists said I had adult acne. I insisted it was the mask. I tried different kinds. My skin looked so bad I had to wear one all the time at work. I was prescribed antibiotics and acutane. My face hurt so much, I had to quit. Shortly after it got better, I researched possible causes. Allergy seemed to fit. I was tested and had a latex allergy. Unfortunately, excessive antibiotics and the allergy caused a chronic fungal folliculitis, causing track like patterns under my chin and neck with deep cysts and ingrown hairs. After 11 years of skin problems, and 5 years after discovering my allergy, I have finally beaten what believe to be a rare type of Folliculitis Declavans.
What has worked for me is washing with Hibiclens 2-7x week, salicylic acid everday, most importantly baking soda and hydrogen peroxide paste a few times until I nipped it in the bud. Retin A is helping with the Keloid formations. Now I need help with the scars.
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Try NEOTIGAZON ( acitretin ) . Is very similar to Accutane ( both from Roche ) but is more effective agains Folliculitis Decalvans . Also , it is safer to use it for long period of time .
ALso , give it a try to the new topical antibiotic by glaxo , Altagro . Use both medicines if you can .
Good luck
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I have reached the point of desperation with my particular case of folliculitis. I was prescribed Cephalexin 500mg for an upper respiratory infection and that has been the only treatment that has made it disappear (temporarily), and once I finished the bottle the red spots reappeared on my body in no time. The only problem is attaining it without a prescription, as I don't believe a doc around here will prescribe it to me to treat my folliculitis. Any suggestions?
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Hello.I had this mysterious skin disorder for more than 13 years with ernormous hair loss.I visited many top dermatolists in Germany, Russia and France but they couldn't help me. Early this year I visted BUMPSCENTRE in London , where I got this skin disorder cured permanently
good luck
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Can folliculitis be a chronic condition? I thought it was caused by inflammation due to an ingrown hair while shaving, or else a bacterial infection.
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Hi Alique, it definitely can be. Either an ingrown hair or a bacterial infection, both can lead to a chronic condition that you will have to battle for an extended period of time. Does that help?
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I've had this condition for 15yrs now. The last 8 yrs its slowly taken my hair leaving me with bald spot on top of head and spots on my sides and now taking my front slowly. There is no cure and my Dr seems defeated when i walk into his office. I've gone to many so called gurus in the NJ/NY area and all i hear is it will eventually burn out. Well i would sign up for that right now even if it meant taking all my hair cause the dryness and the flair ups are awful. I used to take cortisone cream to calm my scalp but a Dr told me my scalp got addicted to the cortisone so i just take antibiotics now...i've tried every drug out there that you all have read about but only a couple have kept me at bay...i currently take doxycycline which makes my scalp manageable although i need to shower daily or my scalp becomes really dry and irritated. I used to take minocycline which really kept it at bay, but my skin in certain areas started changing color...really scary but since i got off my skin color went back to normal(took that medicine for 3+years). I have taken cortisone shots to the scalp when i've gotten bumps and have tried different diets, etc to get rid of this condition to no avail. I have become defeated knowing this will never go away. The only hope i have, all be it a terrible one, is this will be like a tornado...do its damage than go away....this condition has turned me from a confident person to a timid person tryin to coverup my condition. i cant even shave my head cause of the damage to my scalp. I dont wish this condition on anyone but if a person of high importance got this condition, i believe we'll find a cure. This condition is torture..my scalp is so sensitive tonight, i cant even brush my hair.
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I have noticed that I can control my descalvans where there are pustules (or whatever they are called) by dissolving with olive oil everytime they start to form. You can dissolve/detach hardened crusts from the skin too by applying oil and let it be for 1-2 days, but the interesting thing is of course to be preemtive and not let it proceed.
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Well this sucks! Im trying so hard to be positive for my sons sake. He is almost 17 and is dealing with severe folliculitis. At least thats what the derm. says. Although, I'm so confussed as to alot of symptoms are close and overlap.

History is, he started Accutane at 15 for bad acne and was on it for 8 months. About 8 months later he developed pimples on his head that quickly spread. They are never in the same spot. They can range from a handful to a ton all over. They are painful to the touch. The pustuals are yellowish and fun to pop-gross I know.

Been to 2 derms. Had 2 cultures done that came back Pityrosporum Folliculitis (Yeast)...OK...took the Nizoral tablets and shampoo. Went away. Came back a few weeks later. They stay at bay with continual Minocycline. Wants stopped, 2 days later all back again. Took for 5 months.

Went back. More cultures. No yeast this time. Nothing showed up. OK???? Back on Minocyline. Said he had to rotate 4 shampoos. Worked for a while.

Switched derms. Same practice though. Last one mad me cry. LOL. More cultures plus his first Biopsy behind the ear. (required 6 stitches). Sat in lab for a week. They called with finally an answer. This is all they said: It is Gram Variable Bacilli from the Corynebacterium Species. Basically its bacteria. Ok...what ever all that means. They gave him Rifampin. WIPED IT OUT totally.

But guess what? Three weeks later its back. They dont want to put him back on unless neccesary, so there is no resistance since we know it works.

For the last 3 weeks I go through his hair and when I see a pustual or bump I put Tee tree oil direcctly on the spot. Have him still alternate, Head and shoulders, Nizoral, Selsun Blue, T-gel nutregena. The Tee Tree works well! I just ran out and grabbed some Burts Bees Acne spot treatment. All natural. Both of these are working great. I also have him taking a multi-vitamin and a zinc suplament ever night. So far so good...Well exept now his forhead is getting covered in small rash like acne blisters. I DO believe whats on his forhead is yeast. I put Nizoral shampoo on his forehead before bed and it looks much better today. Not sure why bacteria can be in scalp and yeast on forehead????

As far as hairloss...not yet. Im not sure about the top hairline. I think its gotton thinner. He doesnt. I think Im looking for it. That is my BIGGEST fear. He is only 16! The doc said its not decalvans but how does he know?? Im so scared. I wish God would give this to me and cure him.

Anyways, any help would be appriciated. hes very frustrated and his confidence is going down.

Thank you and God bless you all.

Lee
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Hi All

Hopefully I can pass on some knowledge .

I have recently been diagnosed with Foll.Decalvans via a biopsy .

It started with crusts on the scalp ..which caused a patch of hairloss . I had scalp pimples aswell .

Derm took a culture and a biopsy . Put me on Eythroymcin 4x daily for 10 days . This killed the scalp pimples and I havent had any since .

The biopsy found Staph Auerus which causes Decalvans and i am now on long-term Eythromycin 2x daily

My scalp's appearance has improved - less red , no pimples and the patch looks like normal skin now . My Derm is willing to help which is a major thing .

To Guest 5-6-10 : Search the forums for pityro.Folli. theres a ton of info on that . Believe me ...be thankful its not Decalvans .
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any update anyone? I last posted a couple of years ago and I have a heck of alot less hair now than I did 2 yrs ago. Im still in pain, still need to shower daily(if i miss a day i can barely touch my hair). My scalp is very dry and shaving my head is not an option cause certain areas of the scalp are ruined from this condition. Is anyone still out there reading this forum?
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mgugs2424 ,

I am a lurker on several folliculitis sites . My post is above your's - 6/4/2010 .

I have 3-4monthly visits to my Derm . I am currently on Doxycycline having switched from Erythromycin - the pimples started to comeback after 8-9 months - cream and ointment .

I dont have any pain , itchyness occasionally , redness of the area and a circle of hairloss . Since taking antibiotics the appearance of the scalp has greatly improved however i think hairloss is increasing . The Derm freely admits its rare and containment is the main goal . They wont give me  Accutane because my general health is poor .

I'm scared of losing hair - i just dont want it to look freakish . I read your posts and it makes me really scared .

But I know what your going through , so dont despair .


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