Acne Imposters




There is a skin condition called Malassezia folliculitis, formerly known as Pityrosporum folliculitis, that is caused by yeasts (fungi) of the genus Malasseziathat which can look just like acne. It looks like small, non-inflamed bumps that frequently shows up on the forehead, but can be anywhere on the face or body. This skin condition fooled me for years; and I remember being so frustrated that this “acne” wouldn’t respond to acne treatments or products. Oftentimes, people can have a combination of both acne and folliculitis.

What is folliculitis?It is an inflammation of the hair follicles most often caused by a fungal or yeast infection. It can remain dormant for long periods of time and then flare up with humid weather. There are bacterial forms as well and one must be tested to know which it is. (However, trying to find a doctor to test for it has been extremely exasperating – they think it’s acne too….). We can tell that is folliculitis by the way it extracts much differently than an acne lesion. Also, if it’s a condition that “comes and goes” then that is a clue that is folliculitis and not acne.

It can be caused from the extended use of antibiotics, the use of steroids, oily skin, humidity, occlusive clothing, heavy moisturizers and the use of hot tubs/spas.

How to treat folliculitis

  • Mandelic or ketoconazole cleansers and mandelic serums are great as an anti-fungal remedy.

  • Keep the affected areas dry – applying “Gold Bond Powder” can help keep the skin dry (on the body).

  • Avoid sugar and yeast containing foods (bread, alcohol, processed/frozen foods, sandwich meat and dairy).

  • Cotton clothing and cotton sheets are best. Avoid use of fabric softener.

  • Supplements that can help:

Antifungal SupplementsSelect one or two and rotate every few weeks

  • 1. Coconut Oil (or caprylic acid)

  • 2. Undecylenic Acid (bioactive nutrients combines this with two other antifungals: neem and grapefruit seed oil)

  • 3. Olive Leaf

  • 4. Oil of Oregano

  • 5. ACV (tablets or liquid)

  • 6. Garlic

  • 7. Berberine

  • 8. Probiotic supplements – especially for those who have been on antibiotics for a long time. Probiotics don’t need to be rotated out as often. They can be taken for several months at a time, then taken out of the diet for a week or two and then restarted again.


Pyoderma Faciale (Rosacea Fulminans)


Pyoderma Faciale is definitely stress-hormone related. It tends to affect only the face in women in their 20′s to 30′s and is characterized by large, very red painful lesions that occur mostly down the middle of the forehead, cheeks and chin. You can see the pattern in the photograph below – notice how the inflamed lesions are only in the center of her face. Her cheeks are completely clear. This condition can affect women who have never had acne in their life and then they have this horrible breakout right after a very stressful time in their life. Talk about a double whammy!!

So, what looks like severe inflamed acne is really a severe form of rosacea – rosacea fulminans.

Severe emotional trauma usually precedes the onset and is usually preceded by a period of extreme oiliness. (like hair needing to be washed twice a day).It affects only certain women who have a specific enzyme deficiency. This deficiency suppresses the adrenals’ output of hydrocortisone and instead prompts the adrenals to dump out excessive amounts of testosterone.

The condition can be detected from blood samples, and a drug called dexamethasone can slow down testosterone production and reverse the condition. Because the drug dexamethasone is a corticosteroid, our client was reluctant to take it.

We treated our client with our mandelic serums which are antibacterial and anti-inflammatory, and benzoyl peroxide. We had her use an oxygen emulsion cream (called A02) during the day which is an antiseptic moisturizer that uses oxygen to kill bacteria. The right products can help to get this devasting form of rosacea under control.


Staph Infections


Staph Infections on the face or the body can look much like acne, but staph is much more severe. One way to tell the difference is that the staph will not have symmetrical borders like a pimple or a pustule does. If you suspect that you or a loved one has this, direct them to go to a physician immediately for testing.

Staphylococcus is a group of bacteria that includes more than 30 types of staph, the most common being Staphylococcus aureus. This type of staph usually causes skin infections that may look like red, swollen pimples or boils with pus. It can lead to crusty skin or red, swollen skin that’s hot to the touch.

Telling acne and staph apart can be easy if the staph infection is large, as they will usually resemble boils. It often will not respond to typical acne products and/or treatments. It needs to be treated with the correct antibiotics in order to get it under control.


Keratosis Pilaris


Acne isn’t the only condition that results in red, raised bumps on the skin. If your bumps are small, rough, and look like patches of goose bumps on your arms, back, and/or thighs, chances are it’s not acne but keratosis pilaris, a condition that affects up to 40 percent of the population.

Keratosis pilaris most commonly affects teenagers and disappears by age 30, but many people struggle with this annoying, but harmless skin condition well into adulthood. Like acne, keratosis pilaris is an inherited disorder of the hair follicles. It is not contagious. It occurs when the body overproduces keratin and forms hard plugs on the skin’s surface. For the millions of people who struggle with this unsightly condition, the real question is, how do you get rid of it?

Lotions and creams containing lactic acid can effectively manage keratosis pilaris symptoms by exfoliating away rough bumps from keratin overgrowth. For mild to moderate cases, daily or twice daily application of a lotion containing 12% lactic acid, such as AmLactin (that can be bought at the drugstore), may be sufficient. Moderate to severe cases may benefit from a deeper exfoliation from products containing stronger concentrations of lactic acid and vitamin A propionate (Clear Body Therapy), such as those available at Face Reality Acne Clinic.

Keratosis pilaris is not acne, but is bothersome and can be difficult to treat.



Content provided courtesy of Face Reality Acne Clinic


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