Troubleshooting Acne Treatments

1. Keratosis Pilaris

Keratosis pilaris is a skin condition commonly seen on the upper arms, buttocks, thighs and sometimes on the back. The skin cells that normally flake off as a fine dust from the skin form plugs in the hair follicles. These appear as small pimples that have a dry ”sandpaper” feeling. They are usually white but sometimes can be red. They usually don’t itch or hurt.

This condition develops when the skin produces too much keratin , which blocks hair follicles and causes bumps to develop. Keratosis Pilaris is very common and many of our clients suffer from this condition on the backs of their arms. The condition isn’t often serious and usually disappears by age 30.

A good scrub and exfoliant serum or lotion with glycolic, mandelic and /or vitamin a proprionate can be beneficial for clients with Keratosis PIlaris on their body.

2. Rosacea fulminans

Rosacea fulminans, also known as facial pyoderma, is a rare condition, considered as an exacerbated form of rosacea. It occurs mostly in women ageds 15-46. It can also occur in men and children.

The cuase is unknown. However, it is believed that hormones contribute to the development of the lesions since the condition is much more common in females and, in some cases, has been associated with pregnancy. It is rarely associated with other diseases, such as inflammatory bowel disease, thyroid disease, and liver disease. Treatment options include corticosteroids, isotretinoin, dapsone, and antibiotics.

This is typically seen in women who have never had acne before. They suddenly have a horrible breakout mostly down the middle of the forehead, cheeks and chin. It is almost always preceded by severe emotional trauma and by a period of extreme oiliness. These women have a specific enzyme deficiency which can suppress the adrenal gland. Instead of hydrocortisone, the gland dumps out excessive testosterone instead. Send this client to the doctor to get a blood test and treated for this hormonal imbalance.

3. Pityrosporum Folliculitis

Pityrosporum folliculitis, also known as Malassezia folliculitis, is a condition that presents as breakouts on the skin. It may be considered common and underrecognized. It occurs when a specific genus of yeast called Malassezia, which naturally occurs on your skin, infects the hair follicles.

Sometimes people with this condition think they have recurring acne and try to treat it as they would for regular acne. This makes it easy to miss or misdiagnose.

However, an easy way to tell the difference between the two conditions is to compare the symptoms. Pityrosporum folliculitis lacks comedones, which are the whiteheads and blackheads that are common characteristics of acne. It can also be a very itchy condition, while acne is not.

People who have pityrosporum folliculitis are sometimes more likely to have other conditions like dandruff, which is also known as seborrheic dermatitis. Both conditions are linked to the Malassezia yeast.

These two conditions are essentially treated the same as well, with antifungals and often a shampoo, such as ketoconazole two percent shampoo.

This is a very common fungal (or sometimes bacterial) condition of the skin. It can look just like acne, but does not respond to typical acne products like salicylic or benzoyl peroxide. The main clue is in extracting it – it extracts, but has no “core” like acne has. Another clue is to ask them if the bumps “come and go.” If yes, then it’s probably folliculitis, because acne doesn’t typically do this. An effective ingredient for this is a mandelic cleanser and/or serum or a ketoconazole shampoo, both of which have antifungal properties.

4. Steatocystoma Multiplex

Steatocystoma multiplex is a skin disorder characterized by the development of multiple noncancerous (benign) cysts known as steatocystomas. These growths begin in the skin’s sebaceous glands, which normally produce an oily substance called sebum that lubricates the skin and hair. Steatocystomas are filled with sebum.

In affected individuals, steatocystomas typically first appear during adolescence and are found most often on the torso, neck, upper arms, and upper legs. These cysts are usually the only sign of the condition. However, some affected individuals also have mild abnormalities involving the teeth or the fingernails and toenails.