Acne treatment Acne treatment

Acne & Folliculitis

Acne & Folliculitis Acne & Folliculitis


If you take certain medications for your acne, you may be susceptible to a specific type of deep folliculitis. Although acne-like in appearance, the red lesions on your skin are actually the result of inflamed follicles caused by a bacterial infection, according to the American Academy of Dermatology. This type of folliculitis readily resolves when the treatment protocol for your acne is changed.

About Folliculitis

Folliculitis is the medical term for hair follicles that become infected with bacteria or another type of organism. There are numerous variations of folliculitis, each with a different cause, according to Certain types are associated with hot tub use, while others, such as "barber's itch" are associated with ingrown hairs caused by shaving. Most types of folliculitis are superficial, presenting as small whiteheads that crop up around hair follicles. However, more severe forms of folliculitis, such as those associated with acne treatment, can be extremely painful and leave scars in their wake.

Deep Folliculitis

People with acne may develop deep folliculitis that occurs as a result of the acne treatment itself. Deep folliculitis is an infection that occurs deeper within the hair follicle and may present in the form of a large, swollen bump or mass of bumps and pus-filled lesions that rupture and crust over. Deep folliculitis is often very painful and leaves behind scars.

Gram-Negative Folliculitis

Gram-negative folliculitis is a specific type of deep folliculitis that can occur if you've used certain oral or topical antibiotics to treat your acne for a prolonged period of time. Antibiotic use alters certain bacterial strains in your nose, states, which results in an overgrowth of the bacteria. In some people, this condition can spread and lead to the creation of new acne lesions on other parts of your face.

Bacterial Strains Involved

This type of folliculitis is called "gram negative" because the bacteria that causes it have a distinct staining pattern when examined in a laboratory, according to the American Academy of Dermatology. Certain types of bacteria don't stain blue and are referred to as "gram negative." The New Zealand Dermatological Society, Inc. indicates that gram negative bacteria types include Escherichia coli, Pseudomonas aeruginosa, Serratia marcescens and the Klebsiella and Proteus species.


Gram-negative folliculitis is typically resolved by cessation of antibiotic use, although oral antibiotics to which the bacteria have not developed a resistance are sometimes used. Oral isotretinoin is another treatment option for this type of folliculitis. Oral isotretinoin, a synthetic form of vitamin A, is a potent medication reserved for cases of severe cystic acne and acne that doesn't resolve with other types of treatment, according to the AAD.

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