Folliculitis on face due to C. Koseri and Staph

Hi everyone,

I have been dealing with pustules around my chin and mouth for almost 11 years now. I am 26 now and this has been a rough rough journey which has only gotten worse over time.

The first thing I tried 11 years ago was Benzoyl Peroxide. However, I used it without moisturizers and overused it and ended up hurting my skin. It took my skin 3 years to recover and I would still get minor pustules. I was then put on Doxycycline for 3 months and it cleared me up 100%.

Over the next few years I kept using Doxycycline on and off and eventually after being on them for 2 years I stopped using Antibiotics . Everytime I used them, they cleared my face up but after I stopped it would come back much worse, in clusters. I would get 20 at a time which would take almost 2 months to go away.

Diet is the only thing which kept me 100% clear (no sugar, no fruits and no dairy). However, in 2016 I was diagnosed with H. Pylori and put on Antibiotics for 2 weeks. I broke out again badly after stopping it and took 2 months again to control it.

I have now reached a point where I cannot continue this diet as I have lost a lot of weight. I tried cholorhexidine (hibiclens) in September as I suspected my pustules were staph related and it cleared me up for 3 months. I could eat anything! My pustules have returned again since and culture shows citrobacter koseri which is a gram neg. bacteria. I was told to get on Antibiotics again but I didnt, given my bad experience with it.

I met with another derm who wants me to get on accutane to eliminate gram neg. bacteria. However, I just tried Povidone Iodine and it cleared me up for 2 weeks after reading it can kill Citrobacter (gram neg). At the same time, I came across a study which talks about how a person was stuck in a cycle where his folliculitis kept reappearing. His initial pustules were gram neg. Accutane eliminated that but his pustules returned to show staph. Once he got rid of staph, gram neg (c. koseri) came back and he was stuck in this cycle. The article does not talk about any treatment.

I feel like this is what I am going through as my pustules keep reappearing one way or the other. Maybe hibiclens worked because my pustules were staph related and didnt work later because the pustules that returned were gram neg. Since Povidone Iodine works against that, it cleared me up but now that my pustules returned again, it could be staph once more. I am trying hibiclens again with decent success. C. Koseri is also caused by overuse of tetracyline antibiotics which I did.

I really want accutane to be my last resort and hence have come here to see if anything else can help. I have tried everything, tea tree oil, manuka honey, head and shoulders, sulfur ointment... but have had minimal success in eliminating this condition.

It's been 12 years and I really want to get to the bottom of this. Any advice would be appreciated!! Tweet