When is acne not acne?

There is a tendency to think that an antibiotic like Doxycycline is the most effective treatment for any and every ailment. The marketeers for the larger pharmaceutical manufacturers deserve a round of applause. They have created brand awareness and a general demand for their products regardless of the likelihood that the given drug will be effective. Thus, we need to start this article with the simple rule. If your condition is caused by a bacterium that is "killed" by the particular antibiotic you are proposing to take, taking that antibiotic will be an effective treatment. But if your condition is not caused by a susceptible bacterium or not caused by a bacterium at all, taking this antibiotic will be completely ineffective as a treatment. Worse, it will potentially help all the bacteria that survive to build up immunity to that antibiotic. So the next time you fall sick, that antibiotic will be less effective.

So the first question is a simple one. When you get pimples and zits, is this always acne? The answer, unfortunately, is "no". Even though you may get "pustules" or "papules", the technical terms for those "spots" that come on your face, neck and upper body, you may have Pityrosporum folliculitis. This is a common inflammatory skin disorder that looks almost exactly the same as acne. Indeed, it's perfectly possible to have both conditions at the same time. There's just one problem. To cure Pityrosporum folliculitis, you need an antifungal medication, whether in tablet form or as a topical cream. No antibiotic of the market will have any effect on Pityrosporum folliculitis. Worse news! Many of the treatments for acne will make Pityrosporum folliculitis flare up and become even more visible and painful!

So, before you resort to ever more powerful treatments for your skin problem including the use of antibiotics like Doxycycline, make sure you are treating the right problem. This means seeking a proper diagnosis either from a physician with the relevant knowledge or a specialist dermatologist. How do you tell the two apart? The lesions in acne are usually larger, i.e. they may be more than 4cm in diameter and are distributed evenly over the face, neck and upper body. Pityrosporum folliculitis most often affects the body and the lesions are smaller. The only definitive way of distinguishing the two conditions is to have a punch biopsy. This takes a small sample from the skin and tests for the presence of yeasts. If yeasts are found, this proves the source of the inflammation as Pityrosporum folliculitis. Because this is not a bacterial infection, antibiotics are ineffective.

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