White Stretchy Plugs

...and I know you all...ive been floating around for years....Just really launched the major offensive on this recently

Hello All. I had a phone appointment with my family doctor a week ago. We spoke of malassezia folliculitis - he thought it may be it. He prescribed me itraconazole. Fourteen 100mg tablets - one tablet twice a day. I felt relief after the first pill. Two pills remaining. I wish I could share with you pictures. My pain is gone. My wound is healing and I mean healing! Only a tiny portion left. I have kidded around here a bit. I remember my first words here - If only they could feel the pain. I can't confirm what I have is malassezia - more important things going on in the Health world at the moment. I can confirm that itraconazole has worked for me. If you have not tried this medication yet, I strongly advise you to do so. It would be great to have someone try - so we have confirmation of the infliction and cure. Thank you for putting up with me. I think that will go on my tombstone - Ha Ha :-)

Hi Guy...I hope this is the magic for your issue indefinitely. Reading back on these threads is a pain....but if I remember correctly, it's been only one sore?

Thank you all so much for this thread. I found this last night and finally I don't feel crazy! I am about to lose my mind struggling with this issue that doctors continue to dismiss. I have been struggling with this for a year and have seen two different dermatologists, who have recommended topical creams which I have used with no success, and after treatment failed they told me that it was my mental state and neurotic picking basically and that I needed to follow up with my psychiatrist and other healthcare professionals. I know that I'm not crazy, and I wouldn't be working so hard to get sores healed on my face If I was going to stress pick them open again! But it feels so much better after the white plugs are removed, and it's softens the skin underneath underneath and around it after it uncorkes basically. I have read all of your comments and they give me so much hope! I have been using aquacel on my face underneath gauze bandages for weeks which have helped remove the belt up scar tissue and skin around the sores. I know I have staph as well due to the amount of green puss on the bandages. Sorry I know that's gross. But the aquacel has removed all of the built-up tissues, and poorly healed skin that has formed as result of me not picking my skin per doctor's orders - which has only made things worse! The skin will heal over, and then opens back up and we start all over again with the white plug things. There are so many and it's so discouraging., But now they are at the surface. After reading all of your comments I searched through the house to see what I had available. I found selsun blue which I washed the open sores with. this was the most painful thing I have ever experienced I'm not going to lie. But, the white plugs started coming out! One of the dermatologist had recommended a soap called panoxyl which I also use, and it does help some, it is 10% benzoyl peroxide - and I have used it before as a spot treatment which I let dry and that does help heal them.

So I made my own concoction, not Dr. recommended or anything lol, but it seems to be removing all of them! I just keep putting it on the sores and more stuff keeps coming out, I will remind you it is extremely painful!! But the mixture is: equal parts selsun blue, panoxyl, and clean & clear deep action cream cleanser sensitive skin ( by Johnson and Johnson) I mixed all three together, and then added a tablespoon or two of baking soda to make a thick paste. I applied it to the sores, and it's absolutely disgusting that all of these white plugs are coming out everywhere! There is so much, but my skin around the sores that had built up like a dam, is s
softening, and becoming more flush with my face, and it seems to be removing all of the whatever this is! I have only been using it for the day, and just applying more as it starts sloughing off of the sore. Remove it and add more. I don't know if this will work for everyone, but it's what I had on hand and it's working for me! I plan on trying your suggestions for other topical items as well. I've been on spironolactone for six or eight months and it doesn't seem to help much, I'm now currently on my 10th cycle of doxycycline. I just found out I am immune deficient and require life long IVIG.
But this forum has given me hope, and I am so thankful to have found it. I'm hoping one of my doctors will let me have a prescription for accutane. But in the meantime I'm going to continue using this concoction and other suggestions. It's worth a shot. Good luck to you all

I apologize for the long comment, but I should say that typically I do have to pull these out with tweezers, and they are difficult. With the topical solution I mentioned above, I don't have to pluck or pull anything they are coming out on their own and I am wiping them away! No plucking or pulling needed It seems to be doing it all on its own and they are coming out voluntarily for the most part at this point! I will update as I continue with this

I hope this helps someone who is desperately searching for answers as I once was. I suffered from these terrible sores on my face for close to 4 years. In that time they destroyed much of my life. I lost friendships and missed out on so much.

Sores with white plugs can be pretty much anything. Mine were as follows: the skin would first appear just generally disturbed. It would start to look coarse and bumpy, and the general area would redden. Surrounding skin would become thick and flaky. Soon a small bump that was red and inflamed with a white dot deep in the center would appear. If it was popped, a somewhat large white plug would burst out. The spot would ooze like crazy and open up to what seemed like tons of these white plugs clustered together in the same area. The plugs felt deep, like they were down in the hair shaft. They hurt, though not terribly so. They were visible to the naked eye in the bed of the pink wound.

These spots never seemed to dry out or heal correctly. And I went *months* without touching them at times. They just weren’t like normal pimples. If I didn’t pop them, they would just sit on the skin, red and swollen, for months on end. So I’d eventually pop them. When skin finally seemed to start covering the spot again, it was like quasi skin... just very delicate, very thin, very red, and it seemed like underneath there were still many clogs and a lot of inflammation and fluid. The slightest manipulation would cause the skin to come off and reveal a wet-looking pink sore with deep white plugs. And this wasn’t sebum or sebaceous filaments. This was absolutely pus, white like cottage cheese.

If every white dot in the sore was popped, tons of white/pus material will have come out. The slightest amount of pressure would cause the white plug to burst out. Afterwards, even though the skin was now damaged, the area felt so much less painful and swollen. It just felt like there was a lot of gunk and fluid in/under the sore that was trapped and causing inflammation, pain and redness.

These spots, after popping, oozed... A LOT. I mean tons of liquid would come out of relatively tiny spots. Entire droplets would fall down my face for as many as 2-3 days after popping the spot. They also seemed to bleed a lot very easily, then would switch to a pale yellowish clear fluid. If I used a hydrocolloid bandage, it would quickly fill up and smell bad. Any ointment or thick substance seemed to inflame them like crazy and cause even more white plugs. I would use antiseptics and generally let the spots dry out and heal on their own, but again they never seemed to heal right. They always felt inflamed and looked red and gross no matter how much time went by. I am talking months, and I’m a pretty healthy young-20s person with no reason to have non-healing wounds.

I knew something was wrong. This wasn’t normal acne. It didn’t seem like classic staph or impetigo either. Doctors had me on oral antibiotics for extended periods of time, but the spots still didn’t clear during that time. But trying to find answers was so conflicting. Everyone seemed to have a different theory and remedy. I didn’t know if it was bacteria, fungus, acne, inflammation, demodex... the list seemed endless.

So I thought I’d share a detailed description of my sores. And if you can relate, maybe what worked for me will work for you too.

Here is what I tried that ultimately didn’t work: diluted white vinegar soaks, mupirocin, countless oral antibiotics including tetracycline, disinfectants such as benzalkonium chloride, erythromycin gel, ciclopirox cream, ketaconazole 2% cream, pretty much every OTC antifungal, isotretinoin, ivermectin, hydrocortisone 2.5%

What worked: Aczone gel (dapsone)
What seems to help a little but isn’t enough on its own: metrogel and avoiding anything that can clog pores, including all lotions, creams and thick ointments

Aczone was truly a miracle. It cleared the plugs, healed the skin, and returned my skin to smooth and normal. No more white dots. No more oozing. No more deep plugs that hurt and wouldn’t heal. I also use metrogel on my nose and cheeks and have a gentle skincare routine with watery serums and essences only.

I really hope this help someone. These sores are truly horrible to deal with.

I just want to add:

Aczone (dapsone gel) is not a crazy script to request from a doctor. It doesn't seem to have any major side effects and is usually well tolerated even by sensitive skin. I have rosacea, and I think the sores I was getting were related to it, because they only appeared when I hit my 20s, at which point the rosacea also seemed to progress from Type 1 (flushing) to Type 1 and 2 (pimples/breakouts too). Aczone is used to treat pustular/papular rosacea.

I think these sores are infections of the hair follicle (folliculitis) combined with an inflammatory response that's gone awry. Like some type of infected dermatitis/eczema sore. I'm just not 100% sure what the infectious agent is. All I know is Aczone worked when nothing else did. I think it's worth a try if nothing else seems to be working. When I started using it, first I popped all of the white plugs from the still-open sores. Then I washed my face, patted it dry, and for about 24 hours just let it ooze like crazy to let the liquid come out. After ~24 hours, I washed my face with a gentle cleanser and applied the Aczone to dry, clean skin. Since the sores were pretty raw at this point, after the Aczone dried down I put a tiny bit of manuka wound honey (I like Dr. Nordyke's, hate Medihoney which has weird waxy agents) on each sore. I did that 2-3x/day for about 5 days. By the 5th day, the wounds had stopped oozing, scabbed, and the scabs were already starting to fall off. A scab would only ever come off if I was washing my face and gently splashing it with water. I never picked at the scabs or let the shower stream hit my face (the water pressure is pretty high in my house). Within a week, my skin was more or less transformed. The scabs had fallen off to reveal fresh, pink healthy skin. My skin looked totally normal! For the first time in 4 years! No weird white dots, no chunky dry skin, no oozing, no swelling, no redness. So I continued with this routine for about 1 more week. After 2 weeks on the Aczone and wound honey combo, the skin where the sores were was just a very faint pink. There weren't any indents or scars or texture issues, just slightly pink skin that was getting better everyday. At that point, I switched to only applying the wound honey at night but was keeping with the Aczone 2x/day. I also started applying a very thin layer of metrogel to the most problematic areas in the morning. The Aczone on its own did dry my skin a bit, but after 3 weeks, I felt healed. Since this started 4 years ago, not at one point did I ever feel like I could say I was healed. I gave most products 6-8 weeks to work, and in that time, my skin either stayed the same or seemed to get worse. Aczone is truly a miracle. It seemed to start working right away. I really hope this finds someone suffering, you give Aczone a try, and it changes your life as it did mine. And if Aczone isn't your thing, stay hopeful and keep searching. Always be patient and make sure you can eliminate products/ingredients/causes fairly (don't pick while you are trialing an ingredient, give it proper time to work--usually 4-6 weeks, etc.). Most of all stay hopeful.

I FORGOT TO mention. I'm also on 50 mg of doxycycline. At such a low dose, it's not anti-bacterial, just anti-inflammatory. I was at maybe my 6th week on this dose when I started the Aczone. I'm not sure if the doxycycline played a role in the sores getting better. They so immediately got better after introducing the Aczone that I mainly attribute their healing to that. But the doxy does help with flushing, so I decided to stick with it.

I felt obligated to update this. A punch biopsy confirmed that... yes, this is fungal!

I think the reason the Aczone helped so much was because it was drying and super anti-inflammatory. It definitely allowed enough healing to occur that my doctor could get a good look at one of the sores and see the white plugs/redness undisturbed.

The Aczone/metro had been working great, until I started having to wear a face mask at work, and the weather started getting warmer. I guess the humidity and heat combined with the prolonged face covering caused it to flare up again. Soon my face had 3 new red spots with the dreaded white plugs resurfacing.

This time, however, I went to the doctor knowing that I *needed* a punch biopsy to get to the bottom of this. I might have a little scar on my cheek, but after 4 years of this hell, I’ll gladly take the scar over 1 more minute with these lesions.

And the results came back, and it was yeast. I had long suspected this to be the case. I was on many antibiotics over the years, and the sores always seemed significantly worse if they came into contact with an antibiotic ointment. But, I was prescribed ketoconazole 2% in the past and didn’t have results and had also tried some OTC products with no success, so I gave up on my fungus theory and moved on.

This time it’s different. I *know* the cause of these hellish sores.

So here is how I’m dealing with it this time around: (1) No products with fungal acne triggers. There are a few skincare websites that will analyze an ingredient list and indicate if anything in it triggers fungal acne. (2) No creams! I honestly don’t know why so many antifungals are in cream form. Creams/oils seem to aggravate this condition like there’s no tomorrow. These sores aren’t dry and scaly but moist and have a lot of fluid beneath them it seems, so anything occlusive angers them like there’s no tomorrow. (3) No touching! I have no doubt that in the past I’ve had concurrent staph/bacterial infections. This significantly prolonged this hell by obscuring the true cause and leading me down the wrong path in terms of what works and what doesn’t.

So based on this I’ve been using (1) a fungal acne-safe zinc pyrithione face wash and (2) aloe vera gel mixed with powder miconazole nitrate and (3) am sticking with metrogel to keep the rosacea managed. I start fluconazole 200mg/day for 3 weeks tomorrow.

I will report back. But even after just a few days on the ZnP/miconazole nitrate, there’s significantly less pain, redness and swelling.

There has been significant and rapid disappearing of the white dots and redness with 2x/daily zinc pyrithione facewash, zinc pyrithione spray and miconazole nitrate 2% powder + aloe vera gel. I saw my parents + my mother said my face hasn’t looked this good in years.

I noticed almost immediate relief with zinc pyrithione. I think the ‘azole’ topicals can take a bit to work. I’m using the Happy Cappy wash and Noble Formula spray. The relief has been so incredible that I’m actually holding off on taking the prescribed fluconazole because atm it’s not needed! Still use the aczone/metro for rosacea, but I think that’s a separate problem from this fungal condition.

Hello bookwormlee - Thank you for sharing your experience. I am back from the dead so to speak lol. My regiment of oral itracozonal has taken it's sweet time but I believe is working. I was so happy to see your post about the punch biopsy confirming a fungal infection. I knew we are not from "off planet". I had to go to emergency about ten days ago. Saw another physician who thinks I need to see a psychiatrist. Passed on that. Got another prescription for itracozonal instead. Please keep us posted about your progress bookwormlee and I will too. :-)

I believe your three week treatment of Flucozonal will solve your problem bookwormlee. The New Zealand study called for a four week treatment. Again, I can not tell you how relieved I was to see your biopsy report. It is like a sign from God, well, all twenty-six million of them - Ha Ha. Okay - must prove the existence of sasquatch next. Cheerio!

I wanted to let you all know I made a mistake in the name of the meds that I am pretty sure cured me. It was oral NYASTIN. And yes, it is for FUNGAL...

Thank you GillCo. Finally, an end to this nightmare.

I just wanted to also say to boomwormlee I had a separate case of roseacea as well. I needed acutane for this.

I also tried Topical Nyastin which i did notice small results. However, it wasn't until I used the oral Nyastin which kills the bacteria systemically. I would encourage you all to look at your tongue and see if you have a white coating. Some will recommend swish and spit because it can upset your stomach but I also had it in my throat so they recommended to swallow. It wasn't until then that this all disappeared for me.

Oral Nyastin you do need a prescription for

Manuka Oil (not honey) See other posts. I tried it and it reduced the healing time significantly

So interesting to see everyone’s updates on this. I’ve been doing a lot of research on this. I think the plugs are keratin plugs that the immune system creates in response to the fungus. It’s incredibly disappointing how unwilling doctors are to even consider that some people’s acne/pimples might have a fungal cause. ANTIBIOTICS MAKE IT WORSE. Like so much worse. Nonetheless, I’ve made huge progress and am clear and wanted to share some tips as this ruined my life for close to 4 years. (1) Fungal infections are hard to treat. This means that just because you used say 2% ketoconazole and had no results, doesn’t mean it’s not fungal. Sometimes it takes a bit to find something that works. That being said, even when you do find something that works, relapse is almost a given. Especially if you get clear with pills, as soon as you stop taking them, it will come back. That’s why I hugely recommend zinc pyrithione or selenium sulfide to be used regularly. The fungus cannot acquire resistance to these, so they work great to help prevent relapses and keep you clear. I put ZPT on my problem spots, let it sit for a few minutes, then rinse and follow with my normal cleanser. I don’t use it on non-problem areas because ZPT’s mechanism of action is a little sketchy to me. Salicylic acid is also good for helping keep the pores clean and exfoliated, as the fungus thrives on clogs and oil. If you have active sores, benzoyl peroxide WASH as a mask on the spot for 5 or so minutes works fantastically to help dry it out and also eliminate secondary infections such as staph. Only use BP as a wash-off mask however as it massively irritates the skin if left on. Which brings me to my next point: (2) you need a FA-safe and non-irritating skincare routine. Make sure EVERY product you’re putting on or near these spots does not contain ingredients that will feed the fungus. Skincarisma and Sezia have amazing tools for checking the ingredient lists of products. DO NOT feed the fungus. Secondly, don’t irritate your skin. The infection thrives on an irritated and damaged skin barrier. Focus on restoring the integrity of your skin with healing, pH-balanced products. As your skin gets stronger, it will become less susceptible to repeat infection. (3) Be patient. These infections absolutely seem to become worse before becoming better. It’s like all of those plugs have to surface. But it’s incredibly important that YOU DON’T PICK. If a plug is at the surface, extremely visible, and able to be plucked out with a clean, sterile tweezer without damaging nearby skin, that’s fine, and I recommend removing it. But if you damage, irritate or inflame the surrounding tissue in any way, you’ve done more damage than good and have without doubt drove the infection deeper into your skin. Trust me, I *know* that these spots don’t feel right. They hurt, are prone to oozing and swelling, and look awful, but you cannot under any circumstances dig at them. Only remove a plug if it can be done with one quick pluck. Alocaine Emergency Burn Gel has 4% lidocaine and is fungal-acne safe. Use this as you’re waiting for your products to work and the plugs to further surface. It has a numbing effect so you can ignore the pain more easily. Again, these can and do get better, but their progression is not linear and can seem worse at times as they’re healing.

My sores are gone, but I still feel I may be colonized by the infection. I started the fluconazole yesterday and also cut dairy, sugar and alcohol out of my diet to kick it to the curb for good. Granted I’m in good shape and generally healthy, but I definitely think there’s an internal component to this. Prevention is also a really important part of this. The ingredients I mentioned above have proven efficacy against fungal infections, and I recommend incorporating them into your routine to accelerate and maintain results. Finally, I also had amazing results using stabilized allicin (aka garlic). A drop of Allimax Liquid on problem spots resulted in incredible healing. I’m not big on recommending natural remedies, as I wasted so much of my money on them, but of the dozens I’ve tried, only garlic brought undeniable relief. Also, I still use and am going to stick with the dapsone gel as it’s nice on the skin for inflammation, but I ditched the metrogel after 6 or so weeks as I didn’t feel it had much benefit

Appreciate your update bookwormlee. I am also continuing to improve. I have six days remaining of my oral itraconazole. Been topping this up with a few oral fluconazole. I have been applying only the antifungal cream (Lamasil) that I've been prescribed to my wound. I have been using Voltarin to manage the pain but will look for the Alocaine. I also believe this is a life long disease, due to my genetics. I will need to be more proactive to reduce the fungi/yeast on my skin in the future. Never knew what this was until now. You offer great advice bookwormlee and would advise anyone reading this to follow it. Thank you again.