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    Includes Expert Content
    dissecting cellulitis
    gopack4mvp2 posted:
    I have recently been diagnosed with dissecting cellulitis. I am on a antibiotic but it is not helping. I am in so much pain I don't know how much longer I can take this. My scalp is constantly draining fluids. Worse yet my insurance is saying its pre existing. I'm trapped and some days I feel like I'm gonna die. Could someone please help me? I will try anything.
    Mohiba K Tareen, MD responded:
    Dear Gopack,

    Indeed, dissecting cellulitis is such a painful condition. Do not worry, there are a myriad of treatments and we can definitely get you better.

    Which antibiotic are you using? I also like to add a topical benzoyl peroxide wash to the area in the shower. The BP is antibacterial and anti-inflammatory. For more about BP:

    In addition, a topical retinoid such as RetinA or Tazorac can help normalize the skin growth.

    One of my favorite treatments for dissecting cellulitis is intralesional injections of dillute steroid medicine. This rapidly helps control the inflammation and pain.

    If you do not have insurance, you may want to seek out a University Clinic. There you will be treated by Dermatology doctors in training (residents) that are overseen by very intelligent Dermatology Professors. I know at Columbia University in NYC where I trained, there were many patients with no insurance where a low cost payment play was developed.

    Please keep up posted. I hope that helps
    gopack4mvp2 replied to Mohiba K Tareen, MD's response:
    Thank You for all the information! The antibiotic I am currently taking is called minocyclin 100mg. I have been on a bunch in the past and they have not helped. This one is doing something different. I notice the legions are draining much more. They are also much more painful. Could this be the antibiotic working? I do have insurance and I think they may cover this because the diagnoses is new. Do RetinA or Tazorac have to be prescribed? I am going to print this off and take it to my Doctor and see what he says. I have to get this under control because it is ruining my life. Would you recommend any type of surgery? It is a severe case. Thanks so much!
    Mohiba K Tareen, MD replied to gopack4mvp2's response:
    Dear Gopack,

    Indeed, minocycline is more effective for all inflammatory skin conditions because it concentrates better in the oil glands (sebaceous glands) than most other oral antibiotics. I prefer the extended release version of minocycline called Solodyn which is safer and more effective. Speak with your derm about it.

    The Retina and Tazorac are prescriptions. But please definitely start the benzoyl peroxide in the meantime. Let me know how the injections go -- some of my patients have told me that they changed their lives!

    I hope that helps
    djackson18 replied to gopack4mvp2's response:
    Hey, did you try the Solodyn? I'm going through the same problems, the only difference is that I didn't start the minocycline yet because I'm doing research on it. And from what you're going through I don't plan on startng it.
    gopack4mvp2 replied to djackson18's response:
    After all this time I finally found a dermatologist who could help me. She prescribed me celephelexin along with rifampin. She also administered steroid shots. I still have minor flair ups but the major infected area has been reduced to bumps and scars. I actually thought I was going to die. Wouldn't want anyone to have to go through it! I hope this information can help somebody else.
    reded82 replied to gopack4mvp2's response:
    I tried the cephalexin form called Keflex but not in combination with anything else. I have a new dermatologist and will ask about getting on that cocktail and hope it works. I have been living with dissecting cellulitis for about 10 years now and haven't found anything that works for me. I have even had a surgical scalp scrape that seemed to make it worse. but if any more advise or successful measures would be grateful.
    Mohiba K Tareen, MD replied to reded82's response:
    There are many options for dissecting cellulitis. Most dermatologists try to avoid only using oral antibiotics, due to the risk of resistance over time. Topical and oral retinoids can be very effective. Please ask your new dermatologist about these.

    Dr Tareen
    Dr. Mohiba Tareen
    Tareen Dermatology, Roseville, Minn
    Castle Connoly's America's Top Cosmetic Dermatologists
    Adjunct Assistant Professor Univ of MN Dept of Dermatology
    reded82 replied to Mohiba K Tareen, MD's response:
    I am now on hibiclen wash and dioxycycline. I might be starting humira we found that it has been successful in other cases, as long as my insurance covers the cost. It is after I have tried every approach. Hope I can get this curse under control once and for all.
    An_260265 replied to reded82's response:
    I was diagnosed with this condition. It really sucks. Solodyn has gotten rid of it completely. Every once in a while (roughly 2-3 months) I have to take a few weeks of Solodyn because of a small flare up. Then I don't use the medicine at months at a time. It has changed my life. 100 Mg of it. I feel normal again!
    concernedparent424 replied to Mohiba K Tareen, MD's response:
    I am just curious... my son has dissecting cellulitis of the scalp. During my hours and hours of research I have noticed that it is mostly men who have this condition. Actually I have not come across any women that have it. Is it possible that it has something to do with clipper hair cuts? My son never had any problems with his scalp until I cut his hair with a new type of clipper called a balding clipper. It seems like his hair grew differently after that. I noticed 2 hairs coming out of 1 hair follicle. Then came the problems. I don't know I just think this needs to be looked into more by the medical field, it may be related.
    ryryg replied to concernedparent424's response:
    Ive had this for 5 years. My theory on this is that i got it from a haircut. I got cut by a barber which i figured no biggie but a couple of months went by and it started with simple folliculitis so i hopped on doxycycline not really to effective but I figured there just small white heads then the painfuls nodules came! I had enough!! I search for a top notch dermatologist and she put me on IT WORKED WONDERS! I thought i was cured! Slowly it came back not as severe but still bothersome. Then i got minocycline because i did not want accutane side effects lethargy, dry lips....but minocycline worked for about 2 years then I tried clindamycin and rifampin for 1 month a special regimen it worked great! But came back months later. ..finally I decided to spend hours studying this online..and I read that this disease will wax and wane for YEARS! Total remission is highly unlikely although possible , its rare! I read removal of the hair ..laser hair treatment will cause the disease to vanish reason being the hair is the major factor causing blockage then creating an infection...bacteria is a secondary factor..why the heck the does a simple haircut cause this is the question?!?! All in all right now im on a long term acctuane regimen LOW DOSE too avoid sidr effects i read prolonged terms of accutane can send this into long term remission. Id loved to email if anyone wants to know more.
    blakes_mom68 replied to ryryg's response:
    My son has this as well. And has done the very same thing. Antibiotics, surgical draining of the huge bumps, washes, topicals, ect. He's been on Accutane and claravis. for about 5 yrs now. He's 22 today. We went through 5 different primary doctors and 7 derms before we found one who even know what he had. He was in a better remission with the higher dose of Accutane. He did the hebicleans, peroxide washes too, some worked for a short time then back just as bad as before. Tea tree oil in his shampoo helps, and switching to a shampoo with out sulfates help too. He says it makes it less sensitive. He also has been combing his hair (whats left of it, he keeps it buzz cut) to help stimulate the scalp, getting blood to the pustules and bumps to promote healing, he says it hurts but a good hurt. His bumps go from the crown of his head, to the nap of his neck, behind the ears. He also has them in his groin and pubic region he says. . He also has lumps in his lymph node in his neck. The Doc said that's typical. His showed up from hitting his head on the corner of a kitchen cabinet. I see in the above comment ryryg's showed up after a nick from a haircut.... Did everyone else's show up after a trauma to the scalp? The side effects and long term accutane on the body are horrible. We are currently looking for other treatments as well. And the cost of the drug is outrageous. We recently switched insurance because of my job, (his job doesn't offer insurance) so im concerned about the cost now. Im praying it wont be to costly. Even on the Accutane lower dose 40mg daily. His head constantly hurts, still spontaneously drains, and he cant even lay his head down to sleep, like everyone else does. The chronic pain of it makes him a bit "fussy" at times. If anyone hears of any new findings in this disease please, PLEASE share. I just want a cure for my son and others who are suffering with this. I know the doctors say there isn't one. I refuse to accept that. There has to be something out there to cure this. I pray for each and everyone of you who are fighting this, I see what my son goes through daily.
    blakes_mom68 replied to concernedparent424's response:
    I see what your saying!!! Iv said this very same thing! My son wears his hear in a buzz cut we do at home too! He had cut his own hair and then hit his head on the corner of a cabinet in the kitchen....GREAT OBSERVATION! Does everyone wear their hair, (who has this) in a very short style and use clippers??!!
    reded82 replied to blakes_mom68's response:
    I currently have my hair longer to hide the bumps and scars ( as I usually where a hat to hide when hair is short). My dermatologist wanted me to try Humira but my insurance won't cover it because of the diagnosis isn't one of the approved treatment applications for the drug. How can the application be determined if it isn't tried as a treatment. I'm currently on Dioxycline 100mg x twice a day and dapsone 50mg x once a day but the headache side affects are a nuisance but not as bad as the pain of no medicine is. They seem to shrink the bumps but still get a flare up once in a while. I also wash with a hand bacterial wash like the surgeon use it is in the medical cleaners at Walgreens blue-green bottle (hubreus I think) with a dandruff shampoo with a zinc sulfate (head and Shoulder is the best I have found) that relieves the scabs that itch and hurt. I just started on a 15 day dose of presnoine to spark the antibiotics the work better. Hope I can get some better results. would be nice if Humira had a study for new treatment options I would diffidently sign up. That's all I can contribute right now. will post more once I get results.

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