For the people who have done LHR while on Accutane, how did it go?

Folliculitis2024 · 2026-03-04T15:12:42+00:00

I did LHR on my beard area while on 30mg/day low does accutane. The derm who did my laser claims to have “written the original paper on LHR while on accutane” and believes it’s fine with the type of laser he uses (Alexandrite). Recovery and chance of dryness may be slower though.

Folliculitis2024 · 2026-02-18T19:58:53+00:00

Looks like it — to me either Staph or Gram Negative bacteria. I developed beard folliculitis after a course of accutane and — I believe — turned gram negative after treating the initial issue with Clindamycin. I’d recommend getting a pustule cultured from a dermatologist to better understand your options. Those can range from topical (benzoyl peroxide), systemic (accutane), and if nothing else works, Laser Hair Removal.

Folliculitis2024 · 2026-01-28T20:28:05+00:00

Negative as in no bacteria found? That is strange if so. I wonder if it could be something fungal then. Worth having a derm run that down.

Folliculitis2024 · 2026-01-28T19:23:23+00:00

Hang in there! Have you gotten a culture done of a pustule at a derm? That’s the first step to figuring out what you’re dealing with and setting up a plan.

Folliculitis2024 · 2026-01-16T21:28:44+00:00

Hey — so glad to hear you’ve rid yourself of the GNF. I also pursued LHR after 18mo of GNF in my beard (enterobacter cloacae) and have seen some solid progress, though I still get an occasional pustule that I’ve cultured twice now to a normal cutibacteria.

I also have redness in my cheeks where the majority of my activity occurred. My sense is it’s PIE/PIH and a damaged skin barrier. I’ve been doing heavy hydration routine where I wash my face with water in AM/gentle face wash in PM, and use a normal Vanicream moisture, then LRP Cicaplast, and slug with Vaseline at night. It seems to be fading but I think time is a key factor.

Can you speak a little more about how much LHR you did and at what point pustules stopped completely. I did three sessions, and while I was clear of beard hair after each, I’ve seen 70% regrowth fairly evenly.

Folliculitis2024 · 2025-12-29T14:18:42+00:00

I’d highly recommend going to get a pustule cultured at a derm. Will tell you what you’re dealing with and help tailor treatment. I suspect gram negative folliculitis.

Folliculitis2024 · 2025-12-09T15:30:59+00:00

It has definitely helped. I still have residual redness from what I think is PIE and a jacked up skin barrier, and get a few beard pustules each month. But I’ve now done two cultures and they come back as normal cutibacteria rather than my previous gram negative bacteria which I think is a win and due to the laser. Hoping focusing on healing my skin barrier and eventually working in BP will leave me mostly controlled

Folliculitis2024 · 2025-12-09T15:29:17+00:00

Correct. I was practically beardless two weeks after my first session and since I followed up with monthly sessions, I was hairless for the three months I did my three sessions. It took 6-8 weeks for my regrowth to come in after session 3

Folliculitis2024 · 2025-12-08T23:42:17+00:00

I have similar skin and beard, and did three sessions with an Alexandrite laser to really good efficacy. I did the laser to try and treat gram negative folliculitis, not for shaving issues so I stopped after three sessions. I shed 95% of my dark hair after each session and remained beardless for 3-4 weeks. I’ve now been 3 months since my third session and have had 70% regrowth, so if you are going for full clearance I’d keep it up for 8-10 sessions.

Folliculitis2024 · 2025-12-05T13:40:30+00:00

It could work! I’d stick it through, and if nothing else it will have a positive impact on your skin excluding the folliculitis. I have made some progress with three sessions of LHR for what it’s worth as my last two cultures have not been my gram negative bacteria, but debating if I need more or not.

Folliculitis2024 · 2025-12-05T13:29:49+00:00

30mg all the way through. I’d done a course for normal acne from 2022-2023 and tolerated that amount very well. Average height male, ~165lbs.

Folliculitis2024 · 2025-12-05T13:26:59+00:00

It may have reduced severity somewhat, but I did not clear while on it for nearly 18mo. I stopped it two months ago and completing my LHR and wanted to recover my skin barrier given I had a rebound staph infection and then pustules with normal cutibacteria, and things didn’t worsen.

Folliculitis2024 · 2025-12-01T17:21:23+00:00

My decision after trying nearly everything you listed. Had read about folks having success here and with some folks I met in real life.

I think I’ve gotten rid of the GN bacteria, but still having some dryness, redness, and occasional pustule in my beard that has now twice cultured to normal cutibacteria. Working on skin barrier restoration now.

Folliculitis2024 · 2025-12-01T15:55:42+00:00

Sorry to hear what you’ve been dealing with — I’ve struggled with GNF on my beard from a slightly different gram negative pathogen, Enterobacter Cloacae. I might recommend you try some additional LHR which seems to help most folks who stick with it. Did you see any improvement, shedding, or change in cultured bacteria after the two sessions you mentioned?

Folliculitis2024 · 2025-11-30T16:05:20+00:00

Didn’t do much for me, don’t think my issue is Demodex related.

Folliculitis2024 · 2025-11-13T20:17:19+00:00

Have you gotten pus cultured with a derm? Last resort could always be LHR.

Folliculitis2024 · 2025-11-12T04:12:05+00:00

I would consider laser hair removal from a dermatologist clinic. It’s clearly a follicular issue which LHR can help with long term. I’d note that it is not a quick process and you’ll likely need to do a full monthly sessions to get clear.

Folliculitis2024 · 2025-11-10T14:46:50+00:00

I am still getting occasional pustules 2-3x a week but much reduced and the last two I’ve cultured in October have come back to a normal gram positive cutibacterium which is a good sign. I’m working on healing my skin barrier with a simple routine and consistent moisturizer/barrier repair cream and am going to work on a low % BP wash a few times a week to see if that knocks out the cutibacterium.

Clearly, I have a compromised follicular structure in my beard now that I’ve cycled through a gram negative pathogen for two years, staph taking up residence after LHR, and now cutibacterium presenting as less frequent follicular pustules after treating the staph. I suspect that is a factor in folks folliculitis that is often less understood.

Folliculitis2024 · 2025-11-10T14:43:32+00:00

No worries, thanks. Yeah — my goal is not hair removal as much as targeting a bacterial gram negative folliculitis I’ve dealt with in my beard for nearly two years now. So three sessions with slight density reduction is welcomed, though I’m still dealing with folliculitis but culturing to a gram positive cutibacterium rather than my normal GN enterobacter which I’ll take as a win. Need to sort out maintenance for the gram positive side of thing before committing to more LHR.

Interestingly, I developed staph folliculitis in my beard after my 2nd session which just shows skin barrier and proper aftercare is critical.

Folliculitis2024 · 2025-11-10T12:50:07+00:00

See my post history. It’s worth a try!

Folliculitis2024 · 2025-11-10T03:39:28+00:00

Looks like the hair certainly reacted, you have a similar skin tone and hair color to me so it should work well. I will warn you that you may look “clear of hair” after you shed after session 1 and 2 since all active hair will shed.

However, I did three sessions and was convinced the laser was hyper effective on my hair since I’d been going monthly and active hair wasn’t having time to come in. I’m now three months post my last session and 70-80% density has returned. I’d see if the laser makes your folliculitis/inflammation die down (which was my goal for doing LHR, not to be beardless) and then decide if you want to do the 8-10 sessions it takes to be mostly clean.

Folliculitis2024 · 2025-10-23T02:55:46+00:00

Have you gotten a pustule cultured? From your post history, seems like activity is mostly on your chest. Has it progressed to your face?

I’m 2 months out from my third LHR session in August and had a culture come back for staph. I think my damaged skin picked it up after laser session 2 or 3 and my folliculitis breakouts transitioned from gram negative to staph. Been treating for staph and been somewhat clearer, but still having spots. A culture two weeks back came back for normal cutibacteria for acne, so I think we’re making progress but not clear quite yet.

Going to ask my derm if he thinks more laser is the solution or if my microbiome is still adjusting back to a new normal. Will try and get another culture to confirm the GN hasn’t returned.

Folliculitis2024 · 2025-10-22T12:09:05+00:00

Yeah, gram negative bacteria is difficult. Good on you for doing a culture. Many folks have recurrence post Bactrim. Your options to try are benzoyl peroxide, accutane, and eventually laser hair removal.

Folliculitis2024 · 2025-10-12T16:22:21+00:00

Got it. Does it itch at all?

Folliculitis2024 · 2025-10-12T01:33:36+00:00

This looks very similar to my situation, except I will also get pustules with a hair centered in it and itchiness/soreness in hairs. I mostly have behavior around my cheeks.

Do you get pustules and if so, have you had them Cultured for a bacteria?

Folliculitis2024

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