So my lovely boyfriend has dealt with acne since he was a teenager. In his 20s what was left was a few deep cysts on his face that would recur, normally in similar places, and cysts on his neck.
It Started getting really bad 6 months ago when dry patchy skin started developing, under his beard on the lower face. It’s really itchy and sore. He thinks folliculitis or dermatitis. Pustules develop as well. He’s tried shaving and he’s tried leaving the beard but neither seems to be better than the other. He went to a dermatologist a few months ago and they proscribed oral antibiotics for the acne, ketoconizole for the flakiness and sulphur wash. That helped for a while and by the time he finished his antibiotics his skin was perfect, inflammation gone, no issues. Within 3 weeks of finishing the antibiotics the issues returned. Acne started appearing again around the neck. The flakiness is worse than it’s ever been, as seen in pics, it’s very sore, painful and itchy. Topical things don’t seem to be working as well now as they did last time. He’s been on antibiotics before for acne, and it’s never been a long term fix. He has good hygiene, showering every day, washing his face most nights with gentle cerave face wash and moisturising with cerave moisturising lotion. He changes his sheets and towels regularly. What is going on here and do people have any recommendations?? He is 28 now and becoming quite tired of his cystic acne and constant skin issues, it’s becoming something that really gets him down.
He’s hoping someone with experience might know what’s going on here and how to stop it??!!

[Acne] What is this??