Some call it the "acne antibiotic game". First comes tetracycline, then comes doxycycline, and then your doctor finally recommends erythromycin. But what do you do when these common antibiotics fail to control your acne outbreaks? Well typically, your dermatologist might suggest isotretinoin- the ultimate prescription acne drug.

But why is isotretinoin the final pharmaceutical answer for acne? It's probably because excessive or inappropriate usage of antibiotics could lead to gram-negative folliculitis. Gram-negative folliculitis is caused by bacterial interference, and replacement of the gram-positive bacteria on the face and within the mucous membranes of the nose, with gram-negative bacteria.

And while acne is readily diagnosed, according to a study in the American Journal of Clinical Dermatology, incidences of gram-negative folliculitis are probably underestimated in patients with re-occurring and difficult to treat acne.

Even though isotretinoin has been successfully used to treat gram-negative folliculitis, this potent acne drug is not always accessible to acne sufferers because of health or monetary reasons. So the question arises- are there other methods to control or destroy gram-negative bacteria and bring acne outbreaks under control?

Two proteins that bring acne aggravating bacteria under control Researchers from the Department of Veterans Affairs Medical Center at Denver, Colorado have discovered that the protein lactoferrin changes the outer membrane of gram-negative bacteria. As lactoferrin disrupts the protective barrier of the gram-negative bacterium, this new vulnerability allows another anti-microbial protein called lysozyme to further destroy the bacterium.

At-home acne remedy The gram-negative fighters lactoferrin and lysozyme occur naturally in products such as milk. Likewise, whey protein contains several anti-bacterial proteins including lactoferrin, lactoperoxidase, lysozyme and immunoglobulins. You can make an at-home acne mask to help abate pimple outbreaks by using whey protein. (Whey protein is widely available in health food stores.)

Step 1: Cleanse your face using warm water and a clean washcloth. Pat face dry.

Step 2: In a bowl, mix one tablespoon of whey protein with just enough water to create a paste.

Step 3: Apply the paste to your face and allow to dry for 5-10 minutes

Step 4: Rinse off the paste with warm water and a face cloth. Apply moisturizer.

You can use this whey mask once a day as a natural part of your acne control regime. Sources: Böni, R and B Nehrhoff. Treatment of Gram-Negative Folliculitis in Patients with Acne. American Journal of Clinical Dermatology; 2003, vol 4, no 4, pp 273-276(4).

Ellison RT & TJ Giehl. Killing of Gram-negative Bacteria by Lactoferrin and Lysozyme. The Journal of Clinical Investigation; 1991 October, no 88(4), pp 1080–1091.

Neubert, Uwe, Thomas Jansen & Gerd Plewig. Bacteriologic and Immunologic Aspects of Gram-negative Folliculitis: A study of 46 patients. International Journal of Dermatology; 1999 April, vol 38, no 4, pp 270-274(5).

Séverin, Sindayikengera & Xia Wenshui. Milk Biologically Active Components as Nutraceuticals: Review. Critical Reviews in Food Science and Nutrition; 2005 October-December, vol 45, no 7-8, Number 7-8, pp 645-656(12).