feline acne - does fur fall out in clumps???

My cat has a patch of acne on his face and it's spreading. He has had feline acne once before and me scrubbing off the blackheads with a towel plus some pyoben gel from the vet cleared it up. when he had it before, he got a little bald in the area where the acne was (one side of his face) but it grew right back when the acne went away. But this time, the patch of acne keeps spreading no matter what i do (i'm still trying to wipe the blackheads off and using pyoben gel) and also the fur has started to fall out in clumps on his face where the acne is! he scratches it and it just flies off his face...it's really kind of scary. Is this normal for feline acne? I'm calling the vet tomorrow. I thought some loss of fur was normal since that happened the last time he had acne but it's getting really bad - a quarter of his face is practically bald and the acne isn't getting better and the fur is not growing back....ideas on what to do? Also maybe it's not acne and it was misdiagnosed last time??

Is he having a reaction to the Pyoben gel? Stimpy had 2 different medications when we were dealing with a nasty acne case. It took a couple months to finally get him back to normal. His little chin was a giant scab at one point.

I would definitely talk to the vet again. It could be he needs a different medication.

I suspect that if a cat has repeated outbreaks of acne in the same places, the hair follicles eventually get destroyed and no hair grows back. Mellie occasionally has acne and even though it's relatively easy to get rid of and control, when I look closedly at her chin with a magnifying glass, there are small patches where the hair is very thin and I can see skin, and those spots correspond to where she had acne. I don't know this for a medical fact, but it seems logical....if a cat has repetitive severe acne it might suffer hair loss.

I'd definitely go back to the vet - my Radar is prone to bouts of acne, but he's never appeared itchy or had fur loss (except for when a scab falls off and a tiny bit of hair comes off with it).

It's not a long term solution, but if he's having a particularly bad bout then there are antibiotics that can really help clear it up, but it's worth determining whether it could be an allergic reaction that's causing the hair loss and itchiness.

What does he eat out of? Some cats will flare up if there's any plastic in the vicinity of their feeding area - including mats under the bowls, even if they don't actually eat directly off them. I would go for stainless steel or ovenproof/shatterproof glass food and water bowls (I actually think glass is the better option as it's less likely to get microscopic surface scratches during normal cleaning) and if a mat is required to catch spilled food, try cotton dish towels that can be laundered between uses, or unscented drawer-lining paper.

I hope you see some improvement soon, it does sound particularly bad.