Pityrosporum folliculitis, also called 'fungal acne' is a type of acne due to the yeast Pityrosporum (Malassezia).
Many people experience Pityrosporum folliculitis as itchy bright red pimples that won't go away on the back, chest, scalp, forehead and along your hair line. There may also be numerous small bumps on the involved skin.
This article is Part 1 of a two-part series on Pityrosporum folliculitis acne. This is a type of acne even many doctors overlook.
Did you know that most acne medicines don't work well on 'fungal acne' because they are designed to treat the other more common form of acne called acne vulgaris?
Ingredients often include benzoyl peroxide, salicylic acid and glycolic acid such as in my Ultimate Acne Solutions Kit. Sometimes a Professional Retinol Night Cream is used too. They work well for common acne. If you've tried the usual acne treatments and you still have pimples and blackheads, then you may actually have Pityrosporum folliculitis.
What areas of the skin are most affected by the breakouts of Pityrosporum folliculitis acne?
- The breakouts of Pityrosporum folliculitis type of acne are usually the worst on the forehead, along the hair line and jaw line.
- They can involve the sides of the neck too.
- Pimples and blackheads may also be present on the back, even going all the way down to the waist.
- The chest can be affected too.
- You may even get an occasional tender pimple on the scalp.
People with Pityrosporum folliculitis acne have both pimples and blackheads, but they’re slightly different than the pimples and blackheads seen in acne vulgaris.
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How are the pimples and blackheads of pityrosporum folliculitis acne different from acne vulgaris?
- The pimples of pityrosporum folliculitis are slightly different from those of acne vulgaris.
- The may be brighter red and both itch and hurt. Sometimes they have a bright red area around the pustule and almost look like a bug bite with a central pimple.
- In contrast, the pimples of acne vulgaris are typically a deeper reddish-purple and my patients usually describe them as painful, but not itchy.
- Pityrosporum folliculitis pimples heal differently too, often leaving a brown color along with the red scar.
- Accompanying the pimples of Pityrosporum folliculitis, the skin is often studded with many blackheads. These too are different than the blackheads of regular acne because they may be closed over and look like tiny pimples that aren't red and that feel rough. They can also be open and look more like a normal blackhead. Some people have just a few lesions, others have thousands.
Know that you can have both types of acne - acne vulgaris and Pityrosporum folliculitis at the same time, which is so unfair! The good news is that some of the skin care treatment routine and products overlap.
Who gets pityrosporum folliculitis acne?
Anyone can get Pityrosporum folliculitis, but you're particularly prone if:
- You sweat often (for example, if you're an athlete, have a job where you work up a sweat, or you live somewhere with hot weather).
- You have a personal or family history of asthma, eczema, life-long extreme skin dryness, keratosis pilaris, or hay fever (this genetic collection of conditions is called an atopic diathesis).
What causes this Pityrosporum folliculitis type of acne?
The reason that the Pityrosporum folliculitis type of acne is different from acne vulgaris is that it’s caused by an overgrowth of the Pityrosporum yeast germ that we all have in the pores situated above the waistline. This yeast germ loves sweaty skin and it's the reason that some people get pimples from sweat. It also grows well in people with an atopic diathesis because of the unique elements in their skin’s immunity. C. acnes bacteria may play a role too by helping the yeast create the pimples.
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What is the treatment of Pityrosorum folliculitis acne?
I see a lot of people with Pityrosporum folliculitis. It can be the sole reason for their pimples or it can coexist with acne vulgaris as a double whammy.
My dermatologist's treatment strategy for Pityrosporum folliculitis is three-fold:
1. Control the growth of the yeast.
2. Control growth of C. acnes bacteria that helps the yeast to create the acne.
2. Clean out the pores.
Click here to read more about how I treat my patients who have Pityrosporum folliculitis of the face. In the easiest routine, I add Calming Zinc Soap as a morning skin cleanser followed by Green Tea Antioxidant Skin Therapy to balance skin inflammation. At night I have them use the products and routine from my Ultimate Acne Solution Kit products. The Green Tea comes together with the Calming Zinc in my Redness Relief Kit.
Oil free moisturizer needs to be used to prevent skin dryness and my top choice is my Daily Face Cream for Oily to Normal Skin.
Sunscreen is worn on top to help prevent hyperpigmentation of healed pimples. My top choice for this skin problem is Sheer Strength Pure Physical Spray SPF 50 Sunscreen.
To help simplify your skin care choices I created my Pityrosporum Folliculitis Kit with everything you need for Complete Skin Care to treat fungal facial acne.
To treat acne on the back and chest in my dermatology practice I usually use my Back Acne Kit. This acne often is caused by Pityrosporum yeast so the product combination is perfect. It includes pyrithione zinc and benzoyl peroxide. Remember, I recommend that you start any treatment by seeing your dermatologist for an accurate diagnosis and medically-supervised care.
In Part 2 of this two-part series on Pityrosporum folliculitis acne , I'll give you additional info on my treatment approach to this treatable form of acne.
The take home message about fungal acne is that not every breakout of pimples and blackheads is acne vulgaris. The skin yeast germ Pityrosporum can cause acne too, and standard acne medicines don’t treat it. Treating this yeast may be all that stands between you and clear skin. See your dermatologist if you think you have Pityrosporum folliculitis acne. ~ Dr. Cynthia Bailey, Dermatologist