Pityrosporum Folliculitis Acne: Could This Be Why Your Acne Won't Go Away?

Dermatologist explains Pityrosporum folliculitis fungal acne results

Pityrosporum folliculitis is a type of acne that is common. Many people experience it 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. 

Pityrosporum folliculitis, also called 'fungal acne', is a type of acne due to the yeast called Pityrosporum (Malassezia). 

This article is Part 1 of a two-part series on Pityrosporum folliculitis acne. This is a type of acne even many doctors overlook.

Pityrosporum folliculitis of forehead

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.  These ingredients work well for common acne. If you've tried the usual acne treatments and you still have pimples and blackheads, then you may also have the Pityrosporum yeast causing pimples and you need to address that germ too. 

What areas of the skin are most affected by the breakouts of Pityrosporum folliculitis acne?

  • pityrosporum folliculitis of the jaw and neck
    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. 

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 including:
  • Pityrosporum folliculitis acne on the back
    They 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. 

"My favorite Dr. Bailey skin care product is her zinc cleansing bar"

As an esthetician for the last 12 years it has been a revolutionary yet gentle & simple fix for my clients. The zinc cleansing bar helps profoundly with sensitivity conditions across the board! From folliculitis, rosacea, and dermatitis, I’ve seen it’s magical results time and time again."  Leah C    7/4/14

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.

"I have three products that I can not be without, the Calming Zinc Bar, the Foaming Zinc Cleanser and the Salux cloth. What more can I say, I love this woman and refer all my friends to her blog site!" ~  Kim N 6/24/14

What is the treatment of Pityrosporum 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.
  3. Clean out the pores.

best skin care treatment for acne without prescription

I add pyrithione zinc to an Acne Vulgaris skin care routine. The easiest way to do this is by adding Calming Zinc Bar Soap for acne as a morning skin cleanser. At night I have them use the products and routine from my Ultimate Acne Solution Kit products. These products combine the best medicated acne-fighting ingredients with an acne-friendly moisturizer formulated with skin soothing aloe and glycerin.

I add Green Tea Antioxidant Skin Therapy to help fight the itching and inflammation of the pimples and to help reduce sebum production. Green tea polyphenol antioxidants are capable of doing both these things. I have patients apply Green Tea Antioxidant Skin Therapy after the Calming Zinc during the day. This comes together with the Calming Zinc in my Redness Relief Kit

treatment for fungal acne

Sunscreen is worn on top to help prevent hyperpigmentation of healed pimples. It needs to be an oil free and non-comedogenic product that is also not occlusive on the skin. My top choice for this skin problem is Sheer Strength Pure Physical Spray SPF 50 Sunscreen. 

Ive also created a Complete Skin Care Routine with all the essential products to help get rid of 'fungal acne' in my Pityrosporum Folliculitis Treatment Kit. 

Pityrosporum  folliculitis doctor's treatment

What are the best products for Pityrosporum Folliculitis on the back and chest?

treatment for Pityrosporum folliculitis acne on back and chestTo get rid of fungal acne on the back and chest I recommend the combination of ingredients in 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.

Dermatologist's tips for treating fungal acneThe 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 

Click here to learn more about my dermatologist-developed Pityrosporum folliculitis kit to fight this unique type of fungal acne.