This is Part 2 of a series on the Pityrosporum folliculitis (also known as 'fungal acne').
I see a lot of people with Pityrosporum folliculitis in my dermatology practice. Almost all of them have tried unsuccessfully to treat their pimples with the wrong medicines; they've either used medicated acne skin care products or been treated with prescription acne medicines by another physician. The problem is that acne medicines treat pimples and blackheads caused by the bacteria C. acnes. They don't treat the yeast that causes Pityrosporum folliculitis type of fungal acne. It's also possible to have both regular acne vulgaris AND Pityrosporum folliculitis together, and both need treatments or the breakouts persist.
In Part 1 of this series I described the difference between Pityrosporum folliculitis and regular acne. Here in Part 2 I am going to outline my treatment approach.
My treatment strategy for Pityrosporum folliculitis acne is three-fold:
- Control the growth of the yeast
- Control the bacteria C. acnes since it sometimes conspires with Pityrosporum to create the acne.
- Clean out the pores.
I’ll give you an overview of how I treat my patients who have pityrosporum folliculitis, but I recommend you start any treatment by seeing your dermatologist for an accurate diagnosis and medically supervised care.
Dermatologist Dr. Cynthia Bailey’s Treatment Of Pityrosporum Folliculitis Acne
Best Products to Help Combat Skin Yeast
- 2% pyrithione zinc in either a soap or shampoo are my first choice for Pityrosporum folliculitis. I have patients use Calming Zinc ® soap on their face and Foaming Zinc Cleanser on their back, neck and chest. My Foaming Zinc Cleanser lathers well and works as a shampoo so it can be used on the scalp too. The product's cleanser base is a little harsh for the face which is why I use Calming Zinc for facial skin. 2% pyrithione zinc is over the counter and does not require prescription.
- Prescription medicines such as sodium sulfacetamide cleansers, or a short course of oral anti-yeast pills are a last resort if the 2% pyrithione zinc isn't controlling the breakouts sufficiently. They would only be prescribed by a physician after an exam and consultation if there is no allergy or contraindication to the use of these medicines.
- I stress the importance of washing the involved skin at least twice daily and as soon as possible after sweating using the medicated cleansers. Pityrosporum yeast thrives in sweat and oil so skin should be kept as sweat and oil free as possible.
- A low carb/low glycemic/low fat diet can support skin clearing because yeast organisms love carbs and oil. This is also the dietary recommendation I give my patients with acne vulgaris.
Treatment To Unclog Clogged Pores and Treat Blackheads
- I have patients use products with one or several of the effective keratolytic skin care ingredients (keratolytics are ingredients that break up clumped dead skin cells). These include benzoyl peroxide, glycolic acid, salicylic acid, retinol, or prescription retinoids like tretinoin (Retin A). These are used as cleansers or leave on products in treatment pads, lotions or creams. I choose the product depending on the person’s skin type and tolerance to these potentially harsh ingredients. Powerful professional strength keratolytics are found in my Back Acne Treatment Kit for the back and chest. Another alternative is my Glycolic Acid Body Kit. and Ultimate Acne Solutions Skin Care Kit as well as my Glycolic Acid Facial Treatment Kit
- I recommend the use of exfoliating scrubs and sponges like the Salux Cloth, Exfoliating Facial Sponge and Bamboo and Clay Facial Scrub. These help remove surface dead skin and debris, and help medicated ingredients penetrate deeper into the pores. The Clarisonic Sonic Cleansing Brush System is also a wonderful tool for unclogging clogged pores and enhancing skin penetration of medicated ingredients.
To simplify your skin care choices I created my Pityrosporum Folliculitis Kit. It gives you everything you need for Complete Skin Care for your facial skin including the right moisturizer and sunscreen to help reduce the risk of acne scarring and skin dryness. Add my Back Acne Kit for your chest and back acne and you're set!
The take home message 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.