Pityrosporum Folliculitis Acne Treatment; many doctors don’t even know this

Pityrosporum folliculitis acne treatment is something I do every day in my practice because this fungal acne is common. It is often also overlooked by both patients and other doctors as a cause of stubborn acne. 

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:

1. Control the growth of the yeast
2. Control the bacteria C. acnes since it sometimes conspires with Pityrosporum to create the acne.
3. 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 

Pyrithione zinc soap

2% pyrithione zinc in either a bar soap or liquid skin cleanser 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 anti-yeast medications

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.

Other dermatologist tips to fight Pityrosporum folliculitis

• 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.

Best Skin Care Treatment to Unclog Clogged Pores and Treat Blackheads to Heal Pityrosporum Folliculitis

Keratolytics help to unclog pores and treat Pityrosporum folliculitis

Add keratolytics to the pyrithione zinc products above to get even faster results. The yeast loves being tucked into the deep portion of the pore by a nice big blackhead plug! When you prevent clogged pores, the yeast is better exposed to the pyrithione zinc and treatment works better.

I have patients use products with one or more of the effective keratolytic skin care ingredients (keratolytics are ingredients that break up clumped dead skin cells). 

Four keratolytics in skin care products that help fight Pityrosporum folliculitis

1. benzoyl peroxide - this is my top choice because it also the acne causing bacteria called P. acnes/C. acnes that conspires with Pityrosporum to create this type of acne,
2. glycolic acid (a great ingredient to use in your moisturizer),
3. salicylic acid,
4. retinol, or prescription retinoids like tretinoin (Retin A) can be used at night to the involved areas of skin. 

These keratolytic products can be 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.

My top treatment options for Pityrosporum folliculitis include:

Back Acne Treatment Kit for the back and chest.   

 

Pityrosporum Folliculitis Kit gives you Complete Skin Care treatment for facial Pityrosporum folliculitis type of 'fungal' acne 

 

Ultimate Acne Solutions Kit plus Calming Zinc if you already have a sunscreen that you love

 Retinol Intensive Anti-Wrinkle Night Cream will help unclog pores, reduce uneven skin pigment and fight the signs of skin aging at the same time. 

Glycolic Acid 15% Body Lotion is a great keratolytic body moisturizer to apply after your bath or shower. It also helps keep arm and leg skin soft and smooth. 

Physical exfoliation scrubs and sponges can enhance treatment of Pityrosporum folliculitis

Body Exfoliation

The Salux Cloth is a great alternative for the back and chest. It comes in my Back Acne Kit.

Facial Exfoliation options

The Exfoliating Facial Sponge can be used with the Foaming Acne Treatment Cleanser, and/or my Bamboo and Clay Facial Scrub can be used twice a week for more vigorous exfoliation to brighten the complexion. 

My Triple Action Exfoliating Cleanser has a gentle level of salicylic acid, a robust 10% glycolic acid and fine eco-friendly exfoliating beads. It can be used on both the face and the body to brighten the skin fight acne and the signs of skin aging. When used on wet skin it gently exfoliates. When massaged into dry skin it exfoliates more vigorously. When used with a Salux Cloth on the body, it polishes skin to a satiny smooth texture. 

Physical exfoliation helps remove surface dead skin and debris so that 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.

What is the easiest skin care routine to treat fungal acne?

To simplify your skin care choices I created my Pityrosporum Folliculitis Kit. It gives you the essential products 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 with the best ingredients to fight fungal acne! 

The bottom line with Pityrosporum folliculitis

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.