Do you know why those itchy pimples on your back and chest and along your hair line won’t go away with the standard acne treatment?
Believe it or not, just because you have pimples and blackheads doesn’t mean you have normal acne. Your acne may be different. There are other types of acne and they need different treatments-and that’s why standard acne treatment doesn’t always work for everybody.
This article is Part 1 of a two-part series on pityrosporum folliculitis, a type of acne even doctors overlook.
Most acne medicines are designed to treat the common form of acne called acne vulgaris. 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?
People with pityrosporum folliculitis have pimples and blackheads, but they’re slightly different than acne vulgaris lesions. One of the differences is where the breakouts occur on your skin. The breakouts are usually the worst on the forehead, along the hair line and jaw line, and down the sides of the neck. Pimples and blackheads may also be on the back and they can go all the way down to the waist. The chest can be affected too. You may even get an occasional tender pimple on the scalp.
How are the pimples and blackheads of pityrosporum folliculitis different from acne vulgaris?
The pimples of pityrosporum folliculitis are slightly different from those of acne vulgaris in that they are usually bright red and both itch and hurt. Acne vulgaris pimples are typically a deeper purple red 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. Along with the pimples, there are usually many blackheads and tiny pimple-like bumps that are closed-over blackheads. Some people have just a few lesions, others have thousands.
Who gets pityrosporum folliculitis?
Anyone can get pityrosporum folliculitis, but you’re particularly prone if:
- You’re often sweaty (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 our pores 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.
Treatment of pityrosorum folliculitis
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 treatment strategy for pityrosporum folliculitis is two-fold:
1. Control the growth of the yeast.
2. 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.
In Part 2 of this two-part series on pityrosporum folliculitis acne , I’ll give you my exact treatment approach to this treatable form of acne.
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. See your dermatologist if you think you have pityrosporum folliculitis.
Do you have any “strange” acne stories or surprising acne cures?
I’d love to hear from you if you do. Send them to me as a comment below or using the Ask Dr. Bailey link on the top of the page.
Photo Attribution: Thanks and gratitude to Demented-Pixie