This is Part 2 of a series on the pityrosporum folliculitistype of acne.
I see a lot of people with pityrosporum folliculitis and 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 p. acnes. They don’t treat yeast and the breakouts of pityrosporum folliculitis type acne are due to an overgrowth of the pityrosporum yeast. Medicines that kill this yeast are necessary to control the pimples and blackheads of pityrosporum folliculitis. 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 is two fold: 1. Control the growth of the yeast and 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.
Dermatologist Dr. Cynthia Bailey’s Treatment Of Pityrosporum Folliculitis
Treatment To Control Skin Yeast Growth
- 2% pyrithione zinc in either a soap or shampoo are my first choice to treat 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 a 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 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 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 and Ultimate Acne Solutions Skin Care Kits as well as my Glycolic Acid Facial Treatment Kits and my Glytone Body Wash.
- I recommend the use of exfoliating scrubs and sponges like the Salux Cloth, Buf Puf Body and Face Sponges and Replenix Scrub. These help remove surface dead skin and debris, and help medicated ingredients penetrate deeper into the pores. The Clarisonic Plus Professional Sonic Brush is also a wonderful tool for unclogging clogged pores and enhancing skin penetration of medicated ingredients.
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.
There are even more causes of acne beyond acne vulgaris and pityrosporum folliculitis. If your looking for additional information, please read my article Common Reasons Why Your Acne Treatment Might Not Be Working.
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: Gratitude and thanks to Buggolo