Sweating from a hot and humid climate or from exercising and working your body hard can cause a type of sweat acne called pityrosporum folliculitis. I see a lot of this sweat acne in my dermatology practice both during the summer and during the school year when athletes are training and competing in their sport.
Pityrosporum folliculitis is a tough and stubborn form of acne to treat because some people’s skin is just prone to it. What happens is that a normal skin yeast that grows on most everybody’s skin (Malassezia) starts to overgrow in the pores. For some people, their pores don’t fight the yeast very well and so it easily takes off. A little heat and sweat and – poof, the yeast ‘parties on’ causing pimples.
The treatment depends on how severe the acne is. For my patients, I always recommend an anti-yeast cleanser and my favorite ingredient for that is pyrithione zinc. These cleansers need to be used every day to help suppress yeast ‘happiness’ and overgrowth.
Clogged pores and oily skin also seem to give the yeast cause for celebration, so I like to keep those ‘happy thoughts’ under wraps too. The best choices depend on a person’s skin type and skin sensitivities because the treatment options can be irritating. My ‘go to’ ingredients are benzoyl peroxide, salicylic acid or glycolic acid and physical exfoliation with a slightly rough shower sponge or scrub, and if money is no object, a Clarisonic Plus Sonic Brush.
So, what’s the bottom line….
What does pityrosporum folliculitis look like?
Itchy and tender, red pimples and little clogged white bumps
- situated along the hairline and jawline of the face often covering the entire forehead too,
- running down the sides and back of the neck
- also on the upper chest and back, and sometimes going down the back to the waistline
The best home treatment remedies for pityrosporum folliculitis acne from my dermatology practice are:
For the face:
Wash w/ a Buf Puf Facial Sponge and alternate Calming Zinc Cleansing Bar in the morning with a pore unclogging cleanser at night such as Glytone Mild Gel Wash Cleanser (with glycolic acid), OTB Cleanser #1 (with 10% benzoyl peroxide) or OTB Oil Off Cleanser (with glycolic acid and salicylic acid). Use a Clarisonic Plus instead of the Buf Puf if you can make the splurge (we sell them in my office). Blue text is clickable!
For the neck, back and chest:
Wash as soon as possible after sweating. If you can’t wash right away, then degrease the skin with rubbing alcohol.
Every day in the shower use a slightly rough shower sponge or cloth such as the Salux Cloth, a Buf Puf Body Sponge or the Clarisonic Plus Sonic Cleansing Brush and alternate using a foaming pyrithione zinc cleanser such as OTB Cleanser #2 with a pore unclogging cleanser such as the 3 I listed for the face. I’ve created a ‘turn key’ kit with all 3 of these necessary steps called my Back Acne Kit.
Does diet help this kind of sweat acne?
Maybe. There is no scientific evidence for this – yet – but in my dermatology practice I see that when my pityrosporum folliculitis patients eat a mostly healthy diet with more fruit and veggies and less junk food and sugar, their skin rewards them with fewer yeasty pimples. We know that yeast always love sugar and grease, so, taking away the feast seems to quiet the ‘yeasty party in the pores’.
Are there treatments that can help when the acne is severe and doesn’t respond to home treatment?
Yes, they require a doctor’s supervision and prescription. Pulsed therapy with oral anti-fungals can be helpful, but there are side effects and so the decision is not to be considered lightly. I always start with the skin care that I outlined above, and which becomes a long term skin care regimen for yeast suppression in pityrosporum folliculitis prone individuals.
Diagnosis and Management in 6 Female Adolescents With Acne Vulgaris
Katherine Ayers, BA; Susan M. Sweeney, MD; Karen Wiss, MD
Arch Pediatr Adolesc Med. 2005;159:64-67.
Photo: Thanks and Gratitude to The U.S. Army