Can sweat cause pimples and acne?

Cynthia Bailey, MD|August 5, 2011

Sports and fitnessSweating from a hot and humid climate or from exercising and working your body hard can cause a type of 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.  The cause is an overgrowth of a normal skin yeast germ called Malassezia or Pityrosporum. For some people, their pores don’t fight the yeast very well and so it easily overpopulates the pores - a little heat and sweat and - poof, the yeast happily proliferates causing pimples.

What does pityrosporum folliculitis look like?

The pimples of this type of acne are unusual because they can be itchy and bright red. They can heal with a brown mark that lasts a long time, especially on the back and chest. The itchy and tender, red pimples are often accompanied by little clogged pores seen as white bumps. Blackheads are often present too.

  • Facial involvement is worst along the hairline and jaw line of the face often covering the entire forehead too,
  • Acne can be seen running down the sides of the neck
  • Back and chest acne are common and it sometimes goes all the way down the back to the waistline

What are the best home treatments and remedies for pityrosporum folliculitis acne? 

The treatment of this type of acne depends on how severe the acne is.  In my dermatology practice I always treat pityrosporum folliculitis type of acne with an anti-yeast cleanser. My favorite ingredient for that is pyrithione zinc. These cleanser need to be used every day to help suppress yeast overgrowth. Clogged pores and oily skin also seem to promote the growth of the yeast so I use cleansers that remove oil and have ingredients that unclog pores too.  The best choices depend on a person’s skin type and skin sensitivities because these ingredients can be irritating. To help unclog pores I use benzoyl peroxide, salicylic acid or glycolic acid cleansers. I have my patients use these ingredients on their skin with physical exfoliation achieved with a slightly rough shower cloth. If money is no object, we alternate the shower cloth with a Clarisonic Plus Sonic Brush. 

The best complete skin care routines to fight pityrosporum folliculitis type of acne are:

For the face:

Wash w/ a Clarisonic Brush System and alternate Calming Zinc Cleansing Bar in the morning with a cleanser containing ingredients to fight clogged pores at night. Options include  such as my Foaming Acne Treatment Cleanser (with glycolic and salicylic acids), Foaming Benzoyl Peroxide Cleanser (benzoyl peroxide) or Glytone Mild Gel Wash Cleanser (with glycolic acid), 

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 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 Foaming Zinc Cleanser 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 changing your diet help prevent this type of yeast 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 it is logical to take away the feast to help control the yeast party in the pores. 

Are there other treatments that can help when the acne is severe and doesn't respond to home treatment?

Yes. Additional treatments require a doctor's supervision and prescription.  Pulse 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.

Reference: Pityrosporum Folliculitis 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

I want to thank you for confirming my own treatment that my wife did not agree with but instead made me go to a dermatologist who gave me Minocin.  The problem was my own fault for not allowing my sweaty shirt to dry on me because I was to lazy to take it off or put on another on.  Also not showering immediately when I finished my activity.

Thank you again

By Edward Nofi on 2016 10 18

Hi,
I believe I am currently suffering from this PF initially brought on with a new brand of oral contraceptive. However - my challenge is living in the Caribbean with temps never lower than 30 degrees centigrade. I have started carrying a bandana style cloth with me so that I can pat my face dry at regular intervals but would I be better off with those facial cleansing tissues or using rubbing alcohol as mentioned above?

Also, whats the go with make up? I drastically need to hid the redness, so am applying thin powder when i arrive at work and washing it off as soon as I reach home. Will this seriously inhibit any successes, should I be washing the make up sponge between applications?

I look forward to hearing from you.
Thanks, Claire

By claire samuel on 2016 11 06

Hello!  I am currently living in a very hot and humid region of South East Asia and I do not have daily access to an air conditioned space.  I am constantly sweating and shower twice or three times a day when I arrive home and after sweat-inducing activities. I have altered many things about my daily habits but nothing seems to help clear up my follicultis and mild acne.  The folliculitis is mainly on my chest, neck, and back, and the acne is on my shoulders. I stopped wearing bras entirely because it wasn’t helping any and my symptoms decreased but only slightly.  I am currently taking Doxycyline for malaria prevention and was told that should help, but I have seen no changes after taking it for over a month already.  I am so fustrated and I hope you can help! Thanks!

By Lindsay B on 2016 11 20

Hello Lindsay,
My acne advice pages have a lot of info that may help https://www.drbaileyskincare.com/info/dermatologists-advice/skin-care-tips/acne-tips Know too that not every pustule is acne. Miliaria is a clogging of sweat glands that can look like a pimple. Google search that word as well. Best wishes!

By Cynthia Bailey, MD on 2016 11 22

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