Sweating can cause acne. It happens when you are in a hot and humid climate or from exercising and working out. This type of acne is called pityrosporum folliculitis. I see a lot of this type of sweat-induced acne in my dermatology practice. It happens during the summer when my patients are hot and sweaty from enjoying the outdoors. It also happens 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 reason is that this yeast is a normal skin yeast that grows on almost everybody’s skin. Also called Malassezia, it starts to overgrow in the pores when the conditions are right. Some people’s 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.
What is the best treatment for pityrosporum folliculitis type of acne?
The treatment of this type of acne depends on how severe the acne is and what part of the skin is involved. I always recommend an anti-yeast cleanser for my patients. My favorite ingredient for that is pyrithione zinc. This cleansers need to be used every day to help suppress yeast ‘happiness’ and overgrowth.
Because clogged pores and oily skin also seem to give the yeast cause for celebration, I like to combine pyrithione zinc with a keratolytic product that busts blackheads and clogged pore debris. The best choices depend on a person’s skin type and skin sensitivities because keratolytic ingredients can be irritating. My ‘go to’ ingredients are benzoyl peroxide, salicylic acid and glycolic acid. I also use physical exfoliation with a slightly rough shower sponge or scrub, If money is no object, I recommend a Clarisonic Brush too.
Now the details.
What does pityrosporum folliculitis look like?
This type of acne manifests with itchy and tender, red pimples and little clogged white bumps. The lesions are,
- situated along the hairline and jawline of the face often covering the entire forehead too,
- run down the sides and back of the neck,
- may also involve the upper chest and back, and sometimes going all the way down the back to the waistline
What are the best home treatment remedies for pityrosporum folliculitis type of acne from my dermatology practice?
The best results come when you create a complete skin care routine built from the 4 key steps in skin care:
Cleanse + Correct + Hydrate + Protect
In the case of Pityrosporum Folliculitis, your cleanse and correct steps may be acheived together by your medicated cleanser! If you have really stubborn acne, you may want to apply a leave on product to enhance the ‘correct’ step.
Treatment recommendations of pityrosporum folliculitis acne involving the face:
Wash your skin as soon as possible after sweating. If you can’t wash right away then remove facial oil with the Acne Treatment Pads listed below or with a natural witch containing hazel toner.
Wash your face twice a day by alternating Calming Zinc Cleansing Bar in the morning and a keratolytic cleanser (pore unclogging) at night.
The keratolytic option you chose depends on your skin’s tolerance to the ingredients:
Glycolic acid: Glycolic Acid Face and Body Wash (with glycolic acid),
Glycolic acid and salicylic acid: Foaming Acne Treatment Cleanser (salicylic acid penetrates best into oily pores)
Benzoyl peroxide: Benzoyl Peroxide Foaming Acne Cleanser (the best choice if you also have cystic acne vulgaris).
If your facial acne is severe, you may benefit from a leave on product such as:
Benzoyl Peroxide Lotion applied to acne prone areas or as a spot treatment for pimples.
Hydrate dry skin to prevent irritation with a light and oil free moisturizer. My top choice for pityrosporum folliculitis acne is Daily Face Cream for Normal to Oily Skin.
Wearing sunscreen is important because pityrosporum folliculitis tends to hyperpigment where pimples have healed. Apply sunscreen last on top of moisturizer. My top choices of sunscreen include:
Sheer Strength Matte Tinted Sunscreen with it’s lovely dry and oil absorbing formulation.
Treatment for pityrosporum folliculitis involving the neck, back and chest:
Wash as soon as possible after sweating. If you can’t wash right away, then degrease the skin with the Acne Treatment Pads or Witch Hazel Toner.
Every day in the shower use a physical exfoliation with a slightly rough shower sponge or cloth to help exfoliate thick back skin. Exfoliate the chest too but use only gentle pressure. You can do this with Salux Cloth, a Buf Puf Body Sponge.
Alternate your cleansers to both cleanse and correct in one step. Use a foaming pyrithione zinc cleanser such as Foaming Zinc. Alternate with one of the keratolytic cleansers above that you are using on your face including either the Foaming Acne Treatment Cleanser, the Foaming Benzoyl Peroxide Cleanser or the Glycolic Acid Face and Body Wash.
Does this found like a lot of products and options? I’ve created kits to make it simple.
My Back Acne Kit will work on the back. It even comes with the Salux Cloth.
Hydration of back and chest skin will come naturally as your skin produces oil. Sun protection is important to prevent hyperpigmentation of healed acne lesions. This is best provided by wearing sun protective clothing until the acne has healed.
Does diet help pityrosporum folliculitis type 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