Pityrosporum Folliculitis Acne: Could This Be Why Your Acne Won’t Go Away?

Cynthia Bailey, MD|September 29, 2010

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?

pityrosporum folliculitis acne treatment tipsBelieve 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 acne, 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 acne?

People with pityrosporum folliculitis acne 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.  

"My favorite Dr. Bailey skin care product is her zinc cleansing bar" As an esthetician for the last 12 years it has been a revolutionary yet gentle & simple fix for my clients. The zinc cleansing bar helps profoundly with sensitivity conditions across the board! From folliculitis, rosacea, and dermatitis, I’ve seen it’s magical results time and time again."  Leah C    7/4/14

How are the pimples and blackheads of pityrosporum folliculitis acne different from acne vulgaris?

ThDr. Bailey Breast Cancer Chemotherapy Skin Caree 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 coloralong with the red scar. Along with the pimples, there are usuallymany 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 acne? 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.

  "I have three products that I can not be with out: the calming zinc bar, 2% zinc body wash and the Salux cloth." I also have finally found the facial sunscreen for me through Dr. Bailey- Citrix. I actually look forward to the application everyday! And given my complex skin issues, rosacea and seborrheic dermatitis, that is saying a lot! The extra gentle buff puff and her hand lotion are also favorites. What more can I say, I love this woman and refer all my friends to her blog site!     Kim N 6/24/14

Treatment of pityrosorum folliculitis acne

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 acne.

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 share using the social sharing buttons below.

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