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[White Fox]

Pityrosporum Folliculitis - FAQ


Introduction
A lot of people are struggling with that they think are acne primarily on their chest, shoulders and back. It may also develop on the face(primarily the forehead). After trying countless acne medications or simply by trying to wait it out the condition still persists. The fact is that many "body acne" sufferers got some sort of folliculitis and when the lesions develope on the upper body it's often Pityrosporum Folliculitis they got.
The same questions pop up under the body acne section, and by creating this thread I'm hoping to answer some of this questions. However, be advised that I'm not a dermatologist or expert on the field. The information I'm providing is mostly from what I've read(countless hours of reading up on the subject online) and from what I have experienced.

This thread is a working progress and I hope others also will participate with information they have on the subject. Questions regarding this FAQ or contributions can be done by replying in this thread, but general questions regarding Pityrosporum Folliculitis can be asked in this thread. It has a lot of great information and users own experiences with PF.


What is Pityrosporum Folliculitis?
The first thing you should do is research the subject on your own. There's a lot of information found on the net and here are some good links:
http://www.emedicine.com/DERM/topic338.htm
http://www.americanchronicle.com/articles/16713
http://www.aocd.org/skin/dermatologic_dise...orum_folli.html
http://archpedi.ama-assn.org/cgi/reprint/159/1/64.pdf
http://dermatology.cdlib.org/rxderm-archiv...um-folliculitis
http://www.vgrd.org/archive/cases/2005/pit/pit.htm


Do i have Body acne or Pityrosporum Folliculitis?
This is the first question that people with "Body Acne" ask themselves when they are confronted with the term Pityrosporum Folliculitis. However this is often the hardest one to answer since "Body Acne" and Pityrosporum Folliculitis look a lot alike. Also a lot of people have them both at the same time since both acne and Pityrosporum Folliculitis thrive on oily skin.
Some things you should consider to find out if it's acne or Pityrosporum Folliculitis:
- Go to a dermatologist(This is the safest thing you can do to find out if it's body acne or Pityrosporum Folliculitis). Be sure to contact the derm before you schedule an appointment to be sure that he can do a biopsy or something like that to find out what your condition is.
- Have you tried acne medication without success? If you have it's more likely that you got Pityrosporum Folliculitis
- Have you used antibiotics previously. If this made the condition worse or if you got the spots on your body after the use of Antibiotics it's most likely Pityrosporum Folliculitis you got.
- Does it sometimes itch. If it does it's probably Pityrosporum Folliculitis
- Do you got Acne on your face too? If your face it's pretty much clear, but your body breaks out it's more likely that Pityrosporum Folliculitis is what you got. Pityrosporum Folliculitis can develop on the face to, but it's much less frequent.
- Does it get worse in hot, humid or sweaty environments or in periods where you don't shower much. If it does it's more likely Pityrosporum Folliculitis you got.
- There is no comodones or cysts associated with PF. It's Papules and Pastules and the material expressed from pustules is white to yellow
- Try some sort of medication against Pityrosporum Folliculitis(see treatments below) and see if this improve your condition. A safe bet is to buy a cream containing 2% ketoconazole(Nizoral, Daktarin Gold or something like that), and try it for a couple of weeks to see if it improves the condition.
- Check out the pictures of Pityrosporum Folliculitis below to see if it looks like what you got.


What does Pityrosporum Folliculitis look like?
http://www.aocd.org/images_ddd/Pityrosporu...itis_1_high.jpg
http://www.aocd.org/images_ddd/Pityrosporu...itis_2_high.jpg
http://www.cmaj.ca/cgi/reprint/171/8/851.pdf
http://www.skinatlas.com/pityrosporum.jpg
http://dermnetnz.org/common/image.php?path...img/pitfol1.jpg
http://dermnetnz.org/common/image.php?path...img/pitfol2.jpg
http://dermnetnz.org/common/image.php?path...img/pitfol3.jpg
http://162.129.70.33/images/folliculitis_1_010901.jpg
http://162.129.70.33/images/folliculitis_2_010907.jpg
http://162.129.70.33/images/pityrosporum_f...is_1_040505.jpg
http://www.acne.org/messageboard/index.php...st&id=12078


What kind of treatments are there?

Topical

Most popular on acne.org:

Ketoconazole

• Description: Widely used chemical for PF and can be used topically either as a shampoo(leave on for about 5 min in shower before washing of) or as a cream. It's usually available in 1 or 2% concentrations in various products.
• Research/information:
  - The in vitro antifungal activity of ketoconazole, zinc pyrithione, and selenium sulfide against Pityrosporum
  - Dandruff and Seborrheic Dermatitis
• Products:
  - Cleanser/wash: Nizoral, Fungoral
  - Leave on product: Nizoral, Daktarin Gold, Fungoral

Zinc Pyrithione

• Description: Not as effective against Pityrosporum ovale as Ketoconazole, but used with great success by a lot of members on acne.org. Head & Shoulders has 1% Zinc Pyrithione in it and that is probably why it works so good for a lot of people. Zinc Pyrithione is both antifungal and antibacterial. However, I recommend trying something like ZNP bar since it has 2% Zinc Pyrithione in it and is designed for use on the skin, not specially for the hair.
• Research/information:
  - How I got rid of my bacne - Using only Head & Shoulders
  - i'm clear using head and shoulder shampoo
  - The in vitro antifungal activity of ketoconazole, zinc pyrithione, and selenium sulfide against Pityrosporum
  - Dandruff and Seborrheic Dermatitis
• Products:
  - Cleanser/wash: Head & Shoulders, ZNP bar

Propylene Glycol

• Description: Used by a lot of members on acne.org with great success. Very easy to use since one option is to just spray it on using a spray bottle. It's fast, cheap and easy to apply to f.ex your entire upper body. With a cream it's hard to apply it to f.ex your entire upper body and it's therefore likely that the PF might spread.
  Propylene Glycol is often used in a concentration with water(50/50 of each). Sometimes you can buy 100% percent Propylene Glycol, but then you should dilute it with water before applying. If you look at the ingredients list on a lot of cosmetics you can see that Propylene Glycol is almost always on it. However, don't expect that your regular acne medication might work since it has Propylene Glycol in it. It's often a very low percentage of actual Propylene Glycol in the product.
• Research/information:
  - Pityrosporum folliculitis: a common disease of the young and middle-aged
• Products:
  - Leave on product: PG from chemistrystore.com, 50/50 PG/Water from Cubancrafters.com

Mandelic Acid

• Description: There is very little research on the antifungal effect of Mandelic Acid, but it's a popular product on this board against Pityrosporum Folliculitis. It's claimed to be both antifungal and antibacterial and exfoliates the skin. Therefore it's also good against red marks left from acne/PF. I personally receommend the product from Vivant for Pityrosporum Folliculitis on the body since it's a strong product(15% Mandelic + 2% lactic), it has very little ingredients besides the Mandelic and has some Propylene Glycol in it. However, the serum is very expensive and therefore it might be wise to buy the toner(9% mandelic) if your economy is tight.
• Research/information:
  - Mandelic acid is amazing against blackheads and acne ...
  - Nucelle changed my life
• Products:
  - Cleanser/wash: Vivant Mandelic Acid Cleanser
  - Leave on product: Vivant Mandelic Acid serum, Vivant Mandelic Acid toner, Nucelle Mandelic Acid

Other treatments:

Salicylic Acid

• Description: Used against both acne and Pityrosporum Folliculitis and is always a safe bet if you aren't 100% sure what you got. Mostly used in a concentration from 1,5% to 3% and either as a cleanser or a leave on product. A leave on product is nearly always the best bet since the Salicylic acid in cleansers doesn't sit on the skin long enough to do anything. Also, a Salicylic Acid product has to have a low pH to work(no higher than pH 4 is recommended). Most if not all cleansers has a higher pH than that and therefore the Salicylic Acid is pretty much ineffective.
• Research/information:
  - The antifungal activity of Salicylic Acid
  - Dandruff and Seborrheic Dermatitis
• Products:
  - Leave on product: Dan's Salicylic Acid, Paula's Choice Liquid BHA, Salicylic Acid from dianayvonne.com

Sulfur

• Description: Isn't the most known chemical against Pityrosproum Folliculitis, but has has antifungal, antibacterial, and keratolytic activity. Very drying when used as a leave on product and is therefore often used as a cleanser/wash and washed of after 5-10 min.
• Research/information:
  - The use of Sulfur in dermatology
  - Dandruff and Seborrheic Dermatitis
  - Topical Sulfur Products - Increase cell turnover (dead skin cant harden to create sebum)
• Products:
  - Cleanser/wash: Sulphur Soap(10% Sulphur), Sulphur(10%)/Salicylic Acid(3%), Grandpa's Thylox Soap

Selenium Sulfide

• Description: Selenium sulfide is highly active in inhibiting the growth of P. ovale. It's usually used in shampoos and is washed of after about 5 min on the skin.
• Research/information:
  - Pityrosporum folliculitis: a common disease of the young and middle-aged
  - Dandruff and Seborrheic Dermatitis
• Products:
  - Cleanser/wash: Selsun Blue, Selseb shampoo, Head & Shoulders Intensive Treatment

Tea Tree Oil

• Description: Both antibacterial and antifungal and effective against Malassezia furfur(the same as P. Ovale) Should be diluted with f.ex another oil like emu or jojoba. You can also find it as a shampoo. Never buy Tea Tree Oil in plastic bottles. Also it's best if it's stored in dark glas bottles.
• Research/information:
  - Tea Trees and Their Therapeutic Properties
• Products:
  - Leave on product: Desert Essence Organic Tea Tree Oil

Manuka Oil/honey

• Description: Manuka Oil is 20-30 times more active than Australian Tea Tree Oil
  for gram positive bacteria, and 5-10 times more active for fungi. However, there's a lot more research on Tea Tree Oil and it's effect on the Pityrosporum yeast.
• Research/information:
  - East Cape Manuka Oil, Manuka Cream and Manuka Soap
  - Tea Trees and Their Therapeutic Properties
• Products:
  - Leave on product: Living Nature Manuka oil and honey gel, Manuka oil from http://manukaoil.net/

Ciclopirox olamine cream

• Description: Antifungal often used to treat Pityrosporum folliculitis
• Research/information:
  - Monograph - Ciclopirox Olamine
• Products:
  - Leave on product: Can be bought from drugstore.com

Econazole cream

• Description: Treats fungus infections
• Research/information:
  - Pityrosporum folliculitis: a common disease of the young and middle-aged
• Products:
  - Leave on product: Can be bought from drugstore.com

Oil of Oregano

• Description: Antifungal
• Research/information:
  - More information on this
• Products:
  Leave on product: Oil of Oregano from North American Herb and Spice

Apple Cider Vinegar

• Description: Malic Acid is found in Apple Cider Vinegar and is antifungal. It can be used directly on the skin, but should be diluted first.
• Research/information:
  - Apple Cider Vinegar Cures
  - Apple Cider Vinegar* Pictures On First Page, Reduces Oil, Red Marks, Acne, Dry Skin, Regulates pH levels & More
• Products:
  Leave on product: Bragg Organic Apple Cider Vinegar

Oral

Azole antifungal agents

• Description: The two most used are Ketoconazole and Itraconazole. It's very effective, and if it is indeed PF you got these mediacations should make a remarkable clearing. However, you are lucky if the results are permanent and one should continue topical medication afterwards.
• Research/information:
  - Short term treatment of pityrosporum folliculitis with itraconazole
• Products: You need a prescription to get this medication legally, and therefore you have to contact your doctor to get this stuff.

Isotretinoin

• Description: A lot of people try Accutane after years of struggling. In a lot of cases it's effective against Pityrorsporum Folliculitis since the yeast thrive on oily skin. However, it's not always effective and some people on this board has experinced that their Pityrosporum Folliculitis has come back after the course of Accutane.
• Research/information:
• Products: Ask your dermatologist if you want this drug.

Does diet, hygiene or physical activity affect Pityrosporum Folliculitis?

When it comes to diet and Pityrosporum Folliculitis I'm not an expert. It's always hard to know if something is breaking you out or not. Some people say the fungus feed on sugar, but I have yet to see any hard evidence supporting this. So when it comes to general diet guidelines to help treat Pityrosporum Folliculitis there is a long way to go.
However, there are several things that you can eat which should help to treat the condition from inside. This is a great list of natural antifungals

Pityrosporum Folliculitis often affects athletes. This could be due to the sweating, rubbing from clothes etc. However I don't think working out and sweating makes PF worse if you take a cool shower right after you sweat using a medicated cleanser.
Some people on this board feel that the Pityrosporum Folliculitis/acne increases due to bodybuilding. . I'm not sure about the direct connection between working out and Pityrosporum Folliculitis. The reason people feel that they get PF due to bodybuilding could simple be that they sweat a lot, wear to tight clothing or experience rubbing from weight bars or machines. I work out a lot myself an for a long time I tought Pityrorsporum Folliculitis were a result of that, but I have now realised that I manage to keep it under control by taking a cool shower right afterwards and use a medicated cleanser. However, I will break out if I go days with physical activity and no showering.


What is your experience with Pityrosporum Folliculitis?
Started getting what I tought was acne on my forehead around december/january 2006/2007. I used hair care products full of shitty ingredients and had long hair that touched my forehead. This caused several papules/pastules. However, the damage was done, and now I didn't want to cut my hair to reveal my shitty forehead. After a while I cut my hair and stopped using any products in it, but the problem persisted and got worse.
During the following months I tried Dan's regimen, several diet changes, washes and more. However nothing seemed to do any good for my forehead.

Summer 2007 I went on vacation and was in the sun for hours each day. I got a nice tan and all my acne on my forehead "cleared up". What I actually was doing was damaging my skin and disguising all the red marks behind a nice tan. I still regret this to the very day since it made my red marks stay for ages. At that time I hadn't acne on my body at all(just some spots on the top of my back). However, I got a pretty severe sunburn, and a lot of dead skin on my shoulders and upper back. A couple of weeks later I started getting "acne" on my shoulders, upper back and chest. Mostly I got Pastules and what looked like whitehead on my chest(see the last picture under pictures) and the little deeper kind of pastules/papules on my shoulders/upper back. Mostly it only itched on the upper back and sometimes on the chest. However the itch was far from irritating and was never really a problem.

Through the winter(2007(September)-2008(January)) I didn't do much to the problem. I was hoping it would go away on it's own, and it was winter so I didn't have to reveal my upper body. When the summer got nearer I realised this shit wasn't going away, and I started trying different kind of products. After a while I started vitamin B5. It worked well on my forehead, but didn't do much for my upper body. Read my progress on this in my log

Around april 2008 I started reading about Pityrosporum Folliculitis, and I soon realised this was what I had. Since then I've spent countless hours researching the subject. Started using Head & Shoulders, but without great results. After a while I also started using Mandelic Acid and it began to clear up. However it didn't hold the folliculitis in check and soon I satrted a new topical regimen including a Sulphur/Salicylic Acid soap(sal3.com) and Daktarin Gold(Ketoconazole 2%) cream. it worked well for a while, but the PF soon started to occur again.
The next thing on the agenda was Propylene Glycol which seemed to work great for the first couple of days/the first week, but as I had previously experienced PF is a bitch and after 3 weeks I still got spots on my chest and shoulders/upper back.

September 11th I started Itraconazole 200 mg/day and a new chapter in my treatment history is about to begin.



Without this forum I would have never realised that it's Pityrosporum Folliculitis I have, and I would probably still be struggling with different kind of acne treatments. It's about time I give something back to this community, and I hope this post will help other members.
If I can help one person to get clear by creating this FAQ it's all worth it.

Good luck!

[akko]

Amazing post! I hope it gets stickied.

Just for information's sake, here's what it can look like on the face:

http://www.cfpc.ca/cfp/2005/Apr/_images/cme_2_pic4.jpg


I joined this forum in the Fall of last year, after struggling for two years with what I thought was acne on my forehead and temples. If you look at the picture I posted, I looked exactly like that.

My forehead had always had tiny little pimples that never went away, but I never had enough to bother me, so I mostly ignored them. Then three years ago my forehead started getting abnormally oily. And then the bumps started. It got really bad in the summer- they would itch like Hell, and my face looked burnt. The normal acne treatments seemed to do nothing. I changed birthcontrol, laundry soap, shampoos, face wash you name it, I changed it. And the diets- my God! I gave up chocolate, nuts, sugar, refined grains, milk products everything that MIGHT cause acne, I cut out. And the funny thing about PT is that it fluctuates. So my skin would get bad, then I would switch something and then it seemed to get a bit better, so I thought: "Great! I found the cure!" But it would inevitably become horrible again, and I would be let down yet again. I'm still really superstitious about this- I can hardly bring myself to say "I'm better now", because every time I've said that, my face has gotten worse again.
I went to two dermatologists who both told me I should exfoliate more. Needless to say I am not too impressed by the profession. I feel they really should've been tipped off when I said they itched like mad.

After about a month on this forum I found out about pityrosporum folliculitis- then I found that picture on the web, and I knew I had it. I started washing with Nizoral shampoo, and after a couple of days it started to fade. After two weeks I could see the pores on my forehead for the first time in 2 years (who would've thought I'd be happy to see pores?). I brought the diagnosis and my clear forehead to my dermatologist. Honestly, I went in there to chew her out, but she was really apologetic (and I was in a really good mood) so I let it go. She got the diagnosis wrong, but she's really good at listening, so I still go see her.

I'm still clear now, with a few fluctuations. I alternate between Nizoral and H and S. Coincidentally, I also take fish oil and ACV, as well as zinc, viatmin D, B-complex and probiotics. (Although a lot of people say it doesn't work, I myself found that ACV really helps against both acne and folliculitis.) And because of all this I also clued in as to what my body acne was due to. I seem to be really prone to fungal overgrowth because I've always had a bit of dandruff and I would get these red spots on my legs, back and chest. I'm just a mushroom I guess.

I want to say a big THANK YOU to acne.org. If it wasn't for this awesome forum, I would still be struggling with pt and I'd probably be a fruitarian by now.

Thank you Dan and everyone on here!

[White Fox]

Thank you for the reply.

Yes, it seems that besides the upper body the forehead is a normal place to get PF.

Found a great study showing different chemicals effect upon P. ovale. Hoping someone with some experience with medicine or research could elaborate the results. Especially under Example 7: Test for anti-dandruff effect of the purified egg yolk I don't really understand the test results.

[willow569]

Thank you for the reply.

Yes, it seems that besides the upper body the forehead is a normal place to get PF.

Found a great study showing different chemicals effect upon P. ovale. Hoping someone with some experience with medicine or research could elaborate the results. Especially under Example 7: Test for anti-dandruff effect of the purified egg yolk I don't really understand the test results.

I can't access the results through the link you provided. I'd love to take a look at it though! I just wrote an article on PF that I am hoping to post on the messageboard soon. It would be good to have any other information that is out there on this.

[White Fox]

Thank you for the reply.

Yes, it seems that besides the upper body the forehead is a normal place to get PF.

Found a great study showing different chemicals effect upon P. ovale. Hoping someone with some experience with medicine or research could elaborate the results. Especially under Example 7: Test for anti-dandruff effect of the purified egg yolk I don't really understand the test results.

I can't access the results through the link you provided. I'd love to take a look at it though! I just wrote an article on PF that I am hoping to post on the messageboard soon. It would be good to have any other information that is out there on this.

Hmm. Weird that you can't access the results, the link works fine here.

If anyone feel that something is missing in this post feel free to participate!

[White Fox]

The thing I'm really curious about is the effect of Itraconazole, Ketoconazole etc. for PF. Some people say it only clears them for the time they are on the drugs, while other has seen some kind of permanent results with it.
I'm wondering about going on Itraconazole at the moment since I'm tired of trying new topicals all the time and trying to get totally rid of it. Hower, I won't go on it if it's just a short remission from PF.

Can people who has experience with oral meds for PF please give me some advice?

[chuchu]

thanks for sharing that!
now i know what i have lol great
well i just ordered some sulfur soap
i hope it does good!

[White Fox]

thanks for sharing that!
now i know what i have lol great
well i just ordered some sulfur soap
i hope it does good!

Haha, I know it sucks...

Good luck with the sulphur soap. I think you could try a leave on product together with the sulphur soap to get better results. A lot of people have had great success with Propylene Glycol...

[follici]

thanks for sharing that!
now i know what i have lol great
well i just ordered some sulfur soap
i hope it does good!

Haha, I know it sucks...

Good luck with the sulphur soap. I think you could try a leave on product together with the sulphur soap to get better results. A lot of people have had great success with Propylene Glycol...

hey, can u answer a ques? i think ive got PF. u know anyone whos' gotten rid of it permanently? its killing me....

[White Fox]

thanks for sharing that!
now i know what i have lol great
well i just ordered some sulfur soap
i hope it does good!

Haha, I know it sucks...

Good luck with the sulphur soap. I think you could try a leave on product together with the sulphur soap to get better results. A lot of people have had great success with Propylene Glycol...

hey, can u answer a ques? i think ive got PF. u know anyone whos' gotten rid of it permanently? its killing me....

Most people on these boards seem to be able to keep the PF in check by using topicals, but it's very hard to get rid of it permanently. I'm trying an oral antifungal at the moment so you should follow my thread to see my progress.

However, from emedicine.com:

Colonization by M furfur begins soon after birth, and the peak presence of the yeasts occurs in late adolescence and early adult life, coinciding with increasing activity of sebaceous glands and concentration of lipids in the skin.

[Yankulov]

Hi, guys. White Fox, thanks for the good thread. I'm completely sure I have folliculitis on my back, arms and chest. But I'm wondering what type of acne I have on my forehead. It's constantly oily, a lot of very small bumps and black heads. Do you think this is some form of folliculitis. It doesn't respond to acne treatments or diet. My face looks this way since last 3-4 years. It's always oily and rough.. every single day. I'm posting a pick.

One zoomed and one from a far view.

Attached Thumbnails

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Attached Images

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[White Fox]

Hi, guys. White Fox, thanks for the good thread. I'm completely sure I have folliculitis on my back, arms and chest. But I'm wondering what type of acne I have on my forehead. It's constantly oily, a lot of very small bumps and black heads. Do you think this is some form of folliculitis. It doesn't respond to acne treatments or diet. My face looks this way since last 3-4 years. It's always oily and rough.. every single day. I'm posting a pick.

One zoomed and one from a far view.

Hi

The pictures aren't very clear, I hardly see the bumps you are describing. However, you should definitely read this thread if you haven't already: http://www.acne.org/messageboard/Small-bum...es-t164964.html

Good luck clearing it up!

[Yankulov]

I'm coming from this thread

I have exactly the same skin condition as this: http://img65.imageshack.us/my.php?image=fucneig9.jpg

[Siouxsie]

I'm pretty sure I have this on my legs....
- It gets worse in heat/humidity
- I think tetracycline has made it worse (oral anti-biotics make it worse, right?)
- A derm once prescribed an anti-fungal & anti-bacterial cream for it...but didn't indicate what kind of infection it was...and when pressed, she got irritated with me. She only would say it was a "hair follicle infection", which is sooo vague.

I've tried mandelic acid, BP, SA, dermazinc soap (same as znp bar), and an AHA/BHA body scrub. Only the body scrub helps at all. I don't notice dermazinc doing much and I've used it 3 times a week for months now.
Recently, I ran out of body scrub, the heat/humidity got worse, and I started tetracycline, and it's been downhill.... I just got more scrub, but it still doesn't fully treat it.

I know I have candida, as I am very prone to yeast infections (TMI, sorry!), and I try and keep that under control by eating a lot of yogurt with active cultures. I am also going to get some Candidase. I eat pretty healthy for the most part, but am not open to any drastic candida diet...

There are a lot of other options I see, an overwhelming amount. Any suggestions on what I should try next?

[connect16]

Hmm, about 3 days using 2% Nizoral and H&S shampoo on my face and I can see some noticeable improvement. Just wanted to share that with you.

[Yankulov]

I don't want to say strong words but I think my body folliculitis type pimples vanish from nizoral tablets and shampoo. I'm 2 weeks in and I can notice significant difference, only very small (almost invisible) pimples, my skin is almost soft. I'm hoping hard this thing continue.

[Fashionista]

My body acne is completely clear after using H&S everday in the shower. Maybe this is what I had all along and not "acne".

[richmond]

Great thread. But im still confused, because it makes no mention of it my hair folicals....

Can someone look at these these pics?

http://www.acne.org/...rd/post-a14414-

My thread on this question!!??

[akko]

Hi Richmond,

The way you describe it being in your hair follicles is typical of folliculitis. I'd experiment with Nizoral or Head and shoulders if you haven't already.

Siouxies: for very persistent folliculitis they sometimes prescribe oral antifungals- they do carry a risk of abnormal liver function though (I'm not sure how big of a risk, but it's something to think about). I'm about to go ask my doctor for them, and I'll keep you posted.

[richmond]

Thanks akko!

Hope your right, cos i couldnt find anything relating to the hair folicals on my chest getting infected or just bumpy in general.

Yeah i will try H&S.