Pityrosporum Folliculitis

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Hey guys:

Trust your instincts! If you think is is fungal, the antibiotics will make it worse. Can you get a second opinion? A KOH scraping? Have you tried washing with over the counter products for dandruff to see if it improves?? Zinc Pyrithione has worked best for me. Dr. Cynthia Bailey's website has Noble soap bar. Similiar to ZNP bar but for sensitive skin. Like mine. Try apple cider vinegar. Good test!

Nieheoma-I was right ,my thyroid is low! Heard it can cause overgrowth like this. Sigh another issue. A few folks said it made it go away to fix their thyroid.

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Hey guys,

Quick question..will PF scar you?? My skin no longer itches and it has smoothed out, but I have light red scars. Is there anything you guys recommend to use for these scars?? This is such a pain in the @#4!! Thanks for any response guys!!

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Well my fellow inflammatory sufferers, I have had just about 100% clearance. I am using Plexion and taking Solodyn. So, it is one, the other, or both. Dont know, dont particularly care right now. Super stoked to have clear skin. I might stop taking the Solodyn once the month supply is up, and see if it starts to return. Then I will know which one is working. If my previous posts are evidence, it shows you have to keep with attempting to determine what the issue is, and find the EXACT remedy that works for YOU!!!!

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Nieheoma:

What Plexion are you using? Is it cream in a tube? The wash? I did try the one by Perrigo (generic I think) and seem to be allergic. In the past, I used Sulfacet R (10% sodium sulfacetimide and 5% sulphur) and it was great! I am wondering about the other ingredients in the wierd toothpaste type one with these same ingredients I just tried? You started the Plexion first right? 4 days nothing much changed you mentioned. The minocycline was for acne? 100% clear? Wow that is wonderful!! Good no make that great for you. You did so many things are you 100% certain one of these did the trick?

I am on week 8 Diflucan 1X per week still. Dermie on Friday. Slow progress but not clear. Any mistep....slightest bit warm (do not sweat alot), shower too hot, it grows a bump instantly. I love the way they call this acne. Ever got tiny bit warm and grow an instant acne bump? Not!* Duh I hate this tightrope. I miss normal!

Found out my thyroid is low as I suspected! Will recheck. Heard this leads to PF for some! In general, I was very run down and stressed before this hit. I mean extremely so. Took generic Prednisilone for 20 days right before it hit as well. I think there was a culmination of factors. Oh and wearing tight hats on walks and sunscreeen withmoil during the way. think hormones off so yes to the person who brought up hormones. Thyroid is hormonal. Adrenals. Check bloodwork if you can do so. White blood cell count low and Potassium low for me as well.

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Nieheoma:

What Plexion are you using? Is it cream in a tube? The wash? I did try the one by Perrigo (generic I think) and seem to be allergic. In the past, I used Sulfacet R (10% sodium sulfacetimide and 5% sulphur) and it was great! I am wondering about the other ingredients in the wierd toothpaste type one with these same ingredients I just tried? You started the Plexion first right? 4 days nothing much changed you mentioned. The minocycline was for acne? 100% clear? Wow that is wonderful!! Good no make that great for you. You did so many things are you 100% certain one of these did the trick?

I am on week 8 Diflucan 1X per week still. Dermie on Friday. Slow progress but not clear. Any mistep....slightest bit warm (do not sweat alot), shower too hot, it grows a bump instantly. I love the way they call this acne. Ever got tiny bit warm and grow an instant acne bump? Not!* Duh I hate this tightrope. I miss normal!

Found out my thyroid is low as I suspected! Will recheck. Heard this leads to PF for some! In general, I was very run down and stressed before this hit. I mean extremely so. Took generic Prednisilone for 20 days right before it hit as well. I think there was a culmination of factors. Oh and wearing tight hats on walks and sunscreeen withmoil during the way. think hormones off so yes to the person who brought up hormones. Thyroid is hormonal. Adrenals. Check bloodwork if you can do so. White blood cell count low and Potassium low for me as well.

That's good that you know for sure now. I'm sure that will take away some of the stress. I just had a punch biopsy done last week and am waiting for the results. I think maybe my case is the same. I remember at the time it first happened I was working 12 and sometimes 16 hours a day 6 to 7 days per week, trying to start up a business. Plus I was still working out and it was during the late summer. I was probably sweaty most of the day. I also remember my air condition breaking down for about a week. I'm sure the stress was beating me down too and definitely not eating right. I'm also thinking caffeine has helped the pf too as I was drinking lot of coffee to maintain this type of routine. I'm sure my adrenal glands are burned out at this point.

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Could it be possible I have Pityrosporum Folliculitis if I only have mild acne on my face (mostly dry flaky skin & inflammation) & dandruff on my scalp?


''I'm not clever, but I figure if I ask all the questions, somebody else might have all the answers'' - Quote, Me!


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I am using the generic Plexion from Perrigo. Super stoked, but I am sure it wont last. There are a few small bumps, so I know my body still wants to create inflamed bumps on my forehead, but at least the wash is 99.99% keeping them at bay.

Edited by niehaoma

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Mine doesnt scar. Damn the blimpity berp da bumpy bumps! I have some bumps in the center of my forehead coming back. Hopefully they will not progress, and go away. I was really bad with my diet the last few weeks (gluten, dairy, alcohol), all of which I do not consume normally. I still think there is some link to food/environment. So far the Plexion wash has been the most effective with the longest positive impact (20 or so days now with little to no symptoms). That is the longest in 5 months.

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Hello:

Mine does not scar. MD gave me steroids (topical) and this made me have some broken blood vessels! Grrrrh more money to fix. I think if you scratch it might scar, There are topical over the counter things for scarring. I would give it time personally.

Yes I exercise alot. Sweat is the number one thing that brings it on. And heat!!! Hot showers. Overheat sleeping. Huge factor.

Latest thing MD thinks it is in part Rosacea. I am all over the Demodex mite concept. I did develop what they call Keratosis Pilaris same day as this crap on forehead and along hairline?!Duh connection? Fungal? The mites and their bacteria? Bought a microscope but have not looked yet. They all but refuse to do scrapings?*& Afraid theeeey might catch it or what??

Did try Permethrin and Ivermectin a few doses. Not enough doses if you ask me for Demodex. I am a human guinea pig it seems. Sulfecetamide and apple cider vinegar and Noble Soap bar. Best things so far. Amlactin for supposed (yeah right) KP rash. I vote I have PF. BumpyEllsworth sounds like me all the way.....

I am considering Accutane after 2 years!! Starve the suckers

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So glad I found this thread!

I'm 30 and have been diagnosed with this for some time. I've found that doxycycline on a regular basis and ketaconozole for the flare ups has worked the best. Now the dermatologist has me off the doxycycline permanently and on one month's worth of ketaconozole, plus the ketaconozole body wash and a conozole cream. The idea is that if it worked for the flare ups, maybe I just need to use it longer to completely cure it.

It's been two weeks and I think it's gotten worse??? Usually the ketaconozole works like a charm. Maybe my body is reacting to getting off the doxycycline--I have no clue???

Thoughts or advice?

Tips on back regimen?

Any lotions I should try?

Head and Shoulders shampoo?

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Hey guys,

I just have a quick question:

- About two years ago, after stopping using an abusive amount of benzoyl peroxide for a few days on my face, my forehead sprouted a bunch of red and white dots overnight. Literally, I remember driving home from the mountains with my girlfriend at the time being very happy with my choice of getting rid of all harsh chemicals on my face, and the next morning having my forehead feel like sandpaper. I have no acne on other parts of my face, and I just wash it with water. Both steroid creams (hyrocortisone butyrate - only for two weeks) and Epiduo have been prescribed by my dermatologist, saying that it's just forehead acne since my face is pretty oily. Strangely though, my whole face is oily (mainly in the summer - I live in Colorado, thank god it's dry), I sweat a lot (from constant exercise), but I only get these bumps on my forehead. The Epiduo helps, but they always seem to come back, only on the forehead, occasionally temples, and hairline. Additionally, I'm 22 now, have never really had any acne, and only used the Regimen because in my head my skin was terrible, when truthfully it was fine. Now this is my only problem.

I didn't think that acne appeared like this overnight, but she insisted that I keep putting on BP. Any suggestions for this? Could this be bacterial PF, fungal PF, a yeast overgrowth? Any helpful hints on the best way for clearing a yeast or fungus buildup in or on the body?

Thanks for any suggestions, and I wish you all the best.

Ya and about the scarring, I went to the same office about a year ago, saw a different doctor though. He looked at the oily forehead, saw the bumps, claimed they must be either open or closed comedones (I can't remember what he said), and began to painfully "extract" them. It left me with a viciously red forehead for awhile, but the marks subsided and left no scarring. I hope that helps someone.

Also, lastly, with all this exercise I get very lazy in washing myself, so, the sweat stays on my body for a long time. I have short hair (maybe an inch), and don't wash it, ever - don't really like soap. But, if this does seem to be a form of folliculitis, I would be willing to change all of that really quickly. Thanks again.

Edited by belerak9

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All,

For this condition, which appears to be mostly caused by the Malassezia (Pityrosporum) fungus, check out this link about Raw Honey. You would have to give it a minimum of 4 weeks, but the upside is potentially great. I've had this bastard since my days in college. I'm 45 now. I've only been doing the Raw Honey for less than a week (2 masks and twice per day cleaning). I've noticed dramatic improvement with flaking, itching, redness, and inflammation. I am an exercise nut, 5x min per week, coffee usually makes this condition much worse. I also have steroid induced Rosacea so I have very sensitive skin.

Please give this a try. You'll need to give it a full 4 weeks minimum. If you've used steroid creams , you might need to give it longer to see great results.

The fungus from what I understand does not develop a resistance to raw honey, as it would with any other drug. I think it's worth a try. Good luck.

Paul

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What's the best way to determine if u have this? I have rosacea, dandruff but have tons of clogged pores in my chin area and in the laugh lines around my mouth. My pores are huge and I'm dry and flakey as well as oily. Does that make sense. No derm can tell me what is up with my chin and why no topicals respond to clearing these bumps or clogs. Can u scratch out grain like pieces of sebum off your skin? I can do this every nite and have them fill by morning. I've always said it's like my skin doesn't shed properly. Things get stuck to the hair follicle and it's not normal to have to go around your whole face picking off pieces of sebum. This started two yrs ago and have done more courses of doxy than I can count and it only helped the first time I went on it. I've been on spironolactone for a year thinning it was hormonal and it would slow my oil production but it hasn't done squat. I'm so distraught because yet another derm was like everyone has sebum and oil and maybe I should get lower wattage lightbulbs..Wtf!!!!! Please help me

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An update on here from me:

I started using a zinc-including shampoo (Head and Shoulders) about a week ago, and the bumps have vanished. Completely. This would be the first time in two years that I didn't have to put on some weird topical gel, cream, steroid, or whatever to make that happen. So it's safe to say that I'm elated. For the above poster though, it's also safe to say that anyone who tells you to "just deal with it" is not acting with your interests in mind. That's not to say that whatever you have is the same as me, but the only way to find some sort of remedy is through constant research, trial and error, and a little bit of patience. I had a dermatologist two years ago tell me that I just had acne on my forehead, and that it might never go away. She chuckled and kind of told me that I just had to deal with it as well. And here I am now, free of that plague, all with a simple solution. So I guess I'm just saying that you never have to settle for what you don't want, there's always a solution to your problem out there. Just keep looking and keep trying, please. Hope you're well.

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I also started using Head and Shoulders all over, and drinking apple cider vinegar diluted with water daily AND spritzing it on my back and shoulders after the shower. No clue if that's helping or if the ketaconazole is finally catching up?? Also showering twice a day.

Planning to try baking soda scrubs on my back and tea tree oil next.

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@belerak,

I hope the H&S works out for. Like me, it worked at first (Nizoral worked best), but after a few months it stopped working. When I first used it, it was awesome. It cleared my forehead, which I hadnt been able to do in about 1 year. Unfortunately, it stopped working. I alternated between H&S, Nizoral, even tried 2% Ketoconazole, but no dice anymore. Good luck.

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Hi guys,

Thought I would share my story.

Junior year college after returning from vacation abroad, I suddenly got what appeared to be acne for the first time in my life. I also noticed a change in my skin generally, which was now very red and dry after showering. My doctor told me it was acne and recommended using the typical cleaners. Of, course this didn't work and probably made it worse.

After months of frustration, I tried washing my face with bottled water, and surprisingly, it seemed to help. Encouraged, I starting researching what was in my tap water, and found to my horror that the onset of my symptoms matched the exact date of when my cities (San Francisco) water authority switched disinfectants from chlorine to chloramine (a combination of chlorine + ammonia). By this time, the "acne" was pretty bad on my forehead and cheeks and the bottle water only helped a little and was very impractical to begin with.

After moving to NYC (which doesnt use chloramine, hooray!) I noticed that my skin was feeling like its old self again, but I still get bumps and irritation in the areas it was the worst (forehead and cheeks). After seven years of battling this but not completely winning, I was on the verge of breaking down due to the stress it caused on my relationships.

Surfing the web for answers, I stumbled upon this thread a month ago. The symptoms that people described sounded very similar to mine, so I decided to try some of their suggestions. I tried the ZNP bar and tea tree cleanser, and it seems to be working. I started about a month ago, and since them my face is about 70% clear. I have never been diagnosed with PF but I am almost positive this is what I had for all of these years and NOT ACNE (grrrrrrr). Has anyone herd of PF being caused by chloramine? From my research I have not found anything but am 100% positive this is what started the PF for me.

Right now I am happy with the ZNP and tea tree results so far. But I am afraid that the PF will become resistant. I am so sick of dealing with this and just what my life back. I am thinking about trying and oral anti-fungal but dread having to go to the doctors to get a prescription Is it really worth the side effects since from what I read the PF tends to come back after you stop?. However, since Ive had PF for so long (since 2004 ughhh), I am thinking that the yeast is so deep in the follicles that I may need to treat the blood borne causes to get to the root of the problem. Any stories about oral meds would be very much appreciated.

Stay strong guys, a solution is out there

Edited by ethio84

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How are you doing now, Niehaoma? This is a fantastic thread -- thanks very much for starting it. I have the bumps now, and am trying to use my own brains to cure them, as there seems to be a deficit of intellectual curiosity in the field of dermatology.

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My pityrosporum started about ten days after a round of Z-Pack antibiotics for an ear infection. My skin has been smooth and clear for years so the tiny bumps that started appearing on my skin seemed strange at first then, they took over. I was covered, face, neck, chest, trunk with thousands of bumps. I went through 7 doctors, (if I remember correctly) with three of them being specialists. The treatments they tried just exacerbated the situation. Steriods make yeast worsen and antibiotics, in most cases, are the culprit. Finally, after months of suffering and embarrassment, (I was treated twice for scabies!!!), my friend, a Physicians Assistant, scraped my skin and put it under a microscope to find...budding yeast. My doc put me on a 7 day round of oral antifungal, Fluconasole, a total of 1,500 milligrams. I only made it 5 and got very sick. He also prescribed Extina (ketoconazole) foam. The rash began clearing. I used Extina for months, though. Brown pigment scars remained for almost 9 months before clearing. I use the sulfur wash, Sodium Sulfacetamide 10% and Sulfur 5% occasionally, even now and do not use antibacterial products on my body, only goat's milk soap. I let the sulfur wash sit for 3 minutes on dampened skin before showering. Works great! I also use a product called Aczone for chest and back breakouts now and then. My skin is smooth again!!!!! I avoid antibiotics like the plague!!!!! Our bodies have a natural balance and they mess everything up. When they diagnosed yeast, I began a Candida cleanse diet. No sugar, not even fruit. That probably helped. Now, I eat Greek yogurt sweetened with Stevia now and then to keep my tummy balanced as well. If it is yeast, steroids and antibiotics are just exacerbating the problem. Hope this helps somebody.

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Hey everyone. I am pretty sure I have this same skin condition, I also have used low dose accutane and antibiotics for my acne before this persistent problem surfaced. I get the small bumps, but they usually become inflamed like a pimple with puss inside. Is this acne or malasezzia folliculitis? It just seems like all my hair folliciles are clogged with yeast and all the symptons that aggravate PF do the same for my skin. I also have it along my cheeks and neck and forehead where I have hair. I am on Day 14 of Oral ketoconazole and using 2% wash daily, but it is still there. Not really sure what to do at this point. Desperate for any answers. Anyone?

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I, too, am a PF sufferer - and it's taken a long time to get a dx. My skin has always been fair to good. About a year and a half ago, when working out more, I started getting neck "acne" which I attributed to my hormones. I'm in my early thirties and have some issues with my cycles. Those irritations aside, my skin was good. I went on a vacation to Eastern Europe, and a few days into my trip I "broke out" like a monster. I now believe it was a perfect storm happening all at once, with hormones and exposure to something maybe on a towel or linens. I had some larger cysts along my jaw, but a rash like breakout all over my face, neck, and chest - even on my lower back! It was itchy, painful, and so disturbing. I didn't want to even have my picture taken! This was May of 2012.

What follows is really detailed - so if you want to skip to the end feel free. But this the actual process and costs, for those looking for that information.

I don't have insurance, so as soon as I got home, I started doing OTC regimens with BP, gygolic acid gel, and more. I made an appointment ($200 out of pocket with an endocrinologist.) I thought my hormones were to blame. She agreed, and said that instead of doing $1000s in tests, to try birth control pills. But she couldn't prescribe them. So I had to go to a 2nd doctor. This was June of 2012.

I went to a gynecologist ($100 out of pocket) -July 2012 - and he gave me birth control pills, Beyaz, which he thought would help my skin. I will say, that within 6 weeks, my face had improved a lot. But I had DAILY migraines. Also, my chest didn't improve at ALL. It would seem to get better, then flare up again, sometimes up through my neck. I was getting frustrated. Every month the pills were $75, I was spending $50 on average in products - I was fed up.

For my face, I started using a Clarisonic Mia ($125), and loved the results. My skin looked pretty good except for the occasional hormonal breakout on my face. It was too harsh for my chest, and made that worse, though.

I read online about PF. I was pretty sure that was what was wrong. I saw some people used OTC yeast infection creams to treat it. Also, I saw the dandruff shampoo recommendations. I tried both, and had some clearing on my chest. I But, not completely. I also tried oil of oregano. That stuff stunk, stung my skin, but in a couple of more weeks I was relatively clear, except that it felt like the bumps and redness were still under my skin and that anything might bring it back out, particularly sweating. I couldn't work out at all. It wasn't perfect, but it was livable.

In October, the headaches from the pill increased to the point I had to switch. I started a new BCP in November, Lo LoEstrin - ($75 for the visit, $75 monthly for the pill) I was nervous that the decreased estrogen would hurt my skin again. So I finally just gave up and realized I would have to go to a dermatologist ($150 for the apt) I went 12/5. She did think I had some acne, and gave me clindamycin topically, and tretinoin- both creams ($100 total more). She didn't think anything yeast related was going on.

My face responded great - particularly to the tretinoin. It makes my skin look brighter, and I've had minimal peeling or effects But it hurt my (clear) chest. On December 16th, I woke up with my chest and neck covered in what seemed like tiny pimples, but on almost every part of my chest. Some were larger, but most were tiny. Some had tiny whiteheads. They were in lines or curving shaped clusters too. I knew this was really weird. It was up to my neck and under my jaw, too. It was a strange red color - but reminded me of the severity and suddenness of the initial breakout in Europe. My dermatologist got me in (another $75) on Tuesday. I wasn't sure if it was an allergic reaction, something new - what.

She took one look at my chest and neck while it was intensely flared up, after have seen me a few weeks before - and knew we had to see what was going on. She scraped the chest and tested it. Yeast was the culprit. I began ketocozanole cream ($45) and 200mg pills ($10) and have had fairly immediate lessening of the redness and rash.

I have spent WELL over $1000 out of pocket to get to this point, but I have some good advice I think to share:

1. You can have some acne AND PF - don't accept that "acne" is all that is going on, especially on the body. PF is less common on the face unless you are REALLY ill. You could have both going on however, so watch and see how it responds.

2. If you think you have PF, don't use anti-bacterial washes on your body, use an anti-dandruff shampoo. It won't hurt and could help.

3. If you aren't opposed to BCPs, they can help hormonal acne

4. A decent dermatologist, especially if you are an established patient, should be open to at least seeing if it is PF. My derm's office is large, and they did the results in five minutes. So if you don't have a doctor, finding one with those capabilites might save you some time and stress.

Moving forward, I am going to do a yeast-elimination diet after the new year. I'm cutting out sugars and starches, which has always helped my skin. I hope to be able to resume exercising, but I am worried about sweating still, even with the treatments I have. I will likely try to add a new exercise to my regimen, like swimming, instead of running - which is really sweaty. And being vigilant about clean towels, clean sheets, everything.

This was a long and painful process. I took some serious hits to my self-esteem. It even affected my relationship. I was embarrassed for my partner to see or touch me. I encourage you, if you can, to go to a doctor. It might take a while to find the right treatment, but once you do, you'll be glad you did.

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