Our skin can react in many different ways when responding to threats. In some cases, it is relatively easy to determine the issue by simply viewing the visible signs and symptoms. In other cases, though, pinpointing the problem requires a closer examination, as different factors can result in similar-looking skin reactions. For instance, the common skin condition known as acne vulgaris is sometimes conflated with a less common (or at least less identified) condition called Pityrosporum folliculitis (or Malassezia folliculitis). If the problem isn’t properly diagnosed, you may be searching for an acne solution when in fact your skin requires a different type of treatment altogether.
So, is your acne really Pityrosporum folliculitis (PF)? How can you tell? Why does it matter? And what should you do after receiving your diagnosis?
Before anything else, let’s discuss what PF is in the first place. The naturally-occurring yeast known as Malassezia is to blame for PF. When this yeast enters the hair follicles and overgrows, the skin’s surface breaks out in small, itchy bumps (pustules) that often resemble acne. To make matters more complicated, those with PF may also suffer from acne vulgaris due to an overproduction of sebum. That said, these two conditions are distinct from one another and must be treated via separate means.
Fortunately, PF and its symptoms are considered benign and do not point to more serious medical concerns. Still, this condition can be uncomfortable and affect one’s self-esteem or mental health, so finding relief is important.
As briefly mentioned earlier, acne and PF require different treatments because they are caused by different factors -- acne vulgaris results from clogged pores (dead skin cells, oils, etc.) while PF is caused by the Malassezia yeast. In order to treat either of these conditions effectively, they must first be properly diagnosed. However, the importance of distinguishing PF from acne goes even further. This is because receiving acne treatment (namely antibiotics for severe acne) when you’re in fact suffering from PF can actually aggravate acne symptoms. In other words, what’s good for acne might be bad for PF (i.e. making symptoms worse), and vice versa. And the longer it takes to figure out the root cause of your acne-like symptoms, the worse these symptoms may become.
So, how can you tell what’s what? Your first step should be to seek help from a dermatologist or physician. While no doctor gets every diagnosis right 100% of the time, this route is better than attempting to diagnose yourself or ignoring the problem outright.
The primary way to tell the difference between acne and PF is to closely compare symptoms. More specifically, PF tends to be itchy (acne usually is not), and PF pustules lack comedones (whiteheads and blackheads). Additionally, those with PF may also suffer from dandruff (seborrheic dermatitis), which is also linked to Malassezia yeast. If you or your dermatologist suspect that you may be suffering from PF, they can scrape an area of your skin or perform a biopsy to collect a sample and examine it under a microscope to detect the presence of Malassezia yeast.
Once your dermatologist has delivered the diagnosis (whether it’s acne, PF, or both), they can create a proper treatment plan. Oral antifungals such as fluconazole or itraconazole are typically prescribed to treat PF. Acne vulgaris can be treated in a number of ways, such as topical ointments containing benzoyl peroxide, prescribed oral antibiotics, retinoids, and more. Your dermatologist will help you find the right treatment for PF and/or acne depending on your skin type, medical history, severity of symptoms, etc.
Getting a handle on your skin’s health isn’t always easy, especially if one problem resembles another. If you need help identifying problems with your skin and finding the right solutions, the experts at Premier Dermatology Partners can help. To learn more about our providers and all the services we offer, contact us today.