Chest and back acne can be difficult to control, particularly if there is a concurrent infection that mimics acne. The yeast, Pityrosporum, creates a folliculitis when commonly used acne treatments set up the skin for its growth. Although it looks a lot like acne, there are a few things to note that will lead you to suspicion it is something else.
- Itching (also known as pruritis)
- Comes about after prolonged oral / topical antibiotics to treat acne
- Worsens with antibiotic usage, heat, humidity, stress
- Does not respond to typical acne treatments (acid peels, acne washes, topical retinoids)
“Pityrosporum folliculitis is commonly found in adolescents pr
esumably because of the increased activity of their sebaceous glands. Some colonized individuals develop tinea versicolor, and others develop Pityrosporum folliculitis. Perhaps the density of lipids in the pilosebaceous unit of acne-prone individuals leads to a higher concentration of the organism in hair follicles and thus a folliculitis….The pathophysiologic features of Pityrosporum folliculitis involve follicular occlusion followed by an overgrowth of yeast that thrives in a sebaceous environment.3,7 “
Lab tests to be performed should include:
A potassium hydroxide (KOH) preparation may be helpful for microscopic identification of the yeasts associated with Pityrosporum folliculitis (PF).
Culturing and identification of the organism are rarely performed, and the tests usually are not available.
For Malassezia yeasts to grow, olive oil must be added to the culture media. This is not a routine study for the mycology laboratory.
Resolving acne and other like skin conditions can be difficult because of the many causative and variety of contributing factors. The research study cited above was quite interesting and significant in that all patients achieved success in resolving their skin condition.
For much greater elaboration from a research study and clinical point of view, please click through above links.