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Are Your Lululemons Giving You a Rash on Your Butt?

I have been taking a new fun dance class called DanceBody that is very popular in Miami and New York. You get really sweaty in the class and, because I am a dermatologist, I get asked a lot of questions about the skin issues that result.

Lately, there have been a lot of questions about an itchy rash on the buttocks that lasts about 24 to 36 hours after sweaty exercise. All of the cases I have seen in my dermatology practice have been after wearing Lululemon leggings, so at first, I thought this was a reaction to the fabric. After doing some research, I found that this rash is probably due to an infection called pityrosporum folliculitis.

What Is Pityrosporum Folliculitis?

This infection is caused by a type of yeast called pityrosporum, and has been very common lately. What happens is this yeast makes its way down into the hair follicles, where it multiplies and causes an itchy rash. Like many other microbiota, pityrosporum is commonly found on healthy skin. However, when it becomes overgrown, it can cause this unpleasant rash. So what makes this yeast overgrow? It likes warm, moist environments, which Miami certainly has. Then, when you add tight-fitting clothing like leggings and sweaty exercise, you create the perfect environment for the yeast to thrive.

Interestingly enough, this problem has been so common lately that it has been discussed in a closed Facebook group of board-certified dermatologists. We have found that the rash clears up with topical steroids, but will come back. It does not get better after treatment with oral doxycycline or topical benzoyl peroxide and retinoids, so it is not acne. It is also not a reaction to the fabric or bacteria that is on the skin from exercising, although we are still not sure why it is more common with Lululemon leggings. It could just be because so many people wear them, or that we happen to see it with this particular legging.

Acne vs. Pityrosporum Folliculitis

Pityrosporum folliculitis often resembles acne, but it is unrelated. In fact, misdiagnosing and treating this infection as acne can make it worse. The main difference in symptoms between these two common skin conditions is that acne is rarely itchy, whereas pityrosporum folliculitis does cause itching. To further complicate matters, these two conditions can and often do occur together, so it is best to consult a board-certified dermatologist for an accurate diagnosis and treatment recommendations.

How to Get Rid of Rash after Exercising

As mentioned above, if you have developed a rash after exercising and wearing tight-fitting clothing like Lululemons, schedule a visit to your dermatologist’s office. He or she can prescribe you a few different things to get rid of this rash:

• Ketoconazole shampoo. Your doctor will give you specific instructions, but you typically wet your hair then apply the shampoo and work into a lather. Gently massage it into your hair, then rinse with warm water and dry with a soft towel. Your doctor may ask you to repeat this every other day until the rash clears up.

• Ketoconazole cream. If the rash is on your body and not your forehead or scalp, your doctor may prescribe you ketoconazole cream instead.

• Oral itraconazole. In some more severe cases, oral itraconazole may be combined with the topical treatments mentioned above. Follow your doctor’s treatment instructions and be sure to follow-up with him or her to keep track of your progress.

How Can I Prevent Getting a Rash from My Leggings?

If you notice this rash frequently, even after properly treating it, you might need to consider switching your workout gear to something that fits more loosely. If you’re in love with your Lululemons and prefer to work out in leggings, remember these tips:

In Summary

If you get a rash on your buttocks or other particularly sweaty areas of your body after a good workout, a yeast infection called pityrosporum folliculitis could be the culprit. Before assuming this itchy rash is acne, talk to your dermatologist, because the proper treatment is key to getting rid of it. You might also have to adjust your exercise routine slightly to prevent getting this rash after every workout.

If you still have questions or would like to schedule an appointment in our Miami office, send an email to info@derm.net or contact Baumann Cosmetic online.

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