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What’s Pityrosporum Folliculitis?

 

 

What exactly is Pityrosporum folliculitis?  Pityrosporum folliculitis is also known as Malassezia folliculitis.  Malassezia is a yeast commonly found on skin and is generally harmless.  Generally.  The problem occurs when the environment is ripe causing these yeast to overgrow and invade hair follicles thus causing a fungal infection of the skin.  Often times the result is an acne-like eruption.  In fact, this condition looks so much like acne it’s often misdiagnosed as such!

 

 

Image of Pityrosporum Folliculitis

15 year-old girl with Pityrosporum Folliculitis – Arch Pediatr Adolesc Med.2005;159(1):64-67. doi:10.1001/archpedi.159.1.64 (Image Credit)

 

 

The key difference between Malassezia or Pityrosporum folliculitis and acne is the itch that some say they experience with this condition.  Itchiness, as you might know, is a common symptom of fungal infections.

 

One other notable difference between Pityrosporum folliculitis and acne is the lack of response to acne treatment.  Frankly, acne medications won’t work on Pityrosporum folliculitis for the same reason why they won’t work on Athlete’s Foot.  Two entirely different skin conditions.

 

Aside from acne products being completely ineffective against this skin condition, here’s another reason why you may want to avoid using them.  Many acne medications work by killing bacteria but this only allows for yeasts like Malassezia to flourish. In the absence of bacteria, yeasts have the ability to consume all of the resources and nutrients they would’ve normally had to compete for.  Kill the bacteria and you aren’t just helping yeast live; you’re helping them thrive.

 

Now, here’s where things get a little tricky: acne can still be present along with Pityrosporum folliculitis.  Yes, you read that correctly.  This means you could have acne and an overgrowth of this yeast at the same time.  How?  Well, oily skin is a risk factor for both of these conditions.  The same oil that clogs your pores and causes acne is the same oil this yeast feeds off of.

 

If you think you’re experiencing acne and Pityrosporum folliculitis, try to tackle one condition at a time to avoid complicating matters.  In case you’re wondering which should you try to resolve first, the answer is folliculitis.  Since we know acne treatments may worsen Pityrosporum folliculitis, it’s best to use them only after you have successfully treated the folliculitis.

 

Still, just like other fungal infections of the skin, there’s a possibility of recurrence;  so, even after successful treatment, Pityrosporum folliculitis can come back.  Again, think Athlete’s Foot.  Just because you got rid of it once doesn’t mean it can’t come back again.  Therefore, it’s important to know what the risk factors are and how to prevent it in the first place.

 

DERMAdoctor

The risk factors for Pityrosporum folliculitis include, but are not limited to:

 

  • Obesity
  • Pregnancy
  • Diabetes
  • Stress
  • Taking broad-spectrum antibiotics
  • Taking steroid medication
  • Using oral contraceptives
  • Having a systemic illness
  • Having a weakened immune system
  • Excessive heat and/or sweating
  • Oily, greasy, sebum-rich environment/skin
  • Tight, restrictive clothing

Studies have shown this condition has also been found in healthy individuals, as well.

 

Here are the top ways to prevent Pityrosporum folliculitis or reduce the likelihood of recurrence:

 

  • Spend less time in hot, humid and sweaty environments
  • Keep yourself cool and dry
  • Shower after sweating
  • Wear loose, breathable clothing and especially if exercising or engaging in strenuous activity
  • Avoid applying greasy and oil-based products to the skin and hair
  • Limit usage of broad-spectrum antibiotics and steroid medications unless necessary
  • Boost immune system and maintain a healthy diet
  • Take a daily probiotic like this one or this one.
  • Reduce stress

 

Dr Brandt Skincare

 

Finally, Pityrosporum folliculitis can occur wherever hair follicles are located, but typically appears on the face, back, neck, chest, and shoulders.  It can affect young to middle-aged people, males and females and, unfortunately, is a lot more common than we might think.

 

Nevertheless, this condition is usually only discovered after months and sometimes years of unsuccessfully trying to resolve what is thought to be acne.

 

If you suspect you have Pityrosporum folliculitis, it’s always a good idea to get confirmation from a licensed dermatologist.  If you suspect you might have both acne and Pityrosporum folliculitis, well, a licensed dermatologist can help with confirming that, too.

 

And, here’s the good news: just like acne, depending on the severity, you may be able to treat this condition effectively at home.  Click here to read what might help.

 

 

 

 

References:
  1. Ayers K, Sweeney SM, Wiss K. Pityrosporum Folliculitis Diagnosis and Management in 6 Female Adolescents with Acne Vulgaris. Arch Pediatr Adolesc Med.2005;159(1):64-67. doi:10.1001/archpedi.159.1.64
  2. Ayers K, Sweeney SM, Wiss K. Pityrosporum Folliculitis Diagnosis and Management in 6 Female Adolescents with Acne Vulgaris. Arch Pediatr Adolesc Med.2005;159(1):64-67. doi:10.1001/archpedi.159.1.64 (Image Credit)
  3. Dermatology Online Journal 19(8). 2013. De Andrade, V., Dias, A.C. Pityrosporum Folliculitis in an immunocompetent individual: clinical case description. http://escholarship.org/uc/item/94d335b1
  4. American Osteopathic College of Dermatology [Internet]. Kirksville (MO).; 2017. Pityrosporum Folliculitis; [ cited 2017 Feb 5]; [about 2 p.]. Available from: http://aocd.site-ym.com/?page=PityrosporumFollicu

Treatment Options for Pityrosporum Folliculitis

 

If you have Pityrosporum folliculitis, you may be able to skip the dermatologist and treat this pesky condition right at home.  But it depends.

 

In some research studies, topical treatments like creams and ointments were extremely beneficial against Pityrosporum folliculitis.  In other studies, the most effective treatment occurred when oral medication and topical treatments were used simultaneously.  The varying degrees of treatment may depend on how severe your condition is.

 

Nevertheless, the following treatment options are worth looking into and, in many instances, you may be able to try them right in the comfort of your home.

 

Pityrosporum Folliculitis Treatment Options:

 

  • One of the most common anti-fungal medications used to treat Pityrosporum folliculitis is ketoconazole.  Ketoconazole comes in two forms – oral and topical.  However, as of May 2016, the Food and Drug Administration advised against using oral ketoconazole tablets to treat fungal infections of the skin due to several serious side effects.  Topical ketoconazole, however, has not been associated with these effects and is still a viable option.  Nizoral A-D 1% Shampoo is a dandruff shampoo that contains 1% ketoconazole as the active ingredient.  This topical, over-the-counter product is available at most grocery stores and Amazon.  Be sure to read about my personal experience using Nizoral to treat this condition.

 

  • Shampoos containing selenium sulfide such as Head & Shoulders or Selsun Blue have also been reported to provide some relief.  These products can be found at most grocery stores and Amazon.

 

  • ID Monolaurin Gel Face and Body Acne/Sweat Acne Treatment is advertised as offering anti-yeast, anti-bacterial, anti-viral, and anti-protozoal properties.  This product, in clinical studies, had a 100% successful rate in treating Pityrosporum folliculitis, according to their website.

 

 

 

  • Bentonite clay is worth mentioning simply because of its ability to deeply cleanse pores!  It may not be associated with treating this condition, but it’s widely known for removing buildup of excess oil and sebum.

 

The following options listed below may require a prescription or consult with a licensed dermatologist or healthcare professional.

 

  • Additional members of the Azole family include anti-fungal agents clotrimazole, fluconazole, and itraconazole.  Similar to ketoconazole, they have also been used to treat certain yeasts with varying degrees of effectiveness.  These drugs more often than not require a prescription from a doctor.

 

  • Brand name products such as Xolegel 2% Gel (for seborrheic dermatitis), Nizoral 2% Shampoo (for tinea versicolor), Ketoderm 2% Cream (for dermatophytes and candidiasis of the skin), and Extina 2% Foam (for seborrheic dermatitis) all contain prescription-strength levels of ketoconazole.

 

  • Photodynamic therapy and salicylic acid peels may also help but, it seems, more research is needed in these areas.

 

As noted above, there are several options that could help in treating or reducing the symptoms associated with Pityrosporum folliculitis.  Since this condition can return, be sure to also spend some time learning about the risk factors and how to prevent it to reduce the possibility of recurrence.

 

Can you think of any other products that might be helpful? Please share! The more comprehensive this list is the better!