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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!

 

The Video That Went Viral

 

 

When I created this YouTube video in 2016 I had no idea it would receive nearly as many views as it has.  A year later, this video has been viewed over half a million times and has approximately 700 comments, and growing.  On average, it receives anywhere from 30,000 to 65,000 views each month, and by far is the most watched video on my channel!  Whether it’s related to Pityrosporum folliculitis or not, it’s evident there are people all over the world who are dealing and searching for a solution to the small, persistent, and stubborn bumps like the ones I had.

 

While this video is only a small synopsis of Pityrosporum folliculitis, based upon the numerous comments I’ve received and the follow-up emails, this video may have offered people who are dealing with this condition a glimpse of hope.  In case you haven’t seen it, you can click the video to view it or you can read the transcript provided below.

 

*Please Note: In this video, I mention one treatment option and a few risk factors, however, there are several other treatment options and additional risk factors to consider.  Check out this comprehensive blog post What is Pityrosporum Folliculitis to learn more about them.

 

 

Hi guys, welcome back to my channel.  I wanted to talk about these tiny, annoying, pesky little bumps on your forehead.  You have tried salicylic acid.  You have tried benzoyl peroxide.  You have tried almost every single acne product on the market and they do not seem to work.  What is going on?

 

Pityrosporum folliculitis or Malassezia folliculitis is caused by proliferation of a yeast within the hair follicles.  What?  So, basically it is a yeast.  On the surface of the skin, it looks like it is acne except it isn’t.  One distinguishable difference between acne and this yeast is the itchiness it causes.  If the bumps you’re experiencing are accompanied by an occasional itch, chances are you may have this yeast present.  However, ironically, acne may be present, too; due to the fact that skin oiliness is one of the factors that can lead to this condition, and also, as you know, acne. More on that later.

 

Surprisingly, malassezia or pityrosporum can actually be found on the skin of most adults;  the thing is an over-proliferation of this yeast is usually what causes this acne-like breakout to occur, and like any yeast or fungus an over-proliferation occurs only when the conditions are ripe. Then things go crazy!

 

One more important point to make.  While the title of this video is tiny bumps on forehead, this condition can actually be present on the upper back, the chest, the shoulders, and the neck.  It can really be found in quite a few different place.  But I have found when we are talking about acne and when we are talking about skin care, a lot of people have mentioned this tiny bump-like eruption on the forehead.

 

How did you get Pityrosporum folliculitis?  Or how did you get malassezia folliculitis?  Going back to what I said earlier, it can occur from oily skin.  Other factors include obesity, stress, fatigue, or pregnancy.  Even a systemic illness that can cause a weakening in your immune system or taking certain broad spectrum antibiotics and medications can also be factors.

 

How can you tell if you have Pityrosporum folliculitis?  A clinical diagnosis can be determined by either visually observing the area or microscopically having a skin biopsy done.  Sounds intense, I know.

 

The good news is treatment is entirely way more straight-forward.  If you don’t have the time or, let’s face it, the money to go see a doctor, determining whether or not you have acne or a yeast present can be as simple as applying a topical treatment to treat yeast, and seeing if it works.

 

Nizoral AD Shampoo is a commonly used product used to treat this type of yeast.  Its active ingredient is Ketoconazole.  Ketoconazole is an anti-dandruff, anti-fungal agent.  Basically, it treats dandruff, it kills yeast and kills fungus.

 

Apply a thin layer of this product over the affected areas twice a day – morning and night – for ten days.  It is recommended that you leave it on the skin for ten to fifteen minutes before washing off.

 

If you notice a significant improvement after the ten day application, more than likely an over-growth of this yeast was present and the cause of the bumps you saw on your forehead.

 

If you notice mild improvement, both acne and an overgrowth of this yeast may have been present and may still be present.  After a ten day treatment of this product, try treating the remainder of the bumps you have with acne remedies and acne solutions to see if you notice a difference.

 

Lastly, if you did not notice any improvement, more than likely an overgrowth of this yeast is not present.  It could simply be acne that is causing the bumps on your forehead.

 

For more information on how to treat acne and acne skin care, please check out my other videos.  Please make sure you like, comment and subscribe and please let me know what other videos you would like to see in the future.  Talk to you guys later.  Bye.

 

*June 2017 Update: There are several other treatment options and risk factors for this condition.  Check out these blog posts What is Pityrosporum Folliculitis and Treatment Options for Pityrosporum Folliculitis to learn more!

 

How and Why Ketoconazole Works

 

The term “drug class” refers to a set of drugs that share similar characteristics. For instance, they might have a similar chemical structure, behave the same way by binding to the same target, or treat the same disease.

 

Ketoconazole belongs to the azole drug class. Other members of this class include, but are not limited to clotrimazole, econazole, miconazole, fluconazole, and itraconazole. Azoles are famous for targeting a variety of fungi, including dermatophytes like tinea and yeasts like candida and malassezia. For now, we’ll focus on ketoconazole because it’s the most widely used topical antifungal for the treatment of Malassezia yeast infections.

 

Ketoconazole, basically, works to stop fungal growth.

 

But how does it work exactly? Well think of a cell and a cell membrane. Unlike animal cells, ergosterols can be found in the cell membranes of most fungi and protozoans (for now we’ll focus on fungi cell membranes).

 

Why is ergosterol important? It helps to regulate membrane fluidity. They’re basically membrane reinforcers.

 

Antifungal drugs, like ketoconazole, work by targeting ergosterol. In fact, while ergosterol is being synthesized or made, ketoconazole inhibits it. For many fungi, this interference can lead to an increase in cell permeability, leakage of cell components and, ultimately, cell death.

 

Simply put, ketoconazole is effective because it targets ergosterol, making an otherwise impermeable cell membrane permeable. Once the membrane is permeable, cell death is almost inevitable.

 

Ketoconazole comes in two forms – oral and topical. But 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 like toxicity, liver damage and adrenal gland problems to name a few. Yikes! You can read more about it here. For similar reasons, it has been discontinued in many other countries, as well.

 

Topical ketoconazole, however, has not been associated with these effects and is still a valuable drug for some superficial fungal infections of the skin. Nizoral A-D 1% Shampoo is an over-the-counter anti-dandruff shampoo that contains 1% ketoconazole as the active ingredient. This product can be found in some local grocery stores and on Amazon. You can read more about my personal experience with Nizoral A-D 1% Shampoo here.

 

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) contain prescription-strength levels of ketoconazole and, therefore, are not available over-the-counter.

 

While ketoconazole has not yet been clinically proven to treat or stop the growth of Pityrosporum (Malassezia) folliculitis specifically, it has been shown to inhibit the growth of other common fungi in the laboratory. Be sure to discuss with your doctor the possible risks and benefits of using this particular drug.

 

 

 

 

 

  1. Dufourc, E. J. (2008). Sterols and membrane dynamics.Journal of Chemical Biology,1(1-4), 63–77. http://doi.org/10.1007/s12154-008-0010-6
  2. Food and Drug Administration [Internet]. Drug Safety Communication on Nizoral (Ketoconazole) Oral Tablets; [cited 2017 Apr 8]; [about 2 p.]. http://www.fda.gov/downloads/Drugs/DrugSafety/UCM501983.pdf
  3. Food and Drug Administration [Internet]. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2004/076419.pdf
  4. Rosenthal, L., Burchum, J. Feb. 2017. Lehne’s Pharmacotherapeutics for Advanced Practice Providers.