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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!

 

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.