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Pityrosporum Folliculitis

What is Pityrosporum folliculitis?

It is a health condition wherein the yeast (Malassezia) gets down the hair follicles and thrives causing an acne-like eruption.


It is commonly found on the upper chest, upper back, and sometimes on the face, neck, and upper arms. Yeast is a part of the normal flora of the skin. Pityrosporum folliculitis is not an infection itself but more of an overgrowth of what is already there. The other term for pityrosporum folliculitis is Malassezia folliculitis.

There are a variety of reasons why overgrowth of yeast occurs. They are the following:

  • Weak immune system
  • Hot or humid environment
  • Use of greasy sunscreen and oily emollients, especially coconut oil based emollients.
  • People with oily skin.
  • People with diabetes mellitus.
  • People who are under a great deal of stress or fatigue.
  • Those who are using oral contraceptive and oral steroids.
  • People who are overweight. (1, 4, 7)

Pityrosporum Folliculitis Pictures

Pityrosporum folliculitis rash on a patient’s chest and shoulder areas pictures

Image 1: Pityrosporum folliculitis rash on a patient’s chest and shoulder areas.
Photo Source: www.dermquest.com

A patient with severe pityrosporum folliculitis at the back image

Photo 2: A patient with severe pityrosporum folliculitis at the back.
Picture Source: www.dermquest.com

Pityrosporum folliculitis symptoms

  • Pinhead sized and uniform pimples
  • Itchy papules which appear more prominent when scratched.
  • The rashes are tiny and pink with an occasional tiny white head.
  • The itching comes in episodes and is accompanied by a stinging sensation.
  • The itch is worst after performing activities that produce excessive sweat.
  • When the rashes are scratched, they will resemble a local hive like reaction.
  • The patient may also experience seborrheic dermatitis and a true acne. (2, 3, 4)

What causes Malassezia folliculitis?

The pathogenic agent of Malassezia folliculitis is Malassezia furfur. The very same pathogenic agent responsible for other types of skin disease such as folliculitis, seborrheic dermatitis, and pityriasis Versicolor. Malassezia belongs to the family of superficial mycoses. (5)

Age Distribution

It affects youth and middle-aged adults. It is most common in people between 13 years old and 45 years old. There are also instances wherein very young people are affected. (5)

Diagnosis of Malassezia folliculitis

To diagnose Malassezia folliculitis, the doctor will perform a thorough physical assessment. He will check for an acne-like eruption on the chest and upper back. A histopathological exam of the skin biopsy can also be ordered to detect the organisms present in the hair follicles. (3, 6)

Is pityrosporum folliculitis contagious?

Folliculitis is not contagious, but some types are indeed contagious such as the staphylococcal folliculitis. On the other hand, pityrosporum folliculitis isn’t contagious. However, there are rare reports of immunocompromised patients being at a greater risk of infection. (7, 8)

Pityrosporum Folliculitis Cure

The treatment for pityrosporum folliculitis should focus on controlling the overgrowth of yeast and limiting the predisposing factors. There is pityrosporum folliculitis treatment over the counter which can be effective in mild cases.

  • Topical therapy – The commonly used topical drugs include Selsun shampoos, Nizoral cream, Lamisil solution, and Loprox. These are directly applied on clean skin. Make sure you strictly follow the usage instruction to get the most of the treatment.
  • Oral treatment – It is more effective than the topical therapy. The two commonly used drugs are Sporonox and Nizoral. The dermatologist can also order for Accutane pill, but it should be given as a last resort.
  • Other remedies – One particular remedy for pityrosporum folliculitis is a photodynamic therapy using methyl 5-aminolevulinic acid. (8, 9, 10)

Treatment guidelines

  • It is important to get rid of the predisposing factors.
  • Implement a maintenance regimen, especially if the patient has been suffering from chronic pityrosporum folliculitis.
  • The first line of treatment should be oral antifungals and then followed by topical antifungals.
  • The patient should be seen again by the doctor approximately two to three months after starting pityrosporum folliculitis therapy. This is to check if the treatment is effective or not. It will also check for liver function.
  • The patient must be put on a maintenance therapy using topical antifungals and shampoos. (2, 5, 6, 7)

Pityrosporum folliculitis home treatment

Pityrosporum folliculitis can be treated using a natural approach. Pityrosporum folliculitis natural treatment includes the following:

  • Neem – It contains antiseptic and antifungal properties. All you need to do is to rub a neem oil directly on the affected parts of the body. For faster result, you should apply neem oil two to three times a day.
  • Aloe Vera – Its antibacterial and anti-inflammatory properties make it perfect for treating pityrosporum folliculitis. It helps alleviate the pain and itching. It hastens the healing process.
  • Turmeric – It contains curcumin, a potent anti-inflammatory compound tested and proven effective in the treatment of various skin disorders.
  • Oregano oil – It contains carvacrol and terpenes, which are potent antibacterials. It also contains thymol, a substance that acts as a natural fungicide. (4, 5, 8)

How to prevent pityrosporum folliculitis?

  • If the humidity is high, then you should rely more on your air conditioning unit. As mentioned above, folliculitis is triggered by humid environment.
  • Shower daily using soap-free body wash, especially if you have a sensitive skin.
  • Avoid wearing occlusive clothing such as tight bras and shirts. This type of clothing can trap sweat and oil.
  • Use oil-free sprays and gels rather than cream and lotions. If you are going to apply self-tanner, you should use foams, liquid, or gels. Avoid using creams and lotions.
  • If you have folliculitis, you should avoid using antibiotics for acne because they can get rid of good bacteria causing the yeast that triggers Pityrosporum folliculitis.
  • If the area of the scalp is affected, then you should use medicated shampoos such as Nizoral. Anti-dandruff shampoo containing zinc pyrithinone also helps in the treatment of pityrosporum folliculitis. (1, 2, 4, 5, 8)

Recovery Period

The healing time varies on how soon the condition is detected. If it is detected early, then the condition can clear up in a week or two. To hasten the recovery, the patient should receive the appropriate treatment and avoid things that can trigger pityrosporum folliculitis.

Pityrosporum folliculitis does not raise a serious health issue. However, it can affect the integrity of the skin. It can also recur in the future. There are also instances when it affects the hair follicle causing permanent hair loss.

References:

  1. http://www.aocd.org/?page=PityrosporumFollicu
  2. https://www.dermnetnz.org/topics/malassezia-folliculitis/
  3. https://emedicine.medscape.com/article/1091037-overview
  4. https://emedicine.medscape.com/article/1091037-treatment
  5. http://www.mdedge.com/edermatologynews/dsm/211/dermatology/folliculitis-pityrosporum-malassezia-folliculitis
  6. http://cosmeticscop.com/2016/08/22/pityrosporum-folliculitis/
  7. https://en.wikipedia.org/wiki/Pityrosporum_folliculitis
  8. https://simpleskincarescience.com/pityrosporum-folliculitis-treatment-malassezia-cure/
  9. https://www.acne.org/messageboard/topic/208147-pityrosporum-folliculitis-faq/
  10. https://www.pityrosporumfolliculitis.com/whats-pityrosporum-folliculitis/

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