Malassezia (Pityrosporum) Folliculitis

What is Malassezia (pityrosporum) folliculitis?

Malassezia (mah-luh-SEE-zee-uh) or Pityrosporum folliculitis (pity-RAH-spur-uhm fuh-lihk-you-LIE-tiss) is a fungal infection that causes bumps to form on your skin. Microorganisms (flora) that normally live on your skin include a yeast called Malassezia. When too much Malassezia grows and gets into your hair follicles, pityrosporum (Malassezia) folliculitis may develop.

Who does Malassezia (pityrosporum) folliculitis affect?

Pityrosporum folliculitis often affects adolescents. It’s also more likely to affect people who sweat a lot (hyperhidrosis) and those who live in hot, humid areas.

What are risk factors for pityrosporum folliculitis?

You're at higher risk for developing pityrosporum folliculitis if you're an adolescent or were assigned male at birth. You may also be at higher risk if you:

• Have diabetes.
• Have oily skin.
• Have problems with your immune system.
• Have seborrheic dermatitis or dandruff.
• Sweat a lot.
• Take antibiotics or steroids.

How common is pityrosporum folliculitis?

Pityrosporum folliculitis is a common type of dermatitis, a skin condition. It’s hard to know just how common because it doesn’t always require treatment and can be misdiagnosed as acne.

Does pityrosporum folliculitis have other names?

Pityrosporum folliculitis is also called Malassezia folliculitis.

What body parts does pityrosporum folliculitis affect?

You might get pityrosporum folliculitis on your:

• Face (especially your forehead).
• Scalp (typically near your hairline).
• Shoulders.
• Arms.
• Chest.
• Back.

What is the difference between pityrosporum folliculitis and acne?

Both conditions cause bumps to appear on your face, scalp and upper body. But the causes are different, and the bumps may look different.

• Pityrosporum folliculitis: The cause of pityrosporum folliculitis is a fungal infection in your hair follicles. The bumps look the same (uniform) throughout your upper body.
• Acne: The cause is clogged oil-producing (sebaceous) glands. Bumps (pimples, whiteheads, blackheads, and pustules) on your skin can be different shapes and sizes.

What causes pityrosporum folliculitis?

A yeast called Malassezia (pityrosporum) causes this condition. When too much of this yeast grows on your skin and gets into your hair follicles, it causes a fungal infection.

What are the symptoms of pityrosporum folliculitis?

The main symptom of pityrosporum folliculitis is a breakout of itchy bumps. The bumps are usually the same size and shape.

Is pityrosporum folliculitis contagious?

Pityrosporum folliculitis may be contagious. It can be spread through shared razors and hot tubs or, less likely, through skin-to-skin contact between people.

How do healthcare providers diagnose pityrosporum folliculitis?

Your healthcare provider will check your skin during a physical examination. Your provider may refer you to a dermatologist.

To confirm a diagnosis of pityrosporum folliculitis, your provider may gently scrape your skin to gather some skin cells. They examine these cells under a microscope to look for signs of excess Malassezia yeast. If needed, your provider may do a skin biopsy.

How do I get rid of pityrosporum folliculitis?

If needed, healthcare providers will treat pityrosporum folliculitis with antifungals. They may start with an antifungal cream (topical treatment) to reduce the amount of yeast on your skin.

When pityrosporum folliculitis is severe or doesn’t go away, your healthcare provider may prescribe antifungal pills (systemic treatment). These include antifungal drugs such as fluconazole (Diflucan®) or ketoconazole.

Some healthcare providers may recommend photodynamic therapy.

Do at-home treatments help pityrosporum folliculitis?

You might find relief by using an anti-dandruff (selenium sulfide) shampoo or OTC antifungals for the treatment of fungal infections (like athlete’s foot) on your skin.

Are there natural treatments for pityrosporum folliculitis?

An herbal supplement called tea tree oil may help with pityrosporum folliculitis. Talk with your healthcare provider about whether tea tree oil is right for you.

Are there side effects of pityrosporum folliculitis treatments?

Oral antifungal medications can cause side effects such as:

• Abdominal pain.
• Diarrhea.
• Nausea and vomiting.

How can I prevent pityrosporum folliculitis?

Yeast may grow when your skin becomes too hot, sweaty and moist. To help prevent this:

• Avoid skin care products or sunscreens that are greasy.
• Wear clothes that allow air to get to your skin.
• Wash your skin well at least once a day.

What can I expect if I have pityrosporum folliculitis?

Expect symptoms to clear up within a few weeks of starting treatment.

But pityrosporum folliculitis can last for years. Symptoms often go away with treatment and come back when treatment stops. Your healthcare provider might recommend that you continue to use certain creams or medications to prevent symptoms from recurring.

When should I see my healthcare provider for pityrosporum folliculitis?

Talk to your healthcare provider if you have “acne” that doesn’t go away with treatment – it may actually be a fungal infection.

A note from Cleveland Clinic

Pityrosporum folliculitis happens when too much Malassezia yeast grows on the skin and infects the hair follicles. The condition causes an itchy rash on the face, head and upper body. Healthcare providers treat pityrosporum folliculitis with topical antifungal creams and antifungal medications.