Pityrosporum Folliculitis

Troubled by raised, red bumps on your chest and back that itch and stay red? Is it stubborn acne? An allergic reaction? We reveal the answers and explain how a simple yeast might be the culprit behind the hard-to-pronounce skin disorder, Pityrosporum folliculitis!

In This Article:

What is Pityrosporum Folliculitis?

Pityrosporum folliculitis is an inflammatory skin disorder that’s triggered by any of several types of yeast known as Malassezia, which occur naturally on skin. For most of us, Malassezia coexists peacefully on our skin’s surface and within the pores (also known as follicles). But for others, especially people with oily skin between the ages of 13–45, these yeasts can cause persistent inflammation deep inside the pore lining (hence the name “folliculitis,” which translates to “inflamed follicles”). [1]

By the way, if you’re wondering about the “Pityrosporum” part, it’s another name for Malassezia. The distinction may have come about because the Malassezia yeasts are the culprits behind other skin disorders, including seborrheic dermatitis. Although the “Pityrosporum” name has stuck, modern research refers to this disorder as Malasezzia folliculitis.

Pityrosporum folliculitis resembles (and is sometimes confused with) acne because it’s characterized by clusters of raised, red bumps of various sizes that look very much like pimples. The difference? Pityrosporum folliculitis bumps tend to itch. Along with the itching, skin beneath and surrounding the bumps tends to have a diffuse redness that’s not typically seen with acne and “regular” clogged pores. Last, cyst-like bumps might be seen with acne, but not with Pityrosporum folliculitis. [1]

Of course, it’s also possible to be struggling with acne and Pityrosporum folliculitis at the same time, but the folliculitis won’t respond favorably to most anti-acne medications. If you’ve had no luck treating what you thought was body acne, you may be dealing with this type of folliculitis, meaning the acne products had little chance of working as expected.

Pityrosporum folliculitis occurs most often on the back, but may also show up on the chest, upper arms (where it shouldn’t be confused with keratosis pilaris, shoulders, scalp, and neck. Thankfully, Pityrosporum folliculitis on the face is rare; if you see similar red bumps there that aren’t itchy, you’re most likely dealing with classic acne.

If you have oily skin on the chest, scalp, and back, you’re more likely than others to struggle with Pityrosporum folliculitis. It seems the yeast that triggers the inflammation thrives when excess sebum (skin’s natural oil) is present. In fact, these yeasts not only need the fatty acids in skin’s oils to thrive, they need them to actually survive! [2]

How to Treat Pityrosporum Folliculitis

Successful treatment of Pityrosporum folliculitis requires prescription oral antifungal medication—topical treatments won’t have an effect, so don’t try to treat this condition yourself. Research has shown these drugs can lead to marked improvement in the majority of patients after at least four weeks of use. Examples of antifungal drugs used to treat Pityrosporum folliculitis include itraconazole, fluconazole, and ketoconazole. [3, 4, 5]

Unfortunately, even after successful treatment, Pityrosporum folliculitis tends to recur periodically—but there are steps you can take to prevent it or at least extend the time between bouts of itchy breakouts! [5]

Tips to Prevent Pityrosporum Folliculitis

Research has shown that this irksome skin issue occurs more often in humid climates. Although we can’t control the weather, we do have some amount of control over where we live and, more practically, the steps we take to keep humid weather from affecting us.

Lifestyle tips to try include relying more on air conditioning when humidity is high, not exercising outdoors during the hottest or most humid parts of the day, and showering with a soap-free body wash that rinses clean (soaps can clog pores and potentially make any type of folliculitis worse). Note that if you have very oily skin and live (or work outdoors) in a humid climate, you’ll likely need to shower twice daily.

Other preventive tips to try:

  • Don’t wear occlusive, tight shirts or bras, especially while exercising. These can trap sweat and oil, worsening the bumps and the itchiness.
  • Avoid applying thick, balm-like moisturizers or oils on bump-prone areas.
  • Rather than cream or lotion sunscreens, stick with lightweight, oil-free gels and sprays.
  • If you apply self-tanner, opt for liquids, foams, or gels rather than lotions or creams.
  • If you’re also dealing with acne, avoid acne-treating antibiotics. Antibiotics kill good bacteria, too, which causes the yeasts that trigger Pityrosporum folliculitis to flourish. [1]
  • If your scalp is affected, try washing with Nizoral Shampoo, which is medicated with the anti-fungal ingredient ketoconazole. Anti-dandruff shampoos medicated with zinc pyrithinone may also help [6].
  • DermaZinc is a leave-on lightweight cream that’s medicated with zinc pyrithinone. It may prove a helpful topical product to use along with a course of oral anti-fungal medication.

With a bit of know-how and armed with the tips discussed above, you’re well prepared to identify and take control of Pityrosporum folliculitis! We wish this skin disorder was one that skincare alone could control, but in the case of this stubborn-yet-naturally-occurring yeast, most people struggling with the itchy, red, acne-like bumps will need their doctor’s help to get (and keep) their skin looking clear.

References Cited

  1. Rubenstein R, Malerich, S. Malassezia (Pityrosporum) Folliculitis. J Clin Aesthet Dermatol. 2014; Mar. 7(3): 37–41.
  2. Berk T, Scheinfeld N. Seborrheic Dermatitis. P.T. 2010; Jun. 35(6): 348–352.
  3. Parsad D, Negi KS. Short term treatment of pityrosporum folliculitis with itraconazole. Indian J Dermatol Venereol Leprol. 1999; May-Jun;65(3); 122–123.
  4. Levy A, et. al. Malassezia folliculitis: characteristics and therapeutic response in 26 patients. Ann Dermatol Venere. 2007; Nov; 134(11): 823–828.
  5. Faegermann J. Pityrosporum ovale and skin diseases. Keio J Med. 1993; Sep; 42(3):91–94.
  6. Gupta M, et. al. Zinc Therapy in Dermatology: A Review. Dermatol Res Pract. 2014; July; ePublication.
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