What are the other Names for this Condition? (Also known as/Synonyms)

• Pityrosporum Folliculitis

What is Malassezia Folliculitis? (Definition/Background Information)

• Malassezia Folliculitis is a yeast infection of the hair follicles mostly diagnosed in children and young adults. The infection, also known as Pityrosporum Folliculitis, normally involves the skin on the chest and upper back. It presents numerous tiny itchy skin lesions on the body
• Certain species of Malassezia yeasts are commonly found on the human skin. Under certain circumstances, such as hot-humid weather and/or high production of oil by the sweat glands, there is an overgrowth of Malassezia causing acne-like skin eruptions, which is termed Malassezia Folliculitis
• Use of topical and/or oral antifungal medication form the mainstay of treatment. With adequate treatment, the condition disappears in a few weeks, and the prognosis is excellent. However, it is known to recur in some individuals following treatment

Who gets Malassezia Folliculitis? (Age and Sex Distribution)

• Malassezia Folliculitis may affect individuals of any age; although, adolescent children, teens, and young adults are more prone to the condition
• It affects both males and females without any gender predilection
• There is no preference for any racial or ethnic group observed, and the condition is seen worldwide

What are the Risk Factors for Malassezia Folliculitis? (Predisposing Factors)

The risk factors associated with Malassezia Folliculitis may include:

• Hot-wet weather
• Excess production of sebum - the oily substance produced by sweat glands
• Individuals who sweat excessively
• Wearing synthetic clothing
• Use of certain sunscreens and topical applications (such as body oil)
• Administration of certain medications such as antibiotics and steroids
• Stress and fatigue
• Individuals with poor immune system
• Being overweight or obese
• Uncontrolled diabetes

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Malassezia Folliculitis? (Etiology)

Yeasts are microorganisms belonging to the fungus kingdom. Infection by the following yeast species are known to cause Malassezia Folliculitis.

• Malassezia globose
• Malassezia restricta
• Malassezia sympodialis

Malassezia yeasts are commonly found on the skin surface. Due to certain external factors, they may multiply in numbers and infect the hair follicles, resulting in itchy skin lesions that resemble acne.

What are the Signs and Symptoms of Malassezia Folliculitis?

The signs and symptoms of Malassezia Folliculitis may vary from one individual to another and may be mild or severe. The skin infection typically affects the torso (chest and upper back).

The signs and symptoms of the skin infection may include:

• Appearance of numerous small itchy bumps (papules and pustules)
• These pinhead size pimples are uniformly distributed on the body
• They may also involve the face, neck, and upper limbs
• These skin eruptions are often red in color
• Discomfort and irritability

Individuals with Malassezia Folliculitis may also be simultaneously affected by dandruff and seborrheic dermatitis (due to yeast colonization by the same species).

How is Malassezia Folliculitis Diagnosed?

The diagnosis of Malassezia Folliculitis may involve the following tests and procedures. The disease may be confused with acne or other skin conditions.

• Complete evaluation of medical history along with a thorough physical exam
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Potassium hydroxide (KOH) preparation: Microscopic observation of a sample for structures belonging to fungi
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. A skin tissue biopsy is typically not necessary to diagnose Malassezia Folliculitis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Malassezia Folliculitis?

The complications of Malassezia Folliculitis are uncommon, but may include:

• Emotional stress due to cosmetic concerns
• Lack of sleep due to itchiness
• Secondary bacterial infections
• Recurrence of the condition

How is Malassezia Folliculitis Treated?

The treatment measures for Malassezia Folliculitis may include:

• Use of antifungal topical applications or shampoos, with ketoconazole or selenium sulfide
• Oral medications such as fluconazole
• Adequate skin self-care

How can Malassezia Folliculitis be Prevented?

It is generally not possible to prevent Malassezia Folliculitis. However, individuals with a high risk for this skin infection may use antifungal soaps and shampoos for their personal body care. Other practices that may be considered include:

• Always keeping the skin clean and healthy
• Infected children’s nails should be cut short so that further infection from scratching the blisters can be avoided
• Application of soothing solutions (calamine or oatmeal-based) on the lesions may reduce itchiness
• Frequent washing of hands
• Getting treatment for any underlying medical condition(s) that may decrease immunity in the individual

The entire course of medication prescribed by the healthcare provider should be completed for effective cure and prevention of recurrence. Also, individuals having a high risk for recurrence may be recommended long-term prophylactic therapy (with topical antifungal agents).

What is Prognosis of Malassezia Folliculitis? (Outcomes/Resolutions)

The prognosis of Malassezia Folliculitis is good with appropriate treatment. The infection normally tends to resolve within a few weeks with adequate treatment.

Additional and Relevant Useful Information for Malassezia Folliculitis:

Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition.