What is Malassezia Folliculitis?

Malassezia folliculitis is an infection of the hair follicles that creates little, pimple-like bumps on the surface of the skin. Malassezia folliculitis typically looks like little red bumps that are uniform in shape and size. You may have heard malassezia folliculitis referred to as malassezia acne, pityrosporum folliculitis and most commonly - fungal acne. But don’t get confused by these hard to pronounce names- they all mean the same thing! The tricky thing about malassezia folliculitis is that it can look an awful lot like regular ol’ bacterial acne, but in actuality, the causes and treatments of this skin concern are somewhat different.

malassezia folliculitis

What is malassezia?

Malassezia is actually a type of yeast that naturally occurs on the skin. We all have it! Your body is usually able to balance the yeast, fungi, and other bacteria that are part of your skin’s microbiome, but if the balance of your skin gets out of whack, an overgrowth of yeast can occur. This infects and inflames the hair follicles, which causes malassezia folliculitis, aka fungal acne. Malassezia folliculitis is not contagious, infectious, or an indicator of poor skin hygiene. Some people are just more likely to struggle with this annoying skin concern than others.

What causes malassezia folliculitis?

The most common cause of fungal acne is over production of oil in the skin’s sebaceous glands. Sebum (the skin’s natural oil) is what feeds malassezia folliculitis, so if you have naturally oily skin then you are much more likely to have malassezia folliculitis. Here are some other common conditions or events that might cause malassezia folliculitis to grow:

  • Taking antibiotics (they throw your skin’s natural microbiome out of whack, which can allow yeast to proliferate)
  • Wearing tight synthetic clothing while sweating
  • Living in warm, humid environments
  • Stress and fatigue
  • Diet (fungal acne is exacerbated by added sugars and simple carbohydrates)
  • Genetics

fungal acne on chest

Symptoms of malassezia folliculitis

Malassezia folliculitis gets mistaken for acne vulgaris all of the time. Why is this? Because they look very similar to each other and often exist together. Let’s take a look at some of the most common symptoms of fungal acne:

  1. The Look: Malassezia folliculitis appears as uniform, small, red bumps and pustules that sometimes come to a head with a small amount of white or yellow pus. Malassezia folliculitis tends to grow in tight-knit clusters on the face or body. Blackheads are not caused by Malessezia, and large cysts are rare.
  2. The Feel: If your bumps are itchy or sometimes feel like they’re burning, then you almost definitely have malassezia folliculitis. Regular acne never itches or burns.
  3. The Reaction: If every skincare product you use causes a breakout, then you’re most likely suffering from malassezia acne. Malassezia acne sufferers have to be extremely careful about the personal care products that they use because many common ingredients make breakouts worse. This is why it’s very important to stick to a solid fungal acne skincare routine.
  4. The Environment: Malassezia folliculitis usually fades away during the colder, drier, winter months and returns with a vengeance when it gets hot and humid in the summer.
  5. The Location: Malassezia folliculitis tends to occur in areas where your skin is more oily. You can have fungal acne on the forehead, or you can get fungal acne on the back, chest, buttocks and arms.

fungal acne on back

Malassezia folliculitis treatment

Now that you understand what malassezia folliculitis is and what causes it, it’s time to figure out how to treat fungal acne. This part can be sort of challenging because malassezia folliculitis can be super reactive to many products that are deemed “acne-safe”. Fortunately, we’ve assembled some suggestions for fungal acne treatment:

  • Prescription antifungals: You’ll need to visit a doctor or dermatologist to get a prescription
  • Mandelic acid: this alpha hydroxy acid is antifungal and anti-inflammatory, making it the perfect leave-on acne treatment for malassezia folliculitis-sufferers. Almond Clear’s mandelic acid serums are great for people who struggle with fungal acne on the face and the body.
  • Ketoconazole: Ketoconazole is an anti-fungal ingredient that’s primarily used to treat dandruff, but using this shampoo on malassezia folliculitis-prone skin works wonders for fighting off fungus. Washing the skin with a shampoo like Nizoral can be very effective.
  • Sulfur: Sulfur is a super popular ingredient to use in the malassezia folliculitis community. It’s great at sloughing off dead skin cells and it also has strong antimicrobial properties.
  • Avoid the skincare products that make fungal acne worse. Check out this list by Simple Skincare Science for an in-depth look at what ingredients are safe and unsafe to use. You can also check here to see if your current skincare and makeup products are safe to use.
  • Wear looser, more breathable clothing like cotton instead of synthetic fibers like nylon and polyester.
  • Change out of sweaty clothes as soon as you can
  • Over-the-counter antifungal supplements

fungal acne treatment

* Before and after using mandelic acid

Last Thoughts

Malassezia folliculitis can be difficult to understand and treat at first because most skincare products are geared towards clearing acne vulgaris. The main thing to remember is that this skin concern needs to be treated a little differently than regular acne. Once you know that you have malassezia folliculitis, you can adjust your skincare routine and get great results.

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