Folliculitis refers to an infection of the hair follicle, which can look a lot like acne. It’s sometimes difficult to diagnose and treat due to that similarity—so knowing the ins and outs of the condition can help you find the right treatment.
Let’s take a look at those two words: malassezia and folliculitis. Malassezia is a family of fungi that can infect the skin of numerous mammals. Ptyrosporum is another word for the malassezia fungus, though malassezia is the more accepted term in modern medicine. Folliculitis refers to an infection of the follicle. A hair follicle is a small, pouch-like indentation in the skin that houses the root of a single hair and a sebaceous gland. Sebaceous glands produce oil that is crucial to protecting the skin from a variety of problems including dryness.
Now that that’s out of the way, we can make more sense of the condition in question. You’re probably familiar with skin infections, and how they usually result from damage to the surface of the skin. Infection occurs when a foreign substance or organism (like a bacteria or fungus) penetrates the skin and triggers the body’s immune response. With folliculitis, that infectious material is the malassezia or pityrosporum fungus. This type of fungus is a yeast, meaning it will get into the skin and begin to replicate very quickly. This kind of infection is known for causing intense itching and acne-like inflammation. Since the sebaceous glands are impacted, they produce sebum which accumulates under the skin and resembles the whiteheads caused by acne.
MF is often reported on the shoulders and upper torso. It can occur anywhere follicles are present, so essentially anywhere besides the soles of the feet and palms. Spots look like acne, but are usually itchy, which is often not a symptom of acne. Even if your doctor rules out acne, other types of folliculitis could still be responsible for your symptoms. Commonly, however, bacterial folliculitis impacts the lower part of the body, like the legs and thighs. If your symptoms are on the trunk and shoulders, odds are higher it’s malassezia folliculitis. While the symptoms of MF do resemble acne, a test can be performed by scraping a pustule and examining it beneath a microscope. If your dermatologist is uncertain of a diagnosis, this test can determine the presence of the malassezia fungus.
Treating folliculitis depends on what’s causing the infection. One treatment does not fit all, and that’s especially true for fungal infections like malassezia folliculitis. With this condition, the best course of treatment is antifungal drugs. Topical drugs and ointments like econazole and clotrimazole are often prescribed for a variety of fungal infections. These drugs, applied to malassezia folliculitis, can eliminate the fungus responsible for the irritation, clearing your symptoms. Most of these topical medications are applied once daily, and have minimal side effects.
In some cases, oral medication may be prescribed. Fluconazole and itraconazole are two such drugs that can treat MF orally. They are taken daily for a prescribed amount of time, and then monthly after symptoms clear in order to maintain the treatment. Isotretinoin, an oral medication used to treat moderate to severe acne, can also sometimes help with malassezia folliculitis. Isotretinoin reduces the amount of sebum your skin produces, and by reducing its production it keeps the fungal yeast from growing. Malassezia thrives in sebaceous glands because it actually feeds off of sebum. With less sebum, the malassezia has no fuel to grow and spread.
Malassezia folliculitis is a difficult condition to diagnose, but treatment isn’t nearly that challenging. If you’re suffering from symptoms that match the ones outlined above, it’s time to call the experts at Northeast Dermatology Associates for a treatment plan.
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