What Are the Treatments for Pityrosporum Folliculitis?

Pityrosporum folliculitis, more commonly known as malassezia folliculitis, is a skin condition characterised by the overgrowth of a naturally occurring yeast called malassezia on the skin that infiltrates the hair follicles, causing the development of acne-like pustules on the skin.

It commonly occurs on the upper back and chest, and although uncomfortable, it is easily treatable through a number of topical or oral treatments, as well as preventive measures.


The symptoms of an overgrowth of pityrosporum folliculitis resemble acne, appearing like pink pimples, some of which form whiteheads. They typically appear on the upper chest and upper back, though they can often appear on the back of the hands, forearms, face and lower legs. Those affected typically have oily skin and the urge to scratch, as the pimples tend to be incredibly itchy. The itchiness is often accompanied by a stinging sensation. If you scratch the growths, the skin may become incredibly red. At times, the growths may be mistaken for scabies or other infestations. If you experience any of these symptoms and are sure they are not simple acne, consult with your dermatologist.

Oral Treatment

The most effective way to treat a pityrosporum folliculitis infection is with oral anti-fungal medications such as ketoconazole and itraconazole. They are best taken with acidic drinks or fatty foods. If you have seborrheic dermatitis, a skin condition that often occurs in conjunction with pityrosporum folliculitis, a retinoid medication known as isotretinoin may be prescribed. A common brand of the drug is Accutane. Anti-fungals are typically taken for several weeks, but individual doses may differ from person to person. A regimen can last upwards of eight weeks in severe cases. For seborrheic dermatitis, the medication may need to be taken for seven months or more.

Topical Treatment

Although less effective than oral medications, topical treatments may be used as a secondary line of treatment. Over-the-counter anti-dandruff shampoos such as Selsun Blue may be used, while topical anti-fungal creams or anti-fungal sprays like those typically used for athlete's foot can be used, as well. The shampoos only need to be used once a week, while the topical creams should be used two times a day. Discuss with your doctor the best options and the frequency and duration at which they should be used, as every case is different.

Side Effects

The side effects of ketoconazole and itraconazole are typically mild, if they occur at all. They typically resemble flu-like symptoms such as nausea and vomiting, and they can cause constipation, headache, dizziness and abnormalities in tests of the liver. Itraconazole can cause gynaecomastia (enlarged breasts) in men, while ketoconazole can cause the same, along with alopecia and impotence. According to DermNet NZ, both these drugs and isotretinoin should not be taken by those with heart conditions or by women who are pregnant. If you have to use isotretinoin, be aware that the side effects, such as impetigo and an infection of the folds in the nails, can be very severe. Discuss with your doctor the potential for other side effects and drug interactions.


The best way to effectively treat a pityrosporum folliculitis overgrowth is to identify the factors that contributed to it, such as excessive oily skin, a humid environment and even certain types of medications such as prednisone, and eliminate them. For example, if you're obese, losing weight can help reduce the risk, while wearing loosefitting clothing that doesn't encourage excessive sweating can prevent the warm, humid environment in which the yeast can grow. Stress can increase the chance of a malassezia overgrowth, and if you feel this contributes to your case, you should take steps to alleviate your stress levels. Examples include yoga and meditation.