Malassezia Folliculitis

If you’re battling persistent, itchy breakouts that look like acne but don’t respond to traditional treatments, you might be dealing with Malassezia folliculitis—a common but often misdiagnosed condition. At SOMA Skin & Laser, our dermatology team specializes in accurate diagnosis and effective treatment for fungal skin conditions like this one.

What Is Malassezia Folliculitis?

Malassezia folliculitis, also known as pityrosporum folliculitis, is caused by an overgrowth of yeast (Malassezia species) that naturally lives on the skin. Unlike bacterial acne, this condition results in itchy, uniform pustules due to yeast infecting the hair follicles.

It is not contagious, but it can be chronic or recurrent if not properly treated.

Common Symptoms

  • Small, itchy red or skin-colored bumps (papules and pustules)

  • Breakouts on the chest, back, shoulders, upper arms, and sometimes the face

  • Often appears in hot, humid weather

  • May flare with sweating, heat, or antibiotic use

  • Frequently mistaken for acne, but does not respond to acne treatments

What Causes It?

Malassezia folliculitis occurs when the yeast that lives on your skin multiplies excessively, often triggered by:

  • Heat and humidity

  • Excessive sweating

  • Occlusive skincare products or clothing

  • Long-term antibiotic use (which disrupts normal skin flora)

  • Oily skin types

  • Immunosuppression

How We Diagnose Malassezia Folliculitis

Because it mimics acne, this condition is often overlooked. At SOMA Skin & Laser, we use:

  • Clinical examination by board-certified dermatologists

  • Microscopic evaluation or skin scraping (in select cases)

  • History review of failed acne treatments or flare patterns

Treatment Options

Malassezia folliculitis requires a different approach than acne. Our treatment options may include:

1. Topical Antifungals

  • Ketoconazole cream or shampoo

  • Ciclopirox or selenium sulfide lotions

  • Used daily or as maintenance to prevent recurrence

2. Oral Antifungals

  • Fluconazole or itraconazole for moderate to severe cases

  • Short courses often clear lesions quickly

3. Skincare Adjustments

  • Avoiding oily or comedogenic products

  • Incorporating gentle, antifungal cleansers into routine

  • Switching to breathable clothing and managing sweat

4. Maintenance Therapy

Since the yeast is a natural part of the skin, maintenance may be necessary for long-term control—especially during summer or humid conditions.

Why Choose SOMA Skin & Laser?

  • Accurate diagnosis of hard-to-treat skin conditions

  • Board-certified dermatologists experienced with Malassezia and other fungal disorders

  • Customized treatment plans for lasting relief

  • Evidence-based skincare guidance to prevent recurrence

Say Goodbye to Itchy, Acne-Like Bumps

If your “acne” isn’t responding to traditional treatments—or seems to get worse with antibiotics—Malassezia folliculitis could be the culprit. Let the expert team at SOMA Skin & Laser help you uncover the real cause and get your skin back on track.

Call Us Today: 973-763-7546

**Results may vary patient to patient. There is no guarantee that any specific result can be achieved.
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