You Might Have Fungal Acene!
Have you ever had itchy red bumps on your skin? You might be having what is known as Malassezia folliculitis (MF) or formerly known as pityrosporum folliculitis.
Malassezia folliculitis is an infection of hair follicles caused by Malassezia sp. of yeast (fungus). These yeasts are naturally found on normal human skin, living harmoniously with other normal bacteria on our skin. They can cause disease under certain conditions.
Is Malassezia folliculitis the same as your regular acne?
The bacterial or hormonal acne that we usually get has pus-filled bumps, nodules, open comedones (blackheads), closed comedones (whiteheads) or cyst. These bumps can be in different sizes.
On the other hand, Malassezia folliculitis usually presents with the following characters:
- 1-2mm pustules or papules (red bumps)
- Those red bumps usually have a uniform shape
- Itchiness
- Skin becomes red
- Usually involving the forehead, upper back and chest
Sometimes, both conditions can occur at the same time which makes diagnosis even more challenging. If you are in doubt, you should always consult your doctor for advice.
What condition can trigger Malassezia folliculitis?
Hot and humid weather especially in Malaysia may make some of us more prone to getting this condition but it can occur without any specific time or season. Other triggers like:
- Wearing tight clothing
- Using too much makeup
- Sunblock may block hair follicles
- Oily skin
- Excessive sweating
- Antibiotic use

Who can get Malassezia folliculitis?
This condition is commonly seen in adolescents and young adults. Conditions that make it more likely to get these infections include:
- Diabetics/ HIV
- Immunocompromised individuals/ corticosteroids/ immunosuppressant therapy
- Pregnancy
How to avoid getting Malassezia folliculitis?
- Wear loose-fitting clothes especially when you are outdoors
- Change your sweaty clothes and shower as soon as possible after your workout or exercise
- Avoid wearing excessive makeup, sunblock or moisturizer
Is there treatment for Malassezia folliculitis?
Yes. Sometimes these red bumps will resolve on their own without treatment but the time it takes to recover really depends on the individual.
If lifestyle changes do not work, then your doctor may start you on some topical medications like clotrimazole cream, econazole cream, selenium sulfide or ketoconazole shampoo.
In severe cases, you may require systemic antifungal therapy to treat the infection. There is always a risk of recurrence even if it is treated since the fungus lives on our skin. Some individuals may require maintenance therapy.