Malassezia Folliculitis: The Yeast Behind Fungal Acne
Malassezia folliculitis is an itchy rash of small, look-alike bumps caused by a yeast that already lives on almost everyone's skin. When that yeast multiplies inside hair follicles, the follicles become inflamed. Because the bumps sit on the chest, back, shoulders and sometimes the face, the rash is very often taken for acne, which is why it is nicknamed "fungal acne." It is not acne, and the treatments that help acne, especially antibiotics, do little for it. The Folliculitis page gives a short summary of this form alongside the bacterial ones. This page goes further: what the yeast is, why it overgrows, how the rash is told apart from acne, how each test performs, what the treatment studies found, how often the rash comes back, and what the drug labels say about the oral medicines used for it.
Table of Contents
- Malassezia Is a Yeast That Lives on Healthy Skin
- Why the Yeast Overgrows Inside Hair Follicles
- How the Rash Looks and Feels
- How It Differs From Acne Vulgaris
- How Antibiotics and Steroid Creams Can Make It Worse
- How It Is Diagnosed, Test by Test
- Treatments That Have Been Studied
- Relapse Is Common Once Treatment Stops
- What the Labels State About Oral Antifungals
- Children, Weakened Immunity and Darker Skin
- What Is Not Known
- Key Research Papers
- Connections
- Featured Videos
Malassezia Is a Yeast That Lives on Healthy Skin
Malassezia is a group of yeasts, a kind of single-celled fungus. A 2025 review by Chalupczak and Lipner counts more than 18 recognised species. Unlike most fungi, they cannot make certain fats for themselves, so they live where the skin produces oil (sebum) and feed on it. That is why they gather on the scalp, face, chest and upper back, the areas with the most oil glands.
These yeasts are not something a person "catches." The same review describes a study of 27 healthy newborns in which Malassezia was found on 89% of skin samples on the day of birth and on 100% the next day. Almost every adult carries them without any rash.
The species that matter most in this rash, according to the review, are M. globosa, M. restricta, M. furfur and M. sympodialis. A 2009 Japanese study (Akaza and colleagues) compared 32 people with Malassezia folliculitis and 40 healthy people, using both culture and a DNA test. The species found inside the inflamed follicles were the same ones found on the patients' normal skin and on the healthy volunteers. The authors concluded that the rash is caused by the person's own resident yeast, not by a strain picked up from outside.
The same genus causes other skin conditions. Tinea versicolor produces flat, scaly patches of lighter or darker skin, and seborrheic dermatitis produces greasy, flaking redness on the scalp and face. The difference in Malassezia folliculitis is where the yeast grows: deep in the follicle opening, where the hair comes out, rather than on the skin surface.
The name has changed over time. The condition was first described in 1969, and older papers call it Pityrosporum folliculitis, after the yeast's former name. Both names refer to the same rash.
Why the Yeast Overgrows Inside Hair Follicles
The reviews describe the rash as a shift from harmless living-together to overgrowth. A 2020 critical review in the journal of the European Academy of Dermatology and Venereology (Vlachos and colleagues) splits the triggers into two groups: those inside the body, such as a weakened immune system, and those outside it, such as high temperature, humidity and clothing that covers the skin. The 2025 review lists humidity, blocked follicles (occlusion), antibiotics and immune suppression as the host factors that let the yeast multiply. A 2026 review (Draelos and colleagues) names hot, humid weather, blocked hair follicles and a weakened immune system.
Heat and sweat
The condition is more common in hot climates. In one study of 48 people with the rash cited in the 2025 review, 83% worked in a warm environment and 71% said sweating made it worse. In a multicentre study from seven teaching hospitals in Indonesia (Niode and colleagues, 353 cases), most patients were men (66.3%) and the largest age group was 17 to 25 years (44.5%).
Oil and age
The rash is seen most often in teenagers and young adults, a pattern the 2025 review links to the higher output of the oil glands at those ages. A review of 15 studies of people with normal immunity (Green and colleagues, 2023) found that 64% of patients were male and the average age at presentation was about 24.
Antibiotics and steroids
Antibiotics and corticosteroid medicines appear again and again in the patient histories, and they are covered in their own section below. In short, both are linked with overgrowth of the yeast and with the rash being mistaken for something else.
A weakened immune system
The rash is reported in people living with human immunodeficiency virus (HIV), organ transplant recipients and people taking corticosteroids. A 2000 report (Rhie and colleagues) describes 11 heart transplant recipients on standard three-drug immune suppression who developed the rash over just four months. A systematic review of 50 patients with weakened immunity, summarised in the 2025 review, found that the rash started after immune-suppressing treatment began, or after the immune system became weak, in 94.1% of them.
How the yeast causes inflammation
Laboratory work summarised in the 2025 review describes Malassezia prompting skin cells to release inflammatory signalling proteins (such as interleukin-8 and tumour necrosis factor) through a sensor called Toll-like receptor 2, and setting off the complement system, part of the body's defences. The itch and redness are the visible result of this immune reaction around the follicle.
How the Rash Looks and Feels
The 2025 review describes the typical rash as mildly itchy, red or skin-coloured bumps and small pus spots, 1 to 2 millimetres across, each centred on a hair follicle. Dermatologists call the pattern monomorphic: the bumps are all about the same size and look alike. Scratch marks and darkened skin are common.
The usual sites, from several studies:
- Chest, back and shoulders. In the review of 15 studies of people with normal immunity, lesions were on the chest in 70% and on the back or shoulders in 69.2%. In the Indonesian series, 68.3% had lesions on the chest, back and shoulders.
- The forehead and hairline. In a United States review of 110 patients aged 0 to 21 (Prindaville and colleagues, 2018), the bumps were typically on the forehead running into the hairline and on the upper back.
- The face. In a study of 49 patients from Turkey (Durdu and colleagues), described in the 2025 review, 71.4% had more than one area involved, and the face was the most frequent site (57%), followed by the back (53%), the outer arms (38.8%), the chest (36.7%) and the neck (18.3%).
Itch is the symptom most patients mention. It was reported by 65% of the 110 patients in the Prindaville review, by 71.7% across the 15-study review, and by 83.9% in the Indonesian series. Not everyone itches, though: in the 48-patient study cited above, 37 reported itch and 11 had none at all.
The rash tends to last. In a 2007 French series of 26 patients (Lévy and colleagues), people with normal immunity had had the rash for an average of 61 months before it was diagnosed. In a Singapore series (Yong and colleagues), most patients had symptoms lasting more than one month.
How It Differs From Acne Vulgaris
Ordinary acne (acne vulgaris) and Malassezia folliculitis both produce bumps in oily areas, and they can occur in the same person at the same time. The reviews describe several features that tell them apart.
- Blackheads and whiteheads. Acne has comedones (blackheads and whiteheads) and often deeper nodules or cysts. The 2025 review describes Malassezia folliculitis as lacking comedones, nodules and cysts.
- Uniform bumps. Acne is a mix of lesion types and sizes. Malassezia folliculitis bumps look alike.
- Itch. Acne is usually not itchy. In a Thai study of 320 people with newly diagnosed acne (Paichitrojjana and Chalermchai, 2022), those found to have Malassezia folliculitis were 7.38 times more likely to report itch.
- Location. In the same Thai study, people with Malassezia folliculitis were 8.89 times more likely to have acne-like lesions on the scalp or hairline and 9.17 times more likely to have them on the upper back.
- Response to treatment. Acne treatments that work, such as antibiotics, fail or make things worse, while antifungal treatment helps.
How often the two overlap
Two studies looked for the yeast in people already diagnosed with acne. In the Thai study, 28.8% of 320 acne patients had Malassezia folliculitis: 24.7% had both conditions, and 4.1% had only the yeast rash. In a Turkish study of 217 acne patients (Pürnak and colleagues, 2018), 55 people (25.3%) met the study's microscope definition of Malassezia folliculitis. The 2026 review adds that the condition is more common in people diagnosed with acne than in the general population.
A 2005 report (Ayers and colleagues) describes 6 teenage girls who had both conditions at once. All improved with antifungal treatment, and all also needed ongoing acne treatment. The authors wrote that the yeast rash often worsens with traditional acne therapy.
Other look-alikes named in the 2025 review include rosacea (which brings flushing and visible small blood vessels), bacterial folliculitis (usually more tender and more localised), gram-negative folliculitis around the mouth and jaw after long antibiotic courses, and steroid-induced acne-like eruptions.
How Antibiotics and Steroid Creams Can Make It Worse
Antibiotics
The 2025 review states that systemic antibiotics are almost always ineffective for this rash and may make it worse. The proposed reason is that they disturb the normal mix of microbes on the skin, removing bacteria that compete with the yeast and letting it overgrow. Prolonged antibiotic courses can also calm inflammation for a while, which confuses the picture, and the rash then flares again when they stop.
The patient histories reflect this. In the Prindaville review of 110 young patients, more than 75% had acne that had recently been treated with antibiotics, and the authors concluded that, unlike classic acne, the yeast rash was more common after antibiotic use. In the French series, 65% of patients had already been given topical or oral antibiotics or anti-acne drugs, and these were ineffective in every case. In the review of 15 studies, 40.5% of patients reported earlier treatments that had not worked.
Corticosteroids
The 2025 review describes topical corticosteroid creams as giving short-lived relief, usually followed by a rebound flare when they stop. Steroid creams can also change how the bumps look, which makes the correct diagnosis harder. It describes a case in which a steroid cream flattened the bumps and left dark marks.
Steroid tablets are linked too. In a study of 34 people diagnosed with steroid acne, cited in the same review, 76% (26 people) had Malassezia visible under the microscope. The authors suggest the yeast may play a part in some acne-like eruptions caused by steroids.
How It Is Diagnosed, Test by Test
The 2025 review describes the diagnosis as mainly clinical: the look of the rash, where it is, the itch, and a history of failed acne treatment. Tests are used to confirm it, especially when the rash has not responded to acne treatment. A 2023 position statement from the European Academy of Dermatology and Venereology Mycology Task Force sets out which positive findings its expert group requires before treatment starts. As summarised in the 2025 review, the group recommends a clinical examination plus a direct microscope examination, and supports treatment on clinical grounds alone where a microscope is not available.
A key problem runs through every test. Because almost everyone carries Malassezia, finding the yeast on the skin does not by itself prove it is causing the rash. Several of the tests try to show that large numbers of yeast are inside the follicle.
Potassium hydroxide microscopy
Material from a bump is placed on a glass slide with potassium hydroxide (KOH), which dissolves skin cells and leaves fungal cells visible. The 2025 review calls it the most accessible and lowest-cost test. Its performance varies between studies:
- In the Durdu study of 49 patients, the potassium hydroxide test picked up 81.6% of cases.
- In the Indonesian series, 87.4% of patients were positive on potassium hydroxide examination.
The 2020 Vlachos review notes that a sample taken by tape stripping or with a comedo extractor (a small tool that presses out the follicle contents) usually shows round yeast cells budding from one end, without the threads (hyphae) that are typical of tinea versicolor. That is one reason the "spaghetti and meatballs" picture described on the tinea versicolor page is not the usual finding here.
Stained smears
Staining the same kind of sample can make the yeast easier to see. In the Durdu study, a May-Grünwald-Giemsa stained smear was positive in 100% of the 49 cases, compared with 81.6% for potassium hydroxide. The Thai study used methylene blue staining, and the Singapore series confirmed 214 of 375 suspected cases (57.1%) with a Gram stain.
Wood's lamp
A Wood's lamp is a handheld ultraviolet (UV) light used in a darkened room. Affected follicles may glow yellow-green. In the Durdu study, the glow was seen in 66.7% of patients, and in the Indonesian series 69.1% were positive. The 2025 review notes that the glow is not specific to Malassezia or to any one species, so it supports the diagnosis but does not prove it.
Dermoscopy and ultraviolet dermoscopy
Dermoscopy uses a lighted magnifier held against the skin. In a series of 15 patients described in the 2025 review, scale was the most common finding (73.3%), followed by a pale hair shaft in the affected follicle (60%) and bumps resembling keratosis pilaris (53.3%). A newer version uses ultraviolet light. In a multicentre study of 208 patients with various skin conditions (Errichetti and colleagues), Malassezia folliculitis showed a blue glow confined to the follicles. The 2025 review reports from that study that 11 of 13 patients (84.6%) had this glow, a sensitivity of 84.6% and a specificity of 100%. Acne, by contrast, usually shows no such blue glow.
Culture and DNA tests
The 2025 review states that fungal culture is generally not recommended. Malassezia needs special oil-containing growth media, and a positive culture may only show the normal resident yeast. DNA (polymerase chain reaction) tests can identify the species but, for the same reason, cannot show that the yeast has turned harmful. They are not yet widely used.
Skin biopsy
A small sample of skin examined under the microscope is described in the 2025 review as possibly the most definitive test. It can show yeast inside the follicle with inflammation around it. In a Korean study of 52 patients (An and colleagues, 2019), fungal spores inside the follicle opening were the finding most consistent with Malassezia folliculitis, while inflammation inside the follicle, irregular plugs of keratin and fragments of broken cell nuclei pointed instead to an acne-like eruption.
A biopsy can also miss the yeast. In a Korean study of 100 people with folliculitis (Song and colleagues, 2014), 20 were first diagnosed with Malassezia folliculitis. Cutting the remaining samples into 10 serial slices found yeast in 10 more, and a special stain (diastase periodic acid–Schiff) found it in 6 more. In total, 16 diagnoses changed. Results also differ between methods: in the French series, direct microscopy was positive more often than biopsy (89% versus 33%). In a Saudi Arabian series of 62 patients (Abdel-Razek and colleagues, 1995), the biopsy was positive in 87%.
Response to antifungal treatment
The 2025 review lists a good response to antifungal treatment as one of the findings that supports the diagnosis. The 2026 review warns that interest in "fungal acne" on social media has led some people to apply antifungal products without a confirmed diagnosis.
Treatments That Have Been Studied
The 2025 review notes that treatment studies are few and mostly small. The 2020 systematic review by Vlachos and colleagues found 21 studies that met its criteria for judging treatments. The figures below are what each study reported. They are not a treatment plan. Doses are given only as the studies used them.
Topical azoles and other skin treatments
The azoles are a family of antifungal drugs that includes ketoconazole, econazole, miconazole, clotrimazole, itraconazole and fluconazole. Results with azole creams, lotions and washes vary widely between studies:
- Ketoconazole cream and shampoo. In a Japanese series of 44 patients (Suzuki and colleagues, 2016), 37 used 2% ketoconazole cream and 7 took oral itraconazole 100 mg. All improved, with no side effects reported. Improvement (flattening of the bumps) took an average of 27 ± 16 days with the cream and 14 ± 4 days with the oral drug. In the Prindaville review of 110 patients, the most common treatment was ketoconazole shampoo, which led to improvement or clearing in most cases.
- Econazole and miconazole. In the Saudi Arabian study, econazole 1% solution and miconazole 2% cream used alone failed in 20 of 22 patients.
- Topical ketoconazole alone in the French series cured only 12% of patients.
Selenium sulfide and propylene glycol
The 2025 review describes an open-label study of 51 patients. After 4 weeks, 80% of those using selenium disulfide 2% shampoo once a week had recovered (20 of 25). The figure was 75% with 50% propylene glycol twice a day and 70% with econazole cream. After 4 more weeks, the figures were 88%, 100% and 80%. Many patients relapsed after stopping, although the review gives no exact number. In the heart transplant series, a topical combination of clotrimazole 1% and selenium sulfide lotion worked in 6 of the 11 patients.
Oral itraconazole
- Placebo-controlled trial. In a double-blind trial of 26 patients (Parsad and colleagues, 1999), the trial gave itraconazole 200 mg once a day for 7 days or a placebo. At the end, 84.6% of the itraconazole group were healed or markedly improved, compared with 8.3% of the placebo group. Mycological tests turned negative in 84% versus 8.3%.
- Durdu study. The 49 patients took itraconazole 200 mg a day for 2 weeks, and 79.6% recovered completely.
- Acne overlap study. In the Turkish study, the 55 patients with the yeast rash were given oral itraconazole (100 mg twice a day) plus topical ketoconazole for 4 weeks. Of the 38 who completed treatment, 26 (68.4%) had their lesions reduced by half or more.
- Comparison with cold plasma. A randomised trial of 50 patients (Wang and colleagues, 2024) compared daily cold atmospheric plasma treatment with itraconazole 200 mg a day for 2 weeks. Success was 40.0% with plasma and 58.3% with itraconazole, a difference that was not statistically significant (p = 0.199).
Oral fluconazole
The evidence for fluconazole comes from case series rather than controlled trials. In the heart transplant series, the 5 patients who did not respond to topical treatment took fluconazole, and all lesions resolved within 3 weeks. In the Prindaville review, 16 patients took oral fluconazole and, as the 2025 review summarises it, all improved.
Oral ketoconazole in older studies
In the Saudi Arabian study, oral ketoconazole 200 mg a day plus ketoconazole 2% shampoo daily cleared the rash in all 20 patients (100%), while oral ketoconazole alone cleared it in 15 of 20 (75%). In the French series, oral ketoconazole alone or combined with the topical form cured 75%. The label safety section below explains why oral ketoconazole tablets now carry a boxed warning.
Oral versus topical
Across the 15-study review of people with normal immunity, treatment was most successful with an oral antifungal (92%), followed by a topical antifungal (81.6%). The 2015 Danish guideline states that oral treatment is probably more effective than topical treatment, but that a combination may be favourable. The 2023 European position statement, as summarised in the 2025 review, lists topical treatments as first-line for people with normal immunity: azoles, ciclopirox, propylene glycol, zinc or selenium disulfide. It lists oral itraconazole and fluconazole for people with weakened immunity, and suggests a 2- to 4-week trial aimed at clear improvement rather than complete clearing.
Acne treatments and other options
The 2026 review suggests that benzoyl peroxide and retinoids, which act on mechanisms the two conditions share (more skin oil, the fat-splitting enzyme lipase, and inflammation), may help, and states that this needs further study. For oral isotretinoin, the 2025 review describes three case reports with mixed results: one patient improved after 20 weeks, one cleared completely after 5 months, and one showed no improvement after 3 months. The same review notes that isotretinoin causes birth defects. In a pilot study of photodynamic therapy (a light-activated treatment) in 6 people with stubborn cases, 3 improved.
Relapse Is Common Once Treatment Stops
Clearing the rash and keeping it away are two different problems. The 2025 review describes a chronic, relapsing course: the rash responds quickly to antifungals, but recurrences are frequent. The 2025 abstract states that relapses are common.
- In the French series, the rash came back consistently within 3 to 4 months of stopping treatment, and the authors called treatment difficult because of how often it relapses.
- In the Saudi Arabian study, as summarised in the 2025 review, 25% of those who first responded relapsed, usually within 4 months. The other 75% stayed clear at 6 months while using ketoconazole shampoo twice a week as maintenance.
- In the report of 6 teenage girls, 5 of the 6 who responded to oral antifungals needed maintenance with ketoconazole or selenium disulfide shampoo.
- In the selenium disulfide, propylene glycol and econazole study, many patients relapsed after stopping.
The 2025 review states that no study has directly compared maintenance approaches. The approaches described in the literature are intermittent use of the same topical antifungals, applied less often than during active treatment, together with changes to the things that set the rash off: sweat, skin covered by tight or non-breathing clothing, and unnecessary antibiotic courses. The 2015 Danish guideline states that maintenance treatment is often necessary to prevent relapse in the related Malassezia conditions.
What the Labels State About Oral Antifungals
The oral antifungals used in these studies are prescription drugs approved in the United States for other infections. Malassezia folliculitis is not among the uses listed on the itraconazole capsule or fluconazole tablet labels. Their use for this rash is off-label, a point the 2025 review raises when it notes that access to off-label treatments may be limited. The facts below come from the United States prescribing information published on DailyMed by the National Library of Medicine.
Itraconazole capsules
- Heart failure. A boxed warning states that the capsules are not to be used for nail fungus in people with evidence of a weakened heart pump (such as congestive heart failure) or a history of heart failure. It states that when itraconazole was given into a vein to dogs and healthy volunteers, it weakened the heart's pumping force.
- Drug interactions. The boxed warning states that taking itraconazole with a number of drugs broken down by the liver enzyme CYP3A4 is contraindicated. Its examples include methadone, quinidine, oral midazolam, triazolam, pimozide, lovastatin, simvastatin and ticagrelor. Higher levels of some of these drugs can cause an abnormal heart rhythm (QT prolongation and torsade de pointes), which can be fatal.
- Liver. The label reports rare cases of serious liver injury, some within the first week of treatment. It recommends that liver monitoring be considered in everyone taking the drug, and it states that treatment is to be stopped and liver tests done if signs of liver trouble appear.
- Other effects. The label reports nerve damage (neuropathy) and hearing loss, temporary or permanent.
- Pregnancy. The label reports birth defects in rats and mice at high doses. It states that there are no studies in pregnant women, and it calls for highly effective contraception during treatment for nail fungus and for 2 months afterwards.
Fluconazole tablets
- Liver. The label reports rare cases of serious liver toxicity, including deaths, mainly in people with serious underlying illness. It states that no clear link to dose, length of treatment, sex or age has been seen, and that the injury has usually, but not always, reversed when the drug was stopped.
- Heart rhythm and interactions. The label reports QT prolongation and rare torsade de pointes. It lists as contraindicated other drugs that prolong the QT interval and are broken down by CYP3A4, such as erythromycin, pimozide and quinidine. It also reports that fluconazole raises blood levels of some sulfonylurea diabetes drugs (tolbutamide, glipizide, glyburide).
- Pregnancy. The label cites case reports of a distinct pattern of birth defects after high doses (400 to 800 mg a day) through most or all of the first trimester. It also states that retrospective studies have suggested risks of miscarriage and birth defects with 150 mg taken once or repeatedly in the first trimester.
Ketoconazole tablets
Oral ketoconazole, used in several of the older studies above, carries a boxed warning. It states that the tablets are not indicated for skin infections caused by dermatophyte fungi, for Candida infections or for nail fungus. They are to be used only when other effective antifungal treatment is unavailable or not tolerated. The warning reports serious liver injury, including deaths and cases needing liver transplantation, sometimes in people with no obvious risk factors. It also lists dangerous heart-rhythm interactions with drugs including methadone, quinidine and pimozide.
The 2025 review lists active liver disease, markedly raised liver enzymes, past liver injury from antifungals and interactions with drugs processed by the liver as reasons oral antifungals are not used. The 2023 European position statement includes a separate treatment pathway for people with impaired liver function. Decisions about these medicines belong with a prescribing clinician.
Children, Weakened Immunity and Darker Skin
Children and teenagers
A 2024 review in Pediatric Dermatology (Chang and Stein) covers the Malassezia-linked conditions seen from infancy to adolescence. These are tinea versicolor, Malassezia folliculitis, infant and adolescent seborrheic dermatitis, head and neck dermatitis, and a pimple-like rash of newborns called neonatal cephalic pustulosis. The review covers how each looks across different skin colours. The Prindaville review of 110 patients covered only people aged 0 to 21, and the teenage-girl series showed the yeast rash and acne occurring together.
Weakened immunity
The heart transplant series and the 50-patient systematic review show the rash following immune suppression. In that review, as reported in the 2025 summary, improvement was seen in 16 of 18 people treated with oral antifungals (88.9%), in 12 of 13 treated with topical ones (92.3%), and in all 6 whose underlying condition was treated. The 2025 review also describes a study of 185 people with HIV, of whom 25 (13.5%) had a Malassezia infection and 4 of those were diagnosed with Malassezia folliculitis.
Darker skin
The 2025 review states that the rash can be harder to recognise on darker skin. There, dark marks left by inflammation hide the redness, and the rash can be mistaken for follicular eczema, acne or keratosis pilaris. It notes that data on darker skin are very limited, mostly single case reports. In such cases, it says, the diagnosis leans on itch, uniform bumps in oily areas and the absence of blackheads and whiteheads.
What Is Not Known
- How common it is. The rate depends on the region, the climate and the test used. Studies in acne clinics found about a quarter of patients affected, but these were single clinics in two countries.
- The best test. Studies differ on which test performs best. Potassium hydroxide picked up 81.6% of cases in one study and 87.4% in another, and biopsy was positive in 33% in one series and 87% in another. There are no agreed standard diagnostic criteria, which the 2025 review lists as a research priority.
- The best treatment. Most treatment studies are small, open-label or retrospective. Only a few compared one treatment against placebo or another. The 2025 review calls for prospective head-to-head comparisons.
- How to prevent relapse. No study has compared maintenance approaches directly.
- Acne treatments. Whether benzoyl peroxide or retinoids help is a hypothesis based on shared mechanisms, and the 2026 review calls for it to be studied.
- Newer options. Cold atmospheric plasma and photodynamic therapy have been tested in small numbers of patients, and long-term safety and effectiveness data are lacking.
- Who is studied. People with darker skin and people with weakened immunity are under-represented in the research.
Key Research Papers
- Chalupczak NV, Lipner SR. Malassezia Folliculitis: An Underdiagnosed Mimicker of Acneiform Eruptions. J Fungi (Basel). 2025;11(9):662. PubMed PMID: 41003208
- Draelos ZD, Barbieri JS, Tanghetti EA, Farris P, Lain ET, Prevete S, Choi SY, Wroblewski K, Baldwin H, Kircik LH. Malassezia Folliculitis Presentation, Diagnosis, and Treatment: A Review of "Fungal Acne". J Drugs Dermatol. 2026;25(5):427-434. PubMed PMID: 42081639
- Chang CH, Stein SL. Malassezia-associated skin diseases in the pediatric population. Pediatr Dermatol. 2024;41(5):769-779. PubMed PMID: 38776177
- Vlachos C, Henning MAS, Gaitanis G, Faergemann J, Saunte DM. Critical synthesis of available data in Malassezia folliculitis and a systematic review of treatments. J Eur Acad Dermatol Venereol. 2020;34(8):1672-1683. PubMed PMID: 32012377
- Henning MAS, Hay R, Rodriguez-Cerdeira C, Szepietowski JC, Piraccini BM, Ferreirós MP, Arabatzis M, Sergeev A, Nenoff P, Kotrekhova L, Nowicki RJ, Faergemann J, Padovese V, Prohic A, Skerlev M, Schmid-Grendelmeier P, Sigurgeirsson B, Gaitanis G, Lecerf P, Saunte DML. Position statement: Recommendations on the diagnosis and treatment of Malassezia folliculitis. J Eur Acad Dermatol Venereol. 2023;37(7):1268-1275. PubMed PMID: 36912427
- Hald M, Arendrup MC, Svejgaard EL, Lindskov R, Foged EK, Saunte DM; Danish Society of Dermatology. Evidence-based Danish guidelines for the treatment of Malassezia-related skin diseases. Acta Derm Venereol. 2015;95(1):12-9. PubMed PMID: 24556907
- Green M, Feschuk AM, Kashetsky N, Maibach HI. Clinical characteristics and treatment outcomes of Pityrosporum folliculitis in immunocompetent patients. Arch Dermatol Res. 2023;315(6):1497-1509. PubMed PMID: 36517586
- Prindaville B, Belazarian L, Levin NA, Wiss K. Pityrosporum folliculitis: A retrospective review of 110 cases. J Am Acad Dermatol. 2018;78(3):511-514. PubMed PMID: 29138059
- Paichitrojjana A, Chalermchai T. The Prevalence, Associated Factors, and Clinical Characterization of Malassezia folliculitis in Patients Clinically Diagnosed with Acne Vulgaris. Clin Cosmet Investig Dermatol. 2022;15:2647-2654. PubMed PMID: 36531566
- Pürnak S, Durdu M, Tekindal MA, Güleç AT, Seçkin D. The Prevalence of Malassezia Folliculitis in Patients with Papulopustular/Comedonal Acne, and Their Response to Antifungal Treatment. Skinmed. 2018;16(2):99-104. PubMed PMID: 29911526
- Durdu M, Güran M, Ilkit M. Epidemiological characteristics of Malassezia folliculitis and use of the May-Grünwald-Giemsa stain to diagnose the infection. Diagn Microbiol Infect Dis. 2013;76(4):450-7. PubMed PMID: 23706503
- Niode NJ, Suling PL, Adji A, Miranda E, Bramono K, Astari L, Ervianti E, Sondakh ORL, Rusmawardiana, Yenny SW, Widasmara D, Lubis FM, Widaty S. Clinico-laboratory findings of Malassezia folliculitis in Indonesia: A multicentre study. Mycoses. 2022;65(10):953-959. PubMed PMID: 35920036
- Errichetti E, Pietkiewicz P, Bhat YJ, Salwowska N, Szlązak P, Stinco G. Diagnostic accuracy of ultraviolet-induced fluorescence dermoscopy in non-neoplastic dermatoses (general dermatology): A multicentric retrospective comparative study. J Eur Acad Dermatol Venereol. 2025;39(1):97-108. PubMed PMID: 38288676
- An MK, Hong EH, Cho EB, Park EJ, Kim KH, Kim KJ. Clinicopathological differentiation between Pityrosporum folliculitis and acneiform eruption. J Dermatol. 2019;46(11):978-984. PubMed PMID: 31489692
- Song HS, Kim SK, Kim YC. Comparison between Malassezia Folliculitis and Non-Malassezia Folliculitis. Ann Dermatol. 2014;26(5):598-602. PubMed PMID: 25324652
- Akaza N, Akamatsu H, Sasaki Y, Kishi M, Mizutani H, Sano A, Hirokawa K, Nakata S, Nishijima S, Matsunaga K. Malassezia folliculitis is caused by cutaneous resident Malassezia species. Med Mycol. 2009;47(6):618-24. PubMed PMID: 18949624
- Lévy A, Feuilhade de Chauvin M, Dubertret L, Morel P, Flageul B. [Malassezia folliculitis: characteristics and therapeutic response in 26 patients]. Ann Dermatol Venereol. 2007;134(11):823-8. PubMed PMID: 18033060
- Abdel-Razek M, Fadaly G, Abdel-Raheim M, al-Morsy F. Pityrosporum (Malassezia) folliculitis in Saudi Arabia--diagnosis and therapeutic trials. Clin Exp Dermatol. 1995;20(5):406-9. PubMed PMID: 8593718
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Drug label facts: United States prescribing information for itraconazole capsules, fluconazole tablets and ketoconazole tablets, DailyMed, National Library of Medicine.
PubMed Topic Searches
Connections
- Folliculitis — the parent page covering every type of follicle infection
- Tinea Versicolor (Pityriasis Versicolor) — the same yeast genus, growing on the skin surface
- Seborrheic Dermatitis — another Malassezia-linked condition of oily skin
- Acne — the condition this rash is most often mistaken for
- Fungal Infections — the wider family of skin fungal infections
- Isotretinoin — the acne drug tried in a few stubborn cases
- Dermatology — the skin conditions section