FUNGAL ACNE "SAFE" SKINCARE EXPLAINED | Dermatologist

Summary

This video script delves into the misconceptions surrounding 'fungal acne,' which is actually a condition known as pitted keratolysis or malassezia folliculitis. Caused by the yeast malassezia, it thrives in oily, moist environments and can affect those with weakened immune systems or those using topical steroids. The script clarifies that skincare products don't cause this yeast overgrowth and emphasizes the importance of seeing a dermatologist for proper diagnosis and treatment. It also discusses various treatments, including topical and oral anti-fungal medications, and lifestyle changes to manage and prevent recurrences, debunking the myth of 'fungal acne safe' skincare products.

Takeaways

• 🔍 Fungal acne is a misnomer; the correct term is Pityrosporum folliculitis or Malassezia folliculitis, which is a type of folliculitis, not acne.
• 🌱 Malassezia is a yeast that naturally lives on the skin and can cause various skin conditions like dandruff, seborrheic dermatitis, and tinea versicolor.
• 💡 Malassezia folliculitis is more common in people with weakened immune systems, such as those with HIV, or those taking medications that suppress the immune system.
• 🌡 The yeast thrives in hot, moist, and humid environments, making it prevalent in tropical settings and among people who wear tight clothing or have hyperhidrosis.
• 🚫 Prolonged use of oral antibiotics can disrupt skin microflora, potentially leading to an overgrowth of Malassezia.
• 🔍 Malassezia folliculitis presents as red bumps and pustules around hair follicles, differing from acne by lacking blackheads and whiteheads.
• 🚫 There is no such thing as 'fungal acne safe' skincare products, as products do not feed Malassezia, which is sustained by sebum, not ingredients in skincare.
• 🧴 Skincare products can help remove excess oil from the skin's surface but do not directly influence sebum production.
• 🌡 Heavy or occlusive products can exacerbate the condition by slowing down sweat evaporation, leading to increased sweating and a favorable environment for Malassezia.
• 💊 Treatment for Malassezia folliculitis typically starts with topical anti-fungal agents, such as anti-dandruff shampoos or Nizoral shampoo with ketoconazole.
• 👕 Lifestyle changes like wearing lightweight, breathable clothing and avoiding occlusive fabrics can help manage and prevent recurrences of the condition.

Q & A

What is the correct medical term for what is commonly referred to as 'fungal acne'?

The correct medical term is either pitted keratolysis or malassezia folliculitis, not acne.

What is the role of the malassezia yeast in skin conditions?

Malassezia is a yeast that naturally lives on everyone's skin and can cause different skin conditions such as dandruff, seborrheic dermatitis, tinea versicolor, and head and neck dermatitis under certain circumstances.

Why is the condition called malassezia folliculitis not actually acne?

Malassezia folliculitis is a type of folliculitis, which is an inflammation around the hair follicle, whereas acne is a problem with clogged pores and is not caused by the malassezia yeast.

Which populations are more commonly affected by malassezia folliculitis?

People with weakened immune systems, such as patients in hospitals, those with HIV, or those taking medications that weaken the immune system, are more commonly affected.

What environmental factors contribute to the development of malassezia folliculitis?

Hot, moist, and humid environments, as well as wearing tight or occlusive clothing that traps moisture, can contribute to the development of malassezia folliculitis.

How does the use of oral antibiotics relate to the development of malassezia folliculitis?

Oral antibiotics can disrupt the skin microflora, potentially leading to an overgrowth of malassezia within the hair follicle, which may result in malassezia folliculitis.

What are some distinguishing features of malassezia folliculitis compared to acne?

Malassezia folliculitis presents as monomorphic red bumps and pus bumps that overlay a hair follicle, are itchy, and do not have blackheads or whiteheads, unlike acne.

Can a person have both acne and malassezia folliculitis simultaneously?

Yes, it is possible to have both conditions at the same time, especially since acne treatments may involve oral antibiotics which could lead to the development of malassezia folliculitis.

What is the general advice for treating malassezia folliculitis?

The first line of treatment typically involves topical anti-fungal agents, and it's important to see a dermatologist for an accurate diagnosis and treatment plan.

What is the role of isotretinoin in treating malassezia folliculitis?

Isotretinoin, also known as Accutane, is a treatment option for those with frequent recurrences of malassezia folliculitis, as it is the only therapy that shrinks the oil glands and suppresses sebum production.

What is the significance of photodynamic therapy in treating malassezia folliculitis?

Photodynamic therapy can help destroy malassezia spores and is anti-inflammatory, potentially providing a recurrence-free period for some individuals with malassezia folliculitis.

Outlines

00:00

🧬 Understanding Malassezia Folliculitis vs. Fungal Acne

This paragraph introduces the misconception about 'fungal acne,' clarifying that the correct term is Malassezia folliculitis or Pityrosporum folliculitis. It is a skin condition caused by the yeast Malassezia, which normally resides on human skin but can lead to inflammation under certain conditions. The paragraph explains that this yeast thrives in oily areas and can cause various skin conditions, including dandruff and seborrheic dermatitis. It also points out that malassezia folliculitis is more common in individuals with weakened immune systems, in hot and humid environments, and in those who use topical steroid creams or have hyperhidrosis. The symptoms of malassezia folliculitis are described as red bumps and pustules around hair follicles, differentiating it from acne which involves blackheads and whiteheads.

05:00

🌱 Debunking Myths About Fungal Acne Safe Skin Care

This paragraph dispels the myth that certain skincare ingredients can feed Malassezia yeast, emphasizing that sebum production is governed by hormones and genetics, not by topical products. It advises against self-diagnosing malassezia folliculitis and recommends seeing a dermatologist for proper diagnosis. The paragraph also discusses the inappropriateness of using 'fungal acne safe' as a term, explaining that skincare products do not influence sebum production directly. It highlights the importance of considering the texture and consistency of products used on the skin, especially avoiding heavy or occlusive products that can exacerbate the condition by slowing down the evaporation of sweat and promoting a moist environment for yeast growth.

10:01

💊 Treatment Options for Malassezia Folliculitis

The paragraph discusses the first-line treatments for malassezia folliculitis, including topical anti-fungal agents and anti-dandruff shampoos with specific active ingredients that can help control the yeast. It mentions the use of Nizoral shampoo containing ketoconazole as an over-the-counter option and suggests that some milder products, like Dr. Eddie's Happy Cappy shampoo, can be used for maintenance. The paragraph also touches on the potential need for oral anti-fungal medications like fluconazole or itraconazole in more severe or recurrent cases. It advises on lifestyle changes, such as wearing breathable clothing in hot climates and considering treatments like isotretinoin or photodynamic therapy for those with frequent recurrences or oily skin.

15:03

🌡 Lifestyle and Maintenance for Preventing Recurrences

This paragraph focuses on the importance of addressing root cause issues to prevent the recurrence of malassezia folliculitis. It suggests avoiding occlusive clothing in hot and humid environments and using lightweight, breathable fabrics to reduce friction and moisture trapping. The paragraph also recommends adjusting the frequency of using anti-dandruff shampoos as maintenance, especially during hotter summer months, and considering treatments like isotretinoin for those with excessive sebum production. It mentions the potential of new treatments like the Alpha Clear laser and photodynamic therapy as additional options for managing the condition and preventing future outbreaks.

📢 Conclusion and Call to Action

In the concluding paragraph, the speaker summarizes the key points of the video, emphasizing that 'fungal acne' is a misnomer and that the condition is actually related to Malassezia yeast. It reiterates that skincare products do not feed the yeast and there is no such thing as a 'fungal acne safe' product. The speaker encourages viewers to be smart consumers and avoid products falsely claiming to be safe for fungal acne. The paragraph ends with a call to action, asking viewers to like, share, and subscribe for more information and ends with a reminder about the importance of sunscreen.

Keywords

💡Fungal Acne

Fungal acne is a misnomer used by the public to describe a skin condition that resembles acne but is actually caused by a yeast called Malassezia. The term is not scientifically accurate, as the condition is not acne but a type of folliculitis. In the script, it is clarified that 'fungal acne' is a popular name searched online, but the correct term is Pityrosporum folliculitis or Malassezia folliculitis.

💡Folliculitis

Folliculitis refers to inflammation or infection of the hair follicles. In the context of the video, Malassezia folliculitis is a specific type of folliculitis caused by the overgrowth of the Malassezia yeast within hair follicles, leading to symptoms like red bumps and pus-filled bumps, which are mistakenly called 'fungal acne' by the public.

💡Malassezia

Malassezia is a genus of yeast that naturally lives on human skin. It becomes problematic under certain conditions, leading to various skin conditions such as dandruff, seborrheic dermatitis, and tinea versicolor. In the video, it is explained that an overgrowth of Malassezia can cause inflammation, resulting in what is commonly but incorrectly referred to as 'fungal acne'.

💡Sebum

Sebum is an oily substance produced by the sebaceous glands in the skin, which helps to keep the skin moisturized and protected. In the video, it is mentioned that Malassezia yeast thrives in oily areas because it breaks down sebum, and this breakdown can cause inflammation, particularly in individuals with certain immune responses.

💡Immune System

The immune system is the body's defense mechanism against pathogens and other foreign invaders. The video explains that individuals with weakened immune systems, such as those with HIV or taking immunosuppressive medications, are more susceptible to Malassezia folliculitis due to the yeast's ability to proliferate in such conditions.

💡Oral Antibiotics

Oral antibiotics are medications used to treat bacterial infections. The script mentions that prolonged use of oral antibiotics can disrupt the skin's microflora, potentially leading to an overgrowth of Malassezia yeast and the development of folliculitis.

💡Inflammation

Inflammation is the body's response to harmful stimuli and involves redness, swelling, and sometimes pain. In the context of the video, inflammation occurs around the hair follicles when Malassezia yeast overgrows and triggers an immune response, leading to the symptoms of Malassezia folliculitis.

💡Seborrheic Dermatitis

Seborrheic dermatitis is a common skin condition characterized by redness, flaking, and itching, often in areas of the body that produce more oil. The video notes that about 40 percent of people with Malassezia folliculitis also have seborrheic dermatitis, indicating a connection between the two conditions.

💡Tinea Versicolor

Tinea versicolor is a common fungal infection of the skin that causes discolored patches. The script mentions that about six percent of people with Malassezia folliculitis also have tinea versicolor, suggesting that individuals with one condition may be predisposed to the other due to the presence of Malassezia yeast.

💡Topical Anti-Fungal

Topical anti-fungal medications are applied directly to the skin to treat fungal infections. The video discusses the use of topical anti-fungal treatments, such as anti-dandruff shampoos containing ingredients like selenium sulfide or zinc pyrithione, to address Malassezia yeast overgrowth and reduce symptoms of folliculitis.

💡Isotretinoin

Isotretinoin, also known as Accutane, is a powerful medication used to treat severe acne by reducing sebum production. The script mentions isotretinoin as a potential treatment for Malassezia folliculitis in cases where the condition frequently recurs, as it is the only therapy known to shrink the oil glands and suppress sebum production, thereby addressing a root cause of the yeast overgrowth.

Highlights

Fungal acne, also known as malassezia folliculitis, is not acne but a type of folliculitis caused by yeast.

Malassezia folliculitis commonly affects individuals with weakened immune systems, those on immunosuppressive medications, and people in hot, humid environments.

The yeast Malassezia thrives in oily areas by breaking down sebum, leading to inflammation in some individuals.

Common coexisting conditions with malassezia folliculitis include seborrheic dermatitis and tinea versicolor.

Symptoms of malassezia folliculitis include red bumps and pus bumps centered around hair follicles, which are often itchy.

Unlike acne, malassezia folliculitis does not involve blackheads or whiteheads and is not caused by clogged pores.

Diagnosis should be confirmed by a dermatologist as many conditions can mimic malassezia folliculitis.

There is no such thing as 'fungal acne safe' skincare products; skincare ingredients do not feed Malassezia yeast.

Managing oiliness and avoiding heavy, occlusive skincare products can help prevent malassezia folliculitis.

First-line treatment involves topical antifungal agents, such as those found in anti-dandruff shampoos.

Severe or persistent cases may require oral antifungal medications like fluconazole or itraconazole.

Preventative measures include wearing lightweight, breathable clothing and avoiding tight, occlusive fabrics.

Reducing excessive sweating and managing oily skin can help mitigate the risk of malassezia folliculitis.

Isotretinoin, a medication that reduces sebum production, can be effective for stubborn cases.

New treatments like photodynamic therapy and lasers targeting sebaceous glands show potential for managing malassezia folliculitis.

Transcripts

well hey guys the time has come for us

to revisit the topic of fungal acne and

fungal acne safe skin care fungal acne

is not actually the right name for this

Condition it's just a popular name that

people frequently search out online when

they are looking for more information on

this condition the correct name is

pitterosperm folliculitis or malassezia

folliculitis it's not acne it is a

folliculitis folliculitis is just the

medical term for any skin condition that

leads to inflammation around the hair

follicle aka the poor malassezia

otherwise known as pitterosparam is a

yeast that naturally lives on everyone's

skin however under certain circumstances

it can cause different skin conditions

like dandruff seborrheic dermatitis

tinea versicolor head and neck

dermatitis recently I did a video all

about skin signs of too much yeast where

I go into detail all about these

different skin conditions related to

malassezia yeast so check that out if

you are coping with these skin

conditions because actually you know

it's not uncommon for people who have

malassez colitis to have some of these

other conditions at the same time for

example about 40 percent of people with

malassezia folliculitis also have

seborrheic dermatitis and about six

percent will also have tinea versicolor

malassezia yeast naturally lives on

everyone's skin and it thrives in oily

areas because it breaks down your sebum

which is the oil that is produced in

your hair follicle and that is what it

thrives on and in certain circumstances

the breakdown of that sebum can generate

inflammation and some individuals immune

responses are such that they just react

negatively to that and lead to malcezia

folliculitis who gets this most commonly

this is observed in people who have

weakened immune systems such as patients

who are in the hospital very very sick

patients who have HIV or patients who

are taking medications that weaken their

immune system such as those taken for

transplant patients or patients who are

taking the medication prednisone which

is a steroid that suppresses your immune

system rarely it also can occur in the

setting of prolonged use of topical

steroid creams and ointments this yeast

loves hot moist humid environments

therefore it's very common in tropical

settings especially in individuals who

wear really tight clothing occlusive

clothing that can trap that yeast and

favor further that hospitable warm humid

environment for the yeast to go wild

within the poor and people who have

hyperhidrosis which is a medical term

for excessive sweating often can cope

with this condition because again it

loves the humidity it loves the moisture

the other scenario where this can pop up

is in individuals who have taken oral

antibiotics for a prolonged period of

time because oral antibiotics they can

kind of mess up your skin microflora and

tip things in a direction to favor

overgrowth of malassezia within the hair

follicle the layperson's term for this

is fungal acne but like I said it's not

actually acne it really differs from

acne quite a bit malassezia folliculitis

consists of little red bumps and red pus

bumps that overli a hair follicle

because it is within the follicle that

this problem is occurring if you look

very closely at them they'll be a little

surrounding rim of redness and sometimes

a little bit of scale as well in

contrast to the skin lesions of acne

malassezia folliculitis the skin spots

are relatively all the same size

monomorphic they tend to be itchy and in

contrast to acne there are no blackheads

and there are no white heads with

malcezia folliculitis this is a

folliculitis it is not a problem with

poor clogging it is a problem with

inflammation related to malcezia in the

pore so you're not going to see

open and close comedones AKA whiteheads

and blackheads that being said you

definitely can have both acne and

malassezia folliculitis at the same time

because a lot of patients who have acne

they end up going on prolonged courses

of oral antibiotics to help get their

acne under control and as a result May

develop malassezia folliculitis this is

why it is not ideal for people to be on

oral antibiotics for their acne for a

prolonged period of time and we really

try and limit usage of oral antibiotics

in the duration of time that people are

on oral antibiotics for their acne and

this is one reason to do so all right

now that you know a little bit about

this Condition it's not acne it's very

different from acne how can you get rid

of it the number one thing to do to get

rid of malassezia folliculitis is to

make sure you actually have it don't go

trying to self-diagnose don't fall for

that see a board-certified dermatologist

make sure this is what you actually have

a lot of people online convinced they

have malcezia folliculitis they might

but they may not a lot of things look

like this that are not it for example

you may may have a dermatified infection

in the follicle you've heard of ringworm

well it can affect the hair follicle

looks much different you may have

rosacea kind of can look the same no

comedones just like malcezia

folliculitis or maybe you have acne

vulgaris the formal name for acne so

let's talk about fungal acne safe skin

care or malassezia folliculitis safe

skin care to be more accurate guess what

there is no such thing as fungal acne

safe skin care and what I mean by that

is there are no ingredients that feed

malassezia malassezia thrives in your

sebum in a moist humid environment

there's no ingredient in a product that

is going to feed it so stop reading

ingredient lists trying to avoid certain

ingredients skin care products don't

feed malassezia and they don't drive oil

production sebum production from your

oil gland that the malassezia thrives

off of that is governed by hormones and

genetics hormonal influences are namely

the Androgen hormones that we all have

testosterone as well as insulin-like

growth factor so check out my video on

why your skin is oily I go into things

that trigger oiliness in detail there so

those of you who deal with this

condition check that video out because

things that drive oiliness in your body

you want to know about because excessive

oiliness is going to further support

this condition controlling the oiliness

by modifying things that may be

aggravating that for you can help out a

lot but guess what it's not skin care

products skin care products don't signal

to the sebaceous gland hey put out more

oil to feed malassezia they don't do

that there are certain skin care

products however that can help remove

excess oil from the surface of the skin

and from within the pore to a certain

extent but skin care products they don't

influence sebum production directly

where you can run into problems however

with your skin care products is more

with regards to the consistency the

heaviness of things that you leave on

the skin because as I pointed out in

other videos heavy moisturizers heavy

sunscreens they can slow down the

evaporation of sweat and as a result

your body produces more sweat in the

hopes of cooling your body because the

whole point of making sweat is that it

evaporates and cools your body but if

you've got heavy moisturizers heavy

occlusive products on the face that's

going to slow down the evaporation of

sweat your body is going to get warm and

your body's going to try and make more

sweat and the malassezia is going to be

like thank you so much so while there's

no such thing as you know fungal acne

safe AKA malassezia folliculitis safe

ingredients or products you do want to

be mindful of the textures of things and

how they feel on your skin in my videos

I will often Advocate as a money-saving

strategy in a practical strategy in your

skincare routine to just try using your

body lotion your body creams on your

face because oftentimes they work this

is a situation where that might not be

the right choice for you because because

body moisturizers in contrast to facial

moisturizers are often a lot heavier a

lot thicker a lot more occlusive and

they can make your face feel a lot

warmer and can further aggravate this

condition you can also develop

malassezia folliculitis on your body too

so just be mindful of the consistency of

products likewise sunscreens that are

really greasy and heavy you may want to

back away from and choose more

lightweight formulas lean into gels tend

to be a lot more lightweight fast

absorbing allow for good evaporation of

sweat so you don't feel overheated they

don't feel greasy a lot more comfortable

on the skin and will help you in your

journey to preventing recurrences of

malassezia in order to get rid of this

the first line treatment is typically

some sort of topical anti-fungal to

address the yeast I have videos all

about stuff that you can buy over the

counter to tackle this issue and you'll

recall from those videos that

anti-dandruff shampoos with the

ingredients selenium sulfide a salsan

blue or zinc Pyridium such as what is in

Head and Shoulders shampoo they can help

reduce the amount of malassezia yeast

now there's an over-the-counter

anti-fungal shampoo called Nizoral

shampoo it has Ketoconazole in it that

is another option lathered to the

affected area leave it on the skin for a

few minutes and then rinse it off do

that every night for a couple of weeks

and then do it weekly as maintenance

that will help control things now that

being said anti-dandruff shampoos with

these ingredients they can be a little

drying a little irritating a product

that a few years ago I discovered and is

actually really good for this condition

Dr Eddie's happy Cappy I think it's

called shampoo for cradle cap it's meant

for babies because cradle cap is is

another condition caused by the by the

malassezia it has zinc Pyridium it's a

very mild mild shampoo for babies gentle

on the face so that's one that may not

be robust for clearing it up but it

could be used as maintenance as a face

wash but in some cases you may need a

prescription topical anti-fungal from

your doctor if you are dealing with this

condition so that's kind of a first line

approach but if you really think about

where malassezia is causing the issue

it's down within the follicle down

within the pore so accessing it with

topicals sometimes can be an issue

especially on certain body sites you

know this isn't just a facial issue a

lot of people develop it on the back or

the chest especially if you wear you

know really occlusive clothing it's

sweaty so it's down in the follicle

right that means for a lot of people to

clear it up an oral anti-fungal is

needed that's going to be

fluconazole or intraconazole both can be

effective unfortunately with malassezia

folliculitis after you treat it with an

anti-fungal it'll clear up but it can

often recur especially if the root cause

issues have not been addressed if you

are someone who lives in a hot humid

tropical environment try and avoid

wearing occlusive clothing if you are

someone who gets this on like your chest

your back your body uh make sure you're

wearing lightweight breathable clothing

not only is that going to cut down on

friction and trapping of sweat and

moisture up close to the skin to favor

this but it's also going to keep you

from overheating it'll keep you cooler

select moisture wicking Fabrics speaking

of hot humid climates you may find that

you need to dial in the topical anti

seborrheic ingredients the anti-dandruff

shampoos more so in these summer months

like you know I mentioned as maintenance

doing the anti-dandruff shampoo

treatment to the affected area like once

a week to control the condition but you

may need to amp that up more in like the

summer months when it's a lot hotter

especially now like when I'm filming

this video it is pretty hot outside

that's why I'm inside with the air

conditioning blasting it's actually cold

in this room but outside it is like a

sauna you know in the more humid hot

summer months you may need to do this

more frequently now one of the root

cause issues with malassezia

folliculitis is people who have oily

skin excessive C1 production so again

check out my video on why you have oily

skin and I go into some of the nuances

of oily skin there and triggers

aggravating lifestyle factors for excess

sebum production in terms of hormonal

influences bodybuilders May abuse

supplements that actually drive more

Stephen production sarms are called

selective Androgen receptor modulators

that can make you oilier or testosterone

replacement therapy also can make more

sebum production you can see this

condition alongside acne vulgaris

actually because acne you know both

conditions are going to thrive off of

the excessive oiliness so another

treatment that is an option for people

who fail these things have frequent

recurrences is actually

isotretinoin AKA Accutane because

isotradinoin is the only therapy that

shrinks the oil gland and suppresses

sebum production you know you have

topical retinoids like tretinoin for

acne they don't suppress sebum so

they're not going to do anything for

malassezia folliculitis but isotretinoin

and acne treatment actually can help

this condition a lot Alpha clear is a

newer acne treatment it's a laser that

targets the sebaceous oil gland and

shrinks it it's pretty effective for

acne whether or not it will help with

malassezia folliculitis by shrinking

that oil gland remains to be determined

it hasn't been studied in that regard

yet but it wouldn't surprise me down the

road if we don't see this ending up

being useful for malassezia folliculitis

and other conditions related to

seborrhea AKA excessive oiliness the

other treatment modality that can

certainly help in some people who have

failed all of these other things have

frequent recurrences is something called

photodynamic therapy I have a few older

videos where I'm talking about skin

cancer and photodynamic therapy I think

it's basically a photosensitizing cream

that is applied to the skin and then the

skin is exposed to visible light insert

at certain wavelengths and Doses and

that actually triggers a Cascade that

can actually

destroy the little malassezia spores and

hyphy helping to cut down on recurrences

and that treatment is also

anti-inflammatory so both those things

together can help clear this up and in

some cases can buy you a recurrence free

period of time although for some people

eventually it still ends up coming back

so the maintenance treatments with the

topical anti-dandruff shampoos

anti-fungals are still needed all right

you guys so that's what I wanted to talk

about in today's video because I do get

a lot of questions

um here on YouTube over on my Instagram

and over on my Tick Tock please

recommend fungal acne safe skin care so

the key take-home points that you want

to leave this video with are fungal acne

is not really the right name for this

it's not acne it's totally different

it's related to a yeast and skin care

products do not feed the yeast there's

no such thing as a fungal acne safe

product or a mouse folliculitis safe or

unsafe product so just keep that in mind

that way you are a smart consumer

because there is a market out there of

you know products that allege to be

fungal acne safe so let me know in the

comments if you have dealt with bouts of

malassezia folliculitis this summer

because it has been a one hot one that

is for sure now on the end slate I'm

going to link that video on signs of too

much yeast AKA malassezia so check that

one out next if you were dealing with

this because uh you know I give a lot of

information in there that will likewise

help you out if you guys like this video

give it a thumbs up share with your

friends and as always don't forget

sunscreen And subscribe I'll talk to you

guys tomorrow bye

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thank you

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