(58, 59, 60). Fun fact #6: urea has been used to treat various skin diseases for over a century. These are all pathologically similar, i.e. I’m not sure if you are still responding, but I have a question that was not mentioned… does laundry detergent affect this particular skin condition? And then there’s the fact that sulfur has been used since Hippocrates’ day to cure all kinds of skin diseases. In other words, it takes less ciclopirox olamine to inhibit malassezia compared to ketoconzaole. What is inaccurately referred to as ‘fungal acne’ is actually a condition called pityrosporum folliculitis or malassezia folliculitis (MF). Malassezia folliculitis (Pityrosporum folliculitis) is an itchy acne-like condition usually affecting the upper trunk of a young adult. You can spot fungal acne (ahem, Malassezia folliculitis) by its itchy, red papules or pustules that are about 1 to 2 millimeters in size (about the tip of a pencil). However, even this has limitations and might come out negative because it reveals what yeast are on the surface of skin (i.e. Actually, the best idea is to consult your doctor from the get-go because like the name implies, fungal acne looks just like acne, so better to leave it up to a doctor. More about this in the “natural treatment” section. So basically I mix my own variation of Epiduo tailored for adult skin, replacing the BP with azelaic acid… The azelaic acid/adapalene combination works so well that I’m surprised that there isn’t a pre-mixed product available with it already.”. She cured her seborrheic dermatitis in four weeks using honey masks! I especially notice them after getting my derma-planing done at the dermatologist office. Treatment regimens include application of benzoyl peroxide wash (i.e. But don’t try it! Thank you so much for this extremely important contribution!!! Anti-fungal Product — Nizoral Dandruff Shampoo (15 mins then rinse) *Today, Saturday, marks the 10th day using Nizoral 4. Here's the thing: Even though we call it fungal acne, it's not actually acne at all, says board-certified dermatologist Christine Choi Kim, MD. However, I first came across a video of someone talking about Mal. Fungal acne also tends to appear most often on the chest, back, shoulders, and sides of the arms—basically, anywhere you tend to trap sweat or bacteria, both of which aggravate fungal acne—but Dr. Kim says it can also be found on the neck and face, usually along the hairline and the sides. In the world of topical therapy, urea is such a drug.” (163). If you plan on using tea tree oil, make sure to dilute it at 1% concentration or less. I’ve used butenafine hydrochloride in the past with much success. Thus, the AA/Mino combination can be regarded as valuable therapeutic alternative in patients for whom isotretinoin is not indicated, who do not wish to use or cannot tolerate tretinoin therapy. As with so many of your other posts, it is so well-researched, thorough and helpful! Side note: if you want to take an oral antifungal be aware that there was a recent FDA report of death risk with off-label oral ketoconzaole. Our data suggests that in some cases the metabolism of fatty alcohols by Malassezia may be possible.”. If you need a visual here’s a google search. This is what I recommend doing. I am assuming the dryness/itchiness is a side-effect to the ketoconazole and benzoyl peroxide (I’ve never been itchy or dry on my back before). Excellent work. 2 things most water systems are treated with. For example, psoriasis has decreased levels of ceramide 1, 3, and 6, whereas eczema and acneic skin is deficient in ceramides 1 through 6. Water, butylene glycol, glycerin, PPG-10 methyl glucose ether, hydroxyethyl urea, sodium acetylated hyaluronate (super hyaluronic acid), sodium hyaluronate, hydrolyzed hyaluronic acid (nano hyaluronic acid), hydroxypropyltrimonium hyaluronate (skin absorbent type hyaluronic acid), sodium hyaluronate crosspolymer (3D hyaluronic acid), aphanothece sacrum polysaccharide (sacrum), hydrogenated starch hydrolysate, glycosyl trehalose, diglycerin, sorbitol, pentylene glycol, triethyl citrate, carbomer, polyquaternium-51, PEG-32, PEG-75, ammonium acrylates crosspolymer, disodium EDTA, potassium hydroxide, diethoxyethyl succinate, disodium succinate, succinic acid, phenoxyethanol, methylparaben. to deeply moisturize). And mind you, azelaic acid creams generally come in 10-20%, so I’d expect its inhibitory powers only go up with concentration. So whaddya do? Perhaps you noticed that M. globosa and M. furfur are found in all of the skin conditions above. So now my question to you (or any clever blog-follower): Do you have a ‘safe’ bodylotion that you can recommend for use in the fight against Malassezia and in combination with ketoconazole/benzoyl peroxide? (. Lanette N is a mix of ionic surfactant sodium stearyl sulfate and cetylstearyl alcohol. polyethylene glycol Benzoyl peroxide washes also are helpful in seborrhea control of the trunk and face. None of the products listed below contain fatty acids or oils. In the case of malassezia, that’s facilitated by the fatty acids in your skin’s oil (sebum). I know my anecdotal experience isn’t the most convincing scientific argument but uh…. More alarmingly however, is this patent about ceramides in skincare that states they can be manufactured with C16-C32 fatty acids! today you will be learning absolutely everything you need to know about how to DESTROY this thing once and for all. So…. QUESTION #1: Should I add any steps in? Folliculitis initially causes small, red bumps that look similar to an acne breakout. Ceramides are the main component of the stratum corneum and epidermis, which are the two outer most layers of skin. These are actually used to induce the mycelial phase in vitro because they cause M. furfur to grow the fastest. Plus, they have an impressive shade-range in most things. The solubility properties of cetyl alcohol and palmitic acid are fairly different, so while I am not by any means certain because skin chemistry is complicated — there are a lot of factors involved, like buffers and enzymes on top of the more simple, straight organic chemistry stuff we’re covering here — I’d hazard a guess that cetyl alcohol would not be a feasible substitute [for malassezia].”. glycerin + fatty acid = glyceride, also known as a glycerol ester. My line of reasoning was that adapalene’s strengths are the inverse, in that it’s known to treat whiteheads and blackheads better than inflammatory acne. My face flared about a week after having strep throat and taking antibiotics. Since excess sebum production and sweating can worsen fungal acne, Dr. Kim says it's super common in anyone who exercises a lot or sits around in tight, non-breathable fabrics, especially while getting all hot and sweaty. If you recall they were the water and sweat-resistant sunscreens that were the second place finishers in this AWESOME sunscreen experiment! It’s a bit complicated, but the answer is yes. In fact, one study found that the level of free fatty acids was reduced from 15.9 to 10.5% after 1 month of using azelaic acid. I am changing dermatologists this week so hopefully they will be more helpful. I’ve always had ‘problem’-skin, acne, redness, oilyness + flakyness in face – all in one confusing combination. My hope is to cut out some of the steps once I clear completely but always keep the honey, ACV and stridex pads. Is there any way to tell if the ingredient ending in ATE is an ester? I thoroughly enjoyed this F.C. As you know, finding safe moisturisers is akin to finding a needle in a haystack, so keeping it updated with as many options as you find would be incredibly helpful to a lot of people. It varies depending on the species, what fatty acids were used, and the concentration of those fatty acids. That is, use an anti-fungal until your lesions are completely gone then follow it up with a keratolytic agent till the end of time. High sebum production, excessive sweating, antibiotic use, oral steroids and immunosuppression are all factors that contribute to the overgrowth of Malassezia. glyceryl monostearate Hello! WOW. (111) For this reason, I recommend talking to your healthcare provider about using itraconazole or fluconazole instead. Tried Nizoral last night and bought some of the simple products. glyceryl oleate [1–4] Often misdiagnosed as acne vulgaris, it is easy to miss and thus is likely underdiagnosed. lecithin How To Fix Dehydrated Skin According to Science: GET YO’ GLOW HOMIE, Probiotics For Skin Explained (60 Studies): Everything You Need to Know in 2020, How to Get Rid of Acne Overnight With Black Voodoo Magic. Interestingly enough, zinc pyrithione increases the levels of triglycerides, cholesterol, and ceramides (P<0.05) in the shampoo-treated scalp of dandruff patients. rubbing alcohol) and you get isopropyl palmitate — a common ingredient in many moisturizers like the popular Aveeno Daily Moisturizing Lotion. I started researching Malassezia, and your page was one of the first search results. I am currently using Vanicream face wash and clotrimazole cream USP 1% and I’ve been following this regimen for three days now. I read the entire post about three times just to absorb all of the information, you did such a phenomenal job. Additionally, I’ve been using Lancome’s Teint Idole Ultra 24 H, which also comes in a ton of shades and fits the criteria of the yeast-challenged. Our products featured are hand selected by us for their high quality ingredients that will give you results. The composition of human sebum that has been exposed to pathogenic malassezia is abnormally high in free fatty acids. These are all the questions that really stuck in my mind, but hopefully I can get your thoughts… Read more ». We will use these terms later so keep them in mind. I will list these in the “natural treatment” section below. (129), “A significant feature of CPO is that no single case of fungal resistance has been reported so far, even though it was introduced into clinical therapy more than three decades ago…. Because Malassezia is normally present on our skin, Dr. Kim says long-term use of the formulas once or twice weekly might be necessary to stop it from coming back. It distinguishes itself from traditional acne in that it’s fungus not bacteria causing the breakouts. Now that we’ve gone over what to avoid with malassezia, let’s discuss how to TREAT it. (80). The usual recommended frequency with ketoconazole 2% shampoo is twice weekly over the span of 4 weeks. It may be considered common and under-recognized. polyglyceryl isostearate Malassezia (Pityrosporum) folliculitis (MF) is an acneiform eruption, described first by Weary et al in 1969 and recognized by Potter in 1973 as a specific disease. NOTE: this is not a hard and fast rule! (137) But don’t worry, this doesn’t mean it’s a bad thing. Therefore, glycerin cannot be used as the additive for the drug susceptibility testing of Malassezia.” (167), Not sure what to think of this, and good luck finding a product without glycerin. One study examined pig skin and found they were mostly C24 and C26 fatty acids. Especially with octanoic acid the Malassezia spp. Reason number two, azeliac acid has been shown to work on both anaerobic and aerobic microorganisms. Although often associated with common acne, this condition may persist for years without complete resolution with typical acne medications.” (4), And by typical acne medications, they’re even referring to Accutane a.k.a. Moreover, a more recent and vigorous study found that cholesterol and a few of its derivatives couldn’t induce mycelium at all. (142) It’s obtained from cinnamon oil, balsams such as storax, or shea butter. Let me explain. Here are the INCI names for the various emulsifiers/fatty alcohols listed above. PEG-100 stearate Oh my God you are amazing Treating fungal acne isn't only about using the right products—you'll also want to make some changes to your everyday routine if you want to prevent it in the future. If you want exclusive updates about our upcoming skincare brand, Malezia — follow us on instagram. Malassezia Folliculitis (MF), is caused by the overgrowth of yeast on our skin. For the past ten days, I have been using the Nizoral Shampoo on my face (15 mins then rinse, twice a day for about two weeks) and I literally had to completely change my entire skincare routine and some makeup products, too. tetracyclines) can alter the gut microbiota and skin flora causing malassezia to proliferate. (138). Me and my mother both now have crystal clear skin because of you. The stuff is amazing. This blogpost has now helped THOUSANDS of people since it was written almost two years ago, gets updated regularly, and contains hundreds of helpful responses in the comment section below. I was still getting a few stubborn whiteheads, so I added adapalene into my routine. They just look dark, big, and horrible. They are not completely gone, but I am happy that my skin is on the road to becoming smoother. I simply send out emails every couple weeks to summarize the content I've written. Because antibiotics and antibacterial products can disrupt the balance of fungus and bacteria on your skin, making Malassezia folliculitis worse. Recall from the info above that malassezia is aerobic, meaning it requires oxygen to grow. Only problem is that once it does this, octanoate acid is like, “BAM B*TCH! the dude and dermatologist who co-invented Retin-A! I started out with a fairly complicated regimen of rinsing with water, wiping with ACV, wiping with green tea MSM mixture, followed by letting msm mixture dry on my face, then putting on an anti fungal. It’s probably been answered already! (52). When a fatty acid is paired with glycerin (a.k.a. I know I mentioned earlier that squalene can cause malassezia to proliferate, but this is not the case for the skincare derived version (squalane). Although the combination was somewhat less efficacious than oral isotretinoin [against comedonal acne], it is better tolerated and associated with fewer risks. Inactive ingredients Also, please note that the Fenty Beauty Match Stix Matte Skinstick is NOT safe as the ingredients include Coconut Oil and Ascorbyl Palmitate. Furthermore, it’s generally a good idea to treat skin conditions by replenishing what they lack. However, my readers would probably like to know about alternatives. “A study of the fatty acid metabolism of the yeast Pityrosporum ovale.” Biochem. It was very inflamed and terribly itchy for the first 2-3 weeks. I’m thinking I may be on to something here…. They enable the fungus to get nutrition and maintain cellular integrity while reducing the efficacy of the formulation. (57) I’m telling you, this thing a nightmare. (9) Or more simply put, it grows in the presence of human skin oil. Recall from the information above how M. furfur shows slight growth in the presence of other sphingoid bases like phytosphingosine. (95, 96, 97, 98, 99, 100, 101) This is why it’s the first stop for many people. I once heard Plato had glowly skin. People with Malassezia-associated diseases have a 10 to 1000-fold higher AhR-activating capacity compared to healthy controls. I’ve written an entire blog post about this awesome ingredient, which can be found here. Phew. 5 Black-Owned SPFs You'll Want to Shop Immediately, I Tried CoolSculpting My Chin and I Have Thoughts, You Need to Try These Natural Sunscreens ASAP, The *Only* Fix I've Found for My Bumpy Arms. That’s it. It seems to thrive in temperatures from 32 to 37 degrees Celcius (89.6-98.6 Fahrenheit) which means that you are more likely to experience flare-ups in the summer. Let’s go over them. (176), I’m not sure how I feel about this one. You may be able to find the same content in another format, or you may be able to find more information, at their web site. Anti-Acne Diet Based on 70 Studies (2020): What to Eat for Clear Skin! I say this for two reasons: Now back to our originally scheduled programming…. Don’t sweat this step, unless your cleanser leaves a noticeable film after rinsing. They play an important role in the health and barrier function of skin. :p I’m telling you, those ancient greeks just knew something we didn’t. I had been battling this crap for 7 years. There’s also additional research that shows glucosyl-ceramide can feed other yeasts like candida. (10, 11) Research has shown that this fungus may play a role in all the following skin conditions: Because there is a lot of overlap between all these skin conditions, the treatment guidelines I will list in this blog post for pityrosporum folliculitis can be applied to treat many of the other diseases with success. Sulfur is a keratolytic (sloughs off dead skin), which promotes the shedding of fungus from the stratum corneum. Scalp Folliculitis Treatment: Folliculitis is a common skin condition in which hair follicles become inflamed. Then my mom starting having the same issues start up on her face (we both had pretty much gotten rid of the scalp seb derm by now). octyldodecanol), I recommend avoiding them altogether if you’re still struggling with malassezia. (Some good ol’ British understatement for you.). “WHAT THE HELL HAPPENED?!?!?“. Unfortunately, malassezia is quite the practical fella and has enzymes (lipases and phospholipases) that can hydrolyze triglycerides into free fatty acids. The more obvious signs that you have it include acne-like bumps on the face (especially t-zone), back, chest, and shoulders which are sometimes accompanied by itching. (88) This eliminates the double bonds which make it less susceptible to oxidation (i.e. Are you an adult wondering why the hell you still have acne? Many of the treatments reccommended for pityrosporum are far too harsh for my skin. For the heck of it, here’s a sweet quote from Dr. Albert Kligman a.k.a. Pure glycerin may help heal SD through its emollient, dehydrating, and slightly irritating effects.” (source), Lastly, researchers in a 2019 study incorporated glycerin into an emulsion that was used as a control, and found it led to no observable growth in conjunction with the following ingredients: Water, Pentylene glycol, Magnesium sulfate, Sodium lactate, Hydroxyethyl acrylate/sodium acryloyl-dimethyl taurate copolymer, Cetyl PEG/PPG-10/1 dimethicone, Acrylates/C10-30 alkyl acrylate, Octyldodecanol, Caprylic/capric triglyceride. There is just so much amazing information that I have read it at least 10 times! You may be able to find more information about this and similar content at piano.io, Calluses? Moisturizing Toner (?) Compared to other antifungals ketoconazole stacks up pretty well. A safe salicylic acid treatment can do wonders though. There is no risk of anti-fungal resistance with zinc pyrithione. I get a lot of questions about whether I oil cleanse. Like many others, I tried everything. And while we’re on the subject of propolis, interestingly enough two recent studies (in vitro and in vivo) showed that propolis extract exhibits antimicrobial activity against M. pachydermatis, staphylococcus, and candida (among other strains and species). “More precisely, they identified glycolipid and glucosylceramide as the first small molecules synthesized by C. albicans that are specifically required for virulence.” (168). A month ago I was diagnosed with pityrosporum folliculitis :-/ The dermatologist has given me Nizoral 2% shampoo to wash with 2 times/week and Benzoyl Peroxide 5% wash to use 2 times/week (not at the same time).