Can folliculitis be caused by a fungus?

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Last updated: June 10, 2025View editorial policy

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From the Research

Yes, folliculitis can be caused by a fungus, and the most effective treatment is oral antifungal medications, with a success rate of 92%. Fungal folliculitis, often called Pityrosporum folliculitis or Malassezia folliculitis, occurs when yeast organisms invade hair follicles, causing inflammation 1. This condition typically appears as small, itchy, red or white pimples around hair follicles, commonly on the chest, back, shoulders, and face.

Key Characteristics of Fungal Folliculitis

  • The most common locations of lesions are the chest (70%) and back/shoulders (69.2%) 1
  • Pruritus is reported by the majority of patients (71.7%) 1
  • A history of unsuccessful treatment regimens is common, with 40.5% of patients reporting this 1

Treatment Options

  • Oral antifungal medications are the most effective treatment, with a success rate of 92% 1
  • Topical antifungal medications, such as ketoconazole 2% cream or shampoo, can be used for less severe cases, with a success rate of 81.6% 1
  • Treatment should be individualized based on the severity of the condition and the patient's medical history

Prevention of Recurrence

  • Patients should avoid tight clothing and shower promptly after sweating to reduce the risk of recurrence
  • Using antifungal shampoos preventatively and wearing breathable fabrics can also help prevent recurrence
  • It is essential to distinguish fungal folliculitis from bacterial folliculitis, as the latter may not respond to antibiotics and may worsen with their use 2

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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