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Pityrosporum Folliculitis and Oral Nizoral Question

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I was recently diagnosed as having pityrosporum folliculitis on my forehead and temples. My doctor prescribed some topical nizoral to apply, and also some 2% Nizoral shampoo to use as a daily cleanser on the area.

My doctor told me that she has seen good results with this regimen and expects it to clear up after a week or two. She did mention that if it did not clear up, she would prescribe oral nizoral pills for me to take.

I am wary of taking oral antifungal pills due to hearing about their effects on the liver. Has anyone taken an oral nizoral course? If so, what can I expect? I have never had liver problems but there is a history of liver issues in my family and I'm wary of doing anything to aggravate this. Of course I have mentioned all of this to my doctor but she seems to think this should not be a problem.

Anyone who has done this type of treatment before, I'd be very interested in your thoughts.

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I've never taken oral anti-fungals for my PF. My docs wouldn't prescribe it to me, for exactly the reason you're mentioning. I remember finding on the net a list of the best (least damaging to the liver) oral anti-fungals, and I remember Nizoral was not on the top of the list. You might want to look that up.

If this helps any, the OP pf this thread took oral antifungals:


But you might never have to take them- how's this regimen coming so far?

Edited by akko
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Sorry for the late reply, it's been a hectic work week.

My doctor has me using 2% prescription Nizoral shampoo as a cleanser for my forehead and temple area once a day for 5 minutes. Twice a day I also apply a small amount of 2% Nizoral cream to the affected areas.

So far I've noticed a slight improvement in my forehead and temple area. There are no more papules on the temples and I've gone from having 10-14 papules per day on my forehead (no joke) to having about 3 per day. The papules I've been getting have been smaller and less irritated as well. The itching has also mostly subsided.

However, I believe the fungus infection may have spread to my upper chest/shoulder area. I woke up this morning to itching in that area, and as soon as I looked in mirror, I saw tiny red papules all over the area. I have not tried to apply any of the Nizoral products to the affected area yet, as I don't want to aggravate the problem if it is not fungal folliculitis. However, the spots do look very similar to pictures of body folliculitis that are out there on the internet.

I should note that I do occasionally get back acne, I have never, ever gotten acne on my chest area and the back acne that I do get is rare and usually large cystic pimples, nothing remotely like the red dots on my chest.

Any thoughts? I would attach a picture, but the size limitations for this forum are too small.

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I heard a large proportion of body acne is actually folliculitis, so it's very possible that it's what you have. I was also worried that anti-fungal stuff could make acne worse (like antibiotics can make fungal infections worse), but so far that hasn't been the case for me- actually, I have less proper pimples now that I've gotten my PT under control. I also asked my derm about that and she said it shouldn't. So give it a try and bring it up with your derm the next time you see them.

how long have you been doing this Nizoral regimen?

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post-62713-1276444552_thumb.pngHmm - I think I figured out how to cut down the size of the photo while preserving how it looks. We'll see how it turns out.

I've been doing the Nizoral regimen for about 10 days now.

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Well, a quick update - I started using some Nizoral shampoo on the new papules that developed on my shoulders and chest, and 4 days later they have started to clear up. I'm guessing this is a pretty good indicator that the folliculitis has spread to that area.

So far my forehead and temples have been back and forth. I will be clear for a couple of days and then I will get a few new papules, then will be clear again. The Nizoral regimen has definitely improved the area.

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I know this topic is quite old -but if the original poster is still here, how did this turn out for you? (or if anyone knows the o.p. ... )

The photo posted by the OP looks so much like what I'm battling. Won't get into the nitty gritty for sake of brevity - but my doc said, "looks like folliculitis ..." It got better over some weeks, then it got worse and spread. My thought is that it is the pityrosporum brand of folliculitis. (She/Doc didn't tell me I'm wrong when I emailed her last to ask if it could be pityrosporum type.)

To the OP, did your spread more? Mine seems to get better, then get worse, and back and forth. One area heals, then a new area starts acting up. Not treating with anything other than keeping the area very dry and well powdered twice a day (obscene amounts of body powder). It does help, but I'm curious to hear from others who have been through this.

Have heard rumor is can be a lifelong battle. Is this true?

Not sure if I should start a new topic - will see what this leads to first.


Edited by LM_06
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