Malassezia Folliculitis

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Pityrosporum Folliculitis a.k.a Malassezia Folliculitis is an acne-like breakout often accompanied by itchiness that flares most in areas with a lot of sebaceous activity. This includes the t-zone area of face (especially forehead), shoulders, chest, and back.
https://dermnetnz.org/topics/malassezia-folliculitis

Before running into Ray Peat I discovered this blog that helped me A LOT and I am sure lot of you already know about it
SimpleSkincareScience Blog: https://simpleskincarescience.com/pityrosporum-folliculitis-treatment-malassezia-cure/

I will leave you the points that I consider that affect my health/skin.

History (Notes taken in September 2021)

Ectomorph body (I was really skinny when I was young), (now slim?)
Usually tired - low energy levels (now improved since I was taking Vitamin D from the Sun, Magnesium Glycinate). But I’d say Magnesium did the most part. Update: I was still feeling tired, just less tired. What changed drastically for the better was starting taking Thyroid. Also high dose of B1.
Never had Acne or severe acne when I was a teenager.
Took lot of antibiotics because I was always sick (mostly Tonsillitis)
Was not diagnosed but at risk of having fatty liver when I was 19. And always had high bilirubin levels.
Developed Dandruff when I was 21.
Combination skin (face) when I was 22 and had Redness and Dry spots on my face, specially on winters.
Started with creams because of reason above, until I developed Malassezia Folliculitis.
Since then, I still have Malassezia Folliculitis on my face, back, shoulders, and chest sometimes (not much really, but not cleared 100%, Id say it cleared out about 98%).

** 7 years doing full research and now under control
** “fix”(under control) by improving diet (avoiding PUFA mostly) AND using Selsun Blue shampoo (selenium sulfide) as facial mask when my skins flares up (happens once a year/year and a half)
** I feel Carbs (vegetables, parboiled rice, sourdough or buckwheat bread/pasta) work better for me than Fat foods (I think it might be due to my Nervous System? - Ectomorph body type?).

I have dyshidrotic eczema 3 times 3 years ago (small watery blisters)
I had a big stye in one of my eyes, they said it couldn't be treated and surgery was the only solution. The day before scheduled surgery it went away (I was taking vitamin A (retinol) pills + Vitamin D to avoid that and worked out?)
Red face (I have olive skin but it has a reddish tone because of my skin issues)
Tested to check up on allergies/intolerances > None.
Used Probiotics for 3 months to restore my gut flora after many years of antibiotics usage. > No improvement really and felt weird..
Never had constipation or similar problems. (Like I always felt I have strong gut).

Current (2024)

Redness: Usually on my face, arms, lower back (once every 3 months)
Fungal acne flareups (1 in 1 year)
Foruncle (usually once a year): Random locations.

Things to add:

I don’t exercise much. I use to do some push ups (once a week), stretching, and walking outside
I am not extreme with my diet and sometimes eat shtty foods AND drink alcohol once a week (more on vacation). I work for the airlines and I am home maybe 10 days a month.
I try not to eat high PUFA content foods. Since it's impossible to avoid them for me I try to eat SFA to offset PUFA.
I am back at eating sugar (Did not have sugar between 2009-2021)
Not really concerned about Zinc and/or Selenium (both known to help prevent and treat skin issues) since I eat lof of seafood, specially when I go to Portugal or Spain (with my job I go often)

=Discussion=

Overall I feel what helped me the most is:

Intake of Fat (A, D, K, E) soluble vitamins
Ditch all moisturizers and other products. I just use 100% Aloe vera gel when my skin is damaged/sunburn or dry
Topical treatment when I have those fungal bumps: Selenium Sulfide shampoo (aka Selsun Blue), Katialis (Sulphur, Zinc Oxide) or Ketoconazole (aka Nizoral)
Oral fluconazole didn't do much to be honest.
Summer (YES. Sun improved conditions and warm temperature as well!)

=Connection between PUFA and Malassezia furfur and other Malassezia species=

Malassezia feeds on fatty acids with carbon chain lengths 12-24.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1198797/pdf/biochemj00724-0062.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC118058/
https://www.sciencedirect.com/science/article/pii/S0022202X15447062
Personal Experience: All oils did not do well on me. Quite the opposite. Except for Caprylic Acid Oil, MCT Oil, Squalane Oil (derived from sugar cane).
Esters (Alcohol + Oils), Polysorbates, Yeast Ferments (I know Andra, @BioavailableNd mentioned about applying Kefir for treatment but I have never tried. Anyone?)
Vitamins. The blog mentions B1, B6 induces the growth of malassezia but I can't be sure about that since I never had problems while taking B1 orally at least.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255962/
Coconut Oil. Contains octanoic acid which is anti-fungal in nature, BUT this only makes up 7.1% of its fatty acid composition. Lauric acid, which has a carbon chain length of 12, makes up 47% of coconut oil! This is a prime fatty acid for malassezia.
Sugars. Contrary to popular belief malassezia cannot grow in the presence of sugars or carbohydrates, with the exception of M. pachydermatis, which can synthesize mannitol and sorbitol. https://books.google.com/books?id=WSKEPJNe_UEC&pg=PA122&lpg=PA122&dq=carbohydrate+assimilation+malassezia&source=bl&ots=uFswHAmCKe&sig=aYD8Q9qyB-fBAqPFr3hCitQrDlg&hl=en&sa=X&ved=0ahUKEwjh-MyspZLTAhVJw2MKHX_wB38Q6AEIJjAC#v=onepage&q=carbohydrate assimilation malassezia&f=false However, M. pachydermatis is only present in 2% of all humans, and has rarely been found in diseased human skin. All other malassezia species cannot ferment sugars. https://books.google.com/books?id=-SkqUVQfXrMC&pg=PA121&lpg=PA121&dq=malassezia+c9&source=bl&ots=Lf5FvPYj-S&sig=bjBjloVCQNsNSgEhUVBPdRfxWxA&hl=en&sa=X&ved=0ahUKEwjXl6bmpJLTAhVExWMKHfM5B6EQ6AEIGjAA#v=onepage&q=malassezia c9&f=false

I understand that the blog is based on products that contain chemicals that can create short and/or long term skin problems and I think so because since I stopped using them my skin has improved. However I only intend to find the definitive solution, if there is one, regarding this fungus called Malassezia, specifically the furfur spice. Unfortunately, in most cases only topical treatment turned out to be the only solution. It is possible that there is a connection with the small intestine and the overgrowth of the fungus but it is difficult to know.

The intention of this post is to develop improvement alternatives for those of us who have this problem (either less or more frequently) and to gather more information about it.

Blog:
https://simpleskincarescience.com/pityrosporum-folliculitis-treatment-malassezia-cure/

Other useful websites if you still using products on your skin:
https://sezia.co/
https://folliculitisscout.com/