If you’ve ever struggled with persistent dandruff, red patches on your scalp, or strange discoloration on your chest or back, you might be dealing with an overgrowth of a yeast called Malassezia. As a physician, I see this more often than most people realize—and fortunately, it’s very treatable once you understand what you’re dealing with.

So, What Is Malassezia?

Malassezia is a type of yeast that naturally lives on your skin—especially in oily areas like your scalp, face, and upper chest. In most people, it coexists peacefully with the skin’s microbiome. But under the right (or wrong) conditions—like excess oil, humidity, or immune changes—it can multiply and cause inflammation, irritation, and visible skin problems.

Common Conditions Caused by Malassezia

Here are a few of the skin conditions linked to this yeast:

• Dandruff and Seborrheic Dermatitis: Flaky, sometimes greasy patches on the scalp, face, or behind the ears. Often itchy or red.

• Pityriasis Versicolor (Tinea Versicolor): Faint patches of skin that are lighter or darker than your normal tone, usually on the chest, shoulders, or back.

• Malassezia Folliculitis: Itchy, acne-like bumps on the chest, back, or arms.

• Worsening of Atopic Dermatitis: Especially around the face or neck.

How Is It Diagnosed?

Most of the time, diagnosis is based on how it looks and where it shows up. In the clinic, we might use a simple potassium hydroxide (KOH) test to look at skin scrapings under a microscope—or a Wood’s lamp to check for faint fluorescence in tinea versicolor cases. But in many cases, a trained eye is enough.

How Do You Treat It?

Topical Treatments (First-Line)

• Ketoconazole shampoo or cream – One of the most effective options. Use it on the scalp or skin a few times per week.

• Selenium sulfide – Often found in dandruff shampoos.

• Zinc pyrithione – A good maintenance option.

• Ciclopirox – Another antifungal cream that works well.

These products reduce the yeast population on your skin and calm inflammation.

Oral Antifungals (For severe or stubborn cases)

• Itraconazole or Fluconazole may be prescribed if topical treatments don’t work or if the infection covers a large area.

Lifestyle Tips

• Avoid heavy oils and greasy skincare products—they feed Malassezia.

• Use lightweight, non-comedogenic moisturizers.

• Wear breathable clothing and avoid prolonged sweating without showering.

• Consider using antifungal shampoos once or twice a week even after symptoms clear to prevent recurrence.