Interactive Guide to Adolescent Folliculitis

A Personalized Interpretive Report for You and Your Family

Important Note: The content of this guide is derived from a professional clinical report and is intended to provide clear, educational information. It cannot replace a face-to-face consultation with a licensed physician. A final diagnosis and any prescription medication must be determined by a qualified dermatologist.

Condition Overview: What is it?

Preliminary Diagnosis: Malassezia Folliculitis

Based on the symptoms (itching, red spots, pain with hot water) and images provided, the most likely diagnosis is "Malassezia Folliculitis." This is a very common skin issue, especially during adolescence. The root cause is not poor hygiene, but an overgrowth of a normal fungus on the skin called "Malassezia" under certain conditions (like excessive sweating or oily skin), which triggers inflammation in the hair follicles. It is not contagious.

Core Symptom Interpretation

  • Intense Itching: This is the most typical symptom, far more severe than the itch of common acne.
  • Monomorphic Red Papules: The rash consists of small red bumps of uniform size and shape, mainly on the chest and back where oil glands are active.
  • Pain with Hot Water: This indicates that the skin's protective layer (barrier) is damaged and has become very sensitive.

Cause Analysis: Why is this happening?

The essence of Malassezia folliculitis is an imbalance in the skin's micro-ecology. Multiple factors work together to create a "fertile ground" for this harmless "resident" fungus to overgrow.

At a Glance: What's Happening in the Follicle

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Healthy Follicle
(Balanced Microbiome)

●●●●●●

Inflamed Follicle
(Fungal Overgrowth)

The Skin Barrier: The Secret Behind "Pain with Hot Water"

Intact Barrier
(Tight "Brick & Mortar")

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Damaged Barrier
(Pain from heat)

Differential Diagnosis: It's Not Common Acne

This is the most common point of confusion, but the difference is critical because the wrong treatment (like using antibiotics) can worsen the condition. The chart below helps you quickly distinguish between them.

Treatment Plan: A Two-Phase Action Plan

Goal: Quickly control inflammation, eliminate itching (First 2-4 weeks)

  • 1. Core Therapy: Topical Antifungal Cleanser

    Choose a 2% ketoconazole wash or 2.5% selenium sulfide wash, used 3-5 times a week. Apply it to the affected areas on the chest and back like a body wash. The key is to let the lather sit for 5-10 minutes before rinsing.

  • 2. Oral Medication Consideration (As directed by a doctor)

    For severe or stubborn cases, a doctor may prescribe oral antifungal medication (e.g., itraconazole). This must be done under a doctor's guidance. Do not self-medicate.

Daily Wellness: Creating a Healthy Skin Environment

Scientific Cleansing

  • Stick to lukewarm showers, avoid hot water.
  • Use gentle, soap-free cleansers for daily washing.

Barrier Repair

  • Apply moisturizer within 3 minutes after bathing.
  • Choose non-comedogenic products with ceramides & hyaluronic acid.

Lifestyle Habits

  • Wear loose, breathable cotton clothing.
  • Shower and change clothes asap after heavy sweating.
  • Change towels and bed linens frequently.

Dietary Recommendations

  • Reduce intake of sugary foods and drinks.
  • Eat a balanced diet with plenty of fruits, vegetables, and whole grains.