Can a Fungus Make Eczema Worse?: Understanding the Role of Malassezia

Eczema is commonly caused by genetics, so if someone in your family has it, there's a good chance you may experience it too.

However, eczema flare-ups may also be made worse by a naturally occurring skin fungus called Malassezia. Malassezia is a natural part of your skin's microbiome, but an overgrowth of this fungus can exacerbate existing symptoms.

If your inflammation, itching, redness, and dryness won't settle—even when you diligently use moisturizers and take good care of your skin—this fungus could be playing a bigger role than you think.

In this article, we'll explore the connection between Malassezia and eczema, why some people might experience flare-ups linked to this fungus, and what you can do to manage your symptoms by controlling Malassezia growth.

Table of Contents:

• What is Malassezia?
• Can Malassezia Cause Eczema or Atopic Dermatitis?
• Where Your Eczema Symptoms Show Up and Why This Matters
• Differentiating Eczema and Seborrheic Dermatitis
• Can Antifungals Help With Eczema?
• Practical Tips for Managing Face and Scalp Eczema
• Dermazen for Barrier Support

What is Malassezia?

Malassezia is a type of yeast that naturally resides on the human skin. It's part of your normal skin flora, which is the community of bacteria, fungi, and other microorganisms that live on it and help maintain a healthy skin barrier [1].

This lipophilic yeast is attracted to the free fatty acids. This is why Malassezia tends to thrive in oil-rich areas of the body, such as the face, scalp, chest, back, or behind the ears. These body sites are rich in sebaceous glands, which secrete an oily and waxy substance known as sebum.

The Malassezia species that live on the human skin usually do not stir up much trouble. However, in some people, this fungus can contribute to the development of certain skin conditions. For instance, it can cause or worsen seborrheic dermatitis, fungal acne, dandruff, and pityriasis versicolor (or tinea versicolor)[1]. In some cases, it might also trigger eczema flare-ups.

Can Malassezia Cause Eczema or Atopic Dermatitis?

While there isn’t a type of eczema caused solely by this fungus, studies have shown that Malassezia can play a role in triggering or worsening symptoms in some people who are hypersensitive to it.

Here’s how they’re connected:

• A large number of patients with atopic dermatitis, especially head and neck atopic dermatitis, showed sensitivity to the Malassezia fungus, while healthy controls typically did not [2]. This can be referred to as "Malassezia-associated dermatitis" or "Malassezia hypersensitivity."

• Skin prick tests in research studies have shown that individuals with higher sensitivity to Malassezia tend to experience more severe atopic dermatitis symptoms [2].

• Due to skin barrier disruption, the Malassezia species can interact with human skin cells, immune cells, and the immune system. The interaction between Malassezia and human cells may stimulate the production of pro-inflammatory proteins, therefore worsening inflammation in eczema [2].

These findings suggest that Malassezia may play a role in triggering flare-ups of atopic dermatitis, particularly in individuals who experience head and neck dermatitis [3]. So while this fungus doesn’t directly cause eczema, it can act as a trigger, worsening symptoms in those who are naturally more sensitive to it.

Where Your Eczema Symptoms Show Up and Why This Matters

The location of your eczema flare-ups can offer clues about Malassezia's involvement.

If your symptoms often appear in oil-rich areas such as the face, scalp, or chest, Malassezia may be a contributing factor. These areas contain more sebaceous glands, creating the perfect environment for this fungus to thrive.

This may also explain why studies show Malassezia-associated dermatitis frequently affects the head and neck, which are oilier regions of the body.

If you experience eczema symptoms in oily areas of the body, adding antifungal ingredients like tea tree oil, xylitol, or dead sea salt to your skincare routine may help reduce these symptoms.

Differentiating Eczema and Seborrheic Dermatitis

Eczema and seborrheic dermatitis share some similarities but are generally managed in different ways.

Understanding the difference between them is important to ensure you have a proper long-term management plan in place.

Why Seborrheic Dermatitis Is Often Confused With Eczema

Seborrheic dermatitis and eczema (also known as atopic dermatitis) both fall under the broader category of "dermatitis" because they share common symptoms such as redness, itching, and inflammation.

In addition to overlapping symptoms, seborrheic dermatitis and Malassezia-sensitive atopic dermatitis can sometimes appear in similar areas of the body.

Because of these similarities, eczema and seborrheic dermatitis are sometimes mistaken for one another.

Seborrheic Dermatitis vs. Eczema

Once you have a clear understanding of the differences between the two, it becomes easier to tell one apart from the other.

Here are some of the main differences between seborrheic dermatitis and eczema.

• Symptoms: Seborrheic dermatitis is characterized by symptoms such as flaky, red skin with yellowish or whitish scales. It can cause some itching, but usually not to the same severity as eczema. Meanwhile, eczema tends to cause rashes that are dry and red and can be intensely itchy.

• Location: Seborrheic dermatitis usually appears on areas of the body that have a high density of sebaceous glands, such as the upper chest, scalp, and face, especially around the nose and eyebrows. Eczema most commonly affects areas like the bends of the elbows, behind the knees, and on the hands, face, and neck.

• Cause: Seborrheic dermatitis is typically associated with Malassezia yeast overgrowth, while eczema is more closely linked to a dysfunction in immune response, genetics, and environmental factors.

If you're unsure which is the likely cause of your symptoms, it's always a good idea to seek the advice of a healthcare professional or dermatologist.

Can Antifungals Help With Eczema?

In general, eczema is most effectively managed using anti-inflammatory treatment, such as corticosteroids.

That said, antifungals might also help reduce inflammation in some people with Malassezia-sensitive eczema. This is because these antifungal agents can target the Malassezia fungus, which is known to worsen eczema in certain cases [2].

Of course, this doesn't mean that you should try antifungal treatment for your eczema from the get-go. Not all eczema is Malassezia-sensitive, and many other factors, such as allergens, irritants, or a compromised skin barrier, can trigger flare-ups. Because every case is different, what works for one person may not work for another.

Practical Tips for Managing Face and Scalp Eczema

If you have eczema, here are some simple tips that could make a difference in improving your symptoms.

Lifestyle Factors for Improving Eczema

These small lifestyle changes can help reduce flare-ups and irritation:

• Avoid your eczema triggers: Observe when your eczema tends to flare up, and what is the most likely cause of these flare-ups. Some examples of common triggers include harsh soaps or heavily fragranced products. Whenever possible, try to avoid your personal eczema triggers.

• Choose barrier-friendly skincare: Gentle, fragrance-free cleansers that are designed for sensitive skin can help restore and improve your skin barrier function. Applying moisturizer to areas of dry or itchy skin can help soothe irritation, reduce the urge to scratch, and prevent further damage to your skin.

• Be cautious with oils: If you're concerned that your eczema could also be Malassezia-sensitive, it is best to avoid oils that can feed the fungus. Examples of these oils include coconut oil, jojoba oil, and olive oil. Instead, you can use Malassezia-safe oils like MCT oil and squalane oil.

• Keep stress in check: Long-term stress can worsen inflammation and trigger flare-ups [4]. This is why it's important to build a healthy stress management routine so you are equipped to manage tough emotions well.

At-Home Antifungal Remedies That Might Help Improve Inflammation

Some natural remedies can help improve inflammation and reduce the impact of Malassezia on the health and mood of your skin.

Some of these natural remedies include:

• Sea salt: Sea salt is known to have antimicrobial and antifungal properties. You can dissolve sea salt in water to form a solution to massage onto the affected areas of your skin. Leave this mixture on for a couple of hours before rinsing it off.

• Honey: Due to its hydrating, antimicrobial, and anti-inflammatory properties, raw honey can help soothe irritated or inflamed skin in eczema [5].

• Apple cider vinegar: Diluted apple cider vinegar may help inhibit the growth of the Malassezia yeast, which can be helpful in Malassezia-sensitive eczema.

These remedies can be drying or irritating for some skin types, so always patch-test with a small amount first to err on the side of caution.

Dermazen for Barrier Support

When dealing with Malassezia-sensitive eczema, it's important to choose products that can soothe the inflammation and support your skin's natural barrier without feeding the fungus.

Here at Dermazen, we've formulated products that help to reduce redness, calm irritation, and support your skin's health while clearing away Malassezia.

Here are two of our most popular formulations that can be helpful for those with Malassezia-sensitive eczema:

• Dermazen Calming Seborrheic Serum: This serum is designed specifically for skin prone to Malassezia overgrowth. It targets the natural protective barrier of the fungus and penetrates, allowing the antifungal ingredients in this formulation to work their magic and effectively clear away Malassezia. At the same time, it soothes, hydrates, and nourishes the skin.

• Dermazen Soothing Malassezia Moisturizer: This moisturizer helps to restore hydration and protect the skin's natural barrier without feeding Malassezia, making it an excellent option for people with Malassezia sensitivity.

Our goal is to help you achieve peaceful skin without the worry of feeding fungus or irritating sensitive areas. That's why we keep our formulations simple—free from parabens, sulfates, fragrances, and harsh chemicals—while using only Malassezia-safe ingredients that support healthier, happier skin.