White Piedra is a superficial fungal infection of the hair shaft caused by a yeast-like fungus. This condition colonizes the outside of the hair, leading to visible changes in the hair strand. While White Piedra does not cause hair loss from the root, it severely compromises the structural integrity of the hair shaft.
What Exactly is White Piedra?
White Piedra is a fungal infection of the hair caused by species of the yeast Trichosporon. The name “piedra” is Spanish for stone, referring to the characteristic deposits, known as nodules, that form on the hair. These deposits are soft, light-colored, and typically white, gray, or light brown.
The infection appears as a sleeve of nodules that encircle the hair shaft. While scalp hair can be affected, White Piedra frequently targets body hair, including the beard, mustache, and pubic hair. Trichosporon ovoides and Trichosporon inkin are common species responsible for this condition.
How White Piedra Impacts Hair Integrity
White Piedra does not cause true alopecia, which is hair loss resulting from a problem within the hair follicle itself. The fungus colonizes the external cuticle of the hair shaft and does not affect the living cells in the scalp that produce the hair. The perception of hair loss is due to the structural damage caused by the fungal growth.
The formation of the soft nodules creates distinct weak points in the hair strand. This colonization structurally compromises the integrity of the hair shaft, leading to fragility. The hair becomes brittle, and these weak points are prone to snapping. This results in hair breakage, often close to the scalp, which is perceived as hair loss or thinning.
The extent of perceived hair loss relates directly to the severity and duration of the untreated infection. Extensive colonization leads to numerous weak points and a greater likelihood of breakage. Successfully treating the infection removes the fungal colonization, eliminating the source of structural weakness and allowing new, healthy hair to grow.
Effective Treatments for White Piedra
The primary goal of treating White Piedra is to eliminate the Trichosporon fungus from the hair shaft and prevent recurrence. Treatment generally combines physical removal of the infected hair with the application of antifungal agents. For localized or mild infections, the most direct method is cutting or shaving the affected hair, which removes the colonized hair shaft entirely and eliminates the fungal burden.
Medical treatment centers on topical antifungal medications, which are often sufficient for resolution. Antifungal shampoos containing agents such as 2% ketoconazole or ciclopirox olamine are frequently used. These medicated shampoos are applied to the affected areas to kill the yeast. Selenium sulfide and zinc pyrithione are also used as topical options.
In cases where the infection is severe, resistant to topical treatment, or widespread, a healthcare provider may prescribe an oral antifungal medication. Oral azole antifungals, such as itraconazole, may be used to eradicate the fungus, particularly if it lingers within the hair follicle. Maintaining good hair hygiene and avoiding excessive moisture helps prevent the conditions in which the fungus thrives, reducing the chance of the infection returning.