Fungus – Piedra

Piedra, also called Trichosporosis, is a fungal infection that I encounter in both my The Woodlands dermatology and Conroe dermatology clinics.  There are two main types of Piedra: White Piedra and Black Piedra.  Black Piedra is most often seen in the tropics and is caused by the fungus Piedraia hortai and appears like black nits surrounding the hair shaft along the entire length.  It can occur in hair on the scalp, eyebrows, eyelashes, and beard.  White piedra occurs in more temperate climates and is caused by the fungusTrichosporon beigelii.  White piedra appears as yellowish/brown nit like nodules along the entire hair shaft which causes the hair to appear as if it has a slimy coating.  Treatment involves either shaving the hair off or using topical antifungals.  Black Piedra responds best to Lamisil and White Piedra responds best to an -Azole such as Clotrimazole.  Oral antifungals can also be used.