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Peer-reviewedCC BY-NC 4.0Dermatology and Therapy

Supramolecular Salicylic Acid Chemical Peeling Combined with Supramolecular Active Zinc for Malassezia Folliculitis: Efficacy and Safety from a Multicenter, Single-Arm Trial

  • Yuanzhi Liu1
  • Jinjin Zhang1
  • Wei Lai2
  • Xingdong Ye3
  • Yanhua Liang4
  • Xiuli Wang5
  • Shanshan Li6
  • Weihui Zeng7
  • Hong Fang8
  • Qingbiao Wa9
  • Xiujuan Wu10
  • Ningjing Song11
2 more authors
  • Bin Yang1
  • Zhenfeng Liu1
11 affiliations
  1. 1Laser and Dermatology Surgery Center, Dermatology Hospital of Southern Medical University, No. 2 Lujing Road, Yuexiu District, Guangzhou, 510091 China
  2. 2The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
  3. 3Guangzhou Institute of Dermatology, Guangzhou, China
  4. 4Shenzhen Hospital of Southern Medical University, Shenzhen, China
  5. 5Shanghai Skin Disease Hospital, Shanghai, China
  6. 6The First Hospital of Jilin University, Changchun, China
  7. 7The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
  8. 8The First Affiliated Hospital of Zhejiang University, Hangzhou, China
  9. 9Chengdu Second People’s Hospital, Chengdu, China
  10. 10Xuhui District Central Hospital, Shanghai, China
  11. 11Shanghai Tongren Hospital, Shanghai, China
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Abstract

Introduction: Traditional antifungal therapy for Malassezia folliculitis (MF) is often associated with high recurrence rates and limited long-term options. This study evaluated the efficacy and safety of 30% supramolecular salicylic acid (SSA) combined with supramolecular active zinc (SAZ) in adults with moderate-to-severe Malassezia folliculitis.

Methods: In this 12-week, multicenter, single-arm trial, adults with moderate-to-severe (grade 2–3) MF received weekly 30% SSA peeling for 8 weeks combined with once-daily topical SAZ application. The primary end point was the overall efficacy rate at week 8 in the full analysis set (FAS), based on skin lesion reduction and Malassezia microscopy. Secondary end points included symptom response rates (pruritus, scaling, erythema, greasiness), recurrence rate, patient satisfaction, and quality-of-life (QoL) outcomes.

Results: The overall efficacy rate at week 8 was 95.42% (95% confidence interval [CI] 91.95–97.69%) in the FAS (n = 240) and 99.52% (95% CI 97.35–99.99%) in the per-protocol set (PPS; n = 212). Clinically meaningful improvements were observed from week 2 (69.17%). By week 8, erythema (94.76%), greasiness (95.24%), pruritus (90.95%), and scaling (86.67%) had all responded. During the 4-week post-treatment follow-up, recurrence was observed in 2 of 237 patients included in the FAS recurrence analysis (0.84%). Treatment-related adverse events (AEs) occurred in 2.92% of patients and were all mild-to-moderate; no serious AEs were reported.

Conclusions: In this multicenter, single-arm study, the combined regimen was associated with clinically relevant improvement and was generally well tolerated in adults with moderate-to-severe MF. These encouraging findings support further evaluation in controlled studies with longer follow-up.

Trial registration: MR-44-22-009680.

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Cite

BibTeXRIS
BibTeX
@article{liu2026supramolecular,
  title = {{Supramolecular Salicylic Acid Chemical Peeling Combined with Supramolecular Active Zinc for Malassezia Folliculitis: Efficacy and Safety from a Multicenter, Single-Arm Trial}},
  author = {Yuanzhi Liu and Jinjin Zhang and Wei Lai and Xingdong Ye and Yanhua Liang and Xiuli Wang and Shanshan Li and Weihui Zeng and Hong Fang and Qingbiao Wa and Xiujuan Wu and Ningjing Song and Bin Yang and Zhenfeng Liu},
  journal = {Dermatology and Therapy},
  year = {2026},
  month = sep,
  doi = {10.1007/s13555-026-01915-7},
  url = {https://doi.org/10.1007/s13555-026-01915-7},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Supramolecular Salicylic Acid Chemical Peeling Combined with Supramolecular Active Zinc for Malassezia Folliculitis: Efficacy and Safety from a Multicenter, Single-Arm Trial
AU  - Yuanzhi Liu
AU  - Jinjin Zhang
AU  - Wei Lai
AU  - Xingdong Ye
AU  - Yanhua Liang
AU  - Xiuli Wang
AU  - Shanshan Li
AU  - Weihui Zeng
AU  - Hong Fang
AU  - Qingbiao Wa
AU  - Xiujuan Wu
AU  - Ningjing Song
AU  - Bin Yang
AU  - Zhenfeng Liu
PY  - 2026
DA  - 2026/09/01
JO  - Dermatology and Therapy
DO  - 10.1007/s13555-026-01915-7
UR  - https://doi.org/10.1007/s13555-026-01915-7
AB  - Introduction: Traditional antifungal therapy for Malassezia folliculitis (MF) is often associated with high recurrence rates and limited long-term options. This study evaluated the efficacy and safety of 30% supramolecular salicylic acid (SSA) combined with supramolecular active zinc (SAZ) in adults with moderate-to-severe Malassezia folliculitis.  Methods: In this 12-week, multicenter, single-arm trial, adults with moderate-to-severe (grade 2–3) MF received weekly 30% SSA peeling for 8 weeks combined with once-daily topical SAZ application. The primary end point was the overall efficacy rate at week 8 in the full analysis set (FAS), based on skin lesion reduction and Malassezia microscopy. Secondary end points included symptom response rates (pruritus, scaling, erythema, greasiness), recurrence rate, patient satisfaction, and quality-of-life (QoL) outcomes.  Results: The overall efficacy rate at week 8 was 95.42% (95% confidence interval [CI] 91.95–97.69%) in the FAS (n = 240) and 99.52% (95% CI 97.35–99.99%) in the per-protocol set (PPS; n = 212). Clinically meaningful improvements were observed from week 2 (69.17%). By week 8, erythema (94.76%), greasiness (95.24%), pruritus (90.95%), and scaling (86.67%) had all responded. During the 4-week post-treatment follow-up, recurrence was observed in 2 of 237 patients included in the FAS recurrence analysis (0.84%). Treatment-related adverse events (AEs) occurred in 2.92% of patients and were all mild-to-moderate; no serious AEs were reported.  Conclusions: In this multicenter, single-arm study, the combined regimen was associated with clinically relevant improvement and was generally well tolerated in adults with moderate-to-severe MF. These encouraging findings support further evaluation in controlled studies with longer follow-up.  Trial registration: MR-44-22-009680.
SN  - 2193-8210
SN  - 2190-9172
ER  -