#1

Anyone else get a tinea capitis infection?

I’ve had two episodes of tinea capitis while taking rapamycin. Responded well to just some 1% ketoconazole shampoo and pausing rapamycin but resulted in some pretty notable hair loss.

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#2

That really sucks.
Haven’t heard of that possibility before.

Rapamycin is a fungal suppressant. Odd?

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#3

That’s interesting—rapamycin does have antifungal properties, but it’s not effective against fungal infections of the hair or skin, like tinea capitis. It works better against yeasts, such as Candida and Cryptococcus, rather than dermatophytes (the fungi that cause tinea infections).

You also can’t cure tinea capitis with ketoconazole shampoo alone—it requires an oral antifungal, like griseofulvin or terbinafine, to fully eradicate the infection.

I wonder if you might be dealing with seborrheic dermatitis instead, which can be triggered by stress and is often linked to an overgrowth of Malassezia, a type of yeast. Interestingly, rapamycin itself is a physiological stressor, and since seborrheic dermatitis is thought to involve a yeast component, I’m not sure whether rapamycin affects Malassezia specifically. It raises the question of whether rapamycin could be influencing the skin microbiome in some way.

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#4

Yeah I just assumed its immune suppressant effect was bigger than its anti fungal effect thus the fungus won since the immune barrier is more important.

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#5

Yeah… regular dosing of rapamycin did not treat my onychomyosis - toenail fungus. I had the fungus before I started rapamycin. I had to orally take terbinafine daily for 3 months to clear the fungus.

See: Rapamycin and onychomycosis toenail fungus.

Terbinafine works by inhibiting the synthesis of ergosterol, an essential component of fungal cell membranes. This disrupts the fungal cell wall, leading to cell death and inhibition of fungal growth.

Free and clear of toenail fungus now 1 1/2 years. So yeah, oral rapamycin can’t on it’s own clear fungus. But using a homemade topical of rapamycin and terbinafine with DMSO can remedy fungus too.

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#6

Time for a crossover n=1 study

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#7

I got some fungal overgrowth when I first started on rapamycin. With my first dose of rapamycin there seemed to be a war in my body of various microbes/viruses and fungus that became active. I have had herpes, TB, shingles and who knows what else. Though all of these were latent I got a rush of symptoms with my first doses of rapamycin then with more doses everything calmed down.

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