White Piedra (Piedra is a Spanish word for stone) is a rare type of hair fungal infection caused by multiple species of fungi of the genus, a yeast-like fungus called Trichosporon. Primarily there are two types of fungus that cause this infection- T. Inkin and T. Ovoides. Though the ailment is generally not contagious, it causes small, stone-like discomforting concretions on hair. The ailment is divided into two main subtypes, one is White Piedra and the other is Black Piedra. Black Piedra has similar traits to white but as the name suggests, it is black in colour and is more commonly seen on the scalp and not on body hair. White Piedra shows up with white nodules on hair shafts or other hair-bearing areas. The nodules are about 1 mm in diameter. 

white piedra

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Symptoms Of White Piedra

The following symptoms are noticed in this fungal hair problem:

  • Pearly nodules surrounding the hair follicles
  • Brittle hair
  • Gritty hair
  • Pain at the end of hair root
  • Itching in the scalp

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White Piedra can be confused with other hair or scalp conditions that may cause an infection, but this problem is different from other hair anomalies:

Lice And White Piedra

Lice infestation is a common hair problem. Hair Lice are insects that attach to the hair shaft, lay eggs, and keep sucking blood from the scalp. Unlike lice, White Piedra does not create any creatures in the head. White Piedra nodules can easily be removed while lice need medication to be taken off the head.

Tinea Versicolor And White Piedra

White Piedra is also misdiagnosed with another condition called Tinea versicolor. Tinea versicolor is a fungal skin infection caused by yeast and not by fungus and comes up in form of scaly patches anywhere on the entire body and not just on the hair. These patches can be lighter or darker depending on the original skin tone. On the other hand, white Piedra appears as tiny nodules only around the hair and are seen either in black or in white colour.

Dandruff And White Piedra

Dandruff is a condition that affects only the scalp and is always white in colour, unlike the White Piedra which affects the hair shaft and can be seen in two colours. Dandruff is relatively thinner and either may get stuck to the scalp or can be dry and fall from the scalp. White Piedra does not fall from the scalp.

Causes And Diagnosis Of White Piedra

Primarily there is only one type of fungus that can cause this hair problem to occur which is the Trichosporon fungi type. This fungus has been found mostly in the soil. The real cause of this fungus cannot be exactly found but people getting this infection have been in contact with someone who has been infected with the problem and already has Trichosporon fungus on their skin. To diagnose the problem and segregate it from other hair and scalp infections, doctors examine the hair shaft and the nodules through physical examination besides taking and performing tests on the fungus to rule out the precise cause and start the course of treatment as the hair fungus will not generally die on its own.


The most common problem of White Piedra is mild to severe hair loss that may lead to thinning of hair. A change in hair texture from soft to severely brittle hair is also one of the problems fungi can bring.  While dandruff and other hair problems may cause itching, this kind of fungal-borne infection sensation on the skin gives a feeling that you want to scratch and is only seen in people who are immunosuppressed or in patients who have been advised to undergo chemotherapy. However, the first line of treatment in all chemotherapies is to shave off all the hair, it automatically helps to get rid of the fungus. Other treatment options to ward off the fungus are topically using an antifungal cream or washing the hair with anti-fungal shampoos. In rare cases when the infection has become grave and the tough fungus does not get cleared with the topical applications, shaving the hair completely may be the only resort. In general, White Piedra is not very severe and most people will recover with shampoo and ointment. Moreover, by keeping the scalp clean, the fungal-borne hair will fall, and healthy hair will start to grow.