What Is Fungal Acne?
Fungal acne may not be something you’re familiar with but once you know what it is, it isn’t hard to treat.
There is a lot of confusion around fungal acne, what it is, how to treat it and how to know if you have it but perhaps the first place to start in terms of addressing the confusion around fungal acne is with the name.
Fungal acne isn’t technically acne, it gets its name from the blemish-like rash that appears on the skin. Fungal acne as the name suggests looks remarkably like acne, however, while it isn’t acne it is caused by a fungus. Fungal acne or pityrosporum folliculitis is caused by an overgrowth of yeast or Malassezia on the skin.
Fungal acne or pityrosporum folliculitis is caused by an overgrowth or infection of yeast around the hair follicles on the face and body. When these tiny hair follicles become infected they present as small papules or bumps that resemble blemishes or pimples.
What Does Fungal Acne Look Like?
Fungal acne looks remarkably similar to acne which can make it hard to identify if you experience acne already or experience periods of breakouts, whether they be hormonal or otherwise. Fungal acne presents as mostly uniform red bumps on the skin.
Where Does Fungal Acne Usually Occur?
Fungal acne most commonly occurs around the chest, back, face, or upper arms.
Unfortunately, these are also areas that you may experience acne as well. This can make it difficult to identify, however, there are a few things to look out for if you are trying to identify fungal acne.
How Do You Know If You Have Fungal Acne?
While it can be difficult to discern the difference between acne and fungal acne, there are a few ways you can tell the difference.
Unlike regular acne, caused by bacterial infections, fungal acne doesn’t vary in size. With bacterial acne, you will often get a number of different sized bumps, with fungal acne they tend to be uniform in their size.
Blackheads and Whiteheads
Fungal acne, unlike bacterial acne, tends to not be accompanied by blackheads and whiteheads. Blackheads and whiteheads are more commonly associated with regular acne.
This is probably the biggest indicator of fungal acne. If it is itchy then it’s probably fungal acne. Fungal infections are usually accompanied by itchiness.
While not everyone with fungal acne will experience the itch it is a very common indicator. Bacterial acne can be itchy but it’s not particularly common and the itch associated with fungal acne is usually more intense.
Fungal acne is most commonly found on the chest, shoulder, back, and upper arms. While it can occur on the face, it is less likely to do so than bacterial acne.
Treatment not working
Another way to tell if you might have fungal acne is if your normal acne treatments such as spot treatments or creams aren’t working on the blemishes.
What Causes Fungal Acne?
Fungi are a normal part of healthy functioning skin. Bacteria and fungi live on your skin and actually help to prevent infections from bad bacteria or fungi. However, it is when the balance is out of wack that conditions such as fungal acne can occur.
The balance between fungus and bacteria on the skin is a somewhat delicate balance. It can be easy to sweat, irritate, over-cleanse, or antibiotic your way into an imbalance. However, while these actions can contribute to fungal acne there are many factors at play and some people are just more prone than others, more on that in a bit.
Antibiotics are one of the main ways that the fungus vs bacteria balance can be disrupted. The antibiotics can kill off bacteria, as they are designed to do, leading to extra space and resources for the fungus. This can allow the fungus to overgrow and disrupt the balance.
One of the other main ways fungal acne can occur is through sweat and wearing non-breathable fabrics that trap sweat. Sweat makes for a very hospitable environment for fungus, it’s moist and warm, the two things they need to thrive. It can be easy to create an imbalance if you are re-wearing gym clothes, reusing damp towels, or just working out too long in tight workout gear.
Changes in diet can also impact fungal acne. Fungi feed on carbohydrates, so your diet can sometimes be an impacting factor.
Unfortunately, some people are just more likely to experience fungal acne due to being predisposed to overgrowths of fungus. Often people with chronic health conditions, weakened immune system, diabetes, HIV, and even burnout.
How To Prevent And Treat Fungal Acne?
Once you have identified fungal acne, the treatment is usually pretty simple.
Often with a change of lifestyle such as reducing the time your exposing your skin to damp warm environments, changing out of your gym clothes after working out, and showering after workouts, can help to resolve the fungal acne.
However, this will depend on the severity of the fungal acne and probably what caused it.
Anti-fungal washes such as those that contain pyrithione zinc or selenium sulfide can do the trick. The main thing is to follow the instructions carefully as anti-fungal washes often require you to leave them on your skin for a certain period of time before rinsing.
You will often find these two ingredients in anti-dandruff shampoo formulations as well.
Antifungal creams and lotions
Anti-fungal creams and lotions are another way to treat fungal acne, these can be a little stronger than wash-based treatments as they are usually applied a couple of times a day for an extended period, days to weeks.
Speak with your local pharmacist and have them advise you as two which of the anti-fungal ingredients would suit your lifestyle and needs best.
If none of these solutions seem to be working it may be time for a trip to your dermatologist. There are some prescription products that may be more suitable. A dermatologist will be able to advise you on the best treatment plan.
Prevention is the best treatment
Prevention is actually the best treatment when it comes to fungal acne, particularly if you are someone who experiences it regularly.
Make sure to avoid trapping moisture close to the skin, particularly in non-breathable or tight clothes. This also includes towels, swimwear, and wetsuits, you get the idea.
If you are someone who has a suppressed immune system or someone who experiences fungal acne regularly, it may be beneficial to speak with your doctor to get some further advice. Depending on the severity a dietitian may be helpful and finding ways to support your immune health has shown some benefit as well.
Rubenstein RM, Malerich SA. Malassezia (pityrosporum) folliculitis. J Clin Aesthet Dermatol. 2014;7(3):37-41.
Song YC, Hahn HJ, Kim JY, et al. Epidemiologic Study of Malassezia Yeasts in Acne Patients by Analysis of 26S rDNA PCR-RFLP. Ann Dermatol. 2011;23(3):321-328.