Fungal acne isn’t hard to treat—once you know that’s what you’re dealing with. The challenge can be in the fact that fungal acne can look pretty much the same as regular acne. In short, the condition we call fungal acne is the result of an overgrowth of yeast, “otherwise known as pityrosporum folliculitis (malassezia folliculitis),” according to board-certified dermatologist Morgan Rabach. In fact, to set the record straight: fungal acne is a total misnomer—"it actually has nothing to do with fungus, nor is it really acne—it’s a folliculitis, or infection of the tiny hair follicles on the face or body,” which leads to “papules, small, raised, solid bumps resembling pimples,” explains board-certified dermatologist Ava Shamban.
We know how difficult it can be to identify and treat this type of acne, so we asked Rabach, Shamban, and board-certified dermatologist Joshua Zeichner to break it all down for you. Below, discover what fungal acne looks like, what can cause it, and of course, fungal acne treatments to be aware of.
Meet the Expert
- Ava Shamban, MD, is a board-certified dermatologist based in Los Angeles.
- Morgan Rabach, MD, is a board-certified dermatologist based in New York City.
- Joshua Zeichner, MD, is a board-certified dermatologist based in New York City.
What Is Fungal Acne?
“Fungal acne is usually papular acne (red bumps),” explains Rabach. One sign your acne is fungal and not of the acne vulgarism variety (which is what we typically think of as ‘normal acne’) is if it’s itchy.Also, if you spot whiteheads or blackheads that are roughly a millimeter big, chances are it could be fungal. This type of acne usually shows up on the chest, back, or upper arms, but can also occur on the face, just like typical acne can, making it difficult to decipher which you're experiencing.
Causes and Prevention of Fungal Acne
There are a few reasons you may be getting fungal acne, here's what they are and how you can mitigate them.
- Heat and humidity: Fungal acne is closely related to hotter climates. According to Zeichner, it’s relatively uncommon in the United States and is seen at much higher rates in areas of the world where the weather is always warm, such as the Philippines. This is because the yeast that causes fungal acne thrives in moist environments with excessive sweat and heat.
- Sweat: You probably already know that it's best to shower as soon as your exercise is over and that it’s not ideal to sit around in sweaty, clingy clothes (ahem, yoga pants), but this can do more than just make for an uncomfortable fit. To avoid sweat-induced fungal acne, Shamban advises to “Choose loose clothing with natural fabrics, avoid spandex, and change clothing often after exercise or excessive sweating. This can be helpful particularly in hot weather when it can flare up.”
- Overuse of antibiotics: The yeasts on our skin are part of our microbiome, and they’re not a problem when they’re not in excess. However, “in certain circumstances—such as long-term use of topical and/or oral acne antibiotics—the normal skin flora is wiped out by the antibiotics, and so the yeast flourishes, causing inflammation and fungal acne,” Rabach explains. If you have acne that’s not responding to normal treatments and a history of regular antibiotic use, you may have found your culprit.
- Contact with others: Fungal acne might be contagious (after all, yeast is known for spreading). If you've had bodily contact with someone who has fungal acne, it may be the cause of yours.
Treatment
The good news is that once you’ve identified fungal acne, it’s not so hard to treat—especially, Shamban notes, because “the cause is one-dimensional.” In fact, according to Zeichner, you can “even try a few over-the-counter tricks before visiting your dermatologist.”
Use an Anti-Dandruff Shampoo
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NizoralAnti Dandruff Shampoo$15.00
Anti-dandruff shampoos contain an active ingredient called zinc pyrithione, which is antifungal. Needless to say, for fungal acne, these shampoos actually make a good skin cleanser (for face or body—wherever the affected area is). “Apply, let it sit, and lather it up while you sing the alphabet before rinsing it off,” Zeichner says. "The shampoo needs enough contact time on the skin for it to exert its effect.”
Apply an Athlete’s Foot Cream
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Another nontraditional treatment lies in athlete’s foot cream. "Athlete's foot is caused by a similar fungus that causes fungal acne" Zeichner explains. As such, over-the-counter creams can be used. "These contain a potent anti-fungal medication called clotrimazole," Zeichner notes. He recommends applying it twice daily to affected areas. But if these don’t work, or if your rash is not improving in a week or two, Zeichner recommends visiting a board-certified dermatologist for evaluation.
Get a Prescription for a Topical
If your fungal acne is stubborn—as many cases can be—a prescription-strength treatment may be needed. Rabach notes that she'll often prescribe "an antifungal cream, like Ketoconazole 2%, twice a day, for two to three weeks to help reduce the yeast on the skin, leading to a significant reduction in the lesions present."
Exfoliate Excess Dirt and Oil
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We know that exfoliating can get rid of dead skin cells, but how does this fare with those prone to fungal acne? Turns out dead skin cells, excess dirt, and oil might all contribute to the increase of yeast growth. Use a body exfoliator regularly (and especially post-workout) to lessen the chance of getting fungal acne.
Make Body Wipes a Gym Bag Staple
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A body wipe-down after a workout session is both refreshing and helpful in fending off breakouts. Keep a stash of body wipes in your gym bag to encourage a habitual routine of wiping away sweat and oil, at least until you can get to a shower. Salicylic acid wipes, in particular, may help reduce the potential of clogged pores and are ideal for acne-prone, sensitive skin types.
Use an Oil-Free Moisturizer
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When you have fungal acne, the last thing you'll want to do is exacerbate it with what it loves most: oil. Especially if you're treating it with a strong topical (whether prescribed or not), you'll likely have bouts of dryness and irritation, and will want to reach for a moisturizer. Opt for one that's oil-free to try to keep fungal acne at bay.
Apply a Topical Tea Tree Oil
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Touted for its antiseptic, antifungal properties, tea tree oil is an effective treatment for fungal acne. Dilute one to two drops of tea tree oil with 12 drops of a carrier oil (like olive oil) and apply topically (never orally). Since some with sensitive skin have experienced an allergic reaction to those with sensitive skin, it's best to do a patch test before applying the concoction all over the affected area.
Use a Blemish Serum
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If you're sporting an acneic skin type, less is more when it comes to your skincare routine. A two-in-one serum that targets active breakouts and works to fade acne spots over time may have some serious benefits for both treating the fungal acne and ensuring it doesn't leave its trace behind.
Try a Prescription Oral Medication
Though it's rare, dermatologists sometimes call in an oral antifungal treatment like Fluconazole (if you’ve ever been prescribed medication for a vaginal yeast infection, this is likely what you took). “It works faster than the cream or shampoo," Rabach says, a pro for her New York City clientele who "need results fast."
What Are the Different Types of Acne? Dermatologists Explain All
FAQs
How do dermatologists diagnose fungal acne? ›
How do I know if my acne is fungal? A fungal acne breakout tends to be uniform in size and doesn't have blackheads, pustules, or cysts. It can feel itchy and tends to get worse when it's hot outside. 8 Your dermatologist can help confirm the diagnosis by doing a skin scraping to look for yeast under a microscope.
How do you know if it's fungal acne? ›How do I know if I have fungal acne? The most common symptom that you'll notice is itchiness of the bumps. Fungal acne is itchy but never painful, as typical acne can be when a blemish becomes inflamed. Fungal acne can be persistent, worsen with sweating, and flare in hot and humid temperatures.
How I cleared my fungal acne? ›Fungal acne is often treated with either topical or oral antifungal medications. Two of the most effective oral antifungal medications are Fluconazole and Itraconazole. Topical options include creams and shampoos.
What triggers fungal acne? ›This can happen when you're exercising for long periods of time or if you live in a hot, humid area. Damage or irritation to the hair follicle causes inflammation. This lets germs get into the area and cause an infection. This is what usually causes pityrosporum folliculitis, or fungal acne.
What products should you avoid for fungal acne? ›Avoid products that contain benzoyl peroxide, fatty acids such as lauric acid [coconut oil], linoleic acid and any product that helps dry skin to recover.
How do I know if my acne is hormonal bacterial or fungal? ›Fungal acne and hormonal acne are often confused with each other because both types of acne start in the hair follicles. Fungal acne occurs when excess yeast develops, whereas hormonal acne is caused by excess sebum. Fungal acne can result in whiteheads, itchiness and often becomes red, irritated and inflamed.
What products get rid of fungal acne? ›- Ketoconazole cream, shampoo, and tablets (Extina)
- Clotrimazole cream (Mycelex, Lotrimin AF)
- Ciclopirox cream and shampoo (Loprox, Penlac)
- Fluconazole tablets (Diflucan)
- Itraconazole tablets (Sporanox)
Because fungal acne is caused by clogged follicles, it's also vital to consistently exfoliate in order to keep pores clear and free of debris.
How long does it take for fungal acne to clear up? ›The amount of time that it takes to cure fungal acne can depend on the severity of the outbreak. Typically, most treatments can take two to three weeks in order to be completely effective. It is important to complete the full course of your prescribed treatment, as is recommended by Dr.
What kills fungal acne naturally? ›One of the best ingredients you can invest in to treat fungal acne at home is tea tree oil. Sourced from the melaleuca alternifolia plant, this nutrient-rich oil is antiseptic and anti-fungal in nature.
Is benzoyl peroxide good for fungal acne? ›
Retinoids, azelaic acid, and adapalene all help open up the pores and balance bacterial and fungal growth. Benzoyl peroxide is an antiseptic that kills everything. In either case, it takes a few weeks for clinical improvement to occur.
Does fungal acne ever come to a head? ›Dr. McKenzie emphasizes that fungal acne will usually appear as uniform inflamed or reddened bumps and pustules on the chest, upper arms, and back—rarely the face, but sometimes the forehead. Also, the bumps that result from malassezia don't usually come to heads.
How do I know if my folliculitis is fungal or bacterial? ›They may take a swab of the infected skin to test for which bacteria or fungus is the cause of the folliculitis. In rare cases, a doctor may order a skin biopsy to exclude the possibility of other causes.
Why is fungal acne so hard to get rid of? ›One of the reasons fungal acne can last for so long is because fungal acne looks similar to acne vulgaris, or bacterial acne. People with fungal acne, not knowing the difference, may treat it with regular acne skin care options. These treatments don't work, and they can make the infection worse.
What is the best routine for fungal acne? ›Now, for the information you've been waiting for: your daily fungal acne skin care routine! On a daily basis, you should always keep it simple with these four steps: (1) cleanse, (2) treat, (3) moisturize and (4) SPF.
Is fungal acne related to gut health? ›Gut imbalances like Candida overgrowth are one of the root causes of acne. This is largely due to increased intestinal permeability – also known as 'leaky gut'. Leaky gut occurs when toxins leak from the gut into the bloodstream, causing both systemic and local inflammation. This in turn can lead to skin problems.
Is CeraVe bad for fungal acne? ›CeraVe Moisturizing Cream: With hyaluronic acid and ceramides, this rich, creamy moisturizer is super hydrating and totally fungal acne-safe. It's perfect for those with sensitive or dry skin, or to use during those cold winter months.
What is fungal acne filled with? ›Fungal acne is caused by the buildup and infection of hair follicles by the yeast Malassezia on your skin. Though bacteria, yeast, fungus live on our skin normally, typically our body does a good job of keeping the levels in balance.
What is the best ingredient for fungal acne? ›Most fungal acne will respond well to ketoconazole 2% which is a broad spectrum anti-fungal agent which can be applied topically and is used as a first line defense for fungal acne. For more severe conditions an oral anti-fungal of itraconazole, fluconazole, ketoconazole and terbinafine may be introduced short term.
What kills yeast on face? ›Yeast infection treatment
antifungal cream, often with clotrimazole as the active ingredient. antifungal lotion, often with tolnaftate as the active ingredient. oral antifungals, often with fluconazole as the active ingredient. corticosteroid cream, such as hydrocortisone.
Does fungal acne spread by touch? ›
Even though most types of folliculitis aren't contagious, it could very well spread to other body parts if you scratch at the bumps and then touch another part of your body. Folliculitis can generally spread from used towels or razors as well. Very close skin to skin contact can also spread this condition.
Is witch hazel good for fungal acne? ›It's also worth switching up your skincare regime to include products with ingredients like Tea Tree oil and Witch Hazel. Both ingredients are naturally antibacterial and anti-microbial, and can help to inhibit the growth of the underlying overgrowth of yeast.
What can be mistaken for fungal skin infection? ›Skin cancers, whether primary or metastatic, can sometimes coexist with or even mimic fungal infections of the skin. This can lead to later diagnosis when skin cancer is mistaken for a fungal infection.
What is the difference between fungal acne and closed comedones? ›When comparing fungal acne vs closed comedones, the top difference that comes to mind is the cause or trigger. An overgrowth of yeast causes fungal acne. Meanwhile, closed comedones develop because of the combination of oil, bacteria, dead skin, and dirt that clogs pores.
How do you know if you have fungal folliculitis? ›To confirm a diagnosis of pityrosporum folliculitis, your provider may gently scrape your skin to gather some skin cells. They examine these cells under a microscope to look for signs of excess Malassezia yeast. If needed, your provider may do a skin biopsy.
Can a dermatologist diagnose a fungal infection? ›A dermatologist can typically diagnose a fungal skin infection with a simple skin exam or by scraping a small amount of skin from the affected area and examining the scales under a microscope. Most fungal infections are treated with medicated antifungal creams, gels and lotions applied directly to the affected area.
Can a dermatologist help with fungal acne? ›In case of a severe or widespread breakout, your dermatologist will almost always prescribe an oral antifungal medication like itraconazole or fluconazole to get rid of fungus and jump-start healing.
Can dermatologist test for fungus? ›How do dermatologists diagnose nail fungus? To find out if a patient has nail fungus, a dermatologist examines your nails and nearby skin. It's important to check the skin because the fungus can spread. You may already have a skin infection caused by fungus like athlete's foot.
How is fungal infection diagnosed on face? ›In some cases, you may need a fungal culture test to identify a specific fungus and help determine the best treatment for you. During a fungal culture test, your provider may take a small sample of skin (biopsy) or fluid (aspiration). For severe infections, you may need a blood test.
How do you tell if a skin infection is fungal or bacterial? ›Skin infections caused by viruses usually result in red welts or blisters that can be itchy and/or painful. Meanwhile, fungal infections usually present with a red, scaly and itchy rash with occasional pustules.
How do you know if a skin infection is fungal? ›
Your GP will usually diagnose a fungal skin infection by looking at your skin and where your rash is if you have one. If your rash looks unusual or has spread, they may take a scrape of skin or nail for testing. They will send this sample to a laboratory to confirm the diagnosis.
What chemical gets rid of fungal acne? ›Most fungal acne will respond well to ketoconazole 2% which is a broad spectrum anti-fungal agent which can be applied topically and is used as a first line defense for fungal acne. For more severe conditions an oral anti-fungal of itraconazole, fluconazole, ketoconazole and terbinafine may be introduced short term.
What cream gets rid of fungal acne? ›Treatment is with topical and/or oral antifungal medications such as: Ketoconazole cream, shampoo, and tablets (Extina) Clotrimazole cream (Mycelex, Lotrimin AF) Ciclopirox cream and shampoo (Loprox, Penlac)
How long does it take for hydrogen peroxide to get rid of fungus? ›To kill them without having to breathe in toxic bleach fumes, spray with undiluted 3 percent hydrogen peroxide and allow it to sit for 30 minutes. Rinse. The peroxide will kill the mold and mildew, but you may still need to remove the stains they left behind.
When should I see a dermatologist for a fungal infection? ›If you have the symptoms of a fungal infection or are experiencing a rash on your skin, an appointment with a dermatologist can help you get a diagnosis & the most effective treatment.
What is the rapid test for fungal infection? ›Gram stain – a rapid test performed to microscopically detect bacteria and/or fungi in a sample. Bacterial culture – used to rule out a bacterial infection or determine if concurrent bacterial infection exists.
What kills fungal infection on face? ›antifungal cream, often with clotrimazole as the active ingredient. antifungal lotion, often with tolnaftate as the active ingredient. oral antifungals, often with fluconazole as the active ingredient. corticosteroid cream, such as hydrocortisone.
How do I get rid of fungus on my face? ›Fungal skin infections caused by Candida are treated with an oral antifungal medication or a topical antifungal cream you put on the rash. Your provider may also prescribe a prescription antifungal cream.
Can a fungal infection on face look like acne? ›Malassezia yeasts can grow in hair follicles, and cause inflammation of hair follicles. This causes spots to develop and this is referred to as fungal acne. Spots may have a white head of pus, just the same as in acne. The medical name for fungal acne is Malassezia folliculitis.