What Is Fungal Acne? Dermatologists Explain Symptoms, Causes, and Treatment Options

Unfortunately, your typical acne treatments won't work here.

Whether it's red and bumpy, capped with a whitehead or blackhead, painfully swollen under the skin, or scattered across more than just your face (hey, bacne!), acne is acne, right? It's caused by the same stuff and treated the same way, no matter where it is, what it looks like, or how it feels.

Well, we hate to break it to you, but this is actually totally untrue. Not all types of acne are the same; fungal acne, in particular, has an entirely different cause than most other types, which means—you guessed it—the treatment is different, too.

Here's what you need to know about fungal acne, including who's at risk for it, how to identify, and what you can do to treat it.

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What is fungal acne?

Most typical forms of acne are caused by clogged pores; while the source of the clogging can be varied between people who have it (hormones, skin care products, diet, and medications are often blamed), the acne itself is essentially the same. Something clogs the teensy hair follicles on your skin and your skin responds with irritation in the form of red, raised bumps, aka pimples, which may or may not have a white or black opening, or "head."

Also known as pityrosporum folliculitis, fungal acne has an entirely different source: a yeast called Malassezia. "Malassezia yeast is a normal inhabitant of our skin, but it can overgrow in certain conditions," Ashley Jenkins, MD, a dermatologist at University of Missouri Health Care, tells Health. When it does, it causes inflammation of those same hair follicles, and can results in acne says Dr. Jenkins.

What causes fungal acne?

Because an overgrowth of the Malassezia yeast is the culprit behind fungal acne, the common causes for the condition are situations and environments that promote rapid yeast growth. Those can include:

  • Living in hot, humid climates
  • Having a high oil gland production
  • Frequent sweating, either because of climate, exercise, or medical conditions
  • Not changing into clean clothes after exercise
  • Certain medications, like antibiotics
  • Wearing tight, restrictive clothing (especially in warmer temperatures)
  • Some immunosuppressive conditions or medications.

Age and gender may also play a part in your risk factors, says Dr. Jenkins: "It's most common in adolescents and young males, but can happen in females, too."

What are the symptoms of fungal acne—and what does it look like?

Courtesy of DermNet NZ

Dr. Jenkins says fungal acne is more common on the chest and back because of how those areas are often covered by our clothing (and thus more prone to becoming hot, sticky, sweaty, and poorly ventilated).

Fungal acne may or may not look like typical acne; it's often itchy, with a rashy, uniform appearance. The red bumps also tend to appear at the same time.

"It may present more suddenly and the breakouts tend to be monomorphic, [which means] all areas look similar," Amie Sessa, MD, a Maryland-based dermatologist, tells Health. "They more often have pustules and are often itchy."

What are the treatment options for fungal acne?

Because fungal acne isn't caused by oil production, you can't slap some salicylic acid on an outbreak and assume it will go away. You have to target the overgrowth of yeast on your skin if you want to reduce your fungal acne.

If your acne is mild, Dr. Sessa advises, you can start by using an over-the-counter antifungal cream or even shampoo, like Nizoral, to control the balance of yeast on your skin. However, this may not work well enough for you, in which case you should probably head to the dermatologist for professional treatment.

"Most commonly, you will need an oral medication [like a systemic antifungal], as the yeast can be too deep in the follicles for the topical medications to get to," says Dr. Sessa. "Often, we will recommend a medicated wash as maintenance if someone becomes prone to this condition."

Unfortunately, you probably will have to do some maintenance for a while if you've developed a case of fungal acne.

"It has a tendency to recur, because many of the ongoing risk factors won't change overnight," says Dr. Jenkins, explaining that adolescent hormones can rage for several years (and you can't exactly move out of Florida or whatever humid climate you live in just because you have acne!).

Can you prevent fungal acne?

Since everyone has Malassezia yeast on their skin, you can't get rid of it completely—and that makes prevention of fungal acne tough, especially since both Dr. Sessa and Dr. Jenkins say some people are just prone to it.

Instead, your goal is to find a routine that helps you keep the yeast in check. Some of these strategies may be beneficial in taming an overgrowth of Malassezia:

  • Avoid wearing tight or restrictive clothing for long periods of time.
  • Shower and change into clean clothes after a workout or any activity that causes sweating.
  • Use antifungal shampoo a few times per week as a body wash to prevent or limit breakouts.
  • Consider using acne-fighting or exfoliating body washes, as well (yeast feeds on oily skin and may grow more when skin hasn't been thoroughly cleansed).

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