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Causes and Treatment of Fungal Acne from a Dermatologist

Dr. Swati Kaktikar

7 Min Read

Fast Check Fact Checked

Fungal acne, scientifically known as Malassezia folliculitis, is a misunderstood and often misdiagnosed skin condition that has gained significant attention in recent years. Despite its name, fungal acne is not caused by the same bacteria responsible for traditional acne; instead, it is attributed to an overgrowth of yeast known as Malassezia. In this article, we will delve into symptoms of fungal acne, causes of fungal acne on face, symptoms, fungal acne treatment options recommended by a dermatologist, and preventive measures.

Understanding Fungal Acne

Fungal acne” is a term used to describe a skin condition known as pityrosporum folliculitis or malassezia folliculitis. It is attributed to an overgrowth of a yeast-like fungus called Malassezia, which is a normal part of the skin’s microbiome. Malassezia is typically harmless, but when it multiplies excessively, it can lead to inflammation of the hair follicles, resulting in small, itchy bumps that resemble acne.

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What Does Fungal Acne Look Like?

fungal acne-how it looks like

Usually measuring between 1 and 2 mm, the spots in fungal acne are red pimples called papules or pustules, or white heads. In comparison to typical acne blemishes, they can be quite irritating and appear in waves. The forehead, temples, and frontal hairline are the most prevalent areas for fungal acne, while it can appear elsewhere on the body.

What Are The Causes of Fungal Acne?

Fungal acne is primarily triggered by the overgrowth of Malassezia, a yeast that naturally resides on the skin. Dandruff due to Malassezia can also be a cause of fungal acne. Factors such as humidity, excessive sweat, and the use of certain skincare products can create an environment conducive to Malassezia proliferation. Unlike bacterial acne, fungal acne is not caused by the same type of bacteria (Propionibacterium acnes) and requires a different approach for effective treatment.

Malassezia Yeast Overgrowth:

The primary purpose of fungal acne is an overgrowth of Malassezia, a type of yeast that certainly resides on the pores and skin’s surface. Malassezia is part of the pores and skin’s microbiota, and under regular situations, it does not cause any trouble. However, certain conditions can result in an imbalance, permitting Malassezia to multiply excessively.

Humidity and Warmth:

Malassezia flourishes in warm and humid environments. Regions with better humidity levels provide a great breeding floor for the yeast. When the skin is constantly exposed to warm temperatures and moisture, especially in climates or conditions that lead to sweating, it creates conditions favourable for Malassezia overgrowth.

Sweat and Tight Clothing:

Excessive sweating can exacerbate fungal acne. Sweat itself isn’t always the reason, however, when it accumulates on the pores and skin and mixes with oils, it creates a moist surroundings that encourages Malassezia growth. Wearing tight or occlusive clothing, which traps heat and moisture, in addition, contributes to this fungal acne.

Use of Certain Skincare Products:

Some skincare products, especially those containing certain oils, fatty acids, or emollients, can nourish Malassezia. Ingredients like lauric acid, oleic acid, and linoleic acid located in some oils can be especially difficult for people susceptible to fungal acne.

Antibiotic Use:

While regular acne is treated with antibiotics, those medications can disrupt the stability of the skin microbiota. In the absence of competing microorganisms, Malassezia can proliferate greater effortlessly, potentially leading to fungal acne.

Weakened Immune System:

Individuals with compromised immune structures may be greater at risk of Malassezia overgrowth. A weakened immune response can permit the yeast to multiply, causing skin problems which include fungal acne.

Fungal Acne-Causing Foods

These foods include sugary snacks, processed foods, and items with high glycemic indexes. (pasta, pizza, burgers, samosa, noodles)

What Are The Symptoms of Fungal Acne?

Small pimples that appear suddenly and may resemble a rash are the result of fungal acne. The lumps resemble one other in size and shape and form in clusters.

Your skin may:

Burn
Itch
Pain

Although they can appear anywhere on your skin, the following areas see the most frequent blemishes:

Chin
Chest
Forehead
Neck
Upper arms
Shoulders
Upper back

Difference Between Fungal Acne and Regular Acne

Acne vulgaris, or “common” acne in Latin, is frequently mistaken for fungal acne. Pimples are caused by both. When oil, dead skin, and germs clog hair follicles, it results in common acne. A fungal infection in the hair follicles is known as fungal acne. Different treatments are needed for fungal and ordinary acne, therefore it’s critical to recognize the difference. However, the two forms of acne can occur together.

Fungal acne often presents itself as small, itchy, red bumps that closely resemble traditional acne or pimples. The distinguishing factor is the absence of whiteheads or blackheads. It commonly appears on the face, chest, and back, areas prone to increased moisture and warmth.

Here’s how to distinguish bacterial acne from fungal acne:

Here is a picture of a regular acne.

regular acne

Here is a picture of a fungal acne.

fungal acne

Size:

Fungal acne can produce pus-filled breakouts that are almost uniform in size. Different-sized bumps and whiteheads can result from bacterial acne.

Area:

The arms, chest, and back are common places for fungal acne to appear. Additionally, it may occur on the face, which is the most common location for bacterial acne.

Itching:

Itching is a common side effect of fungal acne. Rarely does bacterial acne.

Clusters:

Little whitehead clusters are a common feature of fungal acne. There is less clustering and more sparseness to bacterial acne.

Who Might Develop Fungal Acne?

Fungal acne can affect anyone. Male teenagers and young adults are most likely to have it because they typically have oily skin, which is a breeding ground for yeast. Yeast also proliferates rapidly on warm, wet, or sweating skin.

The following people have a higher chance of developing the condition:

reside in a warm, humid area
possess a weakened immune system
possess other fungal illnesses, including tinea versicolor or seborrheic dermatitis
Excessive sweating (hyperhidrosis)
Apply a lot of sunscreen and moisturizers with oil bases
Apply antibiotics

How Is Fungal Acne Diagnosed?

You should consult a dermatologist if you think you have fungal acne problems. Dermatologists are experts in the diagnosis and management of skin disorders. A dermatologist will speak with you about your symptoms to identify whether or not they are caused by fungal acne. This will probably consist of:

How long has the breakout lasted,
what treatments you’ve tried, and
what symptoms are you experiencing?

Occasionally, the doctor might also take one of the following actions:

They might perform a quick, painless skin scraping and use a microscope to look for any yeast that could be causing the fungal acne.

A biopsy, or sample of skin, might be taken. This is a straightforward office procedure. The sample will be sent to a lab to diagnose fungal acne.

Fungal Acne Treatment Options:

Your dermatologist will recommend certain treatment options for fungal acne based on your condition.

Over-the-counter (OTC) antifungal treatments

There are several over-the-counter antifungal lotions and ointments on the market, including treatments for jock itch and athlete’s foot. Seek for items with cream that contains clotrimazole, butenafine, or ketoconazole.

Oral antifungal medication

Consult your dermatologist if using over-the-counter remedies isn’t successful in curing the breakout. An oral medicine, such as fluconazole or itraconazole, can be prescribed by your dermatologist to target the hair follicles and eradicate the infection.

How To Prevent Fungal Acne?

Adopting a skincare routine that discourages Malassezia growth is crucial. This includes avoiding oil-based products, using gentle cleansers, and opting for non-comedogenic, fragrance-free moisturizers. Ingredients like salicylic acid, zinc pyrithione, and sulfur can also be beneficial.

Maintain Skin Hygiene:

Regular cleansing with a gentle, non-comedogenic cleanser helps remove excess oil and prevent the buildup of Malassezia. Showering after sweating and using an antifungal body wash once a week can also be beneficial. Please change your towels and pillow covers at least twice a week. Cover your face and hair with a clean scarf if travelling on a two-wheeler to avoid damage from pollution. Do not leave makeup/cosmetics (on the back/neck etc) on overnight.

Choose the Right Products:

Opt for skincare products based on your skin type and which are labelled as non-comedogenic, oil-free, and free from potential Malassezia-triggering ingredients. Be cautious with makeup, as some formulations may exacerbate fungal acne.

Regulate Moisture Levels:

Maintaining a dry and cool environment is crucial in preventing fungal acne. Using breathable fabrics, avoiding excessive sweating, and using oil-free, non-comedogenic sunscreen can contribute to a healthier skin environment.

Regularly use dandruff shampoo:

As discussed above dandruff can also be a cause for fungal acne, hence dandruff should be treated before it increases and starts to cause acne. There are many dandruff shampoos available in the market. Opt for the ones which are medicated. Ingredients in medicated dandruff shampoos are ketoconazole. Using this rinse regularly could help keep the yeast population on your skin in a healthy balance. You can reduce the usage to once a week after the breakout has cleared up.

Consume a healthy diet:

Yeast and other fungi are present over sweet carbohydrates. Thus, eat a diet rich in fruits, vegetables, and proteins to help prevent their overgrowth.

Conclusion

Make an appointment with your dermatologist on MFine if, you notice any symptoms of fungal acne. Additionally, schedule a visit with your dermatologist if the symptoms reappear soon after you believe they have been resolved.

There might be a medication that can assist in halting the recurrence and shielding you from any long-term problems. You can talk to your doctor about preventive measures and the best skincare routine as well.