What Does Fungal Acne Look Like?

Ever struggle with what looks like acne breakouts that just doesn’t seem to respond to your regular acne treatments? You may have a condition known as fungal acne. It is often mistaken for acne. Unfortunately, normal acne medications won't work for fungal acne. But once you have the correct diagnosis, you can treat fungal acne with proper treatment.

In this article, we'll take a closer look at what fungal acne looks like, its causes, symptoms, and treatment options.

What is fungal acne?

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Fungal acne, also scientifically called Malassezia folliculitis or Pityrosporum folliculitis, is a common condition that occurs due to an overgrowth of yeast. The culprit is Malassezia, a yeast that is naturally found on everyone’s skin. In certain conditions, Malassezia yeast can grow out of control. When this happens, it might clog the hair follicles and trigger inflammation.

Fungal acne is usually confused with acne vulgaris. But the difference is that acne vulgaris is caused by oil and bacteria clogging your pores, while fungal acne is caused by yeast infection in your hair follicles. So, you will need different treatments for fungal acne. If you use regular acne medication to treat Malassezia folliculitis, you can actually make it worse.

What does fungal acne look like?

Fungal acne breakout can look very much like regular acne. But in Malassezia folliculitis, the spots are red bumps (papules) or whiteheads (pustules) of the same size. They cluster together, and they can be very itchy.

what does fungal acne look like

Fungal acne can happen anywhere on your body, but the most common areas are the hairline, forehead, temples, cheeks, upper chest, and mid-back.

Symptoms of fungal acne

Fungal acne causes a sudden breakout of small pimples that may look like a rash. Your skin may also feel itchy and sometimes even painful. Other symptoms that usually accompany fungal acne include red bumps, swelling and redness, burning sensation, and irritation of the hair follicle.

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What causes fungal acne?

As stated earlier, an overgrowth of Malassezia yeast in the hair follicles causes fungal acne. It’s common to have yeast on the skin, but not everybody develops a fungal infection. There are different conditions that may promote rapid yeast growth and cause fungal acne. These include:

  • Oily skin. Fungal yeast often feeds off of sebum. Having oily skin or even using too much sunscreen or moisturizers that can clog hair follicles can put you at a higher risk of getting fungal acne.
  • Warm, moist environments. Yeast multiplies very quickly in hot places. So, people who live in a warm, humid climate are more likely to get Malassezia folliculitis.
  • Trapped moisture. Wearing tight clothes regularly or sweaty workout gear for too long can trap extra sweat and moisture. This can create a skin environment that is ideal for yeast growth.
  • Certain medications. Taking antibiotics can reduce the good bacteria on your skin, which can allow for the overgrowth of yeast. This can increase your risk of fungal acne breakouts.
  • Having a weakened immune system. If you have a medical condition or taking medication that causes immunosuppression, it could put you at higher risk of fungal acne breakout.
  • Have other medical conditions. If you have other fungal infections like tinea versicolor or seborrheic dermatitis, you might be more likely to develop Malassezia folliculitis. This is because you are already susceptible to yeast overgrowth.

Diagnosis of fungal acne

Most often, a dermatologist can diagnose fungal acne from your history and a physical exam. In some cases, they may require additional tests, such as a skin scraping test. This is where the pus from the acne is examined under the microscope to determine whether it has yeast spores.

A doctor can also use a wood lamp exam. This is where a doctor uses ultraviolet light to examine your skin. If you have Malassezia folliculitis, the test will show a yellow-green fluorescence. Getting an accurate diagnosis is really important before you start a fungal acne treatment.

How to treat fungal acne?

Fungal acne usually doesn't go away because a lot of people treat it with the wrong medication. Usual anti-acne treatment against bacteria is not effective in dealing with them. Here are some common fungal acne treatments.

Over-the-counter treatments

Using over-the-counter antifungal products may help treat Malassezia folliculitis. Topical treatments often come in the form of an antifungal shampoo, which you may use every day for a week. Using antifungal creams with ingredients such as butenafine or clotrimazole may also be effective in treating fungal acne. Always follow the guidelines carefully, and if you notice any irritation or dryness from these creams, contact your dermatologist.

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Prescription treatments

If over-the-counter antifungal treatments don't improve your fungal acne, your dermatologist may recommend prescription oral antibiotics or topical medications. Stronger topical ointments like ketoconazole may be more effective against fungal acne than regular OTC treatments. Oral antifungal medications are the most effective treatment — they either kill or prevent the growth of fungal cells. However, oral antibiotics like fluconazole and itraconazole may have some adverse side effects, such as nausea, vomiting, and abdominal pain. If you experience any of these side effects, talk with your doctor about the next steps.

Proper skincare routine

Using antifungal medications can rid the skin of fungal acne, but changing your everyday skincare habits can help keep it away. Look for skincare products labeled 'non-comedogenic,' as they are less likely to clog pores. You should also avoid greasy and thick beauty products that could trap dead skin cells in your pores. This can help eliminate environments where fungi or yeast can thrive. Also, to prevent fungal acne in the long term, develop a gentle skincare regimen with natural and antifungal ingredients.

Home remedies

There are some home remedies that may help you find relief, like using honey or applying tea tree oil. Honey not only has antimicrobial properties but also has great moisturizing properties for your skin. Tea tree oil has antiseptic and antifungal properties that may help kill Malassezia infecting the skin.

Some traditional medicine followers suggest the application of raw honey or diluted tea tree oil to the affected area and leave it on for 15 minutes, then wash it off with warm water. Prior to considering this, discuss such an approach with your dermatologist. It's good to note that while these remedies have been used in traditional medicine, there's no scientific proof that they can actually work for fungal acne. They can also cause irritation, so always do a patch test first.

Red light therapy

Red light therapy (or low-level laser therapy, LLLT) usually involves exposing your skin to a specific wavelength of red light. There are claims that it might help reduce inflammation, which could potentially help with acne. However, there is no scientific evidence to prove if it really works. If you want to try this option, make sure you consult with a dermatologist before trying red light therapy devices.

Maintaining personal hygiene

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It's essential to maintain everyday body hygiene to keep your fungal acne at bay. Some simple tips to prevent fungal acne include showering regularly, wearing clean and loose clothing, and quickly changing out of sweaty gym clothes. The goal is to allow your skin to stay clean and dry. This can prevent the moist environment that encourages excess yeast growth.

Fungal acne is usually mistaken for common acne. But fungal acne is caused by a yeast infection in your hair follicles, and acne vulgaris is caused by bacteria. The treatment is totally different. Fungal acne treatment includes over-the-counter treatments, prescription treatments, a proper skincare routine, and maintaining personal hygiene. Remember, if you suspect you have fungal acne, it is important to consult with a board-certified dermatologist. They can diagnose your acne and offer personalized advice on the best treatment.

Have you ever struggled with fungal acne? Please share your personal experience in the comments and the treatment that helped you treat it.

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