Once you know how to identify it—fungal acne isn’t hard to treat. The problem is that it presents like regular acne, but traditional topical acne treatments don’t work to correct this skin condition and in fact, can inflame it even more. But what is fungal acne, what causes it, how is it different from acne, and what can you do to treat it?

Curious to learn more? We’ve got you covered. Read on to learn about this common skin condition that still remains somewhat of a misnomer and what you can do about it.

What Is Fungal Acne?

Fungal acne, also known as Pityrosporum folliculitis or Malassezia folliculitis, is a type of skin infection caused by an overgrowth of yeast (a type of fungus) in the hair follicles that can cause whiteheads and skin irritation. The sebaceous glands in the skin produce a substance known as sebum. When these glands overproduce oil, the pores and hair follicles can get clogged with oil in addition to bacteria, dead skin cells, and yeast that are naturally occurring on the skin. Furthermore, the contents in the clogged glands are food to these pathogens, further exacerbating the condition. While traditional bacteria cause acne, yeast causes the hair follicles to become inflamed, which is a skin condition known as folliculitis.

What Does Fungal Acne Look Like And How Does It Differ From Traditional Acne?

It most commonly appears as small, uniformed bumps in the hair follicles typically in symmetric rows on the face, forehead, scattered about the cheeks, and occasionally on the upper chest and back that are consistent in size and shape, often accompanied by itching. It is easily confused with acne vulgaris, a type of acne most associated with whiteheads and blackheads. But this condition differs from acne in that it doesn’t produce blackheads, pustules, nodules, or deep-rooted cysts. Not only does acne and fungal acne differ in appearance, so do the treatment protocols. In fact, traditional acne medications can worsen fungal acne.

Fungal acne is not contagious, infectious, or an indicator of poor hygiene. Again, fungal acne is the result of an overgrowth of yeast, so other yeast-related conditions like dandruff and psoriasis may accompany fungal acne, which can help narrow down the culprit and distinguish this condition from traditional acne or another cause.

What Conditions Worsen Fungal Acne And How Is it Prevented?

Yeast thrives in specific circumstances, like an imbalance in the skin or gut. However, there are other specific conditions that can make fungal acne worse including the following:

Medications: Prescriptions, like antibiotics, reduce the amount of bacteria inside the body and on the skin, creating the ideal habitat for bacteria and fungus to proliferate.

Diet Changes: If an individual has a high intake of carbohydrates and sugars, this is a food source for fungi and yeast that not only throws off the body’s balance but can worsen fungi-related conditions like fungal acne.

Trapped Moisture: Since yeast thrives in dark, moist conditions, wearing anything sweaty like gym clothing or a bathing suit, these conditions can allow the yeast to grow. Furthermore, re-wearing clothing that was exposed to sweat again without washing it properly may also expose the skin to fungi that have grown in the clothing. Wearing tight clothing can create the same kind of environment that promotes yeast overgrowth from heightened sweating in warm, dark places.

A Compromised Immune System: Individuals who suffer from having immune systems that are compromised are thought to be more prone to develop fungal acne, as well as accompanying conditions like psoriasis.

Tropical Weather Exposure (Or Similar Environments): Anyone who lives in a hot climate or is exposed to steamy, tropical environments where sweating is more prevalent, may experience a higher risk of experiencing fungal acne more frequently than those who don’t live in climates like this.

What Kind Of Treatments Are Available For Fungal Acne?

Since fungal acne doesn’t respond to the typical acne medications, what does treat this condition?

Topical Treatments: Topical treatments with ketoconazole can be effective at treating most mild cases of fungal acne in addition to selenium sulfide. These ingredients can be found in body washes, creams, and shampoos that are found over the counter. If you need a stronger version (any product with over 1% of these ingredients), you may need to get a prescription. Another topical treatment to treat folliculitis that can be found over the counter in various skincare products, is L-Mandelic acid, a form of alpha hydroxy acid that exfoliates, brightens, and has anti-inflammatory, anti-bacterial, and anti-fungal properties. Serums with L-Mandelic acid will be the most effective at treating fungal acne, but facial cleansers or a facial scrub with this ingredient can help speed up the healing process.

Oral Medications: For more stubborn cases of fungal acne, a trip to the dermatologist might be in order. A doctor may prescribe an antifungal medication like fluconazole or itraconazole to treat fungal acne.

Tips For Preventing Fungal Acne

Now that we have established what fungal acne is, what worsens it, and how to treat it—let’s break down a few tips that help prevent this stubborn skin condition in the first place.

Keep The Gut Microbiome In Balance: If your client has been on long-term antibiotics or has taken antibiotics recently, their gut microbiome could be out of balance due to the fact that antibiotics kill both good and bad bacteria the body needs. When this balance is thrown out of whack, it can produce a variety of skin conditions including Malassezia folliculitis. If an individual suspects their gut needs rebalancing, they should consult their doctor to see which prebiotics and probiotics are appropriate to ingest to regain balance back in the gut.

Maintain A Balanced Diet: To piggyback on the above, the gut plays an important role in nutrition as well. Moderation is always key. But when individuals suffer from yeast-based conditions in the skin, they should moderate how much sugar, yeast, and alcohol they consume since these are food sources for yeast and other bacteria. Individuals who suffer from fungal folliculitis have reported they can quickly tell the difference in their skin when they indulge in any of the above foods and beverages.

Avoid Emollient Products: Thick creams and oils can cause fungal acne—especially on the forehead and cheeks, which is usually from hair care products. Use Anti-Dandruff Shampoo: Individuals can regularly use anti-dandruff shampoos as a body wash to maintain a healthy balance of yeast on the skin until the fungal acne is gone. Once the breakout is under control, individuals can use anti-dandruff shampoos once a week to maintain the skin’s balance of yeast.

Wear Permeable Clothing: Since moist conditions help yeast and other bacteria proliferate, wearing breathable fabrics that allow for air flow can cut down how warm and moist your clothing gets—thus making it less likely for the yeast to grow out of control.


Fungal acne is different from traditional acne and as such, it needs to be treated differently. Over-the-counter medications can be effective at treating mild cases. However, more stubborn cases may require a trip to the doctor for a prescription.