Fungal Acne: How to Treat and Prevent Outbreaks

Fungal acne is a form of an inflammatory skin condition. It causes spots that look like acne to form on the chest, upper arms, or back, and occasionally on the face. Fungal acne looks like red spots that can resemble bacterial acne but are marked by uniform red bumps. Treatment differs from managing regular acne, so It's important to know the distinction and how to treat and prevent fungal acne outbreaks.  

What Is Fungal Acne?

Fungal acne is not your traditional acne breakout. It is a type of yeast infection affecting the hair follicles. This fungal infection is caused by a fungus called malassezia (formerly known as pityrosporum folliculitis), which is a type of yeast. The fungus infects the hair follicle causing acne that may be very itchy. Left untreated, fungal acne can develop into red bumps and pustules that can cause skin irritation also known as seborrheic dermatitis. 

In addition to an overgrowth of yeast that causes acne, irritation, and itching, fungal acne can also result in psoriasis and dandruff. When the fungus thrives, the skin cells' renewal processes are disrupted and the cells flake off, causing dandruff. Although dandruff is very common with fungal acne, it is not the only cause of it and your doctor may consider other possible sources.   

Fungal acne vs. acne vulgaris (bacterial acne)

Fungal acne is very different from bacterial acne, also known as acne vulgaris. The key differences found in fungal acne are:

  • Itching 
  • Uniform red spots or papules that do not come to a head
  • Typically forms on the back, upper arms and chest, and occasionally on the face  
  • Spots often look similar and form in crops
  • May cause skin irritation, leading to psoriasis and dandruff 

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How do you get fungal acne?

Fungal acne is caused by an imbalance or overgrowth of yeast. It’s normal for fungus to grow on your skin, but fungal acne can erupt when it gets out of control. 

Some common reasons you may develop fungal acne include: 

  • Taking an antibiotic 
  • Exercising in tight, non-breathable clothing
  • Not showering right after a sweaty workout creating a condition for yeast to thrive
  • A humid environment 
  • A diet that encourages yeast to grow, such as a diet high in carbohydrates and sugar
  • A genetic predisposition to an overgrowth in yeast 
  • Chronic conditions affecting the immune system, such as diabetes or HIV

Fungal acne often appears if you have oily skin or an excess of sebum. Yeast thrives on sebum, a fatty lipid source that shows up as an oily substance on your skin. When your skin overproduces oil, your pores and hair follicles can become clogged, which can create the conditions for an overgrowth of yeast. 

What products treat fungal acne?

Treating fungal acne depends on the severity of the breakout. You can start by showering immediately after a sweaty workout, changing out of exercise clothes soon after a workout, washing and not re-wearing gym clothing, and wearing loose clothing to prevent the formation of yeast. 

The next step may include an over-the-counter topical treatment. A combination of topical creams such as antifungal creams or antifungal body wash may help clear up mild cases. You should discontinue harsh products like alcohol-based toners which can irritate already sensitive skin. 

If symptoms persist after a few weeks, seeing a dermatologist may be your best bet. Your doctor may prescribe an oral antifungal medication which will treat the infection and reach deep into the follicle and kill off any existing fungus. 

Doctors may prescribe a combination regimen of topical creams, oral medication, and lifestyle changes to clear fungal acne. 

It's important to finish all medication courses even if you feel better because it can take weeks or months for your skin to fully heal and return to normal. 

How can you prevent fungal acne?

Living a healthy lifestyle is the easiest way for you to prevent fungal acne. Wearing loose and breathable fabrics when exercising, washing your face with a gentle cleanser, drinking enough water, and eating a variety of healthy foods are all ways to prevent fungal acne. 

These three steps can be followed to improve and prevent fungal acne. 

  1. Wash your face twice daily using a gentle cleanser to help prevent further breakouts from occurring. These might include a mild antiseptic wash and a salicylic acid body wash. 
  2. Look for products with an antibacterial and anti-microbial element such as tea tree oil and witch hazel to reduce the growth of yeast. 
  3. Use a topical product with an antifungal ingredient such as Differin Gel to keep yeast growth in check. 

If over-the-counter creams aren't giving you relief from chronic fungal acne outbreaks then talk with your dermatologist about what other treatments may work for you. 

Where can I find fungal acne treatments? 

Besides the over-the-counter treatments of salicylic acid and Differin Gel at a pharmacy, a dermatologist may also prescribe medications such as Clotrimazole (an antifungal agent), Tazorac (a retinoid product), or Dapsone oral (an anti-inflammatory tablet). 

Summary

Fungal acne may be confused with regular acne, but the treatment is very different. Fungal acne usually occurs on the chest, upper arms, and back and not usually on the face as with bacterial acne. You will need to look at your daily hygiene habits, especially after exercising to remove sweat and oil which can lead to a fungal acne outbreak. There are over-the-counter treatments such as using a mild cleanser, salicylic acid body wash, and topical antifungal creams that can help. A dermatologist can also prescribe medications to control a fungal acne breakout. 

Sources: 

Malassezia (Pityrosporum) Folliculitis

What is Fungal Acne and Why Do So Many People Think They Have It?

The Acne Family

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