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Understanding fungal acne – and how to get rid of it


Fungal Acne commonly referred to as Malassezia folliculitis is often confused with acne vulgaris (acne caused by bacteria). This makes it one of the skin conditions commonly misdiagnosed. Fungal Acne is caused by an overgrowth of yeast within hair follicles.

Characteristics of Fungal Acne

Yeast levels tend to increase during hot, humid weather or when youโ€™re sweaty. High yeast levels promote inflammation, which manifests on the skin as pus bumps. Unlike regular acne, Fungal acne makes your skin itchy. It can also irritate your skin to the extent that it goes red. Fungal acne can increase in size and even contain pus.

They look like small whiteheads, usually on the chest, shoulders, hair roots, and back and appear in clusters.

Difference between Fungal Acne and Bacterial Acne:

  • Location- fungal acne often shows up on the arms, chest, and back. It can also be on the face, where bacterial acne is most common.
  • Itching – fungal acne often causes itchiness. Bacterial acne rarely does.
  • Size – pus-filled bumps caused by fungal acne tend to be small and nearly all the same size. Bacterial acne can cause pimples and whiteheads of varying sizes.
  • Clusters- fungal acne often appears in clusters of small whiteheads. Bacterial acne is less clustered and sparser.

Diagnosing Fungal Acne

The best way to diagnose fungal acne is to visit your dermatologist and having simple tests done. The tests usually involve scraping the skin and taking a sample to observe either under a microscope or doing a biopsy.

However, since fungal acne doesn’t respond to bacterial acne medication, sometimes you can actually โ€œSelf-diagnoseโ€ if at all the characteristics of your acne are consistent with those of fungal acne and if your acne is not responding well to your acne routine.

How To Manage Fungal Acne

Please note: That seeing a dermatologist is usually imperative!

To treat fungal acne, you need to restore the balance between yeast and bacteria on the skin.

  1. Oral prescriptions of anti-fungal like Ketoconazole, Fluconazole can be prescribed depending on the severity of the condition. These penetrate deep into the follicle and stop the yeast from growing further.
  2. Over- the counter antifungal creams- these creams contain Ketoconazole, clotrimazole, etc., and are usually used for athleteโ€™s foot.
  3. Anti-dandruff shampoo- These contain Ketoconazole, Sulphur, selenium sulfide, or pyrithione zinc.
    Fun fact: These shampoos can be used as a body wash or face washes. And are quite effective in managing Fungal Acne. When you have an active break out use shampoos as masks. Apply on your clean face and leave them for about five to ten minutes before rinsing it off.

To help maintain a healthy balance of yeast and bacteria on your skin and prevent fungal acne from recurring consider using anti-bacterial shampoo at least once a week. Let the shampoo sit on your skin for several minutes before rinsing, for best results.

  1. Keep your skin dry and clean during and after a workout.
  2. Shower twice or thrice a day on hot and humid days.
  3. Remove sweaty clothes right away and don’t wear them a second time without washing.
  4. If you are prone to fungal acne, avoid products that contain benzoyl peroxide, fatty acids such as lauric acid [coconut oil], linoleic acid, and any product that helps dry skin to recover. These products will create a humid condition for the yeast to thrive.
  5. Avoid wearing very tight clothing, especially synthetic fabrics, which block the sweat and don’t let your skin breathe.
  6. Eat a balanced diet. Fungi like yeast thrive on sugary carbohydrates, so balance your diet with fruits, vegetables, and proteins to help discourage overgrowth.

Consider seeking help from a dermatologist if you’ve attempted to treat your suspected fungal acne at home and the breakout persists for more than three weeks or if it keeps recurring.