Fungal Acne vs Bacterial Acne: Symptoms, Causes, and Treatment

woman with clear face

Have you noticed itchy acne on your chest, back, and shoulders that doesn’t seem to clear? Well, the breakout could be fungal acne. Here are facts you need to know about fungal acne including how it looks and ways to treat it.

What is Fungal Acne?

Fungal acne resembles a bacterial or a hormonal breakout. Its technical term is Malassezia or pityrosporum folliculitis. These eruptions are often inflamed and it itches, and also filled with pus. The bumps tend to appear in areas where there is a high amount of oil such as the chest, back, and the T-zone (nose, chin, and forehead). One obvious sign of this infection are bumps that are uniform in size, appearing in clusters of small closed comedones. They are often itchy unlike the regular rashes caused by bacteria. Knowing what you are dealing with and applying the right treatment can produce successful results.

What Causes Fungal Acne?

Although it resembles bacterial acne, Malassezia folliculitis is caused by yeast. This inflames the hair follicles of your skin leading to pus-filled bumps. Understand that everyone has yeast in their skin. However, when it gets out of control leaving an imbalance, a breakout occurs. Changes in diet, medications and a change of environment can trigger an imbalance of the microorganisms of your skin microbiome. Because yeast thrives in a warm and wet environment, it is important that you leave your skin dry at all times.

Studies show that fungal acne is also common among HIV and AIDS patients, people taking antibiotics, and can appear after transplant surgery. While the causes of Malassezia folliculitis are not completely understood, the following factors are believed to come into play:

  • Diabetes
  • Oily skin
  • Application of oily products including coconut oil
  • Stress
  • Oral contraceptive pills
angry red fungal acne on back

How to know you Have Fungal Acne

Several instances can give you a clue that you are dealing with Malassezia folliculitis. Some of them include:

  • Your bumps fail to respond to over the counter (OTC) treatment, or the breakout gets worse upon using the medication
  • The breakout itches and burns to the touch
  • Other signs of fungal infection are present including eczema, psoriasis, and dandruff

Regular breakout varies in size and tends to come accompanied with whiteheads or blackhead. Malassezia folliculitis will usually appear uniform on the upper chest, back, and arms. This fungal infection rarely appear on the face. The only way to tell bacterial and fungal acne apart is by getting extensive tests from a credible dermatologist. The dermatologist will extract a small part of the lesion and look at it under a microscope.

Fungal Acne Treatment

Depending on the depth of the severity of the acne, the right mode of treatment would be as easy as adjusting your lifestyle. For instance, you could try changing your workout gear immediately after exercise.  Changing into loose clothes would eliminate the warm and wet environment that would encourage yeast to grow. If this doesn’t work, your dermatologist may suggest the use of a simple body wash or medication.

The best shower gels contains ketoconazole of about 2 percent. Nizoral is one of the best skincare shampoos. These shampoos can be used to treat fungal infection on the face, hair, and the body.  You are advised to use this shampoo for about two months. Once the breakout clears, continue using it at least once a week for three additional months to prevent a recurrence. The other anti-fungal agent would be zinc pyrithione about one percent or selenium sulphide, 2.5 percent. The application guidelines are similar to ketoconazole. You may be asked to include topical sulfur in your daily bathing routine, which is an anti-fungal and antibacterial element.  

Several studies also show the positive impact of tea tree oil on fungal acne. It contains strong antifungal properties that can combat fungal infections. For it to penetrate the pores, it should be combined with benzoyl peroxide and salicylic acid. Understand that acne can only be fought by oil-free products. Should the breakout fail to clear within a month, an oral anti-fungal medication may be prescribed.  A chemical exfoliate would help keep the pores of the dead skin cells clear. These pores are known to trap oil creating the perfect environment for yeast and pityrosporum Clearing acne is one of the many benefits of microdermabrasion.

How can you Prevent Fungal Acne?

First, cut out on sugary foods and choose the low carb diet. Understand that yeast thrives on sugar. Simple carbs can quickly convert into sugar. Starving them is a good way to get rid of the infection. Also, explore natural antifungals such as black walnut, oregano, and cloves. You can find them in the form of essential oils or capsules. Note that there are ingredients that may increase Malassezia folliculitis.  Ingredients you need to avoid if you have this infection include:

  • Fermented products such as Galactomyces
  • Oils and fatty acids including oleic, lauric, and linoleic acid

Some ingredients with anti-fungal properties can be included in your daily routine. These may include the following:

  • Green tea extract
  • Honey extract
  • Salicylic acid

Because yeast thrives in a humid environment, avoid over-moisturizing your face. Keep off hydrating products that would encourage its growth. After a workout, wipe off your sweat and rinse it off with clean water. Wearing tight clothing that traps sweat for extended periods can contribute to the multiplication of fungus on the skin.

This is why fungal acne is common in areas that are often covered. You can reduce the chances of developing Malassezia folliculitis by wearing breathable materials such as cotton especially if you live in a hot and humid environment. Prevent hyperpigmentation from the sun with microdermabrasion. Also, cool down your skin temperature. High temperatures increase the production of sebum which could encourage the growth of fungal acne. Although heat is inevitable, avoid sunbathing and steaming hot saunas.

Fungal acne can take weeks or even years to clear out if not treated correctly. Severe cases may take longer to respond, but they will eventually clear out. Because acne can be emotionally troubling and physically scarring, it is important that you get professional help to clear it with the right products. You can also look out for skincare threads on Reddit to find out what products people with fungal infections used and how effective they were.

Leave a Comment