The Truth About Fungal Acne: Causes, Symptoms, And Treatment

Featured Image - Fungal Acne

Have you ever found yourself battling persistent and uncomfortable breakouts on your chest, back, and shoulders, only to realize that traditional acne treatments just aren’t doing the trick? If so, you might be facing a formidable adversary: fungal acne.

In a world where skincare concerns are often attributed to familiar culprits like bacteria and excess oil, the concept of fungal acne might seem like a new frontier. This stealthy intruder, however, has been quietly wreaking havoc on the skin, masquerading as its more commonplace counterpart.

Misdiagnosed and misunderstood, fungal acne has a knack for evading detection and leaving individuals frustrated by the ineffectiveness of their well-intentioned skincare regimens.

What is Fungal Acne?

woman applying cream to her pimple acne

Fungal acne resembles a bacterial or hormonal breakout. Its technical term is Malassezia or Pityrosporum folliculitis. These eruptions are often inflamed, and it itches and is 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 is 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 on 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, and 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 certain skincare products like oils and fatty acids

  • Stress

  • Oral contraceptive pills

  • Humidity and sweating

Fungal Acne Symptoms

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

  • Tiny red or white bumps

  • Itching and irritation

  • Other signs of fungal infection are present including eczema, psoriasis[1], and dandruff

Regular breakout varies in size and tends to come accompanied by whiteheads or blackheads. Malassezia folliculitis will usually appear uniform on the upper chest, back, and arms. This fungal infection rarely appears on the face.

But how is fungal acne diagnosed? The only way to tell regular acne, bacterial acne, 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.

How is Fungal Acne Treated?

angry red fungal acne on back

Home Remedies and Over-the-Counter Options


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.

Shampoo or Body Wash

The best shower gels contain ketoconazole of about 2 percent. Nizoral is one of the best skincare shampoos. These shampoos can be used to treat fungal infections on the face, hair, and 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 sulfide, 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.  

Antifungal Cream

Antifungal creams, such as those containing ketoconazole, are effective as antifungal treatments. These creams work by targeting the underlying yeast overgrowth that causes the condition. Applying a thin layer of antifungal cream to the affected areas can help control and reduce fungal acne breakouts.

Salicylic Acid-based Cleansers

Gentle exfoliation with salicylic acid-based cleansers can assist in preventing fungal acne. Salicylic acid helps remove dead skin cells and unclog pores, reducing the risk of fungal overgrowth and breakouts. Incorporating a salicylic acid-based cleanser into your skincare routine can help keep your skin clean and free from excess oil.

Tea Tree Oil

Several studies also show the positive impact of tea tree oil as a fungal acne treatment. 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.

Oral Antifungal Medication

In severe cases or when topical treatments fail, dermatologists may prescribe oral antifungal medication to address fungal acne. These medications, such as fluconazole, are effective in tackling systemic yeast overgrowth that contributes to the condition.

Patients undergoing oral antifungal treatment require close monitoring due to potential side effects associated with these medications. Dermatologists carefully assess the benefits and risks before prescribing them.

man applying facial cream or white facial mask

6 Simple Ways to Prevent Fungal Acne

  1. Dietary Adjustments

Cutting down on sugary foods and opting for a low-carb diet is essential. Yeast thrives on sugar, and simple carbs can quickly convert into sugar. Starving the yeast is a proactive way to eliminate the infection.

By avoiding simple carbs that can readily convert into sugar, you can create an environment less conducive to fungal growth.

  1. Natural Antifungals

Exploring natural antifungal options like black walnut, oregano, and cloves is recommended. These antifungal agents can be sourced in the form of essential oils or capsules, providing a natural way to address fungal overgrowth.

  1. Ingredients to Avoid

It’s important to be aware of ingredients that could make fungal acne worse. Avoiding certain elements is advised, such as fermented products like Galactomyces, as well as oils and fatty acids such as oleic, lauric, and linoleic acid. Being vigilant about these ingredients in skincare and cosmetic products can contribute to prevention.

  1. Beneficial Ingredients for Daily Routine

Incorporating specific ingredients with proven anti-fungal properties into your daily skincare routine can be beneficial. Consider using green tea extract, honey extract, and salicylic acid. These ingredients not only contribute to overall skin health but can also help deter fungal acne.

  1. Moisturization and Hygiene

Balancing moisturization and hygiene is crucial. Yeast thrives in humid environments, so avoiding excessive moisturization is key. After a workout, it’s advisable to wipe off sweat and rinse with clean water to prevent prolonged exposure to moisture.

  1. Clothing and Environment

Choosing appropriate clothing and maintaining a conducive environment can make a difference. Opt for breathable materials like cotton, especially in hot and humid regions, to reduce the likelihood of fungal acne.

Additionally, managing skin temperature is important; excessive heat can stimulate sebum production, creating conditions favorable for fungal growth. To this end, avoiding activities like sunbathing and extended exposure to steam can help minimize the risk of fungal acne development.  

back fungal acne being brushed with cream

Frequently Asked Questions

Can I use regular acne products for fungal acne?

No, regular acne products may not effectively treat fungal acne as they target different causes. It’s crucial to use products specifically designed for treating fungal infections or consult with a dermatologist for suitable recommendations.

How long does it take to see results from treating fungal acne?

The timeline for improvement varies depending on the severity of the condition and chosen treatment method. Mild cases may show improvement within a few weeks, while more severe cases might require several months of consistent treatment before significant results are visible.

Can diet affect fungal acne?

While diet alone may not cause or cure fungal acne, some individuals have reported improvements by avoiding certain foods that can potentially exacerbate fungal overgrowth, such as sugar and processed carbohydrates. It’s best to consult with a healthcare professional for personalized advice.

Can I wear makeup if I have fungal acne?

Yes, you can still wear makeup if you have fungal acne, but it’s important to choose non-comedogenic and oil-free products. Be mindful of ingredients like oils and fatty acids that can feed the yeast and worsen the condition.

Is fungal acne contagious?

Fungal acne is not contagious and cannot be spread from person to person. It is caused by an overgrowth of yeast on the skin, which is typically present in everyone’s microbiome to some extent.

black and white photo of man with face acne


Fungal acne is caused by an overgrowth of yeast on the skin, leading to small bumps that resemble regular acne vulgaris. The good news is that there are various treatment options available for fungal acne. Over-the-counter remedies like antifungal creams and cleansers can help clear up mild cases. With the right treatment and skincare routine, you can banish those pesky bumps and achieve clearer skin.

Remember to be consistent with your chosen treatments and follow a proper skincare regimen tailored for fungal acne-prone skin. For more severe or persistent cases, prescription treatments and oral antifungal medications may be necessary. It’s important to consult with a dermatologist to determine the best course of action for your specific situation.

Also, check out the other comparison review I did below for more options on facial care procedure: