Fungal Acne: Symptoms, Causes, and Treatments

Small pimples, itching, irritation, redness, all of these are symptoms of a skin condition. Skin conditions vary, and some of them have similar symptoms making the self-diagnosis a bit difficult. One of the most common skin conditions with these symptoms is fungal acne aka Pityrosporum folliculitis. However, acne also comes in various forms, each of which has its effective treatment method.

What is Fungal Acne

It’s not a type of acne. Unlike common misconceptions, it’s caused by an infection that affects the skin's hair follicles, causing symptoms of acne. Pityrosporum folliculitis, also known as Fungal Acne, shares similar symptoms with most types of acne which is the occurrence of small pimples, redness, and itching. Nonetheless, with a proper understanding of how it occurs, you can know if what you've got is fungal acne. This type of acne is often mistaken for acne Vulgaris (a different kind of acne) due to whiteheads, a common symptom.

Is Fungal Acne the Same as Acne Vulgaris

Although both types of acne have similar symptoms and occur in similar ways, they’re very different and thus, do not respond to the same treatment.

It can cause whiteheads and skin irritation. It's often confused with acne vulgaris. This is the type of acne most commonly associated with blackheads and whiteheads.

But fungal acne and acne vulgaris occur as two different conditions skin conditions caused by two other things. They won't respond to the same treatment. If you keep using anti-acne therapies, you can make it worse.

That's why it's essential to understand what it looks like and how it occurs for better, effective treatment. Learn the symptoms and signs and what you can do to treat and prevent breakouts.

Here at Radiant Skin Dermatology and Laser, we have a board-certified dermatologist specializing in General Dermatology, Dermatologic Surgery and Cosmetic Dermatology in Manhattan, New York We treat a wide range of conditions affecting the skin, including Fungal Acne.

Causes of Fungal Acne

The primary cause of fungal acne is an infection that affects the hair follicles. Malassezia species cause infection and inflammation of the hair follicles. As a result of the condition, pimple-like bumps occur around the skin with an itchy rash. Unlike acne that affects the skin specifically, Folliculitis shows up anywhere there is hair on the body. Skin types with extra oil production can foster the growth of Malassezia and is prevalent on the shoulders, back, and neck. However, this is not ringworm, a different type of skin fungal infection. While we’ve established the primary cause of fungal acne, it’s vital to note other factors that promote its presence by making a breakout more favorable and therefore possible.

While there is only one primary cause of fungal acne, specific triggers could lead to a fungal acne breakout.

Excessive sweating

Warm, moist environments foster the growth and spread of bacteria and fungi. Fungal acne is common in areas with scorching or balmy weather that causes excessive sweating. This then creates a condition suitable for the growth of the yeast that causes fungal acne.


There are harmful bacteria to keep away from the skin as much as possible. So also, there are beneficial bacteria that are necessary for healthy skin. An example of such is the Lactobacillus which keeps an area slightly acidic. Acidity is unfavorable for fungi, thereby limiting their growth. Antibiotics drastically reduce and kill harmful and beneficial bacteria, including the ones that can reduce fungal growth. No surprise that antibiotic use can make fungal acne worse. If your acne is worsening despite taking prescription antibiotics from your doctor, you should consider a diagnosis of fungal acne.

Excess Oil or Sebum Production In The Skin

Oil and sebum produced by the skin contain nutrients and substances that are nutritionally beneficial to fungi. Excessive amounts of these oils and free fatty acids influence the drastic growth of fungal colonies and also the spread of fungal/yeast elements in a hospitable environment. This growth can develop into a primary infection like fungal acne if not checked.

Ill-Fitting Clothes

Tight or ill-fitting clothes trap moisture and extra sweat, which creates a perfect breeding environment for fungal growth. Wearing sweaty clothes for too long or staying too long in workout clothes can also cause a fungal overgrowth.

Use of skin products incorrectly

There are skincare products or topical medications that can promote the growth of yeasts and fungus on the skin e.g., topical steroids. These skin medications can lower the immunity of the skin allowing fungi and yeasts to overcome the skin’s immune barrier. There is a delicate balance when treating the skin topically with active ingredients because if the balance is tipped in favor of side effects, one can develop all sorts of unintended skin reactions and rashes. Rather than helping your skin look better and healthier, many skincare products end up as a suitable nutrient source for yeast. Using a skincare product that reduces bacteria without equally reducing fungal to strike a balance can also lead to fungal overgrowth. Excessive use of skincare products and makeup that clog up your skin pores is another inappropriate use of skin products that could influence fungal growth.

Immune System

People with weaker immune systems are more likely to have fungal acne breakouts than people with more robust immune systems.

Fungal acne can affect both genders as Malassezia is always present on the skin as part of our normal skin flora. The balance between fungi and bacteria in the skin is a crucial determinant of fungal acne breakouts. An overgrowth of this type of yeast will cause skin irritation, discomfort, and pimple-like bumps. The effects of overgrowth consequently affect the hair follicles. Here is where the symptoms begin to show up.

Symptoms of Fungal Acne

It’s often mistaken for other types of acne, including acne vulgaris, due to the similarity in symptoms. However, for proper and effective treatment, the correct diagnosis matters. Here are some signs you can use to differentiate and diagnose it.

Size of the pimple-like bumps

This type of acne is characterized by whiteheads, small pimple-like bumps with pus inside, covered by a thin layer of skin. The bumps are similar in size, ranging between 1 and 4 millimeters. Other skin conditions usually have bumps of various sizes and the bumps may or may not have pus inside them.  In contrast, fungal acne usually has bumps of the same/similar size.

Affected Area

It is most common in areas with a lot of hair and skin oil (sebum) since the yeast or fungus that causes this acne lives deep in the hair follicles. The condition is common on the chest, the back, and the arms. On the face, it can be difficult to diagnose because it can be confused with bacterial folliculitis or acne vulgaris.

Itching and Inflammation

Fungal acne or Pityrosporum folliculitis tends to be very itchy. Bacterial folliculitis can also itch. But itching occurs very rarely.


As opposed to other types of acne, acne caused by fungal infection appears in clusters, with small bumps closely packed together in the affected area.

Other symptoms

Since it’s caused by a fungal infection of the hair follicles, you may experience other fungi-related symptoms like common dandruff aka seborrheic dermatitis

Fungal Acne: Treatment

You cannot completely eradicate Malassezia since this yeast is practically everywhere on the skin as part of the normal skin flora. In order to treat fungal acne, one needs to strike a balance between the yeast and bacteria present on the skin. Here are some ways to do that:

Have Proper and Regular Showers

Regular showering, especially in hot weather and after a vigorous activity, such as an exercise that makes you sweat, can help prevent fungal acne. Take a shower once a day, and after a workout at the gym. By doing so, you can eliminate excessive yeast that has grown in moist, sweaty areas.

Shower More Regularly

You should shower and change your clothes right after you work out or do your job that causes you to sweat.

Wear Loose and Comfortable Clothes

The clothing you wear should be loose and comfortable to allow for proper airflow, keeping you hydrated, sweat-free, and comfortable. Additionally, loose-fitting clothing reduces the chance of moisture being trapped, which can influence the further growth of yeast.

Use the Right Skincare Products in the Right Amounts

Skincare products that excessively eradicate bacteria on the skin might be doing more harm than good. Instead, look for products that help strike a balance. Avoid using excessive amounts of skin-clogging or comedogenic sunscreen, moisturizers, and other skincare products. Another great way to reduce yeast on the skin is to use anti-dandruff body wash or shampoo.

Get Anti-Fungal Medications

Topical antifungal medications work the same way as topical antibiotics and antibacterial skincare products. The difference is that they target fungal growth and infections.

See a Doctor

In severe cases, fungal acne can cause significant distress and skin scarring. While over-the-counter antifungal medications and skin products can help with fungal acne, you should visit the dermatologist if symptoms persist or in moderate or severe cases.

Frequently Asked Questions on Fungal Acne

Is fungal acne different from bacterial acne?

Yes! Fungal acne is caused by yeast, while bacteria cause bacterial acne or folliculitis. While they might seem to have similar symptoms, they’re very different.

Can I get an anti-fungal skincare product?

There are many great anti-fungal skincare products, just as there are antibacterial skincare products. However, make sure to do proper research on the effects and results before getting one.

Can moisturizing frequently help stop fungal acne?

Moisturizing is vital to healthy and vibrant-looking skin. However, you have to be careful with moisturizers and other skincare products and make sure they are non-comedogenic meaning that they will not clog your pores. Moisturizers can clog your pores when used excessively.

Is fungal acne a skin infection?

Though it's usually thought of as a skin infection, it's an overgrowth of yeast, which is part of the normal flora, so it's not an infection per se.


Fungal acne looks like every other acne, so many people use over-the-counter acne medications to treat it. Unfortunately, these will not work. Using topical antibacterial medications makes fungal acne worse since the topical antibacterial kills more bacteria, allowing the offending yeast/fungus to overgrow. Therefore, the balance between fungi and bacteria favors fungal (yeast) growth. Therefore, it increases the possibility of fungal overgrowth, which can lead to fungal acne. Knowing whether you have fungal acne will help you understand your symptoms, causes and get effective treatment.