Table of ContentsView AllTable of ContentsFungal Acne vs. Regular AcneCauses and TriggersSymptomsDiagnosisTreatmentPreventionWhen to See a Provider
Table of ContentsView All
View All
Table of Contents
Fungal Acne vs. Regular Acne
Causes and Triggers
Symptoms
Diagnosis
Treatment
Prevention
When to See a Provider
Fungal acne can cause papules and whiteheads, so it’s often confused withacne vulgaris, which causes whiteheads and blackheads. However, different treatment is needed for fungal acne to address the yeast overgrowth.
Verywell / Theresa Chiechi
Fungal acne is often confused withacne vulgarisbecause they look similar. “Vulgaris” is the medical term for “common,” and the term “acne vulgaris” distinguishes it from other types of acne.
The causes, symptoms, and treatments of fungal acne and acne vulgaris are different, however.
Most common on the upper back, chest, and forehead
Breakouts are pinhead-sized and uniform
Does not improve (or even worsens) with antibiotics
Intense itching
Most common on the face, neck, and chest
Breakouts usually have blackheads or whiteheads
Sometimes treated with antibiotics
Does not cause itching
What Are the Triggers for Fungal Acne?
Fungal acne occurs when yeast, a type of fungus, enters the hair follicle and multiplies, causing acne-like breakouts on the skin’s surface.
Malassezia, a type of yeast, is common on the skin. It usually doesn’t cause any skin problems, but under specific conditions, it can lead to infection and irritation in the form of fungal acne.
While healthcare providers do not fully understand what causes the yeast to invade hair follicles, there are some factors that can increase your risk:
Causes of Fungal Face Rashes
Fungal acne causes tiny roundpapulesthat are often pink and occasionally have a whitehead. It tends to appear on the forehead, cheeks, upper back, and upper chest.
Reproduced with permission from ©DermNet NZwww.dermnetnz.org2022
Usually, yourdermatologistwill be able to diagnose fungal acne after a brief physical exam. They will look for uniform, pinhead-sized red pustules on the hair follicles on the upper chest and back.
Your dermatologist may ask you a few questions during the exam, such as:
Fungal Acne Is Commonly MisdiagnosedFungal acne is commonly misdiagnosed as commonacne. Differentiating the two is important since antibiotic treatment may make the problem worse.When left untreated, fungal acne may persist for many years. This condition should be considered particularly in people who fail to respond to typicalacne medications, and who haveitchy skinand bumps that are around the same size.
Fungal Acne Is Commonly Misdiagnosed
Fungal acne is commonly misdiagnosed as commonacne. Differentiating the two is important since antibiotic treatment may make the problem worse.When left untreated, fungal acne may persist for many years. This condition should be considered particularly in people who fail to respond to typicalacne medications, and who haveitchy skinand bumps that are around the same size.
Fungal acne is commonly misdiagnosed as commonacne. Differentiating the two is important since antibiotic treatment may make the problem worse.
When left untreated, fungal acne may persist for many years. This condition should be considered particularly in people who fail to respond to typicalacne medications, and who haveitchy skinand bumps that are around the same size.
Your dermatologist may also perform tests to determine whether you have fungal acne.
How Do You Get Rid of Fungal Acne?
Treatment for fungal acne has two goals: to treat the yeast overgrowth and to address the underlying cause of it. If the yeast overgrowth alone is treated, the fungal acne will most likely recur.
Fungal acne is often treated with both antifungals and acne medications.
Oral Treatment
Oral treatment is usually the most effective option for treating fungal acne, especially for controlling the initial symptoms. The most common prescription oral antifungal medication is Sporanox (itraconazole). For tough-to-treat cases, isotretinoin may be considered.
The length of fungal acne treatment depends on how widespread the acne is and how it is responding to the medication. Once the outbreaks and itching are under control, your healthcare provider will help you develop a plan to slowly wean off of the antifungal medications. This process can take months.
Adverse Side EffectsWhile oral antifungals are highly effective at treating fungal acne, it’s important to weigh their benefits with the potential adverse side effects and interactions with other medications. The most common side effects include:NauseaVomitingAbdominal painDiarrheaLiver damage(hepatotoxicity)If you are experiencing any of these side effects from your fungal acne treatment, talk with your healthcare provider about the next steps.
Adverse Side Effects
While oral antifungals are highly effective at treating fungal acne, it’s important to weigh their benefits with the potential adverse side effects and interactions with other medications. The most common side effects include:NauseaVomitingAbdominal painDiarrheaLiver damage(hepatotoxicity)If you are experiencing any of these side effects from your fungal acne treatment, talk with your healthcare provider about the next steps.
While oral antifungals are highly effective at treating fungal acne, it’s important to weigh their benefits with the potential adverse side effects and interactions with other medications. The most common side effects include:
If you are experiencing any of these side effects from your fungal acne treatment, talk with your healthcare provider about the next steps.
Over-the-Counter Fungal Acne Products
While oral treatments are more effective, topical fungal acne treatments can be helpful for the maintenance and even prevention of future episodes of fungal folliculitis.
Topical treatments usually come in the form of ananti-dandruff shampooand are to be used every day for a week.
The most common treatments are Nizoral or Selsun, available in drugstores and online. They can be applied in the shower and left on for 10 minutes before rinsing off.
Studies show that fungal acne is very treatable. However, it does have a high incidence of recurrence.
Once fungal folliculitis has been treated and is completely gone, talk with your healthcare provider about preventive measures you can take to keep your skin clear and healthy. Some tips to prevent it include:
When to See a Healthcare Provider
If you have breakouts that aren’t responding to conventional acne treatments, contact your dermatologist. They can do tests to confirm whether you have fungal acne so you can get the right treatments.
Once fungal folliculitis has been treated and is completely gone, talk with your healthcare provider about preventive measures you can take to keep your skin clear and healthy.
If you’re concerned that your fungal acne is returning, see your healthcare provider right away. The sooner you catch it, the easier it is to treat.
Summary
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Vlachos C, Henning MAS, Gaitanis G, Faergemann J, Saunte DM.Critical synthesis of available data inMalasseziafolliculitis and a systematic review of treatments.J Eur Acad Dermatol Venereol. 2020;34(8):1672-1683. doi:10.1111/jdv.16253Song HS, Kim SK, Kim YC.Comparison betweenMalasseziaFolliculitis and Non-MalasseziaFolliculitis.Ann Dermatol. 2014;26(5):598. doi:10.5021/ad.2014.26.5.598Prindaville B, Belazarian L, Levin NA, Wiss K.Pityrosporum folliculitis: a retrospective review of 110 cases.J Am Acad Dermatol. 2018;78(3):511-514. doi:10.1016/j.jaad.2017.11.022American Academy of Dermatology.Acne-like breakouts could be folliculitis.American Osteopathic College of Dermatology.Pityrosporum folliculitis.DermNet.Malassezia folliculitis.Ohio State Health and Discovery.Pityrosporum folliculitis: What to know about fungal acne.Rubenstein RM, Malerich SA.Malassezia (pityrosporum) folliculitis.J Clin Aesthet Dermatol. 2014;7(3):37-41.Kamamoto CSL, Nishikaku AS, Gompertz OF, Melo AS, Hassun KM, Bagatin E.Cutaneous fungal microbiome:Malasseziayeasts in seborrheic dermatitis scalp in a randomized, comparative and therapeutic trial.Dermato-Endocrinology. 2017;9(1):e1361573. doi:10.1080/19381980.2017.1361573
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Vlachos C, Henning MAS, Gaitanis G, Faergemann J, Saunte DM.Critical synthesis of available data inMalasseziafolliculitis and a systematic review of treatments.J Eur Acad Dermatol Venereol. 2020;34(8):1672-1683. doi:10.1111/jdv.16253Song HS, Kim SK, Kim YC.Comparison betweenMalasseziaFolliculitis and Non-MalasseziaFolliculitis.Ann Dermatol. 2014;26(5):598. doi:10.5021/ad.2014.26.5.598Prindaville B, Belazarian L, Levin NA, Wiss K.Pityrosporum folliculitis: a retrospective review of 110 cases.J Am Acad Dermatol. 2018;78(3):511-514. doi:10.1016/j.jaad.2017.11.022American Academy of Dermatology.Acne-like breakouts could be folliculitis.American Osteopathic College of Dermatology.Pityrosporum folliculitis.DermNet.Malassezia folliculitis.Ohio State Health and Discovery.Pityrosporum folliculitis: What to know about fungal acne.Rubenstein RM, Malerich SA.Malassezia (pityrosporum) folliculitis.J Clin Aesthet Dermatol. 2014;7(3):37-41.Kamamoto CSL, Nishikaku AS, Gompertz OF, Melo AS, Hassun KM, Bagatin E.Cutaneous fungal microbiome:Malasseziayeasts in seborrheic dermatitis scalp in a randomized, comparative and therapeutic trial.Dermato-Endocrinology. 2017;9(1):e1361573. doi:10.1080/19381980.2017.1361573
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Vlachos C, Henning MAS, Gaitanis G, Faergemann J, Saunte DM.Critical synthesis of available data inMalasseziafolliculitis and a systematic review of treatments.J Eur Acad Dermatol Venereol. 2020;34(8):1672-1683. doi:10.1111/jdv.16253Song HS, Kim SK, Kim YC.Comparison betweenMalasseziaFolliculitis and Non-MalasseziaFolliculitis.Ann Dermatol. 2014;26(5):598. doi:10.5021/ad.2014.26.5.598Prindaville B, Belazarian L, Levin NA, Wiss K.Pityrosporum folliculitis: a retrospective review of 110 cases.J Am Acad Dermatol. 2018;78(3):511-514. doi:10.1016/j.jaad.2017.11.022American Academy of Dermatology.Acne-like breakouts could be folliculitis.American Osteopathic College of Dermatology.Pityrosporum folliculitis.DermNet.Malassezia folliculitis.Ohio State Health and Discovery.Pityrosporum folliculitis: What to know about fungal acne.Rubenstein RM, Malerich SA.Malassezia (pityrosporum) folliculitis.J Clin Aesthet Dermatol. 2014;7(3):37-41.Kamamoto CSL, Nishikaku AS, Gompertz OF, Melo AS, Hassun KM, Bagatin E.Cutaneous fungal microbiome:Malasseziayeasts in seborrheic dermatitis scalp in a randomized, comparative and therapeutic trial.Dermato-Endocrinology. 2017;9(1):e1361573. doi:10.1080/19381980.2017.1361573
Vlachos C, Henning MAS, Gaitanis G, Faergemann J, Saunte DM.Critical synthesis of available data inMalasseziafolliculitis and a systematic review of treatments.J Eur Acad Dermatol Venereol. 2020;34(8):1672-1683. doi:10.1111/jdv.16253
Song HS, Kim SK, Kim YC.Comparison betweenMalasseziaFolliculitis and Non-MalasseziaFolliculitis.Ann Dermatol. 2014;26(5):598. doi:10.5021/ad.2014.26.5.598
Prindaville B, Belazarian L, Levin NA, Wiss K.Pityrosporum folliculitis: a retrospective review of 110 cases.J Am Acad Dermatol. 2018;78(3):511-514. doi:10.1016/j.jaad.2017.11.022
American Academy of Dermatology.Acne-like breakouts could be folliculitis.
American Osteopathic College of Dermatology.Pityrosporum folliculitis.
DermNet.Malassezia folliculitis.
Ohio State Health and Discovery.Pityrosporum folliculitis: What to know about fungal acne.
Rubenstein RM, Malerich SA.Malassezia (pityrosporum) folliculitis.J Clin Aesthet Dermatol. 2014;7(3):37-41.
Kamamoto CSL, Nishikaku AS, Gompertz OF, Melo AS, Hassun KM, Bagatin E.Cutaneous fungal microbiome:Malasseziayeasts in seborrheic dermatitis scalp in a randomized, comparative and therapeutic trial.Dermato-Endocrinology. 2017;9(1):e1361573. doi:10.1080/19381980.2017.1361573
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