Do you ever notice how some acne breakouts on your chest, back, or shoulders just don’t clear up and keeps breaking out? We might have the answer to that – fungal acne.


What is Fungal Acne?

Fungal acne which is also referred to as Pityrosporum folliculitis or Malassezia folliculitis, is a type of infection that happens in your skin’s hair follicles. It is actually not really counted as an acne breakout.

Most commonly appearing as small “pimples”, it can cause itching and discomfort. Fungal acne does not typically cause whiteheads/blackheads (ie. Comedones) as opposed to bacteria acne, or also known as acne vulgaris that is commonly associated with blackheads and whiteheads.


Bacterial acne is caused when excess sebum clogs your body’s hair follicles, especially on the face, neck, or chest. When bacterial begins to grow in clogged follicles, it creates blackheads or whiteheads on the surface of the skin. Hormones, oral contraceptives, diet, environment, and a range of other situations can lead to the development of bacterial acne.


Both fungal acne and acne vulgaris are two very different conditions with two different causes.  You need to seek the right treatment in order for it to be cured.  


Hence, it is important to understand what fungal acne looks like, the causes and how it develops. This article will discuss the symptoms and signs of fungal acne, what you can do to treat and prevent breakouts.


Causes of Fungal Acne

Unlike the usual acne, fungal acne is caused by an overgrowth of yeast, a type of fungus. Most people think that it is caused primarily by oil and bacteria in pores, although oil and sebum production also plays a part in the development of fungal acne.


The yeast responsible for fungal acne is always present on your skin. Naturally, your body is able to balance the yeast, other fungi, and bacteria that are also a part of your skin. Yeast levels can increase during hot, humid weather or when you’re sweaty, promoting inflammation, and manifest on the skin as inflamed bumps (papules or pustules).


Should there be an imbalance in your skin, an overgrowth can happen. That’s when the infection of hair follicles develops and acne-like symptoms show up.


Here are conditions which can potentially disrupt the balance of bacteria and fungi:

  1. Trapped and damp areas. Prolonged wearing of sweaty workout clothes may encourage the growth of yeast. Rewearing unwashed workout clothes may also expose your skin to fungi that have grown on the clothes.
  1. Medication. Some antibiotics can cause the reduction of bacteria on your skin and encourage the overgrowth of a fungus
  1. Suppressed immune system. Individuals with compromised immune systems may be more likely to develop fungal acne.
  1. Diet changes. Food with high levels of carbohydrates will encourage growth of the Fungi as they feed on carbohydrates. Hence it is important to balance your intake of sweets and carb-rich foods to help slow down the fungal growth.
  1. Wearing tight clothes. Frequent wearing nonbreathable clothes can encourage extra sweat and moisture in very enclosed areas with poor ventilation. This will become a good environment for fungal growth.
  1. Warm and moist climates. People who live in hot climates, where sweating occurs often may experience fungal acne more frequently.

Symptoms of Fungi Acne


Fungal acne can be hard to diagnose as it looks very similar to acne vulgaris. Typically, someone who experiences fungal acne will treat it with regular acne skin care options. These treatments don’t work, and they can make the infection worse.


Here are ways which you can differentiate between fungal acne and bacterial acne:

  1. Size. Pus-filled bumps caused by fungal acne tend to be nearly all the same size. Bacterial acne on the other hand can cause pimples and whiteheads of varying sizes.
  1. 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.
  1. Itching. Fungal acne often causes itchiness. Bacterial acne rarely does.
  2. Clusters. Fungal acne often appears in clusters.
  3. As Fungal acne is the result of yeast growth, you may experience other yeast-related conditions, like dandruff.


How is fungal acne diagnosed?


Comparing with the symptoms you have with the descriptions above, you should see a dermatologist to confirm the diagnosis.


They may do a simple, painless skin scraping and examine the scraping under a microscope to look for any yeast responsible for fungal acne. Then, they may take a skin sample, or biopsy where it will be sent to a lab where it can be tested to confirm the fungal acne diagnosis.


How is fungal acne treated?

To effectively treat the fungal infection, you will need to restore the balance between yeast and bacteria on the skin. Here are several treatment options which can help:


1. Clinical body wash – Dandruff shampoos which contain pyrithione zinc or selenium sulfide can be used as body washes. This is an off-label use of these shampoos, but it can be effective.

Rinse your skin several times a week with these anti-dandruff shampoos while you’re having a breakout.

You may also consider using it regularly, about once a week, to help maintain a healthy balance of yeast and bacteria on your skin. For best results, let the shampoo sit on your skin for several minutes before rinsing.

2. Use over-the-counter (OTC) antifungal treatments – Products with ketoconazole, butenafine, or clotrimazole cream will help to control the growth of yeast and will dry them up.

3. Try prescription oral antifungal medicine – Your dermatologist can prescribe an oral medication, such as itraconazole or fluconazole, to target the hair follicles and eliminate the infection.



How can I prevent fungal acne?

Although fungal acne can’t be prevented completely, here are preventive steps which can help reduce the chances of a return infection:


  1. Use a dandruff shampoo regularly – A regular rinse can help maintain a healthy balance of yeast on your skin. After the breakout is gone, you can cut back on how often you use the shampoo as a body wash to as little as once a week.
  2. Wear breathable fabrics – Breathable fabrics have a lot of airflow which prevents warm and moist environments that encourage fungus growth.
  3. Shower immediately after sweating – A quick rinse after a workout or sweaty day at work can help prevent yeast growth issues.
  4. Eat a balanced diet. Fungi like yeast thrive on sugary carbohydrates, so balance your diet with fruits, vegetables, and proteins to help discourage overgrowth.


When should you see a medical professional?


If it persists for more than 3 weeks, even though, you have attempted to treat your suspected fungal acne at home, we recommend you to see a medical professional.


Doctors will be able to prescribe antifungal medications that are stronger and more effective at eliminating the infection than topical treatments.



How do I get rid of the fungal acne marks?


After the battle with fungal acne, you might be left with scars of varying degrees, depending on your skin condition, the duration of the acne breakout, and your body’s ability to recover and regenerate.


At M-Aesthetic Clinic, we offer the full range of acne scar removal treatments in Singapore to treat all kinds of scars; raised and red, flat, pigmented or depressed. From Advanced ECO2 Fractional Laser to Subscision, to Chemical peels and to Micro-needle Radiofrequency, Dr Ho Rui Ming will assess your skin condition and personalise an Acne Scar Removal programme just for you.


Enquire now to find out more.

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