What Is Fungal Acne? The Misunderstood Type of "Acne"

Breakouts come in many shapes and sizes, and they're not always going to be treated the same. The method of action for easing cystic breakouts is different from clearing blackheads or body acne. Hormonal acne? That's another story entirely.

Fungal acne is actually a whole other category—and isn't even acne at all, to begin with. It was given the moniker of "fungal acne" because of the appearance (it looks very similar to acneic breakouts), but as dermatologists will tell you, they're very different things.

"'Fungal acne' is actually not acne at all but rather a type of folliculitis (inflammation of the hair follicle) that results when yeast becomes trapped inside of hair follicles, leading to acneiform pustules and nodules," board-certified dermatologist Rebecca Marcus, M.D., FAAD, tells mbg.

Here's how to spot the difference: "Pityrosporum folliculitis manifest as small red bumps centered around hair follicles," Marcus explains. "Unlike typical acne, fungal folliculitis can itch."

Another telltale sign is that fungal acne will all appear consistent (or, all the bumps will look alike), which is known as monomorphic. However, traditional acne is often polymorphic, which means there will be many kinds of acne (blackheads, whiteheads, cysts) and they'll all appear at different stages, notes board-certified dermatologist Cybele Fishman, M.D.

The area can also help you decipher if it's acne or folliculitis: "The breakouts are most commonly seen on the chest, back, and face," board-certified dermatologist Lian Mack, M.D., FAAD, notes. On the face, it most commonly occurs on the forehead and temples.

It also occurs on all skin tones.

As we noted, "fungal acne" is not a type of acne at all, but a type of inflammation of the hair follicle caused by yeast. "Bacterial acne" is, well, actual acne. It forms from the result of when sebum (the oily substance that protects your skin from drying out) and sticky skin cells clogging the pores, and specific strains of a bacteria called C.1

Acnes1 grow inside, leading to inflammation and pimples. (How acne forms is actually quite complex and multifactorial, but this can serve as a brief overview.) So, speaking about the differences between "fungal acne" and "bacterial acne" isn't the most accurate, however, for the purposes of this conversation we'll use the terms to help differentiate between the two.

Marcus notes that tight clothing can lead to a fungal acne breakout as well. Especially if the clothing is damp, be it from rain, sweat, or something else, the chance of encouraging fungal growth increases.

Speaking of: skipping a shower post workout or when you've recently sweat a lot. This can cause other forms of folliculitis (yeast likes sweat) and may contribute to acne as well—so it's best to prioritize your rinse for more reasons than one. If you find yourself struggling with fungal acne, showering after each workout will help reduce the risk of it getting worse.

Some people will use dandruff shampoo on an area affected by fungal acne—this is because these products generally contain zinc pyrithione—like this First Aid Beauty Anti-Dandruff Shampoo — as well as selenium sulfide. These can help deal with yeast overgrowth.

In addition, Fishman notes the use of ketoconazole, which is another common ingredient in anti-fungal shampoos.

Fungi, yeast, bacteria, and viruses are all a natural and needed part of your skin microbiome. Problems arise when the balance becomes out of whack and certain strains overpower the rest. For example, acne is triggered by an imbalance of specific strains of C. Acnes. And fungal acne is an imbalance of Malassezia furfur.

Remember how we mentioned that fungal acne can appear after antibiotic use and that it’s associated with dysbiosis of the microbiome? Fishman notes that she recommends to patients to incorporate a probiotic supplement into their routine to help manage fungal acne. Here’s our favorite probiotic supplements.

As with many forms of breakouts and folliculitis, finding products that work for you, in part, calls for removing those that won't. Overly harsh or irritating products should be avoided if you're actively struggling with a fungal acne breakout.

"Avoid granular scrubs, which may further irritate and inflame follicles, worsening folliculitis," Marcus explains. If you use chemical exfoliants or retinol, it's best to minimize your use if you find them irritating during a breakout.

While fungal acne may look like a normal breakout, it's actually not pimples at all. Fungal acne is a type of folliculitis caused by trapped yeast in the hair follicles. This can be triggered by warm, humid air; wearing airtight wet clothing; skipping a shower; or a weakened immune system.