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Blemishes that appear on our faces and across our body can make us feel self conscious and fungal acne is no exception. Characterized by small, itchy pimples, fungal acne is caused by infection in the hair follicles as a result of the naturally occurring yeast on our body overpowering the bacteria on the skin. When left untreated or when treated improperly, fungal acne can persist and cause discomfort and be a lingering source of frustration in appearance. Diagnosing fungal acne from regular acne vulgaris is the key to the right treatment. Dr. Michele Green has been an expert in the treatment of acne vulgaris, fungal acne, acne scarring, and the best acne treatments, for over 25 years in NYC.

As a name, fungal acne can be deceiving. While fungal acne can often have a similar appearance to acne vulgaris – whiteheads, blackheads, or pustules that are extremely common throughout puberty as hormones change – fungal acne has a different cause and therefore requires different treatment. When patients develop fungal acne, they often mistake if for acne vulgaris and try to treat it as such. But conventional acne treatments do not work on fungal acne and can actually make the condition worse. While there are many dermatology treatments available for fungal acne, it is important to receive the correct diagnosis from a dermatologist so your skin condition can be addressed effectively.

Board certified dermatologist, Dr. Michele Green in NYC, has over two decades of experience in treating all types of acne. Once the proper diagnosis of fungal acne is made by Dr. Green, she can prescribe the most effective topical creams or oral anti-fungal medications. Dr. Green is recognized as one of the best clinicians in NYC and is consistently voted as one of the best dermatologists in New York by Castle Connolly, Super Doctors, and New York Magazine. She is an expert in acne treatment, acne scar prevention, the best skincare, and acne scar treatments. If you are suffering from acne breakouts, Dr. Green is here to help.

What is Fungal Acne?

Fungal acne is a condition in which an overgrowth of yeast on the skin can lead to folliculitis, which is infection in the tiny hair follicles. This infection of the hair follicles leads to small lesions or red bumps. Fungal acne can appear anywhere on the body but occurs most commonly on the chin, forehead, side of the nose, arms, upper back, and shoulders. The condition is often also referred to as Pityrosporum folliculitis or Malassezia folliculitis, as it is an excess of Malassezia yeast that leads to the infection.

Fungal acne takes on the appearance of clusters of papules (spots) like whiteheads or blackheads that are uniform in size and often itchy. Fungal acne looks like regular acne but it is not the same. While bacterial acne is caused primarily by a clogging of the pores with oil and dead skin cells, fungal acne is a caused by a yeast infection in the pores. If patients treat fungal acne with bacterial acne care products, there is the potential to make the infection worse. That is why it is paramount to have fungal acne diagnosed by an expert dermatologist, such as Dr. Michele Green in New York.

What are the causes of fungal acne?

Fungal acne is caused by yeast overgrowth on the skin. This yeast (Malassezia yeast) is always present on your skin along with many different varieties of bacteria. Normally, the yeast and the bacteria balance each other out in the skin. However, if yeast growth exceeds the amount of the bacteria on the skin or the bacteria is somehow diminished (as a result of taking an antibacterial, for example), folliculitis, an infection of the hair follicles, can develop, leading to fungal acne. Malassezia yeast growth is accelerated in warm, moist environments, which is another of the many risk factors that can contribute to the development of fungal acne. The yeast on your skin also feeds off of the oil and sebum produced on your skin, meaning that fungal acne is also more likely to occur on oily skin or in places where oil production on your skin is high.

MG 19 before after accutane acne 1 to 5months MGWatermark

Accutane for Acne – 5 months

What are the risk factors for developing fungal acne?

There are many risk factors that can lead to the development of fungal acne and habits that are relatively easily avoidable. One condition under which fungal acne is apt to develop is being in a warm, moist environment. Yeast is more likely to grow in hot, humid climates where people sweat more. One research study showed, for example, that fungal acne was much more common in the Philippines than in United States as a result of the warm and humid climate there. Similarly, the overgrowth of yeast is stimulated where there is trapped moisture. This can occur if you stay in sweaty clothing for a long time after a workout or after being someplace hot. Wearing workout clothes again before you wash them can cause you to be exposed to fungi that may have grown on the clothing in the time between wearings. If you are working out or spending time someplace warm, it would be better to wear loose clothing. Tight, unbreathable clothes have a higher tendency to trap moisture, which can lead to fungal growth if you are sweating.

Covid-19 masks are another moist environment that is a risk factor for the development of fungal acne and particularly common at this moment in time. Wearing a mask is so important to protect others from Covid-19 but if you are wearing an unbreathable type of mask, you may be at risk for developing fungal acne along your nose and on your chin. Single-use surgical masks and other cloth masks don’t always allow the moisture from your breath to escape, creating the moist environment that is ripe for yeast growth. You can avoid this by changing out your masks if you need to wear one for a long period of time, and/or purchasing masks made of a more breathable material, like cotton.

What is the best guide to acne treatments?

When you are dealing with an infection of fungal acne, it can be difficult to know what is the best treatment method. If you believe that you have an outbreak of fungal acne, you should schedule a consultation with a board-certified dermatologist, like Dr. Michele Green. Dr. Green will be able to assess the type of acne breakout and make the best recommendation for skin care  and an acne treatment plan. With a knowledge of the most effective treatment options, an expert dermatologist, such as Dr. Green, will be the best guide for determining the right treatment for you. Dr. Michele Green will help direct you to the best cleansers, exfoliating pads, moisturizers, or oral antibiotics, whether you have dry, combination, or oily skin.

Medications which cause fungal infections

Uncontrolled yeast growth, or an imbalance between the amount of yeast and bacteria that occur on your skin, can also be a side effect of certain medications. Oral antibiotics, for example, are prescribed to kill bacteria in your body that are making you sick. However, antibiotics can also kill the “good” bacteria that is serving a positive purpose, like the bacteria on your skin. When this “good” bacteria is reduced, there is an imbalance between the bacteria and the yeast on your skin which can lead to Malassezia (pityrosporum) folliculitis. Using skincare products that contain high amounts of oil, such as coconut oil, can further feed the growth of fungal acne and clog pores.

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Acne treatments – 8 months

Diet changes and fungal acne

Fungal acne can also occur as a result of a change in diet. Yeast and fungi consume carbohydrates and sugars. If your diet contains a high concentration of sugars and carbohydrate-rich foods, balancing your diet with foods that are richer in starch, protein, and fiber can help to slow yeast growth. There are carbohydrates in many of the foods we eat but it is important to feature complex carbohydrates in your diet rather than simple carbohydrates – or in other words, food that is high in sugar. Try to limit your intake in food such as high-sugar breakfast cereals, soda, baked goods, and fruit juice and try to incorporate more fruit, vegetables, legumes, and whole grains.

Contact with others & compromised immune system

Researchers believe that fungal acne can be contagious and that this infection can spread from person to person through physical contact. The risk of developing fungal acne also increases if you have a immunosuppressed or weakened immune system. If you are immunodeficient, it means that your body has a weakened ability to fight against a variety of infections such as bacterial, viral, or fungal infections. Having a weakened immune system is something you are born with or something that develops as a result of an illness or medication. With your body’s decreased ability to fight infection, you can be more at risk for developing fungal acne like since your immune system cannot fight this infection.   

How do I know if I have fungal acne?

When fungal acne appears, many patients initially believe that the spots are typical acne, which is caused by pores clogged with oil and dead skin cells. It is important, however, to differentiate between typical acne and fungal acne because the treatments for each are very different. While typically acne can be treated using a salicylic acid cleanser, clearing and exfoliating the pores is not typically sufficient to treat fungal acne. It is best to seek a diagnosis and prescription from a board-certified dermatologist, such as Dr. Green, as she will be able to provide you with the best course of action for treatment. If you are at home, trying to differentiate between the two kinds of acne, some key differences are as follows:

  • Location of pimples on the body – Where bacterial acne occurs primarily on the face, fungal acne can occur on the chest, arms, shoulders, and upper back as well. This is especially true if your fungal acne is caused by moisture trapped in sweaty clothing
  • Size – While regular acne spots are varying in size and shape, fungal acne appears in uniform clusters, where each pimple is generally the same size.
  • Clusters – Unlike typical acne, which can appear randomly across the face, fungal acne appears clustered in one specific area of the face.
  • Itching – Bacterial acne does not usually itch, unlike fungal acne, which is often pruritic.

Will fungal acne go away on its own?

Fungal acne will generally not go away on its own. Fungal acne is a yeast infection that occurs when there is an overgrowth of yeast on the skin, and leads to an infection in the hair follicles. Without treatment, fungal acne can take months to recede. With the proper diagnosis of fungal acne, Dr. Green can help treat this condition effectively and cure your fungal acne.

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Laser treatment for acne – before and after

Can to get rid of fungal acne?

Yes! If you are wondering how to cure fungal acne, the answer is that there are many excellent treatments that range from topical anti fungal creams to oral medications. If you suspect that the pimples on your face are fungal acne, you can make a consultation appointment with Dr. Green. At your appointment, Dr. Green will determine the best treatment plan to rid you of fungal acne. It is so important to properly diagnose your fungal acne, as treating fungal acne as you would a typical acne breakout with regular acne medication can actually make your fungal acne worse.

What is the best skin care to treat fungal acne?

If you are not familiar with fungal acne, you may mistake it for traditional acne and try to treat it at home using products made for traditional acne. Not only will products made specifically to treat acne vulgaris not be effective on fungal acne, they can actively make fungal acne worse. The first step to determining the best skin care for fungal acne is to make sure you have the right diagnosis. If you make an appointment with Dr. Green, she will easily be able to diagnose your fungal acne and create a treatment plan. It is important to treat fungal acne with the products specifically meant to treat fungal or yeast infections. Those products range from topical creams applied to the skin such as Nizoral or Clotrimazole cream, dandruff shampoos like Selsun Blue, or oral medication such as Fluconazole.

What products are good for fungal acne?

In order to properly treat fungal acne, you need to restore the balance between the yeast and the bacteria on your skin. Products that contain ketoconazole or fluconazole are very effective in reducing the amount of yeast on your skin and eliminating the infection of the hair follicles.


Ketoconazole is an anti fungal that can be prescribed as a topical cream or as a shampoo. It is an ingredient commonly found in the dandruff shampoo called Nizoral Shampoo. Ketoconazole has been shown to be very effective in reducing the symptoms of fungal acne. In a 2020 study which compared patients using a 2% ketoconazole cream to patients who received a placebo to treat their fungal acne, nearly 50% of the participants who used Ketoconazole cream saw an improvement in their condition. Ketoconazole is an excellent topical treatment in eliminating fungal acne while still being gentle on the skin. The treatment can be combined with prescription oral medication as well if additional treatment is necessary.

Oral Fluconazole to treat fungal acne

Fluconazole is a prescription oral medication that can be used to treat fungal and yeast infections. This oral medication is needed when topical medications have been ineffective in fully eliminating the fungal acne. Fluconazole is commonly paired with a ketoconazole topical cream. The treatment can be undertaken in one week – with a 100mg daily dose of the medication – or over the course of three weeks – with a 200mg daily dose.

How to use Nizoral® for fungal acne

Nizoral is a dandruff shampoo, which contains Ketoconazole – an anti fungal that works to reduce dandruff and, when applied to the skin, treats fungal acne. Dandruff also occurs as a result of the Malassazia yeast, which feeds off the oils found on the scalp. As such, the shampoo, when applied to fungal acne on the skin, can act as an effect anti fungal. You can easily incorporate Nizoral into your skincare routine to eliminate fungal acne as well as keep it from returning. When you have an active fungal acne infection, apply Nizoral to your skin as a body wash while you are in the shower every other day. After applying the shampoo, let it sit on your skin for at least 30 seconds before rinsing it off again. Once the skin condition clears up, you can use the same procedure with the shampoo once a week to prevent fungal acne from recurring and maintain healthy, clear skin.

How to treat fungal acne

When you are looking to treat your fungal acne, it is first imperative to get the correct diagnosis. If you have fungal acne, it cannot be treated with the tools in your medicine cabinet you have to treat regular acne. For that reason, it is important to get an expert opinion and medical advice from a board-certified dermatologist like Dr. Green. When you meet for your consultation appointment, she will be able to provide you with an official diagnosis for fungal acne and prescribe the best products for treating the skin condition.

How to cure fungal acne at home

There are several habits that you can change at home to reduce the likelihood of developing fungal acne. The first major factor in preventing fungal acne is improving hygiene. If you shower more regularly and remove sweaty clothes immediately after a work out, you are removing yourself from the moist environment in which yeast thrives. As a part of your shower, you can include washing your body with Nizoral dandruff shampoo – which can help reduce the amount of yeast on your body. It is also helpful adjust your clothing choices and wear loose clothing when you exercise and a more breathable, cotton, face mask. There are also over-the-counter anti fungal creams that are typically used to treat other fungal conditions like athlete’s foot that you can use easily at home to address fungal acne. It is important to look for creams that contain ketoconazole or clotrimazole.

How long does it take for fungal acne to go away?

The amount of time that it takes to cure fungal acne can depend on the severity of the outbreak. Typically, most treatments can take two to three weeks in order to be completely effective. It is important to complete the full course of your prescribed treatment, as is recommended by Dr. Green, even if your fungal acne seems to clear before the end of your treatment period.

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How to treat facial fungal acne

Facial acne can be treated with the same products and procedures as fungal acne that occurs on the rest of your body. To treat the condition, you can use prescription topical creams that you can apply to the effected area twice a day or oral medications that are best to treat more severe cases. It can also be helpful to shower more frequently, especially after intense physical activity, to wash away excess yeast that may have started growing on the skin.

How to control fungal acne

Fungal acne can be eliminated with the right treatment plan. It is important to remember that you need to control the environmental conditions which first lead to the outbreak of fungal acne, in order to prevent your condition from returning. In order to prevent fungal acne and keep these outbreaks in check, you can incorporate using a body wash with a dandruff shampoo such as Nizoral Shampoo or Selsun Blue. Dandruff shampoos contain Ketoconazole, which reduces the amount of yeast growing on the skin. These special shampoos help to maintain a balance between the bacteria and the yeast that live on your skin. It is best to use this Shampoo once or twice a week, when you shower. Simply apply the shampoo to your skin and leave it on for 30 seconds before rinsing it off. By incorporating this shampoo weekly into your skincare regime, this process should help to control and prevent future fungal acne.

If you are suffering from acne breakouts, and your current skincare products and treatments are not working, please consult with Dr. Michele Green in her private, discreet, New York City dermatology office. Dr. Green is an expert in the treatment of acne breakouts, acne vulgaris, and acne scarring for over two decades. With the best skin care from her MGSKINLABs line of products, and the most cutting edge lasers such as Fraxel® laser, Vbeam® laser, Clear + Brilliant®, Vivace®, and Thermage FLX®, Dr. Green will help you achieve beautiful, clear skin. To schedule a consultation contact Dr. Green online or call our New York City office at 212-535-3088 to learn more about about fungal acne treatments to keep your skin healthy and beautiful.

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