Fungal Acne Treatment
Blemishes that appear on our faces and bodies can make us feel self-conscious, and fungal acne is no exception. Characterized by small, itchy pimples, fungal acne is caused by an infection in the hair follicles due to an overproduction or imbalance of yeast on the skin. When left untreated or inappropriately treated, fungal acne can persist, cause discomfort, and remain a source of frustration regarding the appearance of the affected area. Diagnosing fungal acne, as opposed to regular acne vulgaris, is essential for effective treatment, as conventional acne medications do not work on fungal acne and can even exacerbate the condition. Dr. Michele Green in NYC has over 25 years of experience treating patients with different types of acne breakouts and can accurately diagnose your fungal acne while recommending appropriate treatment.
As a name, fungal acne can be deceiving. While it can often appear similar to regular acne, fungal acne has a different cause and, therefore, requires different treatment. Fungal acne occurs due to an overgrowth of Malassezia yeast on the skin’s surface. Its development can be accelerated by moist, warm environments and poor hygiene practices, such as excessive sweating or not rinsing the skin promptly after working out. The most effective treatments for fungal acne include antifungal creams, shampoos, and oral medications that work to control and inhibit yeast growth. When you consult with Dr. Green, she will first diagnose your fungal acne and create a customized treatment plan aimed at helping you eliminate it and achieve clear, radiant skin.
Board-certified dermatologist Dr. Michele Green in NYC has more than two and a half decades of experience treating all types of acne, including fungal acne. Dr. Green is recognized as one of the best dermatologists in New York by Castle Connolly, Super Doctors, New York Magazine, and The New York Times due to her expertise and dedication to her patients. She specializes in acne treatment, customizing each patient’s treatment plan to address their specific skin concerns and needs. If you are struggling with fungal acne breakouts and are ready to eliminate them for good, Dr. Green is here to help.
What is Fungal Acne?
Fungal acne, also known as Pityrosporum folliculitis or Malassezia folliculitis, is a condition characterized by an overgrowth of yeast on the skin, which can lead to folliculitis- an infection in the tiny hair follicles. This infection results in small lesions or red bumps that resemble regular acne. Fungal acne can occur anywhere on the body but is most commonly seen on the chin, forehead, hairline, sides of the nose, arms, upper back, and shoulders. Although anyone can develop fungal acne, it is most prevalent among young adults, particularly those with oily skin, where yeast tends to thrive.
Fungal acne appears as clusters of uniform bumps or papules that are often itchy. It resembles regular acne but is distinctly different. Bacterial acne primarily results from clogged pores due to oil and dead skin cells, while a yeast infection in the pores causes fungal acne. Additionally, whereas traditional acne can manifest as comedones (blackheads and whiteheads), pustules, or cysts, fungal acne typically does not. Treating fungal acne with products meant for bacterial acne can exacerbate the infection. Therefore, it is crucial to have fungal acne diagnosed by an expert dermatologist, such as Dr. Michele Green in New York City.
What are the main causes of fungal acne?
Fungal acne results from an overgrowth of yeast on the skin. This yeast, known as Malassezia, is naturally present on your skin alongside various types of bacteria. Under normal circumstances, yeast and bacteria maintain a balance on the skin. However, if yeast growth surpasses the bacteria or if the bacteria are reduced (for instance, due to antibiotic use), folliculitis- a hair follicle infection- can occur, leading to fungal acne. Malassezia yeast proliferation is enhanced in warm, moist environments, which is one of several risk factors contributing to the onset of fungal acne. Additionally, the yeast on your skin feeds on the oils and sebum produced, making fungal acne more prevalent on oily skin or in areas with high oil production.
What are the risk factors for developing fungal acne?
Many risk factors can lead to the development of fungal acne. Patients living in hot, humid climates are at higher risk for developing fungal acne, as yeast is more likely to thrive in warm, moist environments. One study indicated that fungal acne was significantly more common in the Philippines than in the United States due to the warm and humid climate. Similarly, yeast can overgrow in areas where moisture is trapped. Patients who sweat excessively, wear tight clothing, or remain in sweaty garments for extended periods are also at increased risk of developing fungal acne. Additionally, wearing masks is another risk factor for fungal acne. While wearing a mask is crucial to reduce the spread of COVID-19 and other contagious diseases, it can create a moist environment that contributes to fungal acne along the lower face.
Fungal acne can be a side effect of certain medications. For instance, oral antibiotics are prescribed to eliminate the bacteria that cause illness, but they can also eradicate the “good” bacteria on your skin. When this beneficial bacteria is diminished, it creates an imbalance between the bacteria and yeast on your skin, which can heighten the risk of developing Malassezia (pityrosporum) folliculitis. Diet also plays a significant role in the development of fungal acne. Yeast and fungi thrive on carbohydrates and sugars to survive. Patients face a higher risk of developing fungal acne if their diets are high in sugars and carbohydrate-rich foods, such as sugary breakfast cereals, soda, baked goods, and fruit juice. Lastly, the risk of developing fungal acne increases if you have an immunosuppressed or weakened immune system. If you are immunodeficient, it means that your body has a reduced ability to combat various infections, including fungal infections, and is at risk for developing fungal acne.
How to tell the difference between fungal and bacterial acne
Fungal and bacterial acne on the skin can be difficult to distinguish for an untrained eye. Nevertheless, some characteristics can help differentiate the two. Fungal acne usually appears clustered in one specific area of the face but can also develop on the chest, arms, shoulders, upper arms, and upper back. In contrast, bacterial acne typically appears randomly across the face and does not usually develop in other body areas. Additionally, fungal acne is often pruritic or itchy, which is not commonly the case with bacterial acne. Ultimately, the best way to distinguish between bacterial and fungal acne is to have a culture performed by a board-certified dermatologist like Dr. Green. Cultures are painless and involve sending a small sample of the acne lesion to a laboratory for further testing. There, the sample will be cultured to determine whether a fungal or bacterial infection causes the acne.
How do I know if my acne is fungal?
It appears that many patients initially mistake the spots for typical acne, which is caused by clogged pores filled with oil and dead skin cells. However, it is crucial to differentiate between typical acne and fungal acne, as the treatments for each are significantly different. While typical acne can often be treated with a salicylic acid cleanser, merely clearing and exfoliating the pores is usually not enough to treat fungal acne. If you are experiencing an acne breakout and are uncertain whether it is fungal, consult board-certified dermatologist Dr. Green. She will evaluate your medical history and likely order blood tests and a fungus or bacterial culture to identify the type of acne you have. In rare instances, a biopsy of the area may be performed and sent to a laboratory for further analysis. Once a diagnosis is confirmed, she can prescribe topical or oral medications best suited to address your acne breakouts.
How do you get rid of fungal acne breakouts?
There are several effective treatment options for fungal acne, including topical antifungal creams and oral medications. If you suspect that the pimples on your face are fungal acne, you can schedule a consultation with Dr. Green. During your appointment, she will assess your medical history and may order blood work and cultures to confirm a diagnosis. She will then prescribe the best products to treat your fungal acne. It is essential to obtain a proper diagnosis of fungal acne, as treating it like a typical acne breakout with regular acne medication can actually worsen your fungal acne. The following are common treatment options for fungal acne prescribed by board-certified dermatologist Michele Green in her private NYC dermatology practice office:
Acne treatments – 8 months
Ketoconazole cream
Ketoconazole is an antifungal that has proven very effective in alleviating the symptoms of fungal acne. A 2020 study comparing patients using a 2% Ketoconazole cream with those who received a placebo to treat their fungal acne found that nearly 50% of the participants using the Ketoconazole cream experienced an improvement in their condition. In addition to the 2% cream, it is also available as a shampoo, commonly known as Nizoral, which can be applied to the body as directed daily.
Nizoral shampoo
Nizoral shampoo is an antifungal dandruff shampoo that can also help reduce fungal acne when applied to the skin. It can be used as a body wash in the shower every other day to treat active fungal acne. Once the skin condition clears up, you may follow the same procedure with the shampoo once a week to prevent fungal acne from recurring and maintain healthy, clear skin. Ketoconazole is an effective topical treatment for eliminating fungal acne while remaining gentle on the skin. The treatment can also be combined with prescription oral medication for additional support if necessary.
Oral medications to treat fungal acne
Fluconazole and Itraconazole are two oral prescription medications used to treat fungal and yeast infections. They are generally prescribed when topical medications have not fully eliminated fungal acne. To effectively treat fungal acne breakouts, Fluconazole and Itraconazole are often paired with a topical antifungal cream, such as Ketoconazole or Clotrimazole. Monthly blood tests are needed to monitor liver enzymes while patients take this oral anti-fungal medication.
Can over-the-counter skin care products for regular acne treat fungal acne?
No, fungal acne is very different from regular bacterial acne and does not respond the same way to typical acne-fighting ingredients like benzoyl peroxide or salicylic acid. Therefore, it is important to treat fungal acne with products specifically formulated for fungal or yeast infections. These products range from topical creams applied to the skin, such as Ketoconazole or Clotrimazole cream, to dandruff shampoos like Nizoral and oral medications like Fluconazole. Still, a proper skincare routine is essential to ensure that fungal acne breakouts are not worsened. Patients should seek out oil-free skincare products, as those with high oil content can further encourage the growth of fungal acne.
A gentle cleanser should be used twice daily to remove sweat buildup, excess oil, and dead skin cells from the skin’s surface. Dr. Green’s proprietary skincare line, MGSKINLABs, offers a lipid-free Gentle Cleanser designed to cleanse the skin without stripping it of its natural oils. Using a moisturizer is essential for keeping the skin hydrated and reducing irritation. The Ultimately Sheer Hydrating Lotion is oil-free and contains targeted ingredients to reduce sebum on the skin.
How to manage fungal acne at home
There are several habits you can adopt at home to lower the chances of developing fungal acne. The first key factor in preventing fungal acne is maintaining good hygiene. By showering more frequently and promptly changing out of sweaty clothes after a workout, you minimize your exposure to the damp environment in which yeast flourishes. During your shower, you can use Nizoral dandruff shampoo to help decrease the amount of yeast on your skin. Other dandruff shampoos that contain selenium sulfide or are designed for treating seborrheic dermatitis can work in a similar way. When shaving or waxing, it’s crucial to cleanse and hydrate the area to avoid skin irritation, as this can create an opportunity for yeast overgrowth and fungal acne. Additionally, wearing loose clothing while exercising and opting for a breathable cotton face mask can be beneficial.
Changing your diet can help reduce fungal acne since yeast and fungi thrive on carbohydrates and sugars. While many foods contain carbohydrates, it’s essential to focus on complex carbohydrates instead of simple ones (those high in sugar). Limit your consumption of high-sugar breakfast cereals, sodas, baked goods, and fruit juices while incorporating more fruits, vegetables, legumes, and whole grains. Although these lifestyle changes can aid in reducing fungal acne, the most effective treatments remain topical and oral antifungal medications. If you suspect you have fungal acne, consult with a board-certified dermatologist like Dr. Green for an accurate diagnosis and treatment plan.
Laser treatment for acne – before and after
FAQs about Fungal Acne
What are the causes of fungal acne?
The primary cause of fungal acne is an overgrowth of yeast on the skin’s surface. Fungal acne often develops in warm, moist environments where yeast thrives. It can also arise due to poor hygiene practices, such as wearing sweaty clothes long after a workout, reusing sweaty attire, and donning tight, non-breathable fabrics. Additionally, fungal acne may occur as a side effect of antibiotics, which can alter the balance of yeast and bacteria on the skin.
What can be mistaken for fungal acne?
Fungal acne is often mistaken for regular or bacterial acne. Both types present as clusters of small red bumps and can occur in the same body areas. However, it is essential to differentiate between the two, as treatment options vary. Fungal acne is caused by an overgrowth of Malassezia yeast on the skin. Typically, yeast and bacteria levels on the skin balance each other. When yeast overproduces or bacteria levels drop, folliculitis, or infection of the hair follicles, can develop, resulting in fungal acne. Regular acne occurs when pores become clogged with dead skin cells, excess oil, and other impurities. Inflammatory acne lesions, such as cysts or nodules, can form when bacteria get trapped in the pores. A board-certified dermatologist like Dr. Green can assess your medical history and take a culture from your breakout to determine if it is fungal or bacterial.
How to tell the difference between hormonal and fungal acne
Hormonal acne results from an overproduction of sebum, or oil, from the skin’s sebaceous glands. When excess sebum becomes trapped in the pores along with dead skin cells, dirt, and bacteria, acne lesions can develop. Hormonal acne arises from fluctuations in testosterone, estrogen, and progesterone, which can increase sebum production. While hormonal acne is common during puberty, individuals of all ages can experience it. In contrast, fungal acne is caused by an overgrowth of Malassezia yeast on the skin. Fungal acne does not result from excessive sebum production, though excess oil on the skin can worsen existing fungal acne. To distinguish between hormonal and fungal acne, a dermatologist typically orders bloodwork to check for hormonal irregularities and a culture to identify any underlying bacterial or fungal infections.
How to know if folliculitis is bacterial or fungal
Many patients often wonder, “How do you tell if a skin infection is fungal or bacterial?” The easiest way to determine the cause of a skin infection or folliculitis is to consult with a board-certified dermatologist like Dr. Michele Green in New York City. When you consult with Dr. Green in her private Upper East Side dermatology clinic, she will first assess your medical history, past treatments, and current skin condition. She will then take a culture of the infection and send it to a laboratory for testing. There, the sample will be grown out and analyzed to determine if the infection is fungal or bacterial. Dr. Green will then be able to formulate a treatment plan designed to treat and eliminate your infection.
How long does it take for fungal acne to go away?
The time it takes to treat fungal acne depends on the severity of the outbreak. Typically, most treatments take two to three weeks to be completely effective. Dr. Green recommends completing the full course of your prescribed treatment, even if your fungal acne seems to clear before the end of your treatment period.
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. She will also recommend lifestyle changes to help you reduce the risk of developing fungal acne again.
Is benzoyl peroxide good for fungal acne?
When treating fungal acne, it is important to address the overgrowth of Malassezia yeast on the skin in order to reduce the outbreak. Benzoyl peroxide is an antibacterial treatment and is not typically prescribed to address the overgrowth of yeast on the skin. However, benzoyl peroxide can help unclog the pores and exfoliate the skin cells, reducing the amount of sebum, or oil, on the surface of the skin. The yeast responsible for fungal acne feeds off of excess oil on the skin, so exfoliating the skin and reducing the amount of oil in the affected area, as well as benzoyl peroxide, can be useful. If you are wondering about what products will work best to address your fungal acne, it is best to consult a board-certified dermatologist, such as Dr. Michele Green in New York City.
Does salicylic acid remove fungal acne?
Salicylic acid is a beta-hydroxy acid that gently exfoliates the skin, removing dead skin cells, excess sebum, and other impurities from clogged pores. While it is an excellent product for treating typical acne, it is not intended for fungal acne, as it does not reduce yeast production on the skin.
Which shampoo is good for fungal acne?
Dandruff shampoos are highly effective in treating fungal acne on the body due to their antifungal properties. Nizoral shampoo contains ketoconazole to disrupt and prevent yeast growth. Selsun Blue shampoo contains selenium sulfide, which produces pentathionic acid, which kills and eliminates yeast. Dandruff shampoos containing zinc pyrithione also inhibit yeast growth on the skin. These shampoos can be used as a body wash to control yeast production in areas affected by fungal acne.
How to treat pityrosporum folliculitis on the arms and back
Fungal acne, also known as pityrosporum folliculitis, can appear in many areas of the body, including the arms and back. Often, the primary cause of fungal acne breakouts in these areas is moisture trapped on the skin. Patients who remain in sweaty clothes after a workout or wear tight clothing in hot, humid environments may have a higher risk of developing fungal acne on their backs and arms. It is important to shower regularly, change out of sweaty clothes immediately after exercising, and wear loose, breathable clothing to prevent moisture from becoming trapped on the skin and promoting yeast production. To treat fungal acne, there are several options, including topical antifungal creams containing ketoconazole or clotrimazole, Nizoral or anti-dandruff shampoos, and oral antifungal medications like Fluconazole. When you consult with Dr. Green, she will assess your specific skin concerns and develop a treatment plan tailored to reduce and eliminate your fungal acne.
Can you pop fungal acne?
No, you should never pop a fungal acne lesion. Doing so can introduce bacteria into the area, leading to increased inflammation and irritation. It can also spread the infection to other areas and worsen the breakout. Additionally, popping or squeezing a lesion can cause permanent damage to the underlying tissue and result in scarring. If you are experiencing fungal acne, it is best to consult with board-certified dermatologist Dr. Green, who can eliminate your acne with targeted antifungal treatments and help you achieve clear, radiant skin.
How can I get rid of fungal acne?
Fungal acne is a skin condition characterized by an overgrowth of Malassezia yeast on the skin. The first step in addressing fungal acne is to consult with a board-certified dermatologist, like Dr. Michele Green in New York City, who can accurately diagnose your condition and recommend suitable treatment options. Antifungal creams such as Ketoconazole and Clotrimazole are effective in reducing yeast production on the skin. Nizoral and other anti-dandruff shampoos are particularly helpful for eliminating fungal acne on the body. For severe cases, oral medications like Fluconazole or Itraconazole may be prescribed. If you suspect you are experiencing an outbreak of fungal acne, consult with Dr. Green today.
Dr. Michele Green is a world-renowned, board-certified dermatologist who has been treating her patients for over two and a half decades for various cosmetic and medical concerns, including fungal acne breakouts. She is consistently recognized as one of NYC’s top dermatologists by publications such as Castle Connolly, Super Doctors, New York Magazine, and The New York Times. When you meet with Dr. Green, she will assess your skin, provide an accurate diagnosis of your acne breakout, and develop a tailored treatment plan to maintain your skin’s health and beauty. Please call us at 212-535-3088 or email our New York City office today to schedule a consultation with Dr. Michele Green and begin your fungal acne treatment.