What looks like acne, feels like acne, but isn’t actually acne at all? That would be pityrosporum folliculitis—or fungal "acne," as it’s more commonly called (which, btw, only adds to the confusion).
Whereas traditional pimples are caused by bacteria, "fungal acne is caused by a proliferation of a yeast called Malassezia that is a normal inhabitant of the skin," says Dr. Tony Nakhla, a board-certified dermatologist and founder of Eighth Day.
Dr. Tony Nakhla is a board-certified dermatologist based in Newport Beach, California and the founder of Eighth Day. Dr. Nakhla is a leading authority in skin cancer treatment, Mohs micrographic reconstructive surgery and wound healing. He's also a member of the American Academy of Dermatology, the American Society for Dermatologic Surgery, the American Society for Mohs Surgery, the American Osteopathic College of Dermatology and the American Osteopathic Association, and the author of numerous articles and studies in peer-reviewed journals.
The regular, run-of-the-mill kind of acne "tends to occur in the T-zone of the face, as well as the cheeks and jawline," says Nakhla. The fungal variety "usually appears on the upper chest and upper back and sometimes along the hairline." Another clue? If the bumps are fairly uniform in size and color, and they're itchy, it’s most likely fungal.
Since fungal acne results from an overgrowth of the Malassezia yeast on your skin, the most common causes for it are from lifestyle factors like overheating, sweating and/or keeping your skin in poorly ventilated conditions for too long (i.e., staying in a sweaty sports bra long after your workout).
Also, it's worth noting that some people are genetically predisposed to overgrowths of Malassezia yeast and can experience fungal acne more frequently.
Treatment for regular acne usually involves killing off the bacteria on your skin that causes it (e.g., applying a topical benzoyl peroxide) or regularly exfoliating dead skin cells and reducing surface oils that can lead to breakouts (e.g., using a glycolic, salicylic or lactic acid).
Since the root causes for regular breakouts and fungal acne are different, the treatment should be different as well. In fact, "Using the same products on fungal acne can actually make things worse by also killing the normal bacteria that live on your skin and allowing the yeast to overgrow even more," warns Nakhla.
Instead, if your fungal acne is on the milder side, you can try using an over-the-counter antifungal cream or a dandruff shampoo that has zinc pyrithione, selenium sulfide or ketoconazole in it.
If the condition doesn’t improve within a few weeks, see a board-certified dermatologist who can prescribe an oral or topical anti-fungal medication.
You know the saying an ounce of prevention is worth a pound of cure? This applies here. A few simple things you can do to prevent future fungal breakouts from happening include:
