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 that is a normal inhabitant of the skin," says Dr. Tony Nakhla, a board-certified dermatologist and founder of Eighth Day.
How can I spot the difference? The regular, run-of-the-mill kind "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 itch, it’s most likely fungal.
And how is treatment different? Treatment for regular acne usually involves killing off the bacteria on your skin that causes it (e.g., a topical benzoyl peroxide). "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, he recommends looking for products with probiotics to help balance the skin's pH and restore the skin's natural microflora. And if the condition doesn’t improve within a month, your dermatologist can prescribe an oral anti-fungal medication.