What Is Fungal Acne—and How Do You Get Rid of It?

We asked dermatologists to share the best treatment and prevention tips.

Do you have a stubborn breakout on your chest, arms, or back that just won't give in to acne medication? You may have fungal acne (don't worry, it's not as gross as it sounds). The good news is that fungal acne isn't hard to treat—once you know what you're dealing with.

What Is Fungal Acne?

Interestingly, fungal acne is a misnomer: It's not caused by fungus, and it's not even considered acne. "The condition we call fungal acne is actually malassezia folliculitis (infection of the hair follicle), which is triggered by a yeast that inflames the hair follicles in your skin and products pimple-like bumps," says Hadley King, MD, a board-certified dermatologist in New York City. It's totally normal for this type of yeast to live on your skin, but an overgrowth of it can lead to outbreaks, especially during the changing seasons.

Here's where the hard part comes in. Because fungal acne isn't actually acne, no acne medication will make it go away. This makes it even more important to differentiate between the two types of acne.

How Do I Know If My Acne Is Fungal?

While fungal acne can look like your regular run-of-the-mill blemish, there are some notable giveaways. "Regular acne breakouts usually appear on the face and can vary in size and shape—there are both whiteheads and blackheads," says Dr. King. "Fungal acne breakouts, on the other hand, are more monomorphic and appear in clusters—they look like uniform red bumps and small pustules on the chest, upper arms, back, and rarely the face. And perhaps most noticeably, fungal outbreaks are usually very itchy."

woman in shower with fungal acne on back
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Causes of Fungal Acne

So why does fungal acne happen? As with regular acne, it could be a lot of things that cause it to happen, Dr. King says. Some of the most common causes of fungal acne include:

  • Medications Certain medicines could upset your body's bacterial balance enough to cause fungal acne. "For example, antibiotics, used either systemically or topically, can deplete bacteria on your skin and the yeast can then grow unchecked, leading to fungal acne," says Dr. King.
  • Wearing tight, sweaty clothing Wearing tight, non-breathable clothing (or worse, sweaty clothing) creates a moist environment for yeast to flourish.
  • Genetics Blame your parents and grandparents if you're regularly developing fungal acne. Some people are just genetically predisposed to overgrowths of yeast and experience fungal acne more frequently.
  • Chronic medical conditions Conditions that affect your immune system, like diabetes and HIV, can also leave you more vulnerable to fungal acne.

How to Treat Fungal Acne

Fungal acne typically does not respond to traditional acne medications, but it can be improved with the use of topical antifungals, says Joshua Zeichner, MD, a board-certified dermatologist in New York City. "If you suspect you have fungal acne, try using a dandruff shampoo as a body wash. These contain anti-fungal ingredients like pyrithione zinc or selenium sulfide, which help balance your skin's pH levels and decrease yeast on the skin." Both he and Dr. King suggest Dove Dermacare Scalp Dryness and Itch Relief Anti-Dandruff Shampoo ($5; amazon.com) for sensitive skin types. With any product, the key is to let the product sit on your skin (Dr. Zeichner recommends singing the alphabet as a good measure) before rinsing off.

Other similar products containing active ingredients might also do the trick. "Look for an antifungal cream with econazole nitrate, ketoconazole, or clotrimazole, and apply it to the affected area twice daily," says Dr. King. "Don't use topical or systemic antibiotics. This can deplete bacteria on the skin and allow yeast to grow unchecked."

If these treatments are not working, see your board-certified dermatologist, who can confirm the diagnosis, and if needed, prescribe an oral antifungal medication. "This prescription will usually work much faster because it penetrates more effectively into the follicle," says Dr. King.

How to Prevent Fungal Acne

Unfortunately, there's always a risk of recurrence with fungal acne after it's treated. Although there's no surefire way to prevent it, there are methods to keep breakouts at bay. For one, heavy moisturizers and oils can make fungal acne worse by creating a moist environment that allows yeast to grow. Opt for lighter, oil-free, and non-comedogenic body moisturizers that absorb quickly into skin.

Dr. King also recommends wearing loose-fitting, breathable clothing and showering immediately after a workout. "While there's no need to actively treat fungal acne once your system has recovered, you can still use dandruff shampoo in lieu of normal body wash once a week as a preventative measure," she adds.

Frequently Asked Questions

  • Is fungal acne contagious?

    Yeast can spread through close contact, so you may be able to spread the microorganisms that are causing your fungal acne outbreak that way.

  • What are some of the best products for fungal acne?

    Washing affected areas with over-the-counter dandruff shampoos that contain pyrithione zinc or selenium sulfide can be an easy way to try to treat your fungal acne. You can also try anti-fungal creams that contain econazole nitrate, ketoconazole, or clotrimazole to clear up the spots. If those don't work, get in touch with a dermatologist for a diagnosis—and a potential prescription oral anti-fungal.

  • Are there any home remedies for fungal acne?

    One potential home remedy to explore (beyond the dandruff shampoos) is apple cider vinegar, which has some antibacterial and antifungal properties. (Just apply the ACV diluted in water, as pure vinegar can be too harsh for your skin.)

  • What are the most common areas to get fungal acne breakouts?

    You're most likely to see fungal acne breakouts on the chest, upper arms, and back. It's rarer to see fungal acne on your face.

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