Learn all about fungal acne, and how to prevent and get rid of those itchy red bumps.
Ever struggled with small, red pimples that won’t seem to go away, no matter what you do? Unsure why your zits seem to be itching all the time?
It can be frustrating to deal with acne that doesn’t improve despite all the treatments you’ve tried out. However, the reason you’re not getting better might be because you’re dealing with something entirely different than the acne you’re used to. For instance, the symptoms outlined above actually point to fungal acne, and not acne vulgaris.
But, it can be difficult to fully distinguish what is fungal acne, and what isn’t. Thankfully, you’re in the right place! In this article, we’ll discuss everything you need to know about fungal acne–its causes and common triggers, how to distinguish it from acne vulgaris, and even fungal acne-safe ingredients you can try out.
What is Fungal Acne?
Fungal acne, also called Malassezia folliculitis or Pityrosporum folliculitis, refers to a skin condition characterized by small pimples that appear in clusters on the face, back, chest, or arms, often accompanied by itching. This condition is caused by an infection of the skin’s hair follicles due to an overgrowth of yeast commonly present in the body.
Even though fungal acne seems to be a type of acne, it differs vastly from acne vulgaris which we’re more familiar with.
Rather than being caused by oil, bacteria, and dead skin cells, fungal acne is instead triggered when the natural balance of yeast, fungi, and bacteria present in the skin is upset. This is usually the case when moisture gets trapped after we sweat, causing yeast to thrive on the skin.
Despite the stark difference in their causes, fungal and bacterial acne are easily confused with. After all, both present as tiny red bumps on the skin, making it difficult to tell the two apart.
But, fret not! It’s quite easy to identify what is fungal acne and what’s acne vulgaris once you know their key characteristics.
Do I have fungal acne or acne vulgaris?
Aside from their causes, fungal acne and acne vulgaris also differ in terms of their appearance and location, and how they feel on the skin.
Here’s a short table to help you identify whether you have fungal acne or acne vulgaris:
|Acne Vulgaris||Fungal Acne|
|Causes||Sebum overproduction, which, combined with bacteria and/or dead skin cells, may clog and inflame hair follicles||Overgrowth of yeast in the body, causing an imbalance on the levels of yeast, fungi, and bacteria on the skin|
|Appearance||Varying types, such as whiteheads, blackheads, papules, and pustules||Same-size papules & pustules that appear in clusters|
|Feels Like||Rarely itches||Often itchy|
|Common Locations||Face||Face, arms, chest, and back|
If you’re still unsure whether you have fungal acne or not, here’s a quick quiz to help identify your symptoms and your likelihood of suffering from fungal acne.
Alternatively, you can consider doing a Wood lamp examination. This is a diagnostic method which utilizes blacklight to identify existing skin conditions via fluorescence—a colored glow emitted by substances in the skin as they absorb blacklight and re-emit it using a different wavelength in the visible spectrum.
Under blacklight, Malassezia folliculitis emits a bluish-white fluorescence from the hair follicles. On the other hand, acne vulgaris fluoresces as orange-red due to the bacteria Cutibacterium acnes inside the pores.
It is possible to have both fungal acne and acne vulgaris at the same time! This is especially true for those living in hot, humid conditions, where Malassezia tends to thrive and grow.
How to Get Rid of Fungal Acne?
Because fungal acne and acne vulgaris have different underlying causes, knowing which one you’re suffering from will help you identify the correct treatment. Using the same medication or skin care product for both conditions might aggravate them! An easy rule of thumb to remember is that the most effective treatments for fungal acne must target its root cause: fungal infection.
Here are a few things you can do to eliminate fungal acne:
Because yeast thrives in warm, moist environments, sweating excessively can boost Malassezia growth on the skin.
To address this, it’s best to shower immediately and change your clothes right after a workout or an activity that causes you to sweat. This way, you prevent yeast from further growing on your skin or on your sweaty clothes.
Wear loose, breathable fabrics
Tight clothes create friction on the skin, and also limit airflow for certain areas of the body. All of these factors encourage yeast growth, putting you at risk for fungal acne. This gets worse if you pair it with sweating while wearing such clothes. By wearing loose, breathable fabrics, you encourage air circulation in the skin, avoiding yeast overgrowth.
Since dandruff can also be caused by malassezia, anti-dandruff shampoos are normally formulated with anti-fungal ingredients such as pyrithione zinc. Using anti-dandruff shampoo in place of your regular body wash can help control your fungal acne breakouts. Alternatively, using this on the body once a week can help prevent yeast overgrowth, and ensure a healthy balance of yeast and bacteria on the skin.
OTC anti-fungal treatments
Ketoconazole or clotrimazole creams are available over-the-counter for fighting common fungal infections such as athlete’s foot or jock itch. These treatments may also be effective in combating fungal acne, which is caused by the fungus Malassezia.
Consult a dermatologist
If nothing else works, consider consulting a dermatologist. To treat fungal acne, they may also give you prescription medication, such as itraconazole or fluconazole, which targets the hair follicles directly and eliminates the fungal infection.
Common Fungal Acne Triggers to Avoid
Unfortunately, fungal acne is typically triggered by a lot of ingredients commonly found in skincare products. If you unknowingly apply one containing these ingredients, your breakouts might get worse.
Here are some key fungal acne triggers to avoid:
Fatty acids and oils (carbon chain 11-24)
Multiple studies have shown that the Malassezia fungus feeds on fatty acids—particularly those with carbon chain lengths of 11-24. Most oils contain fatty acids, too, and can thus end up becoming food for Malassezia, as the fungus can break down the fatty acids present in oils. An exception to this rule would be mineral oils, which do not have fatty acids.
Unfortunately, most skincare products contain fatty acids. The most common ones include: lauric, palmitic, stearic, oleic, and linoleic acid. Therefore, make it a habit to scour the ingredients list. If you’re not sure if a product is fungal acne-safe, you may consult this ingredient list checker, which specifies if a product is fungal-acne safe.
Esters are also common ingredients for skincare products—usually as a combination of a fatty acid with alcohol or glycerol. Just like with oils, Malassezia can break down, or hydrolyze, esters into their fatty acid and alcohol or glycerin components. Hence, it can use these fatty acids, especially if they are within the C11 to C24 range, as a food source to further grow.
For reference, esters are easily identifiable in ingredient lists, as they typically end in -ate (e.g., isopropyl palmitate, glyceryl stearate, etc).
Polysorbates are another kind of ester, which harms the skin the same way—two strains of Malassezia, namely Malassezia furfur and Malasezzia sympodialis, use polysorbates as food. That’s because these compounds also start as fatty acids, before they get turned into an ester in a process known as esterification.
Fermented skin care products
Galactomyces, a byproduct of fermented sake, and a nutrient-dense yeast known for its moisturizing and antioxidant properties, is a common ingredient in skincare products. This yeast ferment, however, is found to drastically increase activity of the aryl hydrocarbon receptor (AhR)—the same receptor that Malassezia increases the activity of. Overactivity on this receptor is also linked to different skin diseases.
Coconut oil has often been recommended for fungal acne because of its antifungal properties. Sadly, it can actually aggravate this condition. Coconut oil’s fatty composition consists of 48% lauric acid—a fatty acid with a carbon chain length of 12, and a good source of food for Malassezia.
Fungal-acne Safe Ingredients
The good news is, having fungal acne doesn’t mean you can’t use skincare products at all! After all, not everything is bad for fungal acne. There are non-comedogenic oils and other hydrating ingredients that you can check out in place of your typical oils and esters.
Mineral oils have no fatty acids, meaning they shouldn’t contribute to the growth of Malassezia in the skin. It’s also fragrance-free, making it great for sensitive skin types!
Squalane is a shelf-stable compound derived from squalene via hydrogenation. This product is non-irritating, protects the skin against sun damage, and has hydrating and moisturizing properties. Best of all, it has a carbon chain length of 30, which means it’s not the kind of fatty acid Malassezia usually feeds on.
Propolis is known for its healing and anti-inflammatory properties, which are also great at alleviating the redness that occurs with fungal acne. It’s also known to be a great moisturizing and hydrating ingredient.
When we talk about urea, we usually think about urine. But, that’s not all it is! Urea is a primary component of the skin’s natural moisturizing factor. It helps to maintain adequate skin hydration by keeping the skin’s moisture barrier strong.
Additionally, urea used in skincare products are made in the laboratory, and has historically been used in medicine to promote skin rehydration. This is because urea is a great humectant—it pulls water into the skin, and holds it there to keep it supple and hydrated.
The skin is prone to different kinds of conditions, and these conditions require different kinds of treatments. Although some skin problems may look the same, such as acne vulgaris and fungal acne, they vary in their underlying causes and therefore differ as well in their cure. The key is learning how to determine what exactly it is you’re dealing with, so that you know what exactly to avoid and what to do.
In the case of fungal acne, we hope we’ve explained enough just what triggers it and what alleviates it. Hopefully, this helps you with your journey towards even healthier skin.
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