Fungal acne is a common skin infection in which hair follicles become infected by a fungus (yeast or mold) called Malassezia. Although Malassezia yeast is present in everyone’s skin, fungal acne occurs when there is an overgrowth of this yeast. Fungal acne is also known as Malassezia folliculitis and Pityrosporum folliculitis.

Risk factors for fungal acne include being a young adult male, living in hot and humid conditions, wearing tight clothes, using antibiotics, or having a weakened immune system.

Fungal acne breakouts are often confused with regular acne (acne vulgaris). This article will cover what fungal acne looks like, where it appears, and how to differentiate it from regular acne.

What Does Fungal Acne Look Like?

Fungal acne causes small pimples or itchy, red bumps called skin papules that form in clusters. They are uniform in size and appearance, but can sometimes become larger and form whiteheads (small flesh-colored bumps) or pustules (larger, inflamed, yellow or white pus-filled bumps). Each bump can have a red border or ring surrounding it.

Fungal acne can develop anywhere on the body, but commonly affects oily or sweaty areas of the body, such as:

Chin
Forehead
Neck
Chest
Shoulders
Upper arms
Upper back

Common Symptoms of Fungal Acne

Aside from the typical red bumps, symptoms can include skin itching, burning, and discomfort, which are not usually associated with regular acne.

Fungal Acne On The Face

Fungal acne on the face typically develops in clusters in oily or sweaty areas such as the upper forehead (hairline) and chin. The bumps are nearly all the same size.

Fungal Acne On The Forehead

Fungal acne on the forehead typically consists of clusters or rows of small, uniform, red or pink bumps that resemble a rash. Many people experience fungal acne on the forehead due to factors such as sweating, oily skin, and the use of hair and skincare products.

The forehead has a higher density of oil and sweat glands, which can trap moisture and create an environment that allows Malassezia yeast to thrive.

How To Tell If It's Fungal Acne or Something Else

Here is a table comparing fungal acne to other similar appearing skin conditions:

Condition	Cause	Appearance	Common Areas	Other Symptoms	Treatment
Fungal Acne	Yeast overgrowth in hair follicles	Small, red, itchy, uniform bumps in clusters	Forehead, chin, chest, upper arms, back	Itchy, may burn	Antifungal creams or pills
Bacterial Acne	Blocked follicles + bacteria	Mix of blackheads, whiteheads, cysts, nodules	Face, neck, back	Often worsens with hormones	Retinoids, antibiotics, benzoyl peroxide
Rosacea	Immune response to triggers	Redness, swelling, bumps, dilated vessels	Cheeks, nose, forehead, chin	Flushing, stinging	Topicals, oral meds, laser
Heat Rash	Blocked sweat ducts	Small blisters or deep red bumps	Skin folds, areas under clothing	Itchy, worse with heat	Cooling the skin, avoiding heat

How Is Fungal Acne Diagnosed?

Fungal acne can be difficult to differentiate from other skin conditions based on symptoms alone. This is why it is important to consult a dermatologist for an accurate diagnosis and treatment.

Your healthcare provider can diagnose fungal acne in several ways, including:

Physical exam
Wood’s lamp exam (a small black light that shows yellow or green fluorescence in areas of fungal infections in the skin)
Skin scraping or biopsy for laboratory testing.

How is Fungal Acne Treated?

Home remedies for fungal acne include applying warm compresses to the affected area several times a day.

Mild fungal acne treatments include: over-the-counter or prescription topical treatments (creams or shampoos), such as ketoconazole, econazole, and selenium sulfide (dandruff) shampoo or antifungal washes.

If you have moderate to severe fungal acne symptoms or symptoms that do not improve with antifungal creams, your healthcare provider may prescribe oral antifungal treatments, such as fluconazole and itraconazole.

Fungal acne outbreaks that do not respond to other treatments may benefit from photodynamic therapy. This is a two-stage treatment using a photosensitizer drug and laser treatment. The light activates the photosensitizing medicine, which reduces yeast growth.

Skincare Tips for Fungal Acne Breakouts

The following changes to your skincare routine can help manage and prevent fungal acne breakouts:

Wash your skin regularly with a gentle body wash, especially after excessive sweating.
Avoid leaving your skin hot and damp. For example, get out of a bathing suit as soon as possible.
Avoid excessive shaving, plucking, or waxing.
Avoid touching or rubbing your skin frequently.
Avoid the use of oil-based moisturizers, sunscreens, and other skincare products if you are prone to clogged hair follicles.
Avoid wearing tight-fitting clothes or having skin rub against skin.
Avoid using a hot tub or whirlpool, especially if it is not well-maintained and clean.
Avoid unnecessary use of antibiotics. Antibiotic use can upset the natural balance of bacteria in the skin and kill healthy bacteria, which can lead to yeast overgrowth.

Frequently Asked Questions on Fungal Acne

Can Fungal Acne Go Away On Its Own?

No, fungal acne rarely goes away on its own. This condition typically requires treatment.

Is Fungal Acne Contagious?

No, fungal acne is not contagious.