Firstly, fungal acne is a misnomer. It’s not acne, and is actually called pityrosporum or malassezia folliculitis. "Pityrosporum folliculitis leads to solid bumps that can resemble pimples," explains Board-Certified DermCafé Dermatologist Dr. Liu. We know how difficult it can be to identify and treat this, so we're breaking it all down for you.
It’s caused by an overgrowth of a yeast (commonly after sweating) that naturally lives on everyone’s skin. Whereas acne occurs mostly on the face, pityrosporum folliculitis is itchy and appears on the chest, back and upper forehead.
There are a few reasons you may be getting fungal acne
1) Heat and humidity: Fungal acne is closely related to hotter climates/seasons or environmental situations. his is because the yeast that causes fungal acne thrives in moist environments with excessive sweat and heat.
2) Sweat: You probably already know that it's best to shower as soon as your exercise is over and that it’s not ideal to sit around in sweaty, clingy clothes, but this can do more than just make for an uncomfortable fit. To avoid sweat-induced fungal acne, Dr. Liu advises to “Choose loose clothing with natural fabrics, avoid spandex, and change clothing often after exercise or excessive sweating. This can be helpful particularly in hot weather when it can flare up.”
3) Overuse of antibiotics: The yeasts on our skin are part of our microbiome, and they’re not a problem when they’re not in excess. However, in certain circumstances—such as long-term use of topical and/or oral acne antibiotics—the normal skin flora is wiped out by the antibiotics, and so the yeast flourishes, causing inflammation and fungal acne. If you have acne that’s not responding to normal treatments and a history of regular antibiotic use, you may have found your culprit.
4) Contact with others: Fungal acne can be contagious (after all, yeast is known for spreading). If you've had bodily contact with someone who has fungal acne, it may be the cause of yours.
It’s important to get a formal medical diagnosis and treatment for pityrosporum folliculitis, as some standard acne treatments can actually make it worse!
While there is no way to prevent pityrosporum folliculitis, there are many treatment options, ranging from prescription anti-dandruff shampoos to medication creams and anti-fungal pills for those who need a fast recovery.
If using an anti-dandruff shampoo, “Apply, let it sit, and lather it up while you sing the alphabet before rinsing it off,” Dr. Liu says. "The shampoo needs enough contact time on the skin for it to exert its effect.”
Book a Virtual Visit with our DermCafé Dermatologists here to get a personalized treatment plan for your fungal acne concern