Updated: Aug 28
Dual board-certified dermatologist and dermatopathologist in California, Dr. Aegean Chan, is highly experienced when it comes to optimizing skincare to help people achieve a radiant complexion. She is an extensive scientific researcher in skin barriers, electron microscopy, and congenital skin diseases, and a notable author of peer-reviewed medical journals and book chapters in dermatology. She has presented her research at both a regional and national meeting level and holds several awards for her findings and dedication. Much of the information within this article stems from Dr. Aegean Chan's work and her expertise in this subject.
If there is one thing about life that we are sure everyone would much rather live without, it is acne. Those pesky eye-sore bumps are known to kick confidence down a notch, and it can happen to anyone. The fact of the matter is that though yes, our hormone-riddled teenage years foster acne in abundance, it does not magically go away when you reach adulthood. What can be worse is you may notice breakouts in places other than your face, such as on your back, shoulders, chest, etc. Now, if you are suffering from this adversity and have tried everything under the sun to clear it up with no luck, you may be fascinated to realize it might not be bacterial acne after all.
To clear the air quickly, the term fungal acne sounds awful, but it is actually not a real thing. It is a "made-up" name for a scientific thing known as pityrosporum folliculitis, or malassezia folliculitis. Whatever you decide to call it, the cause is typically due to excess yeast (malassezia) that builds up within hair follicles, resulting in an itchy, inflammation, acne-like eruptions.
Everyone has malassezia that lives on their skin, but the levels tend to increase in hotter, humid weather, or when you are exceptionally sweaty. Yeast levels can also rise if you have any drastic diet alterations, take any type of medications, or experienced environmental changes. If you have patches that frequently appear on your chest and back, then it could be your occlusive clothing causing this to occur.
Not so fun fact: What you will also want to be aware of is that “fungal acne” can actually be contagious in close encounters, as yeast can spread.
Spotting the Difference Between Fungal and Bacterial Acne
Pinpointing the difference between fungal and bacterial acne can be tricky, and more often than not, the issue can come to light when you try to treat your acne with products, and it is refusing to go away. Something to consider in diagnosing yourself is that fungal acne can be itchy, whereas regular acne is not. Another tell-tale sign is that fungal acne is typically uniformed in shape and size and appears in clusters.
How Fungal Acne Is Treated
Dr. Aegean Chan says that dermatologists are trained to suspect pityrosporum folliculitis when acne-like lesions do not improve with acne treatments. Because of this, the best way to know for sure if you have fungal acne is to go see a trained dermatologist who knows how to diagnose you accurately. They will be able to run various tests, such as skin scraping and biopsies, to obtain the final verdict.
If they find that you do have fungal acne, they can then proceed with treatment, including things such as:
OTC antifungal creams (for mild cases)
Special shampoos, such as Selsun Blue or other prescriptive ones
Keep in mind that many times, topical medications tend to have a hard time getting to the hair follicle, so oral antifungal medication is likely to be prescribed.
Though there is no 100% foolproof preventative measure(s) that you can take to stop fungal acne from coming back, there are some things you can do to help reduce the risk. You can switch to more breathable clothing material, and make it a habit to wash your body after working out or being in hot/humid weather. Overall, it takes some lifestyle changes, but even then, you may still see those bumps come back from time to time.
By now, you might feel odd figuring out that the very bumps on your face or back could not be actual acne at all. It might also give you a sense of relief, because after trying every commercial product under the sun with no recovery, now you have another opportunity to consider instead of defeat. In the end, if you have tried for weeks to get rid of your acne and it has not cleared up, go see a dermatologist. Even if they rule out fungal acne and it is actually bacterial, they will still be able to help you much better in treating your issue so you can get back to smoother skin in no time.
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As featured in Her World, CLEO, FEMALE, Shape, Nuyou, Singapore Women’s Weekly, Daily Vanity, Layers of Skins.