08/29/2024 | Press release | Distributed by Public on 08/29/2024 13:43
Key takeaways:
Fungal acne (pityrosporum folliculitis) looks like acne but is caused by the overgrowth of a normal skin yeast.
It can be very hard to tell fungal acne apart from regular acne. Luckily, there are some telltale differences.
Acne treatments can make fungal acne worse, but with the right diagnosis and treatment, antifungal treatments can get rid of it.
If you have breakouts that won't go away like regular pimples do, you might have fungal acne, also called pityrosporum folliculitis. Fungal acne is a rash that's easily mistaken for acne. Unfortunately, acne medications can make it worse. But once you have the right diagnosis, you can get rid of fungal acne with proper treatment.
Let's take a closer look at pityrosporum folliculitis, including its symptoms, diagnosis and treatment, and some images to help you understand what it looks like.
Fungal acne, also known as fungal folliculitis or pityrosporum folliculitis, is a yeast infection of the hair follicles. The culprit is Malassezia, a yeast that normally lives on human skin. In certain conditions, this yeast can grow out of control. When this happens, it can invade hair follicles and trigger inflammation.
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It's common to have yeast on your skin, but not everyone develops fungal acne. Different conditions increase the risk of developing fungal acne, including things like:
Having a weakened immune system
Taking antibiotics
Taking oral steroids
Being around heat and humidity
Sweating excessively
Fungal acne might look like tiny pink, red, or purple bumps and pimples around hair follicles. The bumps are usually all the same size.
Fungal acne can happen anywhere you have hair, but more common locations include the:
Upper forehead
Hairline
Shoulders and upper back
Here are some fungal acne pictures to help you know what to look for.
Close-up of fungal acne rash.Fungal acne doesn't always cause symptoms. But when it does, you may experience some of the following symptoms in the area of your rash:
Itching
Burning
Pain
Fungal acne looks a lot like acne, so it can be hard to tell them apart. Like acne, you can get red breakouts on your:
Forehead
Face
Chest
Back
It's also possible to have regular acne and fungal acne at the same time, which can make it even harder to tell the two apart.
But there are some important features of fungal acne that can help you distinguish it from regular acne:
The breakouts are rash-like - tiny pustules that look the same and are the same size.
Fungal acne tends to be itchy, while acne isn't.
You're less likely to see blackheads and whiteheads with fungal acne.
Fungal acne gets worse with antibiotics, rather than better.
Most often, your dermatologist can diagnose pityrosporum from your symptom history and a physical exam. In some cases, they might scrape the contents of a pustule and look for yeast under a microscope. Rarely, a skin biopsy might be necessary.
The best way to get rid of fungal acne is with lifestyle changes and medications. Here are some things you can try to keep your skin clean and dry:
Choose sweat-wicking fabrics whenever possible.
Make sure to change out of your sweaty clothes quickly.
Avoid heat and humidity, especially while exercising.
Don't use heavy moisturizers that can clog pores.
Your dermatologist may also suggest medications as treatment for fungal acne. If you're on topical antibiotics for acne, it's best to discontinue those. They can make fungal acne worse. Treatment for fungal acne typically involves topical and/or oral antifungal medications such as:
Ketoconazole cream, shampoo, and tablets (Extina)
Clotrimazole cream (Mycelex, Lotrimin AF)
Ciclopirox cream and shampoo (Loprox, Penlac)
Fluconazole tablets (Diflucan)
Itraconazole tablets (Sporanox)
The treatment you get will depend on how severe your breakout is, what medical problems you have, and what other medications you're taking.
The creams and shampoos used to treat fungal acne don't usually cause side effects. At most, you may experience some skin irritation or dryness.
Antifungal pills may cause any of these side common side effects:
Nausea
Diarrhea
Vomiting
Stomach pain
In rare situations, people can develop more serious side effects, like liver damage or an allergic reaction.
If you have a mild case of fungal acne, you may be able to improve it at home by eliminating some of the underlying causes. In addition to keeping your skin clean and dry, it can help to avoid any type of hair removal, like shaving or waxing, for a few weeks.
If you don't notice any improvement with these home remedies, talk to your dermatologist. You may need prescription medication or additional treatments.
You may not be able to avoid having yeast on your skin, but you can lower the chance that it turns into fungal acne. Try the skin care and home remedies noted above to prevent fungal acne. You can also use dandruff shampoo (like ketoconazole) a few times a week. Let the soap sit on your skin for a few minutes before rinsing.
No, fungal acne isn't contagious. You can't spread it or get it from someone else. Remember that the yeast that causes fungal acne lives on most people's skin. But other factors like sweating a lot and taking antibiotics can make fungal acne more likely.
Fungal acne can sometimes form pustules (pus bumps), but they should never be squeezed. Just like with acne, this can lead to scarring and more inflammation.
Certain things can worsen fungal acne, like heat and humidity, sweating, and tight, non-breathable clothing. Using antibiotics and picking at your skin can also make fungal acne worse.
Fungal acne is often mistaken for acne, but the treatment is totally different. Fortunately, once you have the right diagnosis, you can get rid of it with some lifestyle adjustments and medications.
Images used with permission from VisualDx (www.visualdx.com).
Ayers, K., et al. (2005). Pityrosporum folliculitis: Diagnosis and management in 6 female adolescents with acne vulgaris. JAMA Pediatrics.
Prindaville, B., et al. (2018). Pityrosporum folliculitis: A retrospective review of 110 cases. Journal of the Academy of Dermatology.
Saunte, D., et ak, (2020). Malassezia-associated skin diseases, the use of diagnostics and treatment. Frontiers in Cellular and Infection Microbiology.
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