How to Treat Fungal Acne in 9 Dermatologist-Approved Steps

We know there are several things that can cause acne, including hormones, diet, not washing your face before going to bed, etc. They can cause whiteheads, blackheads, and cysts, but there's one type of acne that sounds a bit ickier than others: fungal acne. The name suggests it is caused fungus, and we acknowledge that that sounds less than appealing.

Thankfully, fungal acne isn't as terrible as it sounds. There are some very obvious factors that cause it, which makes preventing it way simpler than other types of breakouts, such as hormonal acne. For example, wearing tight clothing can trap heat and moisture, which can yield an overgrowth of yeast, “otherwise known as pityrosporum folliculitis (malassezia folliculitis),” according to board-certified dermatologist Morgan Rabach. In this case, the simple way to prevent it would be to wear loose-fitting clothes.

Let's say you do get fungal acne, though. What's the best way to treat it? Here, Dr. Rabach along with dermatologists, Ava Shamban and Joshua Zeichner, break down exactly what fungal acne is, what it's not, how to treat and prevent it, as well as how to tell what's causing it in the first place. Their answers, below.

What Is Fungal Acne?

First things first, let's set the record straight: fungal acne is a total misnomer—"it actually has nothing to do with fungus, nor is it really acne—it’s a folliculitis, or infection of the tiny hair follicles on the face or body,” which leads to “papules, small, raised, solid bumps resembling pimples,” explains board-certified dermatologist Ava Shamban.

One sign your acne is fungal and not of the acne vulgarism variety (which is what we typically think of as ‘normal acne’) is if it’s itchy. Also, if you spot whiteheads or blackheads that are roughly a millimeter big, chances are it could be fungal. This type of acne usually shows up on the chest, back, or upper arms, but can also occur on the face, just like typical acne can, making it difficult to decipher which you're experiencing.

What Causes Fungal Acne?

There are a few reasons you may be getting fungal acne, here's what they:

• Heat and humidity: Fungal acne is closely related to hotter climates. According to board-certified dermatologist Joshua Zeichner, MD, it’s relatively uncommon in the United States and is seen at much higher rates in areas of the world where the weather is always warm, such as the Philippines. This is because the yeast that causes fungal acne thrives in moist environments with excessive sweat and heat.
• 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 (ahem, yoga pants), but this can do more than just make for an uncomfortable fit, it can cause fungal acne, too.
• 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,” Dr. Rabach explains.
• Contact with others: Fungal acne might 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.

How to Prevent Fungal Acne:

For those who sweat a lot, whether due to the environment or physical activity, Dr. Shamban advises wearing loose clothing with natural fabrics, avoiding spandex, and changing clothing often after excessive sweating. "This can be helpful particularly in hot weather when it can flare up,” she explains. Furthermore, if you've been using antibiotics for a long time, Dr. Rabach says it might be your medication that's causing these flares. So, talk to your doctor if you think they may be the culprit to see if there's an alternative solution.

What's the Best Way to Treat Fungal Acne?

The good news is that once you’ve identified fungal acne, it’s not so hard to treat—especially, Dr. Shamban notes, because “the cause is one-dimensional.” In fact, according to Dr. Zeichner, you can “even try a few over-the-counter tricks before visiting your dermatologist.”

1. Use Anti-Dandruff Shampoo: Anti-dandruff shampoos contain an active ingredient called zinc pyrithione, which is antifungal. Needless to say, for fungal acne, these shampoos actually make a good skin cleanser (for the face or body—wherever the affected area is). “Apply, let it sit, and lather it up while you sing the alphabet before rinsing it off,” Dr. Zeichner says. "The shampoo needs enough contact time on the skin for it to exert its effect.”
2. Apply Athlete's Foot Cream: Another nontraditional treatment lies in athlete’s foot cream. "Athlete's foot is caused by a similar fungus that causes fungal acne," Dr. Zeichner explains. As such, over-the-counter creams can be used. "These contain a potent anti-fungal medication called clotrimazole," Dr. Zeichner notes. He recommends applying a topical treatment twice daily to affected areas. But if these don’t work, or if your rash is not improving in a week or two, Dr. Zeichner recommends visiting a board-certified dermatologist for evaluation.
3. Use a Prescription Cream: If your fungal acne is stubborn— as many cases can be— a prescription-strength treatment may be needed. Dr. Rabach notes that she'll often prescribe "an antifungal cream, like Ketoconazole 2%, twice a day, for two to three weeks to help reduce the yeast on the skin, leading to a significant reduction in the lesions present."
4. Buff Away Excess Oil and Dirt: We know that exfoliating can get rid of dead skin cells, but how does this fare with those prone to fungal acne? Turns out dead skin cells, excess dirt, and oil might all contribute to the increase of yeast growth. Use a body exfoliator regularly (and especially post-workout) to lessen the chance of getting fungal acne.
5. Cleanse With Body Wipes After a Sweat Session: A body wipe-down after a workout session is both refreshing and helpful in fending off breakouts. Keep a stash of body wipes in your gym bag to encourage a habitual routine of wiping away sweat and oil, at least until you can get to a shower. Salicylic acid wipes, in particular, may help reduce the potential of clogged pores and are ideal for acne-prone, sensitive skin types.
6. Use an Oil-Free Moisturizer: When you have fungal acne, the last thing you'll want to do is exacerbate it with what it loves most: oil. Especially if you're treating it with a strong topical (whether prescribed or not), you'll likely have bouts of dryness and irritation and will want to reach for a moisturizer. Opt for one that's oil-free to try to keep fungal acne at bay.
7. Apply a Topical Tea Tree Oil: Touted for its antiseptic, and antifungal properties, tea tree oil is an effective treatment for fungal acne. Dilute one to two drops of tea tree oil with 12 drops of a carrier oil and apply topically (never orally). Since some with sensitive skin have experienced an allergic reaction, it's best to do a patch test before applying the concoction all over the affected area.
8. Use Blemish Serum: If you're sporting an acneic skin type, less is more when it comes to your skincare routine. A two-in-one serum that targets active breakouts and works to fade acne spots over time may have some serious benefits for both treating the fungal acne and ensuring it doesn't leave its trace behind.
9. Take Prescription Oral Medication: Though it's rare, dermatologists sometimes call in an oral antifungal treatment like Fluconazole (if you’ve ever been prescribed medication for a vaginal yeast infection, this is likely what you took). “It works faster than the cream or shampoo," Dr. Rabach says, a bonus for her New York City clientele who "need results fast."