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Stocksy
Hormones or bacteria? That's the first line of questioning that comes to our exasperated minds when faced with the pimple du jour. Every teen magazine from here to Timbuktu has taught us that acne symptoms, like pimples or whiteheads, are triggered by clogged pores, acne-causing bacteria, or, the most futile of them all, stress. Well, it appears that the list is far more expansive than we thought: Fungi could also be a possible factor.
A condition called pityrosporum folliculitis, otherwise known as fungal acne, occurs when pores become clogged with yeast. And, since these breakouts are caused by fungi rather than bacteria, traditional acne-fighting products will do very little to treat them. If your battle against breakouts has felt particularly fruitless, this could be very good news. While fungal acne probably won't bend to regular acne products, it is quite receptive to anti-fungal products, like Nizoral.
We reached out to the dermatologists, Joshua Zeichner and Purvisha Patel, for all the information on using Nizoral for acne and how to know if you're a candidate. Keep reading to find out what our experts had to say about using the traditional dandruff-fighting ingredient on your face.
Meet the Expert
- Joshua Zeichner, MD, is the Director of Cosmetic and Clinical Research in Dermatology at Mount Sinai Hospital in NYC.
- Purvisha Patel, MD, is a board-certified dermatologist and founder of Visha Skincare.
Nizoral
Type of Ingredient: Anti-fungal
Main Benefits: Treats fungal infections, reduces the overgrowth of fungus, prevents fungal acne.
Who Should Use It: Anyone struggling with fungal acne, regardless of skin type.
How Often Can You Use It: Every day, or every other day, for two to three weeks, in which time you should see improvement. If your condition clears up, use it twice weekly as a maintenance medication. If you haven’t seen changes in two to three weeks, talk to your doctor about other treatment options.
Works Well With: Salicylic acid and beta-hydroxy acid
Don't Use With: Oily moisturizers or topical antibiotics
What Is Nizoral?
"Nizoral is a brand-name anti-fungal medication called ketoconazole," says Dr. Zeichner. "It lowers levels of fungus on the skin and is commonly used to treat conditions like dandruff and athlete's foot. It is also used to treat pimples when they are resistant to other therapies."
Benefits of Nizoral for Acne
Anyone who has experienced acne symptoms may easily mistake fungal acne for bacterial acne, which isn’t surprising as they can look similar, each resulting in texture on or just under the surface of the skin.
- Treats fungal acne: If you’re struggling with stubborn acne symptoms that don’t seem to budge when using products marketed to treat acne, you may find some relief with anti-fungal products like Nizoral. A condition called pityrosporum folliculitis that is caused by the fungus that causes dandruff can affect your face, too, explains Dr. Patel. "Overgrowth of this organism on the scalp can spill down onto the forehead, hairline, face, behind the ears, and down the back. It presents as small bumps on the skin and even tiny clogged pores."
- Treats dandruff: Nizoral is, quite simply, a dandruff treatment shampoo that's used on areas of the face and body to treat fungal acne. So, if you have dry, flaky skin on your scalp, Nizoral may help.
- Improves athlete's foot: Dandruff isn't the only fungus-caused condition that Nizoral can treat. Conditions like athlete's foot and even ringworm may be improved with once or twice daily use of Nizoral—just be sure to dry any treated areas well, as fungus thrives in warm, humid climates.
Potential Side Effects of Nizoral
While Nizoral is considered an effective way to combat fungus, there is a potential risk of side effects, just like any medication. A common side effect of Nizoral is itching or the development of a rash on or around the area that’s been treated. Additionally, when taken orally some people may experience nausea, dizziness, stomach pain, and headaches. If you’re pregnant, nursing, or planning a pregnancy, talk with your doctor before taking Nizoral as it may contaminate breast milk, which can be harmful.
How to Use Nizoral for Acne
Nizoral can be easily added to your usual skin and body care routine. "I typically recommend using it daily in the shower for two weeks or so or until the pimples improve,” Dr. Zeichner suggests. "After that, I have my patients use it twice a week as maintenance. Because it comes as a shampoo, I tell my patients to use it like a liquid cleanser. It is important to get enough contact time on the skin for it to do its job, so you should apply, lather, and count to 30 before rinsing off."
If you do have fungal acne, Nizoral is usually effective in a matter of weeks, but if you aren’t seeing signs of improvement just under the one-month mark, finding a different solution will likely be needed to experience results.
There are also other things to consider– just because you may not see immediate results with Nizoral, that doesn't necessarily mean you don't have fungal acne. Yeast thrives in hot, humid climates, so your environment could be to blame. "Pityrosporum folliculitis is most common when the weather is hot and humid because it increases the levels of oil on the skin, creating an environment that allows yeast to grow at high levels," says Dr. Zeichner. "We want to make the skin inhospitable for high levels of yeast to grow."
An effective part of treating any skin condition is becoming aware of how the active ingredients you’re using work with other products in your skincare regimen. Some products may enhance the efficacy of Nizoral, like certain acids. "I commonly pair Nizoral with salicylic acid, a beta-hydroxy acid that helps remove excess oil and dead cells from the skin to keep the pores clear," says Dr. Zeichner.
Additionally, avoiding certain formulas and environmental conditions may help rid your skin of fungal acne symptoms more quickly. Dr. Patel adds that "using products such as coconut oil and olive oil on your scalp and hair can cause forehead acne—edible products such as these tend to increase the growth of microorganisms on the skin if you can eat a product, bacteria, and fungus can eat a product as well."
Nizoral vs. Acne Cleansers
Why choose Nizoral over the plethora of over-the-counter acne cleansers out there? Cult favorite cleansers like Cerave's Renewing SA Cleanser have made waves for their ability to reduce bumps and breakouts on both the face and body, but they may not be as effective on fungal acne. This SA Cleanser, in particular, highlights salicylic acid as its hero active ingredient, an addition that Dr. Zeichner mentioned could serve as an enhancement to the power of anti-fungals, but likely won't treat the root cause of this particular type of acne.
The Final Takeaway
Battling acne may be one of the most frustrating skincare qualms to face, but it doesn't need to be. Correctly identifying the type and cause of acne can make light work of the situation, arming you with the right products to see results. Nizoral, an anti-fungal shampoo commonly used for dandruff, could be the treatment you're looking for if you struggle with fungal acne. With its active ingredient ketoconazole, it is powerful enough to tackle fungal acne, yet gentle enough for the skin.
