What Is Fungal Acne? Causes, Treatments, and Symptoms

If you're noticing that breakouts on chest, back, or shoulders just aren't clearing up, you might be dealing with fungal acne. Trust me, it's not as nasty as it sounds. I asked three dermatologists to break down everything one could ever want to know about fungal acne. Spoiler alert: That coordinating workout outfit you love so much might be messing with your skin. I'm so sorry to break it to you like this.

What exactly is fungal acne?

First of all, fungal acne isn't really a thing. In fact, it's a made-up name for something scientifically called pityrosporum folliculitis, or malassezia folliculitis. No matter what you call it, it's usually due to excess yeast known as malassezia, which is in the same biological classification as fungi, within hair follicles. When this occurs, "it results in inflammation and an itchy, acne-like eruptions," Shereene Idriss, a cosmetic dermatologist at Union Square Laser Dermatology in New York City tells Allure.

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Malassezia actually lives on everyone's skin, Joshua Zeichner, the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City, adds. However, yeast levels tend to increase during hot, humid weather or when you're sweaty. "High yeast levels promote inflammation, which, in turn, manifest on the skin as pus bumps," Zeichner explains.

Also, fungal acne can be contagious. "It actually can be with close encounters," says Lily Talakoub of McLean Dermatology. Because it is a yeast, yeast has a tendency to spread. With that in mind, there's a chance that fungal acne can be passed along to others.

How is it different from other forms of acne?

Well, fungal acne is not acne at all. Zeichner says it's truly an infection of the hair follicle. Some other differences include intense itching and placement. "Inflammatory acne tends to affect the face and is usually either due to increased oil production, follicular plugging, excess bacterial growth of propionibacterium acnes, or hormonal changes," Idriss says. "Fungal acne, on the other hand, frequently appears as uniform papules and pustules on the chest and back or in areas of occlusive clothing."

How can you spot fungal acne?

Fungal acne can be hard to diagnose, Lily Talakoub, a board-certified dermatologist at McLean Dermatology and Skincare Center in McLean, Virginia, says, because it often looks like your run-of-the-mill acne. Look for small whiteheads that are about the size of a pinpoint, or specifically, one millimeter in circumference, she adds. They'll usually be on the chest, shoulders, and back, and will appear in clusters. "Often, it's after wearing restrictive clothing, like a scuba suit, or sweating under clothes and not showering right away," Talakoub explains.

How is fungal acne treated?

Depending on the severity of the infection, your dermatologist might suggest something as simple as a body wash or they might prescribe medication. They'll most likely advise incorporating a topical sulfur wash into your routine, which is anti-fungal and antibacterial, Talakoub says. She, as well as Zeichner, recommend the dandruff shampoo Selsun Blue. Because it's a shampoo, Zeichner has some off-label instructions for using it in this case. "It should be applied to the skin, left to lather while you sing the alphabet, then rinsed off," he says. "If it does not have enough time to sit on the skin, then it cannot do its job properly."

If the infection doesn't start clearing up after a month, your dermatologist is likely to prescribe an oral anti-fungal medication, Idriss says. "Given the fact that fungal acne is due to yeast overgrowth within the hair follicles, systemic oral medication is usually necessary to reach deep into the follicle," she explains. "I usually recommend that my patients plan a sweat session (i.e. workout) 24 hours after they take the oral anti-fungal pill, as the medication has been proven to be secreted through the sweat glands into the hair follicles and onto the skin, which allows for a much more efficient and effective treatment of fungal acne."

How can you prevent it?

Unfortunately, you can't really prevent fungal acne from happening. Talakoub says keeping your skin dry and clean during workouts and taking off your sweaty clothes immediately following your spin class will help. Keeping a salicylic acid cleanser in your shower, like CeraVe's SA Renewing Cleanser, or towelettes formulated with the exfoliating ingredient in your bag will help minimize your risk of developing fungal acne, too, Zeichner says. (Try the Yes to Tomatoes Blemish Clearing Facial Wipes.) "They can be very helpful in removing excess oil and dirt from the skin, which promote an increase in growth of the yeast."

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