Fungal acne appears as small bumps on your chest, back, or shoulders that's commonly itchy and scaly. It’s caused by a yeast called Malassezia, which is typically found on the skin and is a natural part of your skin flora.

This type of acne is not true acne, and treatments for regular acne can worsen the problem. That being said, there are treatments available for fungal acne, including medicated shampoos available over-the-counter.

What is Fungal Acne/Malassezia Folliculitis?

Fungal acne, also known as Malassezia folliculitis, is a condition caused by the overgrowth of yeast on the skin. This type of yeast is already present on the skin, but it can lead to irritation and inflammation when it grows out of control.

Malassezia usually isn't a problem for most people. However, people with certain skin types are more likely to develop this condition. For example, people with oily skin or who suffer from conditions like acne or dandruff are more susceptible to fungal overgrowth.

The bumps caused by fungal acne are not true acne. Regular acne is most noticeable on the face, where it is scattered. It's also usually accompanied by lesions such as whiteheads or blackheads. Fungal acne is found mainly on the chest and back and typically takes the form of small, red bumps.

If you're experiencing itchiness around the acne, it's likely that you have a case of fungal acne. True acne isn't ordinarily itchy. It is possible to have both skin conditions at the same time, which can make diagnosis and treatment difficult.

What Causes Fungal Acne?

The condition of your skin is the biggest contributor to fungal acne. If your skin is persistently hot and damp, it can cause damage and irritation. This is of particular concern for people who live in hot and humid areas or exercise for extended periods.

When the damage happens to the hair follicles on your skin, it provides an opportunity for yeast to grow and spread. This causes inflammation and the formation of bumps.

Other risk factors for developing fungal acne include:

• Excessive sweating, whether from heat or exercise
• Wearing tight clothing or equipment can cause irritation
• Skin that rubs on different parts of the skin can cause damage
• Males are more likely to develop fungal acne than women
• People with diabetes, HIV and other medical conditions are more likely to develop fungal acne.

Common Symptoms of Fungal Acne

Fungal acne can cause a wide range of symptoms. The most common symptom is small, itchy, red bumps in the problem areas.

You may also experience:

• Bumps, pimples, or pustules that are similar to regular acne
• Localized to the chest, back, and shoulders more than other areas
• If a breakout occurs on the face, it will be localized to the chin and jawline
• Around 80% of people who suffer from fungal acne will have itchiness.
• Scaling or flaking skin around the infected area
• Traditional acne treatments aren't helping or making the situation worse
• Accompanies other common Malassezia-related skin conditions, including dandruff and seborrheic dermatitis.

How Is Fungal Acne Diagnosed?

Since true acne and fungal acne share similar symptoms, they can be challenging to diagnose. Instead of relying on self-diagnosis, it's best to get clarification from a doctor who can use various methods to confirm a diagnosis.

Physical Examination

To start, your doctor will likely perform a physical examination. This will help them rule out other conditions causing your symptoms. Your doctor will also ask about any other skin conditions you may have and any recent changes to your skincare routine.

During the physical exam, your doctor will closely examine the affected areas of the skin. They'll look for small, red bumps and other signs of inflammation.

Skin scraping or biopsy

One method of diagnosing fungal acne is by taking a skin sample. Your doctor may order skin scraping. They scrape a small area of your irritated skin with a sterile instrument. They then stain the skin with chemicals and examine the sample under a microscope to see if they can identify the Malassezia yeast on your skin.

There is also the option of a more invasive skin biopsy. This is when your doctor removes a small piece of skin from the affected area. They then send it to a laboratory to be examined for evidence of the yeast infection.

Treatment response

To confirm a diagnosis of fungal acne, your doctor will likely prescribe an antifungal medication. If you don't respond to treatment after several weeks, your doctor may suggest another type of medication. Any improvements to the condition are a positive sign that you have fungal acne rather than common acne.

How Is Fungal Acne Treated?

Treatment for fungal acne typically includes a combination of antifungal medications and lifestyle changes. Some common treatments include:

• Medicated shampoos or creams available over the counter or by prescription
• Antifungal pills taken by mouth

Lifestyle changes that can help treat fungal acne include:

• Washing your skin regularly with mild soap to remove excess oil and sweat
• Avoiding tight clothing or equipment that can irritate your skin
• Use non-comedogenic makeup and skincare products to avoid clogging pores

How to Prevent Fungal Acne

Unfortunately, there is only so much you can do to prevent a breakout of fungal acne. Like true acne, it can flare up even if you're doing everything right. However, there are a few things you can do to lower your risk:

• Wash your skin often, especially after excessive sweating. This includes after exercise.
• Don't stay in sweaty clothing. Take a change of clothes out with you if it's a hot and humid day.
• Avoid using oils or other products that can clog pores.
• Stay hydrated and avoid excessive sugar intake.
• Change your bedding, towels, and clothes often.
• Wear loose-fitting clothing made from breathable fabrics.

If you suffer from another skin condition like dandruff or seborrheic dermatitis, it's essential to manage it effectively. This can help lower your risk of developing fungal acne.

When to Seek Medical Care for Fungal Acne?

If you think you may have fungal acne, it's important to see a doctor to confirm the diagnosis and prescribe the appropriate treatment. In some cases, self-care measures such as over-the-counter antifungal medications may be all that is needed.

However, more severe cases may require prescription-strength medication or other treatments. If you don't treat fungal acne, it can lead to other skin conditions such as eczema or psoriasis.

Fungal acne is a common and treatable skin condition that can be managed with the help of a doctor.

If you think you may have fungal acne, make an appointment to see your doctor. You can clear up your skin and prevent future breakouts with the proper treatment.

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