Is Fungal Acne Actually a Thing?

A few years ago, you may have never heard of fungal acne. Now, it might seem like everyone you know thinks they have it. Lately, there’s been some debate among  skin-care communities on Instagram and Reddit whether the condition is even a legitimate thing. So, is fungal acne real? If so, is it that common and can you self-diagnose it? Here, Chicago-based board-certified dermatologist Dr. Jessie Cheung sets the record straight.

Is fungal acne a real skin condition? 

The answer here comes down to semantics. “You won't find ‘fungal acne’ in the textbooks,” says Dr. Cheung. “Dermatologists refer to this as ‘pityrosporum folliculitis.’ Fungal acne is a colloquial term that’s gained popularity but is misleading because pityrosporum folliculitis is not technically acne at all. 

But doesn’t fungal acne look like acne?

Pityrosporum folliculitis can appear like inflamed whiteheads or pustules, but there are some key differences between it and acne. “It usually presents as uniform itchy red bumps on the back, chest, upper arms and even the upper forehead, but rarely on the face,” says Dr. Cheung. 

What causes fungal acne?

This is what really sets pityrosporum folliculitis from acne apart. “It’s due to an overgrowth of malassezia furfur, a common yeast that is also linked to seborrheic dermatitis and tinea versicolor (a fungal infection),” she says. “The follicles get clogged by yeast instead of bacteria and this can be triggered by the use of antibiotics, sweating and humidity, immunosuppression, the use of steroids or pregnancy.” 

How can you tell if you have fungal acne?

Dr. Cheung says that according to a recent study, “almost five percent of acne patients have had pityrosporum folliculitis at some point during their acne course,” so it is relatively common.  

In addition to telltale signs like the uniform body bumps and itchiness, Dr. Cheung will suspect patients are dealing with it if traditional acne-fighting products are making the condition worse. 

There are some skin conditions, aside from regular pimples, however, that often get mistaken for pityrosporum folliculitis. “Other diagnoses include steroid acne, a systemic yeast infection, insect bites, or infections due to other bacteria or fungi, and even scabies,” says Dr. Cheung. This is why it’s important to consult with a dermatologist and avoid trying to diagnose it yourself. If confirmed, a doctor would then prescribe an oral medication to manage it.

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